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Narayana Health founder Dr Devi Shetty tells Firstpost that artificial intelligence, robotic surgery and technology-led productivity could fundamentally disrupt India’s healthcare industry, bringing down treatment costs by 40–50% over the next five to seven years. He believes India could become the first country to decouple the quality of healthcare from a patient’s wealth.
India’s healthcare affordability crisis remains a major concern. A 2018 study estimated that 50 million Indians were pushed into ‘hidden poverty’ by medical expenses in 2011–12, while a 2023 study found that 15 per cent of households seeking healthcare fell below the poverty line because of out-of-pocket spending. Can artificial intelligence, robotics and technology change this equation?
In an exclusive conversation with Firstpost, Dr Devi Prasad Shetty, founder and chairman of Narayana Health and recently conferred France’s Knight of the National Order of Merit (Chevalier de l’Ordre national du Mérite), makes a bold prediction: AI and robotic surgery could bring down healthcare costs by 40–50 per cent over the next five to seven years.
Shetty discusses how technology could democratise access to quality healthcare, India’s ambitions to become a global medical tourism hub, the future of robotic cardiac surgery and the growing importance of preventive heart care. He also flags rising obesity and lifestyle-related health risks, while explaining why he believes India could become the first country to decouple healthcare quality from wealth.
Edited Excerpts:
You have received several prestigious awards, and this time it is the French National Order of Merit. How does it feel? Do you think this award also reflects India’s growing contribution to global healthcare?
More from BusinessYes. This reinforces our belief that India is becoming a relevant country in the global scenario. It really makes all of us happy. Of course, I’m very happy I received the award. But more than me receiving the award, it is an award for the country rather than for Devi Shetty as a person.
How has India’s healthcare industry changed over the years? Affordability remains a major concern, and India continues to face high out-of-pocket healthcare expenditure. What changes are you witnessing?
India will become the first country in the world to dissociate healthcare from wealth. India will prove to the world that the wealth of the nation or the wealth of the family has nothing to do with the quality of healthcare its citizens will enjoy.
And it’s not going to take 50 years or 100 years to happen. It is going to happen within the next five to seven years because I am very optimistic it will happen. All the foundation pillars of this massive disruption are already in place.
We belong to a generation battling information overload when it comes to health. We are constantly told to take supplements such as magnesium glycinate, melatonin and omega-3 fish oil, walk 10,000 steps and follow different diets. What is your advice to people in their thirties and forties to keep their hearts healthy?
The most important thing for youngsters, especially those who want to get into extreme sports or extreme physical activity, is a detailed cardiac evaluation.
Everyone, irrespective of their age, must know their heart numbers. They should know their blood sugar levels, kidney function, liver function and heart function. Everyone should know their ECG findings. Irrespective of their age, people should know what their echo findings are.
People past the age of 30, 35 or 40 should go for a CT scan to find out how their coronary arteries are. This is extremely important before you do anything dramatic. First, know your numbers. That’s the most important thing.
Then, of course, comes your lifestyle. I, as a person, believe very strongly in walking 10,000 steps and diet control. Everybody knows what their weight should be. So maintain your weight and preferably keep away from tobacco. These are my simple recommendations.
What about supplements? They have become increasingly popular.
Supplements are not natural. I have my own reservations about anything that is not natural. Unless a doctor thinks you need a supplement, you should avoid it. If a supplement is prescribed by a doctor for a medical condition, yes. But those cases are rare.
Prime Minister Narendra Modi has been focusing on obesity. The US is an example of how obesity can lead to major health complications, particularly heart-related conditions. Obesity is becoming an alarming concern in India as well. What policy interventions do we need to tackle this growing problem?
Nothing will work through policy. Everything will work through education. We have to convince our youngsters of the power of physical activity. When I was a child, every school had a large playground, and we spent more time on the playground than in the classroom. Today, there are schools without playgrounds.
Children are made to sit in classrooms for hours and hours. The concept of physical education has disappeared from our professional education. It is very sad.
It is important that human beings live outdoors, enjoy nature, walk to their place of work and walk back home. But we are doing everything that we are not supposed to do. So naturally, we have to look at all these issues not as a policy problem but as a question of adopting a proper, decent lifestyle.
There is also a growing argument that 10,000 steps are not enough and that people must do strength training four times a week, preferably at a gym with a fitness trainer. What is your take?
Extreme sports are not good for anybody. If you are a youngster interested in sports, fine, take it up, but get a detailed evaluation done. I am saying this because youngsters start running marathons and get into all kinds of cardio exercises. If they don’t know their cardiac status, they can land in trouble.
When you are free, just Google FIFA, the Federation of International Football Associations, and then type cardiac arrest. You will find a series of articles published by FIFA. In the last five years, about 670 professional footballers had a cardiac arrest during practice sessions. This is what is documented. The undocumented number will be 10 times more. Can anyone claim to be fitter than a professional footballer in his twenties?
So, it is very important that if you are getting into extreme sports, you must know your cardiac status. Otherwise, past the age of 35 or 40, you have to know the condition of your heart.
Every other day, we come across a CEO of a Fortune 500 company in his forties, a fit person on a treadmill, who collapses. We keep debating these incidents without knowing that if this person had undergone a CT scan of the heart 10 years earlier, he wouldn’t have died.
In today’s corporate and hustle culture, many people have no option but to sit in front of their laptops for nine hours. They cannot always step outside. What can they do in such circumstances?
