This case is written by Abhijeet Srivastava (PGP2011-13) of Indian Institute of Management, Raipur. The case raises the questions whether doctors should work for charity or profit. It also looks at a third dimensions where doctors can work for themselves and then work for the underprivileged out of a part of the profit earned. The larger question is whether the huge hospitals, which have nowadays started resembling 5-star hotels, can work for a "service of the poor" model or is it financially not viable.

1. The Making of a Business
Dr. Ram Mathur had done his MBBS from Ganipal University and completed his MD from the United
States of America. After completing his studies in 1996 Dr. Mathur came back to India and joined Reepal
Hospital, New Delhi where he spent 3 years. Realizing his ability of curing some of the diseases that even
the best in the city could not and considering his ever increasing fame, Dr. Mathur thought of going his
own way by opening his private clinic. It was 1999 when Mathur started his private practice. A room in
his house became his clinic and most of the patients who consulted him at the hospital started coming
to his house for consultation. But there was a decrease in new patients coming to him for consultation.
Realizing that the income from private practice was not enough Dr. Mathur two years later in 2001 again
joined a hospital but this time as a part time consultant. It was Nortis Hospital.
New Delhi, where Dr. Mathur started his career with a hospital in 1996, is a place where people were
ready to pay any price to a heart surgeon. New Delhi being the capital of India attracts people from all
over the country for getting treatment done for major diseases. Dr. Mathur, although since his college
days knew the power of doctors, was now getting the practical experience. He could see how people
were ready to sell of their belongings to get their family members treated. Perhaps, medical service was
a place where price elasticity of demand was very low.
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
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2. Mathur wanted to do Engineering. The sole purpose of doing engineering was to combine it with an
MBA diploma and fulfill the entrepreneurial dream. In class XIth when Dr. Mathur had to chose subjects
he chose Physics, Chemistry, Biology, English and Mathematics. This subject combination opened gates
for both medical as well as engineering streams. A balanced approach towards all five subjects meant
that Mathur could go in for any one of engineering or medical stream though his inclination was still
towards pursuing an MBA at some point of time in his life. But as fate would have liked it Mathur
couldn’t clear the IIT-JEE exam instead cracked a medical entrance exam. Under immense pressure from
his family Mathur joined MBBS course. After joining the course and realizing the spectrum of
opportunities he had he started concentrating on his studies. Thought of failure at not being able to be
an Engineer (or rather an MBA) had faded away in a similar manner as his memories of not being able to
crack IIT-JEE. But Mathur was realizing fast enough where his interest lied. Mathur cleared MBBS and
after that cracked MD Entrance Exam. It was clear that he was on a success path. But somewhere the
urge of doing an MBA was still there. Mathur felt that MBA is not possible now but the businessman in
him was still very much alive.
Dr. Mathur kept on practicing as a doctor but his aspirations were still not realized. As a doctor he had
reached a position from where earning money was not difficult now. Mathur was charging Rs. 30000 for
a single operation and a consultation fee of Rs. 1000 was not that all could pay easily. Dr. Mathur was
booked with appointments for 2-3 weeks in advance both at his residence and at Nortis Hospital.
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
Copyright © Indian Institute of Management Raipur Page 2

3. It was the spring of 2008 when Dr. Mathur while sitting with Dr. Sharma thought of opening his own
small hospital with the funds they had. Dr. Sharma and Dr. Mathur knew each other since 7 years and
had been working together in Nortis Hospital. Dr. Sharma was senior to Dr. Mathur and the head of
Neuroscience department. Both were respected doctors in their field. Dr. Sharma had gauged the
entrepreneurial skills of Dr. Mathur. Dr. Sharma knew that Dr. Mathur would be the best choice for a
partnership. With Dr. Mathur always having this hidden desire of going big in his own way, the support
and idea from Dr. Sharma was like a long felt desire turning into a reality. Dr. Mathur instantaneously
agreed. Both agreed to quit as consultants in the hospital to concentrate on developing their own
hospital but would continue their private practice.
Dr. Ashwini Mathur, wife of Dr. Ram Mathur, a gynecologist by profession was going to be the third
partner in the business. She didn’t have as roaring practice as the other two partners but having her in
the team was an obvious choice for two reasons. First, pitching in for any kind of loan would be easier
with three partners and second the diversity of the professional expertise base of founders would
increase. Dr. Mathur said- “You are my wife and you have to help me out on this. If that means
concentrating full time on the operational activities involved in this project then let it be. If that means
giving away your job then let it happen like that. We are going to build the best medical facility in Delhi.
We will change the whole system of medical facilities in this city” Dr. Mathur was motivated in his idea
of the hospital. Dr. Mathur wanted to have a hospital that would have the best of the medical
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
Copyright © Indian Institute of Management Raipur Page 3

