Shashank Nd Curated
Co-Founder & CEO, Practo
CURATED BY :
What would you have done differently if given a chance?
We grew really fast in the last 12 months. When you grow so fast, it puts a lot of pressure on the customer base. Our service levels to customers have dropped. We have taken time to stabilize again, but we gave our customers more pain than we wanted to because of this growth. We made mistakes. We took time to scale up our teams and train them. There were gaps in our service levels. I would have focused more on service levels. The sheen that we had got dented. In the next two to three years, if we work really hard, we will get that shine back and the relationship will get fixed.
What are the challenges you face as a digital healthcare start-up?
Challenge one is to take all the providers along. For consumers, it is a behaviour change but for providers, it is a big change. For instance, their business model may have to be tweaked. The second challenge is, health tech is very nascent across the world. Initial public offerings in health tech, at least the consumer-facing side, are very few. The industry has a lot more to figure out, monetization being one, behaviour change being the other, the role of technology being another. The industry itself will take some more time to peak. Thirdly, our international expansion could have been faster but regulatory framework in each country is different. In some countries, there are more government hospitals than private. Because of such different dynamics, business models must be different. Consequently, it takes time to penetrate these markets.
How often have you failed in your professional journey?
You fail only if you stop trying. One of our core values is "First Principle Thinking". This means that you must think deeply about what you're trying to do — a product you're making or a problem you're solving. Only then, you will uncover the real insights and make sound decisions.
If you had to choose three traits of a good boss, what would they be?
First, hire only the 'A' players. You should hire people who can do that specific task better than you. The second: trust and empower. If you've got smart people on your team, your role is to just enable them. Third, and I think the most important, is to always ensure you maintain the culture of the company. Culture is the single biggest difference between good and great companies.
How do you spend your leisure time?
Squash is what I turn to when I need to unwind. I play squash on a regular basis and apart from unwinding, it keeps me fit and agile too. I am an avid reader and I used to read a book a month. Now I try to read a book a week. Also, if there is a subject that interests me, I pick up 3-4 books and dig into it. When I get time, I enjoy catching up on good movies as well.
What does it take to become a successful entrepreneur?
Over the last 7 years that I have been building Practo, there are a few things that I’ve learned. First, always optimise for the vision. Articulate the vision continuously and ensure each step you take is towards this. Vision helps align the entire team behind a common purpose. Second, usage is king. Focus more on the usage of the product than how much the users are paying for it. Usage is the single most important metric to determine product value. Pay close attention to what your customers tell you. Product insights will come through interpretation of customer feedback Third, solve hard problems. At the start, try picking the tough problems to solve. These are usually the ones no one else would have tried solving. Ask yourself, ‘Why hasn’t anyone done this before?’ Logically, due to technology advancements, problems that were harder to solve so far, would become easier now. Fourth, hire 'A' players only. That should be one of your top priorities. Only get the best of the best. They can give you exponential growth. Ensure they buy into the vision of the company and focus equally hard on retaining them. One of the keys to retention is to build a great culture from day one. It will remain through the life of the company. Fifth, think global. One of the best things we did was launch in Singapore. The market there really stress-tested our product and helped us improve by leaps and bounds, which was instrumental in us getting such a high market share so quickly. Sixth, get advisors & consultants. There are many industry experts out there. Take advantage of their expertise, its faster. Don’t try to do everything on your own. Seventh, growth is the only oxygen for a startup. Continuously focus on the growth. Take risks and do everything possible to grow fast. Eight, build great products. Never ever ship a subpar product. Customers have an innate sense to detect carelessness. They will penalise you by moving away. Ninth, choose the right investors. Don’t optimise for valuations, optimise for building a great product or service that people love. Investors will see value in that. Optimise more for who is investing in you than how much. Investors can be great partners in helping you grow so they must share your medium and long-term vision and their goals should be aligned to that. Tenth, focus. You have limited resources and time. Don’t spend too much time attending conferences, networking events etc. Focus all energy on ensuring there is progress. In our earlier days, we used the mantra of ‘Code & Sell’, everything else is useless. And finally, have fun. You will spend long hours doing this so make sure you love doing it and are excited by it. There is no room for half-heartedness.
