TESTING TIMES FOR INDIA

Brig (Hony) Arvind Lal

Brig (Hony) Arvind Lal is a pioneer in bringing laboratory services in India at par with the international world. He has modernized Indian medical diagnostics and initiated the first Public Private Partnership (PPP) in the field of laboratory testing in India. Under his guidance, Dr Lal PathLabs (LPL) has become one of the most reputed laboratories in Asia having to its credit quality accreditations from various national and international bodies. Currently they operate over 172 labs, including Asia’s biggest lab at Rohini, New Delhi with 1,500 collection centers and pick-up samples from another 7,000 medical establishments all over India. The lab tests over 50,000 patients every day or nearly 10 million patients in a year.

He holds the honorary rank of a Brigadier in the Indian Army and the Government of India conferred him Padma Shri (Indian national award) in 2009, for his contributions to Medicine.

In an interview with KANIKA CHAUHAN InnoHEALTH , he sheds light on the evergrowing demands of quality testing and test labs in the country and shares his vision of a healthier future for India and every Indian.

Q1. When the Lal Path Labs started 68 years back, what was the scenario of Indian healthcare industry? How do you see the market now? And how has been the journey?

My late father Dr. Major S.K Lal started this lab in April 1949. He was a displaced person from the partition and came to India from Rawalpindi in 1947. After coming to Delhi he worked in a government lab for one-and-a-half years and then started the first pathology lab in North India. At that point of time there were hardly any pathology tests as we know neither there were any routine tests like, HP, TLC, ESR, Urine Test, Blood sugar Test, Cholesterol test. So there was not any competition then.

Q2. What is your future business plans both at National and International level?

We are running 1700 laboratories in India and about 1600 collection centers. In addition we take another 5000 collections of blood samples from our pick up points. For example Medanta, Fortis, Moolchand and Apollo are some of the pick-up points we have.

Last year we tested about 1.35crore patients, so the average of the samples we can test is about 55000 in a day. We are the biggest Histopathology Biopsy Centre in the world.

Histopathology Biopsy is a test basically to detect cancer. Suppose if a lady has a lump in her breast, so she feels something has to be done about the lump, a part of the lump is surgically taken out which is known as the biopsy, it is the biopsy we test and find out the results. There is a possibility of two things either the tumor is benign (Non-Cancerous) or malignant (Cancerous). If the lady has malignancy she under goes with further tests, chemotherapy and radioactive therapies as per clinical requirement. We are the largest Histopathology in the world. We test about 1000 biopsies in one day and we are the second largest kidney biopsy center in the world. We are the only laboratories in India which have their own electro-microscope for very high end testing. We have our centers in all the major cities of India.

Our next step would be to set up another comprehensive laboratory in Lucknow. We have such research center in Kolkata and next year we will make one in Lucknow. With this we will provide high end services for the people in the region for whom the services are not available.

Q3. With so many market players why people should opt for Dr. Lal? What additional value you bring to the table?

We have many reasons, first of all people know that we are not fly by night operators and also they have faith in us since last 70 years plus people come to us for their pathological tests because 70% of all the medical decisions are nbased upon the pathology test of a patient, hence if the pathological tests result aren’t in place 70% of the medical decision can’t be taken. Gone were the days when people used to visit the “vaids” and doctors and they felt the nerves and pulse gave medicines, now it is evidence based medication. If someone has fever the doctor would suggest the person to get a blood test because it could be malaria, chikungunya, dengue or it could be anything. And if the person is diagnosed with anything she or he will get the treatment for the same. Now the medicines are completely evidence based, there is no hit and trial. These are the reasons why people come to us.

Q4. With Dr. Lal Path labs entering into the international market with operations in countries like Middle East, Malaysia, Bangladesh, Nepal and many more, where do you see the potential for growth of your organization?

The first reason is, India is not having the kind of quality labs that it should have. There is a demand and supply problem. That is because there are no large laboratories. There are lots of facilities that claim to do testing, but they are not testing laboratories but testing shops. This is what is to be changed and people give the example of our establishment and say that “they should be like Dr. Lal’s laboratory.” All these countries you have mentioned, we are getting their samples for testing but only one lab is set up in Nepal and next would be in Bangladesh and then we will go to other countries. The reason we are slow on this is because our own country is huge. I usually say to people that if we will take out Uttar Pradesh and put it in the Indian Ocean, India would be the 5th largest country in the world. So this is the reason that we want to look at our country first and then look at the outside market.

