Holistic Pulse

What’s behind the people practices in healthcare industry, ETHRWorld

Highlights

  • Max Healthcare currently has a workforce of around 35,000 employees. Among them, there are more than 8,000 nurses, about 800 front office employees, and around 3,900 technicians.
  • In 2023-24, the organisation allocated Rs 60 crore to enhance its employee wellbeing initiatives.
  • Generally, in the healthcare industry, achieving an attrition rate of 20 percent is considered ideal.

<p>Umesh Gupta, Senior Director - HR and Chief People Officer, Max Healthcare</p>
Umesh Gupta, Senior Director – HR and Chief People Officer, Max Healthcare

In the healthcare sector, HR practices are not just about hiring or retaining talent, but about building a system where clinicians and caregivers can grow.

In an exclusive interaction with ETHRWorld, Umesh Gupta, Senior Director – HR and Chief People Officer at Max Healthcare, exemplifies this approach within his organisation too.

Gupta also highlights what Max Healthcare is doing for its employees, what challenges HR people can see in the Healthcare sector, and much more!

Starting a career in operations at Apollo Hospitals in 1998, Gupta’s experience gave him an understanding of the challenges faced by healthcare professionals. This experience became valuable when he moved to HR at Fortis in 2004, at BLK Max Hospital in 2010, again at Fortis in 2011 and finally Max Healthcare in 2019.

Throughout his career, Gupta has worked with hospitals, handled unions, managed VRS (Voluntary Retirement Scheme) and tackled strikes too.

HR has to act as a sales person!

Gupta believes that to attract senior clinicians, HR needs to do more than just interview candidates. Since these professionals are often in high demand, focusing on selling the vision of the organisation is very crucial.

For this, a significant event for Gupta was starting the senior clinician hiring process in 2010. Before that, HR was not involved in hiring senior clinicians; it was primarily handled at the business and CEO level.

However, when Fortis Hospital was opened at Shalimar Bagh in Delhi, Gupta proposed that HR should take on the senior clinician hiring role as they were already hiring junior doctors. Dr Praneet Kumar, who was Facility Director at the time, supported Gupta’s initiative, and since then, there has been no looking back.

“When I interact with doctors, I approach them not just as an HR person, but as someone who understands operations as well. I can relate to their pain points and requirements regarding infrastructure, technology and manpower. This depth of understanding proved crucial when I was hiring a senior clinician for our bone marrow transplant unit, a niche specialty. Many operational staff are unfamiliar with the specifics of bone marrow transplants, but my experience working closely with Dr Dharma Choudhary at BLK Max Hospital allowed me to grasp every detail of that specialty,” Gupta says.

To support this, Gupta gives an example that in 2021, when he was hiring BMT (Bone Marrow Transplant) doctors for Nanavati Hospital in Mumbai, he reached out to Dr Balkrishna Padate, a well-respected haematologist at Hinduja Hospital.

During this meeting, Dr Padate’s first question was about Gupta’s understanding of BMT! For the next 40 minutes, Gupta had to explain various aspects of BMT and haematology, and by the end of the conversation, Padate expressed his interest in joining the organisation.

Besides this, Gupta emphasised on how the hospital should also provide top-notch infrastructure, advanced technology, and a positive work culture, offering clinicians a chance to grow professionally and make an impact.

Additionally, to attract top talent, HRs in the Healthcare sector must demonstrate the potential for professional growth and access to advanced technology that they might not have in their current roles.

Employee Numbers and Ratios

The five key pillars which contribute to Max Culture are called the five Ps: Performance, Patient Centricity, People, Processes and Projects

Max Healthcare currently has a workforce of around 35,000 employees. Among them, there are more than 8,000 nurses, about 800 front office employees, and around 3,900 technicians.

This means that Max Healthcare has over 13,000 frontline employees, which include nurses, technicians and front office staff, all of whom play a crucial role in patient interactions and care. In addition to these groups, the organisation has about 10,000 employees in housekeeping, security, F&B (Food and Beverage service) and other support roles who contribute to its frontline services. It has over 2,000 doctors who are an essential part of the healthcare team.

In terms of recruitment for the 2023-24 fiscal year, the organisation onboarded 68 senior management employees, 682 middle management employees, 818 junior management employees and 9,005 frontline staff.

At Max Healthcare, the gender ratio stands at around 48 percent female representation. Gupta says that the organisation does not differentiate between male and female candidates in hiring, compensation, or during their professional development journey; all employees are offered equal opportunities for upskilling and advancement.

Besides this, a total of Rs 60 crore was allocated to enhance employee wellbeing initiatives in 2023-24.