What do you think about the innovation and start-up boom in India?
Startups boom in India is fueled by innovation and creation of ground breaking products and services. Companies are working on a real-time basis and are hungry to stay ahead in the game. Startups have empowered a new breed of thinkers and nurtured talent to constantly push the envelope and think out-of-the-box. New ventures are now being seen as exemplary business models and are attracting funds for venture capitalists, which re-assures the fact that the product is unique and has the potential to scale up at a fast pace.
Do you believe India needs more entrepreneurs?
The past few years has seen a boom of entrepreneurship in India. Many young ventures are now looking at solving a problem and not just starting a company for the sake of it. Today, entrepreneurs are getting the opportunity to create product and services that are world class. There is talent, access to capital and a sense of belief in the system that great global products can come from India and that is the direction we should all move in.
How do you plan to transform the healthcare sector?
Healthcare is one of the last industries to be completely transformed by technology. We are now seeing the growth potential and effect of these services and products on patients as well as healthcare providers. Doctors and healthcare providers want to improve patient healthcare experience but so far, all the technological change had been focused on large medical devices and new medicines. But the next phase of innovation will be centered around improving patient ability to make more informed healthcare decisions and making all the magic of modern medicine accessible to consumers easily, transparently so they can live healthier lives. We at Practo envision a world where technology will help consumers find the best doctors with a few clicks. Generating, accessing and storing health records would be entirely digital. Patients will have a single health account linked to their families that will store their health information securely, and provide helpful information in a timely manner and also prescription reminders to take medicines.
What are the competition and challenges you face in India?
We are the leaders in the digital healthcare segment. As more and more doctors digitise their practice, it improves the consumer experience by providing them with digital health records, digital prescriptions (and reminders), easy repeat checkups or existing appointment reminders etc. From a Practo Search perspective, the biggest challenge is to get reliable information about doctors and clinics. We want information to be 100 per cent reliable and accurate so we decided to build our own healthcare map of the world. It is vital to build the right infrastructure to scale our product. We are growing at an extremely fast pace. We are growing at a phenomenal 50-100 per cent every quarter. So obviously, the infrastructure, servers etc. have to keep pace and also maintain the highest levels of security and encryption. Hence, we keep a dedicated team that ensures our service is always available and is hyper responsive.
How different is your software from the existing ones?
We are the only company (perhaps in the world) that is solving the healthcare problem simultaneously from both - the doctor as well as the patient side. As more and more doctors digitise their practice, it improves the consumer experience by providing them with digital health records, digital prescriptions (and reminders), easy repeat check-ups or existing appointment reminders etc. Practo is your health app. We want it to become the only app you need for any healthcare related activity.
How has the Practo software made things easier for doctors and patients?
By digitally connecting patients and doctors we have been able to simplify the access to quality healthcare. Within a few clicks patients can book an appointment with a doctor without waiting in long queues. They can also do diagnostic search by the test name instead of lab name to see the list of labs near them that offer that test. They can check the quality of the lab by reading through the accreditation information, see real high quality photographs and filter results by proximity, home pickup facility as well as price. All this can be done in a matter of seconds. From a doctor’s perspective, Practo Ray has simplified healthcare practice management and has streamlined processes that can prove to be tedious for healthcare providers such as maintaining appointment calendar, healthcare records and customised billing.
What kind of an impact do you intend to make in the healthcare space?
I imagine a world where all your health records are digital, where test reports and fitness stats flow into this account automatically. You can consult with any doctor, anywhere in the world by sharing your records with one click. A world where you live healthier, longer because technology helps you make better healthcare decisions.
What are the advantages of using this software?
We designed Practo Ray from the ground up to simplify practice management and help doctors focus on the patients. We realised that the reason many healthcare practitioners and establishments were averse to adopting software was because it turned them into IT managers instead of being doctors – they had to worry about computers, software updates, data backups and of course, security and privacy. This is why we built Practo Ray to be cloud based – there is zero installation issues, automatic upgrades, continuous data backups and world class security and privacy policies.
What difficulties did you face initially?