4. equipment. These were the equipment he had used during his MD in the USA. He wanted to bring his
experience of 12 years and his foreign education both to use. Dr. Ashwini liked the idea of a hospital
and was also ready to get involved in the project full time. But with a salary of Rs. 60000 per month Dr.
Ashwini found it slightly difficult to leave the job and venture into the project. But she knew she had the
support of some of the best known names in medical services in the city. Dr. Ashwini, after
understanding the project from the point of view of facility location to building and to bringing some of
the finest facilities in the world under one roof, thought that all her efforts would largely be the same
even if the scale of the hospital is large. The only factor would be funds. Considering the goodwill of Dr.
Mathur and Dr. Sharma the banks were not going to create much issue. Added to that was the contact
base and the influence Dr. Sharma commanded amongst the creamy class of Delhi. Some of these
contacts were made as part of profession and some other due to a strategic marriage. Dr. Sharma’s wife,
Mrs. Shalini Sharma is the only daughter of Mr. Adityajay Raizada. Raizada has one of the most
established businesses of medical equipment supplies. He is based out of Greater Noida and besides
India supplies his medical equipment to Netherland, Austria, Australia and Spain.
Dr. Ashwini didn’t agree on opening a small hospital. She urged that it should be at least a 150 bed
hospital. She was well aware of the business minds of the other two doctors and also their business
intentions. They wanted to provide the best facility but to those who could buy these facilities at the
maximum retail price. She wanted to have a bigger hospital so that both rich and poor could be treated.
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
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5. Part of the excess money earned from rich patients could be used for patients from economically
deprived class. Dr. Sharma was not in favor. He said- “We are going to invest crores of rupees in this
hospital. You say we need to have a 150 bed hospital and I also agree to that but we need to understand
that we are not opening a charitable trust. Government is there to look after the economically
deprived.” Dr. Ashwini was not pleased with the response but knew that her husband would also not
support her. Dr. Ram Mathur had an unfulfilled dream of doing an MBA. He had always stayed in touch
with many of his MBA graduated friends, clients and patients. Perhaps this gave him a vicarious
satisfaction. MBA, he understood, taught people how to get higher returns on their investments. Profit
was deep rooted in his mind. Dr. Ashwini was not quite at the same wavelength as her husband or Dr.
Sharma but thought of working within the constraints and was convinced that in a period of few years
she would be able to change the minds of the two “businessmen”.
Dr. Ashwini knew that all project development work, from strategizing to finding a good location to
making plans for hiring the best doctors, would be her job. Dr. Ram and Dr. Ashwini both coming from
good educational backgrounds knew the importance of education. With no prior knowledge of projects
or handling a business, Dr. Ashwini enrolled for one of the most reputed MBA institutes of NCR region
for one of its evening course. The course was a short term course which specifically taught the
management of small business. Her free time would now be invested in finding the best place,
contractors, equipment etc for the hospital. In the evening she would learn about the intricacies of
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
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6. business. Some of the aspects which inspired her most were the management of a business from the
point of view its operations management. Dr. Ashwini learned things like Facility Layout for a hospital.
She knew how good services and meticulous operations management could take the hospital to greater
heights. The hospital that had made a deep impact on Dr. Ashwini’s psyche regarding this was Apollo
Hospitals, Delhi. As a student of the short term course, Dr. Ashwini concentrated on the operations and
services management. She would spend time on understanding how hygiene and quality control are
necessary in a hospital. She met Mr. Mahesh Raina who was working as a Procurement manager in a
construction company based out of Gurgaon. He was into the procurement department and was
involved in purchasing heavy equipment like dozers, excavators, stone crusher plants, pipelayers etc. He
advised Dr. Ashwini on negotiation skills while making a purchase decision. Though the two industries
were different but Dr. Ashwini could still relate as eventually it was going to boil down to vendor
management, reliability of suppliers and best sourcing practices for the medical equipment.
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
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7. Kindly analyze the case on below mentioned aspects. Assumptions can be made.
1.) Are the aspirations and intentions of Dr. Ram Mathur and Dr. Sharma justified? Are they being
ethical in their approach?
2.) How should a project of this scale be handled by a team and what is the importance of Service
Operations in a Hospital? How can Dr. Ashwini use her new found knowledge of operations
management in her hospital when it is built?
3.) Present a competitive strategy for the Hospital keeping the competition this new Hospital will have
from other hospitals in Delhi, Noida and Gurgaon.
This case is written by Abhijeet Srivastava, PGP student of IIM Raipur. This case is for discussion purpose only and not to
show the effectiveness or ineffectiveness of any individual or profession.
Copyright © Indian Institute of Management Raipur Page 7