1.    Introduction

Health spring is a social enterprise,
pioneer, and leader in organized primary health care community medical centers in
India. Started by Dr. Gautam Sen (Chairman and Founder) along with his son
Kaushik Sen (Co-founder & CEO) in 2010. Healthspring’s foundation was the
result of the realization that the primary healthcare delivery sector in India
is broken and needs immediate attention as it is the most critical part of
healthcare delivery being the entry level of care. Currently they are disrupting
conventional primary healthcare delivery in India and creating a culture of
good health.

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1.1  The outreach model to
all sectors of the society

Healthspring believes that
effective primary and preventive care can only be delivered by providing
tailormade solutions to address the needs of diverse groups.

Offerings:

a)       One roof solution for an individual
and families

b)      One roof solution for communities,
corporates houses, industrial complexes, multiple health packages, a variety of
insurance schemes to cater to a diverse population (Figure 1 and 2).

2.    Infrastructure,
Coverage and Management Team

2.1  Physical
Infrastructure

·      
30 clinics
across India

·      
Aspires
to have 150 clinics in future

·      
100
doctors and 500 other health experts

·      
Served
350,000 patients, 150 corporate clients, 100000 health check-ups and handled close
to 2000 emergencies

2.2  Management Team

Healthspring’s
management team is highly decorated and technically very strong where founder
and co-founder have a strong background in clinical healthcare and healthcare
management along with multiple affiliations with national and international healthcare
organizations (Appendix- Figure 3) (Source: www.healthspring.in).

3.    Theories of
Organization Culture and Ideological Currency

3.1.  Schein’s Model of Culture

Let us discuss direct and indirect cues of Healthspring’s
organization culture through Edgar Schein’s organization culture model
also popularly known as the Onion model.

                                Source:
www.toolshero.com

3.1.1.     Artefacts and Symbols:

These are observable facts about the organization that
employees can see.

ARTIFACTS & SYMBOLS

Visible Cues

Stories

Jargons
 

Rituals

Management Practices

Norms

Logo: Red cross mark and green leaves suggestive of
call for Healthy India

Source: www.Healthspring.in
 

Client Testimonials: Praises for  Healthspring
 

Jargons used on the website:
‘Pioneers
in Primary Health care’

No
mention of any regular organization specific events on the website.

Hierarchy: Power structure of the organization is very
hierarchical, formal and mechanistic.
 
Tasks,
roles, and responsibilities are clearly defined.

Quality
and value-based primary healthcare which meets a specific individual’s
requirement.

Website: Call to Action – Very well organized and
intuitive website in terms of use of icons, symbols etc. Use of images which
are very subtle, close to common man’s imagination and promising.

Blog:
‘Emergency assistance program’, ‘Difference between life and death- the
golden hour’, ‘U.S. steps up as loan guarantor for expanding India’s primary
healthcare network’.

‘You
are a patient second, person first’

No
mention of employee award system on website

Shared Values: ‘Delivery top-quality primary health care’.

No
compromise of the quality and standard of care.
 
This
is also suggested by the mission, vision statement, and Jargons used on the
website.

Facts: Success facts in terms of number of patients
served, number of emergencies handled, number of clinics etc.

Success stories: ‘Mr. Kaushik Sen
India’s top 40 Business Leaders in 2017’, ‘Healthspring wins “Best Building
of a Brand” Award at HBI Business Model Innovation Global Award – 2017’

‘You
can never be prepared for emergency, your doctor ought to be’

 

Executive body – has the decision-making authority which is
comprised of extremely competent board members.

 

Mission: Correct the broken health delivery system in
India

Stories
like ‘Get Fitness 360’, ‘Health benefits of Flax seeds’.

‘Ready
access to family physician is your right’

 

Clearly
defined responsibilities in terms of designation and role

 

Vision: Achieve excellence in healthcare delivery
through best of knowledge and skills, provide people focused, transparent,
ethical care and 24*7 care

 

‘You
should have your questions met with answers and not just prescriptions’

 

 

 

Service offerings on website: Customised service packages for all
needs pertaining to primary health care

 

 

 

 

 

Physical Arrangement: Formal dressing, one cafeteria,
separate role specific sitting based on status and function

 

 

 

 

 

Source: www.Healthspring.in, Direct
Observation

 

 

 

 

 

Interpretation of Artefacts and Symbols:

·       
Visible Cues

Advantages/Positives

Disadvantages/Negatives

Formal organization with a sharp focus on healthcare
delivery and quality (Martin, 2002)