When you aim to redefine an industry the challenges are many but that also helped us in getting better. When we started building Practo Ray, the biggest challenge was how to build a hyper responsive product in a market where Internet penetration was low and speed not as good as what we see in many other markets. While building Practo.com, the biggest challenge was how to get reliable information about doctors and clinics. We have an on-ground team that goes to the streets, city by city, to capture doctor and clinic information which is then put through a rigorous verification system to ensure we only have genuine doctors with absolutely accurate details. Scaling this to traverse all of India and of course globally is complex but we believe the effort is worth it because we want our customers to be able to trust and rely on the information we provide. Third challenge, we face of course is building the right infrastructure to scale our product. We were growing at an extremely fast pace – we got over 4 million searches every month – and this is growing at a scorching pace every month! So obviously, the infrastructure, servers etc. have to keep pace and also maintain the highest levels of security and encryption. So we keep a dedicated team that ensures our service is always available and is hyper responsive.
Were your parents supportive?
My parents have always been supportive and continue to do so.
Was it difficult to convince people to join you?
We have always looked for and continue to look for a unique blend of talent and passion for solving the problem we have taken up. We have found that if people understand and believe in the vision and care about the problem, then they will join you to solve the problem – else why would you want them there in the first place?
How difficult was it to start working on a new idea?
We were pretty convinced that this was a meaningful problem for humanity and that we were going to solve it. We started with Practo Ray – our cloud based practice management software that helps doctors and clinics manage digitise and make their practice more efficient. We found great acceptance and interest from doctors. Further, we actually found them passionately interested in the product and over the last several years, Practo Ray has evolved based on direct feedback from doctors and is therefore keenly tuned into their workflows and specific needs.
What were your plans when you joined NIT?
The goal has never been about being an entrepreneur or starting a company – it has always been about solving a problem we care deeply about – a problem that, no one is solving but when solved, will impact billions of lives and make them better. We started Practo because of personal incidents that made us realise how broken healthcare was and how poor the experience was for consumers and decided that there has to be a better way – and then went ahead and built it.
How do you unwind and relax?
With a book in my hand or by watching a movie.
One liner advice that you have for someone starting their own company.
Easiest way to win – Don’t give up.
What has gotten you this far?
By building the future everyone needs.
When you were growing up, what did you want to be?
Till I was 14, I was convinced I would open the batting for India. Only for my hopes to be dashed by my boards. From then on till I was 20, I wanted to be a stock broker. One thing I never in my wildest dreams thought I would want to do, till I was 20, was to start a company.
What has been your single biggest challenge in sourcing and retaining talent and qualities that you look out for in a potential hire?
Hiring at Practo is a serious affair. Every one in the senior leadership takes this seriously and interview people in their teams personally no matter what the position is. We are extremely choosy about who we let into our group because you need a very different energy level, mindset and attitude to be here. We are looking for people who can solve problems that no one in the world has even dared to solve before. No one has built products like us before so being able to look at a model that exists and get inspired from that is really not an option. It requires a whole new level of dedication, stubbornness and a commitment to the cause. We look for smart, creative, original thinkers with a serious can-do attitude who come up with solutions and not excuses. This is hard because not many people are real original thinkers.
What is the best marketing move that you’ve initiated which sets you apart from your competitors?
Our biggest marketing strategy is building great products that impact lives of millions of people. And our biggest strength is being able to create a platform that connects patients and doctors while simultaneously digitizing all their healthcare data to enable them to make better more informed healthcare decisions every day. This requires behavioral change which is impossible to do unless you can create some really compelling experiences which is only possible if you own both the doctor and patient side of the play.
Was there anyone/anything who inspired you to manage Practo the way you do?
Our ultimate goal is to build an ever lasting enterprise that will continue to build great products long after we are gone. TATAs are a good example of this. We have always thought of Practo as a global company which happened to start in India. For this we follow the usual suspects – Google, Facebook, Apple. We are tuned to thinking long term and it’s normal for us to take bets which will pay off 5-10 years from now. In this regard, Elon Musk’s Tesla & SpaceX are a source of inspiration.
How different is Practo’s model from others in the same segment?
