Pitfalls of scaling wide in healthcare and how focus on niche solutions yields better patient outcomes

Many businesses and establishments, especially those that seek rapid growth within a stipulated time, invariably gravitate towards expanding their service portfolio and / or reach. They wish to stand out and become all-in-one comprehensive solutions that meet a whole range of requirements, appealing to a much wider audience over a larger geographic expanse.

At first glance, it may seem that this strategy would make a business more appealing to potential customers or shareholders, but there are actually a number of inherent disadvantages to spreading wide. This "scaling wide" strategy may not be the best bet, especially in the healthcare context.

Firstly, one key reason to expand product or geography choice is demand. Healthcare, especially in India, remains an under-served market by a huge margin. Growing disease burden in the country, coupled with improved life expectancy, greater willingness to spend on health, and growing insurance penetration are among the many drivers of growing demand.

Secondly, taking this approach leads to expertise and resources getting diluted across many services and products, limiting focus. In the case of hospitals, super specialisation is the need of the hour as specific conditions require focused care and attention from professionals who have extensive training and experience in that particular area. Specialists are also better equipped to stay updated with the latest advancements and treatment protocols in their field. Which is why even with the increase in multi-specialty hospitals we continue to see a greater focus on one to two, or maximum three specialties as ‘centres of excellence’. Setting up healthcare infrastructure requires significant capital, with long break-even periods and hence it is critical to optimise both capital and resources.

Thirdly, a one-size-fits-all approach simply cannot work in a field like healthcare. Patients come from different backgrounds have different needs and sensitivities, and each medical case is as unique as the last.

The era we live in is marked by personalisation in every domain, and healthcare is no different. Patients with complex conditions will expect personalised treatment that is tailored to their individual needs and demands. Moreover, personalised care can significantly enhance patient satisfaction and adherence to treatment plans, leading to better health outcomes. While there are standardised protocols that ensure no inadvertent errors, the high degree of variability with each patient warrants personalisation.

Lastly, the logistics involved in overseeing an expansive healthcare system with a wide range of services present significant practical challenges. Managing a broad array of services often leads to inefficiencies, as resources are spread thin, and coordination becomes increasingly complex. This can result in potential gaps in care, where patients might receive ineffective treatments due to the lack of specialised focus. What compounds this issue is the concentration of critical healthcare personnel in select urban geographies. Which is a large reason for the gap in urban vs rural healthcare, while nearly 65% of Indians reside in rural areas the healthcare supply equation is inverse favoring urban markets.

On the contrary, a more concentrated approach can yield greater results, both in quality metrics and on business outcomes. And there are many domestic and global examples of concentrated players creating much larger impact, with successful delivery models. Experts who comprehend the subtleties of a specific disease or condition provide better, enhanced care to patients, while also improving communication and trust. The creation of evidence-based treatment plans and targeted treatment protocols that are especially suited to a particular patient population enables faster recuperation times and increased efficacy. Healthcare providers are also able to streamline their operations and guarantee the effective provision of high-quality care by focusing resources on a particular area.

One of the best examples of specialised solutions offering many benefits is the homecare health sector, where the objective is to focus on providing medical treatment in the comfort of patients' homes, meeting specific needs, and giving those who need it most a convenient and customised healthcare experience. Businesses that provide homecare services can tailor their programmes to the unique needs of individuals recovering from surgery, managing chronic illnesses, or requiring rehabilitation.

The healthcare sector ultimately depends on precision, expertise, and effective treatment. While “scaling wide” may enable quick expansion, it comes with its own set of challenges given variability in demand, limited supply choices over expansive markets, and essentially limiting focus given bandwidth spread.

Conversely, a more focused approach of going deep in service and market choices can help provide for better, more sustainable results.

(Vishal Lathwal is the CEO of Apollo Home Healthcare, Apollo Hospitals)