Sixty-year-old PN Singh (name changed) was brought to the emergency department of a prestigious corporate hospital in Mumbai, complaining of chest pain. A diagnosis of stable angina was made. However, angiography was carried out since the ECG showed some transient changes, which in serial ECG at 5 minutes, 30 minutes and 1 hour was normal. 2D echo and cardiac markers were negative. Following angiography, a refined diagnosis of triple vessel disease was made and a bypass surgery was advised.

However, the family was in a dilemma on angioplasty vs cardiac bypass surgery. So, it sought a second opinion from a UK-based interventional cardiologist, whose team runs a chronic total occlusion PCI programme in Lead Guy and St Thomas NHS Foundation Hospital, UK. The second opinion advised angioplasty under intravascular ultrasound (IVUS).

Thus, the patient was able to avoid triple bypass surgery.

This happy turn of events was made possible, thanks to Dr Inder Maurya’s company, Foreign OPD, which facilitated this intervention that saved both life and money through right medical advice and treatment option.

From bringing second opinion to India-based patients from doctors based overseas, Foreign OPD is now going one step ahead — beginning January 2020, it is bringing in overseas doctors to India for face-to-face consultations with patients to facilitate second opinions. “These doctors will be stationed in India at one of our Foreign OPD clinics. We have six clinics now in Mumbai and Delhi. Every month, we will add at three to four clinics in select cities. So, at these clinics, patients will come to meet our national and international doctors. We charge $400 for face-to-face consultations. Nowhere in India is this facility of face-to-face consultation offered. Everywhere, second opinion is offered via email and Skype consultation,” says Dr Maurya.

Drawing the best

The global Medical Second Opinion market was valued at $2.7 billion in 2018. It is expected to reach $7.10 billion by end-2024, growing at a compounded annual growth rate (CAGR) of 28 per cent. China and India are among the fastest-growing regions in Medical Second Opinion market.

But isn’t the fees higher in the West? So, why should these senior doctors come to India? How has Dr Maurya managed to keep the doctors at this rate? Explains Dr Maurya: “Thanks to my medical background, these specialist doctors connect with me, and I negotiate the rate. They see me as a colleague, not as a businessman. They all are quite senior. When they see a 30-year-old doctor like me, they are curious. Also, they love India and they know the potential of it. So, when they see a 100 patients, two or three of these specialists will fly to London and do the surgeries.

“Foreign OPD has a dedicated team which looks into the doctor’s experience, research and publications, and area of specialisation. We offer these specialists a position on our company’s Board of Governance for Scientific Advisory.

Of course, for this, the doctor has to be unique. For instance: We have got Dr Antonias Pavlidas, an interventional cardiologist from Lead Guy and St Thomas NHS Foundation Trust. They are running a chronic total occlusion PCI programme. In medicine, we are taught that if your heart vessel (left main coronary artery) is blocked, you have to go for bypass because it’s a main vessel. Blockage of stent will result in instant death. But in London, these people have developed the cryothermic rotatory technique under IVUS, where they locate it and put the stent in it, thereby, avoiding bypass surgery in 25 to 30 per cent cases,” he says.

Dr Maurya visited London and got in touch with many consultants. Foreign OPD then signed up three-year exclusive contracts with these specialists. “And, we have signed up these consultants from London, Manchester, Nottingham, and Birmingham, who, along with my Indian doctors, will offer joint consultation to our Indian patients,” he says.

On Foreign OPD’s expansion plans, Dr Maurya says the company is currently operational in Mumbai, Delhi and Lucknow. It has over 150 national and over 90 international doctors on its panel. It will soon spread to Bengaluru, Hyderabad and Chennai. “Our plan is to take this brand to 30 cities in India, covering more than 70,000 patients, with total revenue of more than ₹200 crore. It’s costing me $1 million per city. Till now, we have invested ₹1.5 crore in doctors and branding,” says Dr Maurya.

Exercising caution in the current scenario, where lawsuits are filed for perceived wrong diagnosis by doctors, Foreign OPD has registered itself with the Medical Council of India although it’s not mandatory.

Currently, the therapeutic areas covered by Foreign OPD are oncology, CVTS, organ transplant, neurology, neurosurgery and hepatology. It plans to expand to over 25 sub-specialities, going forward.

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