Well, first, there are really no other companies that are trying to solve the digital health problem for both doctors and patients simultaneously. Secondly, our decisions and models are guided by our ‘Patient first’ philosophy. This is why listing doctors on Practo.com is completely free. We do the due diligence of verification but don’t charge doctors for the listing. We also don’t charge doctors for any appointments booked with them via Practo.com; nor do we charge patients for finding doctors and booking appointments via practo.com. This ensures that we are able to offer the widest choice of doctors to the millions of patients visiting us every month. Now considering that we are aggregating patient demand via Practo Search and digitizing records and helping doctors manage practices via practo Ray, it puts us in a unique position to drive the interplay between the two services. For example, when a doctor writes a digital prescription, we could potentially send the consumer a reminder at the appropriate time for him to take his medication. We can also tell the consumer how long since he went in for his routine check-up. Both these drive healthier medical habits which are important in helping people live healthier. There are many more things that only we can do because of our unique position. Stay tuned. Lots more magic is coming.
How much iteration did it take from the initial idea to the current product?
When you are building a product that impacts healthcare of millions of people around the world and tens of thousands of doctors depend on it, you work constantly to improve it. This is what we do at Practo every day. We are constantly improving Practo Search in every way – whether it is new feature additions (like Patient Feedback) or geographic (more cities, countries) and service expansion (e.g. covering diagnostic centers), Practo search is improving on a daily basis to help consumers make better healthcare decisions by finding the best doctors and managing their records digitally.
Was the idea of Practo based on a personal experience or did you simply see it as an existing gap in the market?
We started Practo with the vision to help mankind live healthier, longer lives by making better healthcare decisions. In 2008, when I was still in college, my father had to undergo a knee replacement surgery and to get a second opinion from a doctor in the US, I wanted my doctor in India to provide me the health reports digitally. To my surprise, he couldn’t do it because his software was missing something as simple as an email button! This led to much frustration as I had to manually take photos of the records, upload them into my email and send it to the doctor – who then came back and said some of the photos weren’t clear and I had to redo the process. I figured that there must be a better way! So me & Abhinav Lal built Practo Ray, a cloud based practice management software which helped doctors manage their practice and helped digitize their patients’ records and made it easier to share it with patients. Today we have over 90% market share amongst practitioners using some kind of online practice management software. In 2013 we launched Practo.com to help people find the best doctors and book instant appointments. Today 1.5M people visit us monthly to find the best doctors for them.
What is your take on the culture/ habit of self-medication and self-diagnosis?
We see this in many other countries as well and I think it is a very bad idea. In fact, very often people don’t even realise they are self-medicating because it has become habitual. Often times self-diagnosis and/or self-medication leads to incorrect diagnosis and inappropriate dosage of medicine – which has far-reaching ramifications for your immune system and drug resistance. When this happens systemically, it creates serious countrywide issues. For instance, if many people in a country routinely take antibiotics stronger than required (because they self-medicate and don’t know the right dosage), this creates resistance towards that drug on a country level. Virus strains will become increasingly resistant towards that dosage of medicine. Everyone will have to increase the dosage, and the process repeats until the default dosage is significantly higher than what you would take otherwise. This has immense implications on the long-term health of the individual, as well as the overall healthcare system in the country. At Practo, we are trying to solve this by making it easy to find the right doctor and to book instant appointments. We also have two products – Health Feed and Consult that help to solve the self-diagnosis problem. With Health Feed, we have health articles written by qualified and experienced doctors, ensuring that the articles are not just based on research by a content writer but are actually from practicing doctors with considerable medical experience. With Consult, you can initiate a 24-hour chat with your doctor right from our app or website and ask him any queries you have – whether it is an active health issue or a concern about a potential issue. With this online chat, you can get far more reliable responses about your health concerns than simply searching for them online. Both these products are currently available only in India but we will be expanding these to international markets soon.
How does Practo plan to change Singapore's reactive mindset when it comes to taking care of our health?