Stress to perform and deliver high quality care

Facts, figures, vision and mission statements, display of
awards is symbolically reflective of organization’s good performance (Meyer
and Rowan, 1977)

High stress on performance can lead to employee stress

The physical arrangements in the office can interpret a great
deal of organization ethos (Tom, 1986). Healthspring has a very role specific
sitting

Less communication, less flexibility

Formal dressing is suggestive of high focus on
image, professionalism, sincerity towards their work

Less communication, less flexibility, more work stress

 

                  Healthspring workspace-  Source: https://www.practo.com

 

·       
Stories

Advantage

Disadvantage

Suggestive of a sense of pride and achievement in what they
do

Performance stress

Visible cues to gain credibility and attention among
customers

Performance stress

 

·       
Jargons

Advantage

Disadvantage

Strong statements about promising the best quality primary
care suggests strong focus on quality primary healthcare delivery

Performance stress, work stress

 

·       
Rituals: No mention of any public or internal organization specific
events on the website hence suggestive of not so strong focus on employee
engagement and employee wellbeing.

·       
Management Practices

Advantage

Disadvantage

A hierarchical, formal and mechanistic organization with
strong focus on quality is suggestive of a strong operational, goal-oriented
focus, clear chain of command and specialization

No flexibility, poor communication, disunity

 

·       
Norms

Advantage

Disadvantage

Suggestive of high focus and motivation on quality
of care (Vroom, 1964)

Suggestive of high-performance pressure to achieve

 

3.1.2.        Espoused Values

·      
Uncompromised Quality
Primary Healthcare – Patient First: The mission and vision of Healthspring are to provide the best
quality primary healthcare through medical excellence and customized healthcare
offerings to bridge the gap in existing healthcare delivery. Dr. Sen
highlighted the issue of ‘more emphasis on secondary and tertiary care’ and a
huge neglect towards primary care’ and further said this is the main cause of
poor health outcomes in India. (Interview with Healthcare Executive, 2016).

·      
The expansion plan to
create a major impact in healthcare delivery: Healthspring wants to make sure quality care reaches the
majority of the Indian and hence to create impact they have plans for pan-India
expansion (up to 150 clinics from today’s 30 clinics) (Business Line, 2013).

·      
Affordable, available,
accessible care- Empathy: The
founder Dr. Sen spoke about a big vacuum in healthcare delivery for consumers. Dr.
Sen said – “Consumers need someone to take care of themselves, treat them
fairly, give them good consistent care, with basic facilities under one roof,
and for higher level things they don’t need on a routine basis to send them to
someone who will treat them well” (Moneylife, 2011). He emphasized on the cost-effectiveness
of the healthcare provided and importance of having
trusted family doctors (the culture which has died in India) to make the care
affordable and accessible (Interview with Healthcare Executive, 2016).

 

3.1.3.     Assumptions

                             The underlying assumptions which are self-evident
are:

·      
Quality: Healthcare delivery and services should be of top quality as
human life cannot be compromised.

·      
All primary care ailments
will be taken care of.

·      
Customized: Should provide customized healthcare which is need-based.

·      
Cost-effective care: High ethical and moral standards of health care delivery.

3.2.  Kotter’s Theory of Organization Culture

The way Healthspring has brought about change in primary
healthcare delivery can be explained well using Kotter’s change model
for organization culture:

·      
Create Urgency: There are only has 1 million allopathic doctors to treat a
population of 1.3 billion population in India (Hindustan Times, 2017). Self-styled
doctors without formal training provide up to 75% of primary care visits. Lack
of quality primary health care services leads to poor health outcomes (WHO,
2017). Hence Healthspring leadership spoke on various platforms about urgent
attention to address this gap in quality of primary health care and reinforcing
the need for one-stop shop for comprehensive primary care under a single roof
as well as person-focused care rather than disease-focused (Appendix – figure 4).
Dr. Sen spoke about strengthening primary care in the public sector and missing
in the Indian private sector. He called for policy reforms for strengthening
the primary care. He is currently an advisor on the central government
committee for strengthening Primary care delivery in India (Interview with
Healthcare Executive, 2016).

 

    Source: www.hindustantimes.com

·      
Form a powerful
coalition: The founder and
co-founder formed a team of relevant experts and doctors who had accomplished
success in their respective roles and had a common interest in transforming the
primary care delivery from what it was. (Appendix – Figure 3)

·      
Create a vision for
change: Defined roles with all
working towards bridging the gap in primary healthcare delivery by providing a
one-roof solution to suit specific individual/community/group need.