You can wake up a little earlier in the morning and go for a walk in nature. Everybody has the freedom to do that. If possible, you can walk to the metro station or to your workplace, or cycle to work. That may not always be possible, but walking certainly is.
In the office, you can get out of your chair every hour and walk for five minutes. That is not difficult. Whenever you are on a mobile phone, use an earphone and start walking instead of sitting and talking.
When you come home, walk after your breakfast, lunch and dinner. If you walk for 12 to 15 minutes after meals, it is as good as taking insulin. Your blood sugar gets stabilised, especially if you are diabetic. These are little things we can do that will make a massive difference.
Everyone should wear a smartwatch because it is only a matter of time before smartwatches start giving us information about everything happening in our bodies. They are already providing a lot of vital details. Count your steps and aim for 10,000. Of course, you may not reach that target on the first day, but gradually, over a period of time, you will get there.
India is emerging as a potential medical tourism destination, with many patients from the Middle East and African countries coming here for treatment. How do you assess India’s potential as a global medical tourism hub? What is holding us back, and what more needs to be done?
Yes, we should be the busiest medical tourism destination in the world because we have outstanding doctors, outstanding hospitals and amazing skills. But our biggest problem is infrastructure. International flights land mainly in Delhi, some in Mumbai, and only a few other cities have direct international connections. That is one problem.
When there is no direct flight and a foreigner has to change flights within the domestic sector, that puts them off. So the majority of medical tourists land in Delhi. Medical tourism is thriving in Delhi, but the same can happen in other cities as well, provided the connectivity is good. Of course, today, visas and everything else are getting much better.
More than anything else, if you open Newsweek or any international magazine, you will find pages and pages of advertisements for heart treatment in Singapore. They are projecting Singapore as a global destination for heart care. The number of heart surgeries performed in Singapore in a month is performed in one day at our hospital in Bengaluru. But we don’t have direct access to advertise and showcase what we have in our country.
Things are getting much better now. It is only a matter of time before we are able to showcase the performance of all our hospitals on international platforms. This is very expensive, and an individual hospital cannot afford it. A lot of things can happen.
There is considerable debate around diets. Some recommend intermittent fasting, others advocate the Mediterranean diet, Blue Zone breakfasts, keto, MIND or DASH diets. What does your own diet look like? What do you eat throughout the day?
I can simplify it by saying that you should reduce rice, chapati and sugar.
All along, we have blamed oil for the mischief played by carbohydrates. The villain is carbohydrates. Unfortunately, in India, our staple diet consists of carbohydrates, whether rice, chapati, or wheat. Consuming these in large quantities is very bad. Of course, small quantities are fine.
So, we have to control rice, chapati and sugar. This is the most important thing.
And, of course, we talk about all types of oil. All oils are bad. There is nothing to choose from, but use little oil whenever possible. Avoid red meat. Everything else you can eat. It is not a problem.
Artificial intelligence and robotic surgery are transforming healthcare. What kind of disruption do you expect from these technologies in surgery and the broader medical field? Will they make healthcare more affordable or more expensive?
Robotic surgery will have a massive impact on cardiac surgery because cardiac surgery is one type of surgery where, for every operation, you have to break the bone.
And the moment you break the bone, healing gets affected dramatically, especially in elderly people. Today, with a small cut on the side of the chest, through the muscle, we are able to perform most heart surgeries with the help of a robot. It is amazing how quickly patients recover.
I have videos of patients, including a 66-year-old man who underwent bypass grafting through a small cut with robotic assistance. Forty days later, the old man was able to climb a coconut tree, which is unthinkable. These are the massive impacts of technology.
If there is one industry where AI will have a massive impact, it is healthcare because this industry runs on protocols and data. For AI, these are the best components to flourish.
Do you think AI and robotic surgery will make healthcare more affordable or more expensive?
Dramatically, it will reduce costs by increasing the productivity of doctors, nurses, technicians and hospitals. When productivity increases, the cost of healthcare goes down dramatically.
Let me return to the question of affordability. India’s best healthcare infrastructure is concentrated in private hospitals. In Delhi-NCR, treatment for severe diseases is prohibitively expensive for economically weaker sections. Government hospitals, meanwhile, face huge backlogs, and not everyone can access treatment. How do we navigate this situation?
In any business where most of the costs are fixed costs, somebody is going to disrupt that business.
This is what happened with the airline industry. Earlier, flying was something only rich people could afford. Today, everyone can fly. Mobile communication is another industry with very high fixed costs. The healthcare industry is also an industry with huge fixed costs. Somebody is going to disrupt it. Somebody will concentrate on volume. Things will change. I am optimistic that the cost of healthcare in India will go down. It will go down dramatically.
Do you have a timeline for when this change could happen?
It will happen within the next five to seven years.
Can you quantify how much healthcare costs could come down?
I personally feel the cost of healthcare will go down by at least 40–50 per cent.
Social media is flooded with advice suggesting that people need eight or nine hours of sleep. Historically, people have worked hard and managed with four or five hours of sleep. How should we understand these changing recommendations?
Generally, for an adult, six to seven hours of sleep is more than enough. This is what I believe.
Finally, what are the biggest changes you expect in India’s healthcare sector over the next five to ten years? How will India emerge on the global healthcare map?
As I said at the beginning of our conversation, India will become the first country to dissociate healthcare from wealth, and it will happen within five to seven years.
India will definitely prove to the world that the wealth of the nation or the wealth of the family has nothing to do with the quality of healthcare its citizens will enjoy.