It is actually true more or less around the world. The problem is not that it is reactive, but that consumers are ignoring their health issues because it is far too complicated to resolve them earlier. For instance, let’s say you wake up one day with a neck pain, but you lead such a busy life that you ignore it. It goes away in a couple of days, and you forget about it. This continues to happen every few months but you keep ignoring it because it is far more difficult to access the doctor (waiting time, discovering the right one etc.) than to just ignore it for a few days and continue with your life. One year later, it turns into spondylitis (inflammation of the backbone joints), and it now becomes a life-long issue you have to deal with – all because you didn’t see a doctor in time. This is why we are so focused on making healthcare simpler, easier and much more approachable so that more consumers would engage in it routinely rather than only when the issue becomes serious. This change in approach towards healthcare – from reactive to preventative/proactive, will reduce the number of hospitalisations; become more sustainable and efficient; and benefit not just patients but the entire healthcare system as a whole.
What are your views on US insurance companies forcing clients to own wearables to keep track of their health?
I think it’s great! Wearables provide consumers with real-time data of their health which enables them to take proactive measures to prevent health issues. The future of health is real-time and not episodic. This disruptive change in technology can save lives, reduce healthcare costs, and enable an ageing population to lead longer, healthier lives.
Do you think disruptive technology such as Practo will reduce healthcare cost significantly?
Most definitely. Practo advocates for preventive care, encouraging patients to see a doctor early and not postpone their treatment. Sky-high medical costs are largely caused by worsening conditions as a result of delayed treatments. Sometimes, patients don’t see a doctor when they first fall sick as they don’t have a reliable or convenient means to reach one – and this is the exact problem we are trying to address. Our collaborations with other companies such as the Twitter partnership, gives consumers real-time access to consultations with doctors online. Furthermore, by presenting accurate information, we are able to drive more transparency into the system. This ensures better value for consumers and more opportunities for great providers to serve more patients.
Were there any legal hiccups Practo encountered during its launch in Singapore?
Singapore has been a fantastic country for us to operate in, and we have received great support from the government and a lot of love from consumers and doctors as well. In recent years, there has been an increase in healthcare information made available online, blurring the line between providing health information and marketing. On Practo’s platform, we verify and list every provider for free. We also do not charge consumers when they book appointments via Practo. Our software also helps to push digitisation among clinics further and we hope to accelerate this.
Were all the investors from Belgium Japan's china and US inbound investors?
We love what we do. We try pick up problems faced by doctors and patients and are committed to solve them. We have little time to go out in the market seeking funding. All these investments are inbound. I have not gone to many of the locations that you mentioned here. As long as you solve a large problem and deliver values, you will get funding.
What is your strategy to leverage on rural market in India?
In fact, we did multiple different attempts to penetrate into the rural markets. We did word of mouth marketing, etc. People in the hinterland India have access to mobile phone and internet, etc. Of course, we have a lot of room to grow, even though language is a huge barrier. Anyway, eventually it will happen. Currently, we have lot of headrooms to grow in the top 10 cities we are focussing now.
Why don’t you look at Europe, which has a higher smartphone and internet penetration than Asia?
We’re focussing largely on developing economies. You are right that even in Europe, there are some developing economies that we can target. Our first criterion for expansion to any market is it needs to be a developing economy. Second factor is the privatisation of healthcare. The third criterion is that we are looking at clusters and regions. We are present in Southeast Asia, Latin America, and the Middle East. These are the regions we are currently focussing on. Our initial plan is to consolidate in these markets. Having said that, if we are presented with a good opportunity, we will look at Europe. It is just a matter of time.
What opportunities do foreign countries offer?
We have an ambition to go to as many countries as possible. We chose Brazil because even though its economy is in bad shape, the healthcare sector is growing fast. Brazil’s healthcare market is twice as bigger than that of India. Moreover, it has all the characteristics of India. We are happy to see the initial results.
In India, there is more than enough headroom to grow then why did you look at foreign markets for scale?
The fact is that it very hard to deeply penetrate in India. India is a vast country with hundreds of languages and cultures. I would explore both options if presented with massive opportunities. But I also see more opportunities in foreign countries, because there is a lack of availability of similar products in these markets. For instance, Indonesia has higher per capita than India, and has higher disposable income. Adoption of tables are much higher than in markets like the Philippines.