Q5. What kind of environment does your organisation provide to patients?

Our organisation provides a very sterile kind of an environment, it doesn’t smell, and blood is not spilled around, there are no flies buzzing around the surroundings. This is a kind of a place where anyone would like to go to.

Q6. Now days there so many machines available in the market for test like sugar, BP etc, which we can be used by the patients themselves. How good is that? What are your views?

These are known as point of care testing and people can test a few things but in India people can only test blood sugar. For which we suggest the patient to check his or her blood sugar on a regular basis of 15 or 20 days, so these are called Point of Care Testing (POCT).

The POCT in India is not established because firstly, it is very expensive and secondly the Indian people aren’t savvy. There are seven types of care testing which is emanated by a lady. A lady can go to the bathroom and test her pregnancy by a UPT (urinal pregnancy test) in which she gets to know whether she is pregnant or not then in this case there is no need of a pathological test. When I was young we never had cats and dogs as pets but we had rabbits , so I never couldn’t understand why my father killed those rabbits and I got my answer when I was studying medicine. The reason why rabbits were killed during that time i.e, in early 1950s people used to check the pregnancy through it. A pregnant woman’s urine was injected into a female rabbit and after killing them they use to dissect the abdomen area to find ovulating ovaries. This is how pregnancy test were conducted.

Q7. Now a days Dr. Lal Path labs is focusing on inorganic growth; how beneficial it is to patients?

The growth in any sphere or in any business is either organic or inorganic, organic means when a person is creating his own set up, say if a person is doing well in Delhi so he decides to open a set up in Uttar Pradesh and then in Uttarakhand, and inorganic growth is when other person is ready to give up her or his lab to somebody else irrespective of any reason the former will give some certain amount of money to the latter in position of the lab this is called inorganic growth. We have done 10 inorganic growths till now and yes we will buy some more from south of India and west of India.

Q8. What innovations you think can bring down cost, keep quality and improve efficiency on which researchers and start-ups concentrate?

There is no start-up in my line, if one is a qualified pathologist either he can work in a pathology lab or can start his own lab. The start-up in Delhi is difficult because Delhi has become a saturated city. there are many people who are running many pathology labs and they shouldn’t run these pathology labs and the reason they are running the labs is because it is very lucrative, which is very unethical and should not be done.

So the government of India has also started the voice to our ways and they said that we are going to have a clinical establishment act which has been passed by the parliament in 2010. Since the healthcare is state subject so all the 29 states have not adopted it or implemented it. There are a chain of pathology labs which are not run by the pathologists they are run by the non-pathologists they are not even doctors they are quacks. So this brings out the quality and efficiency of the whole industry.

They are many diseases which affect the mankind these days and these diseases are called the non-communicable diseases. The non-communicable diseases can’t communicate with others, whereas malaria, chikungunya and dengue are communicable diseases because it happens through a mosquito bite. TB is a communicable disease too and if a person’s lungs are infected by TB people around them will get infected. In India we lose two patients of TB in every three minutes, India has a burden of communicable diseases which includes Hepatitis A.

But a bigger set of diseases have come out which are called NCDs (Non Communicable Diseases) and the NCDs are killing 65% of our people and if we will not control the NCDs it will also affect the two per cent of our GDP. The NCDs are headed by the high blood pressure, obesity, smoking, cardiac diseases, lung diseases, cancer, kidney diseases and stroke. Why it is becoming so important to us because it is also called the life style diseases, it changes the lifestyle of the person which has suddenly come up. India has large number of cancer patients and also large number of blood pressure patients. There is an element of genetic transfer of physical appearance of a person but some diseases are also transferred which only run in families.

The problem with Indian people is they only come in illness, but they should know that they should get their self-check on a regular basis to keep a check on their health, my main point is to make people aware of the annual healthcare which is very important for one’s health which is in between the doctor and a patient and also make them aware of the testing in wellness not in illness.

Read all the issues of InnoHEALTH magazine:

InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw

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