·      
Communicate the vision: Founders continuously voiced their vision at multiple social,
national and international platforms. Their web page itself showcases blogs,
stories and award stories putting emphasis on top class primary care (Interview
with Healthcare Executive, 2016).

·       Remove Obstacles: Healthspring did a huge marketing campaign to generate the
awareness on the need of having specialized quality primary care under one roof
as this idea in 2010 was disruptive. They got into partnership with ‘Association
for Trauma Care in India’ to facilitation the process of coming up with
multiple primary care clinics (Source: www.healthspring.in).

·      
Create short-term wins: Just in a span of 7 years from inception, they managed to
350,000 customers, 2000 emergencies and 100,000 health checks! They have
managed to open 30 primary care clinics and further intend to expand up to 150
clinics across India.

        Award for Dr.
Sen, Source: www.healthspring.in

·      
Build on the change: Need for expansion was realized to outreach and further
diversify to community/group specific solutions. They further went ahead to
partner with 150 corporate clients and want to have 150 clinics in future which
they are working towards.

·      
Anchor the change: They are working on further building the team with likeminded
people to bridge the gap between need and feed (Dauber, Fink & Yolles, 2012).
They are planning on collaborating with the Indian government and international
organizations to help them achieve their long-term goal.

4.    Theories of Leadership Style

4.1.  Burns Theory of Leadership

·      
Quality Over Profit (Burn, 1978): The challenge in front of Healthspring was to provide
primary healthcare to the larger masses in India, maintain quality as well as
be able to make a profit to further re-invest in growing the numbers of primary
healthcare clinics across different states in India. Hence it made it all the
more important to be profitable to make the vision happen (Wendy K. Smith, Marya L. Besharov,  Anke K. Wessels, and Michael Chertok, 2016). To achieve so, Healthspring took some strategic
steps like approximately $5.5 dollar/consultation (www.healthspring.in) which
is very competitive pricing in the Indian market, multiple services under one
roof to capture market better to name a few. Primary Healthcare clinics in
India is a ‘Disruptive Idea’ and hence there was a huge value proposition for
customers to get all primary care under one roof! Dr. Sen overcame Juxtaposition
of social mission and business outcomes without compromising on quality (Antonakis,
John; Day, David, 2017). In his interview with ‘Healthcare Executive 2016’, Dr.
Sen emphasized on bringing back top quality healthcare management and
development practices and family medicine practices in Hospitals and clinics. In
2010, Medical Council of India was dissolved on account of corrupt practices
and Dr. Sen was a part of 6 member board created to investigate this matter. This
was a result of his top quality, ethical healthcare services to the nation
(Interview with Healthcare Executive, 2016).

The Allocentric Leader: As per the psychographic matrix of leadership (Burn, 1978), Dr.
Sen is allocentric who is highly influences by Indian culture, his education
and general awareness of healthcare scenario in India. In his interview with
‘Healthcare Executive 2016’, he said he had the strong desire for serving the
healthcare needs of Indians.

Wants (Burn, 1978): Dr. Sen was driven by collective
expectation since childhood, social aspirations and political demands to
transform healthcare needs of developing India. He voiced out the fact in
multiple instances that primary health care being the first level of care is
very important. The authenticity of the idea, it being disruptive then, lead to
the success of the venture (Gandhi, 1927).

Transmutation of Needs (Burn, 1978):
Healthcare scenario in India is not up to the mark in terms of quality and
reach. This inspired Dr. Sen to create a setup which could address the
shortfalls of health care delivery.

Morality- Ideas as moral power (Burn, 1978): Dr.
Sen often said Healthcare is the right and everyone should have access to good
quality care (Interview with mixcloud.com, 2016) (Appendix – Video Link 1)

Transformational leader (Burn, 1978): Dr.
Sen and his team are trying to deliver affordable and quality healthcare to
raise the bar for quality care in India. Dr. Sen strongly believes that for an
impact, the whole team needs to perform at their best to achieve high-quality
outcomes especially amidst resource constraints (Interview with mixcloud.com,
2016).

 

 

 

 

 

 

 

 

5.    Key Arguments Around
Organization Culture and Recommends

 

 

 

 

 

 

 

 

 

6.    Key Argument Around Leadership and
Recommends

 

7.    Conclusion

Healthspring has started something which is very disruptive in the Indian
market and that is Transforming Primary healthcare which was otherwise is not
given upon due importance. Through thought leadership and value driven service,
Healthspring can make its mark. But more importantly, it needs to work towards
an organizational culture which is motivating the employees towards giving
their best. As Healthcare industry is very stressful as it deals with human
lives, it very important to create an environment which is conducive to work
for everyone and is stress-free!

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