What difference do you see between in Southeast Asian and Indian healthcare market ?
We started looking at Southeast Asian markets one to two years back. Now, we are present in Indonesia, Singapore and the Philippines. We target markets that are similar to India. In all these countries, healthcare is largely private, unlike China where healthcare is mainly run by the government. Insurance penetration is slightly at the lower end. If you take Indonesia, it has a large population and product adoptions are very similar to India. In Indonesia and Philippines, the need for technology is much higher. Singapore’s healthcare market is also largely private-run.
How do you view the trend of the newgen startups adding AI capabilities to their product?
As you rightly said, everyone has started using Artificial Intelligence these days. This way, startups are able to give an enhanced consumer experience and gather a lot of user data. I believe that every product and every app needs to add AI and deep learning capabilities. There is a hug opportunity to use data that can help doctors take better decisions, improve quality of outcomes, etc. We have not adopted any AI capabilities yet. We are almost there, and you will see some good developments on this front in the coming months.
How did you mange to overcome challenges and frustrations?
Challenges are part and parcel of the startup life, and you need to face them with mettle. I run a lot, exercise a lot, and work out at gym regularly. I also play various sports such as Squash. I started doing many of these things to manage extra work loads. When I feel frustrated, I go to gym and unleash my frustrations on the equipment out there (laughing).
Do you think you were too late to indulge into healthcare market?
Is it safe to consider Practo Ray as the leading SaaS product in its category?
How should an entrepreneur deal with difference of opinion with an investor?
How should a board meeting be run effectively?
What does effective board mean to you?
How many members do you have on your company's board?
To which other sectors do you plan on expanding Practo?
What are your views on Tencent's investment in Practo?
What makes a good entrepreneur?
What is your view on building an idea to executing it?
What is your opinion on the expansion of the startup ecosystem in India?
What your view on the slow monetization of healthcare startups?
Do you think diversifying in healthcare can make you lose your original focus?
How does Practo help bridging the internet gap in rural India?
How are Indian healthcare markets different from that of international healthcare markets?
What strategy did you implement to make Practo successful?
How does Practo make money?
Who invested in Practo in the Series C round of funding?
How did it feel to be in the Forbe's 30Under30 list ?
Why did you choose to bootstrap your startup?
As an entrepreneur, are you excited about the digitization across India?
In your opinion, what are the challenges that exist in healthcare?
Where does all the traffic in your company come from?
What are your views on the phenomena of emerging markets across the world?
According to you, what are the components of digital health?
What is your opinion on digital health?
What is your message for healthcare IT startups?
What is your advice for EMR adoption?
What are your views on the startup ecosystem in India?
Why did you decide to expand globally?
Which companies has Practo been able to acquire?
What has been your mission with Practo?
How did your product impact doctors?
How did your product impact patients?
What were your plans to improve the quality of healthcare across India?
What was the flagship product of your company?
How did you overcome doctors' apprehension to use technology?
What were the impressions of doctors on your technology based on your meetings?
What has helped your company evolve over the years?
What are some major internal challenges that your company focuses on?
What is the philosophy behind having multiple startups within practo?
What did you focus on after your series C round of funding?
What are your most productive hours?
What are one of the biggest things you have learnt?
What has been your favourite book?
What is your advice to attract good people into your company?
What is your advice for building and leading a team?
What kind of culture did you want to build at Practo?
How important is team in initial entrepreneurship ?
What was the philosophy behind "procto.com" ?
How did the idea of "Procto Ray" come up?
How important are legal aspects in entrepreneurship?
How you think that investors can destroy the company?
What mistakes should a startup avoid to survive?
What has been your vision for growth?
How should an entrepreneur choose the right initial team?
What was your initial team like?
How have you used social media marketing to promote your product?
What was Practo's marketing strategy?
What was the marketing communication plan for Practo?
What has been Practo's business model?
How does consumer feedback affect your venture?
What are some difficulties you faced during your journey?
What are some targets that you want to achieve through practo?
What is your vision behind Practo?
What other products are offered by practo?
What pain points were you trying to solve?
What lead you to start your entrepreneurial journey?