Policies and Culture

“Our key differentiator is that we deliver on what we commit to our doctors. This is crucial. Doctors require several factors to feel secure and satisfied in their roles,” Gupta says.

He highlights the following points which make the organisation a catch for doctors:

1. Infrastructure: It’s not just about what benefits the doctor, but what benefits the patients as well.

2. Technology: At Max Healthcare, the management is not hesitant to invest in the latest technology. The company ensures that it has the best available tools and systems.

3. Patient Care Services: Providing better patient care services is essential to retaining the medical staff.

“If we can provide these three essentials, doctors are more likely to stay with us. Additionally, we are a very transparent organisation. If we cannot deliver on something, we communicate that upfront. We tell our doctors honestly what we can and cannot do, which builds trust,” Gupta says.

Moreover, Max Healthcare prioritises fast decision-making. If a doctor needs something that the organisation lacks, it responds promptly, saying, “This is possible, and we’ll make it happen within stipulated timelines.”

Interestingly, the function heads and the entire leadership team are empowered to make decisions. Unlike many organisations where decision-making is centralised at the top, Max Healthcare has inverted the pyramid. Now, decisions are made at the bottom level, empowering most people in their roles to take initiative.

For instance, the functional heads or the unit heads can make decisions on-site without needing lengthy approval processes. They assess the situation and take the necessary actions, and only afterward do they report back on what decisions were made.

Learning and Development

To address the quick changing needs of the industry, Max Healthcare is running many L&D programmes.

To start with, Gupta explains that there is a Max Talent Development Programme designed for the entire workforce, aiming to enhance skills and capabilities across various levels, while a Leadership Development Programme specifically targets current and aspiring leaders.

Within the context of a nursing transformation project, a significant concern was the high attrition rate among nurses, primarily due to better compensation opportunities abroad. While it is challenging to reduce attrition rates entirely, the focus shifted towards upskilling the existing talent.

To address the issue of new nurses struggling to adapt, a structured on-the-job training programme was implemented, assigning one nurse educator for every 50 nurses.

“This ratio significantly improved the educational support compared to the previous model of one educator for 200 to 300 nurses, which was ineffective in providing adequate training,” Gupta adds.

Similar programmes have been introduced across various departments, such as the Front Office Process Champion Programme and the Supervisory Skills Programme, which aim to enhance service training and overall capabilities within the organisation.

The Leadership Development Programme, which began two years ago, has seen participation from approximately 250 people at the Associate General Manager level and above, focusing on cultivating leadership skills.

The Hospital Operations Programme is designed to provide a comprehensive understanding of the various functions within a hospital setting. It spans six to eight months and enables the participants to gain insights into every department, including HR, front office, administration, and finance, ensuring they comprehend end-to-end operations.

In the HR segment, the training includes practical aspects like manpower planning, doctor engagement and recruitment challenges. The participants learn about optimal staffing levels in relation to occupied beds to maintain an efficient workforce. The training is hands-on, with sessions led by various department teams, including sales and marketing, finance and operations.

The participants are assigned projects aimed at improving operational efficiency. These projects might include reducing discharge times, or increasing patient satisfaction scores.

For newly graduated nurses, the Sashakt programme aligns with the apprentice programme and the Pradhan Mantri Upskilling Initiative. Upon successful completion of the course, these nurses are absorbed into Max Healthcare.

Attrition Rates, and Hiring Activity

Gupta mentions that attrition rates among junior clinicians can be high, primarily due to their pursuit of higher studies. After completing their MBBS, many junior clinicians choose to work for a brief period before preparing for advanced degrees like MDs or specialised fellowships.

This journey often involves several years of education and training typically around 10 years in total during which they are also balancing work commitments. Consequently, the desire to further their education leads many to leave their positions to focus on these studies.

To mitigate these challenges, Max Healthcare has implemented a robust academic framework. It currently has around 750 postgraduate students enrolled in various programmes, including DNB and fellowship programmes, as well as specialised training like MRCP programmes accepted from the Royal College of Physicians.

This structure allows Max Healthcare to engage junior clinicians for about three years with the organisation, helping to maintain continuity in patient services.

“We don’t only focus on developing our internal talent but also contributing in a big way to enhance the employability factor of the students for the industry at large. Annually, more than 10,000 trainees benefit from our medical education programmes,” Gupta says.

Moreover, the hospitals are also designated as teaching hospitals, which fosters a strong academic environment. They allow junior clinicians to engage in training and hands-on experience. This does not only help in retaining them longer but also builds strong relationships between junior and senior clinicians.

Generally, in the healthcare industry, achieving an attrition rate of 20 percent is considered ideal. Currently, Max Healthcare’s overall attrition rate stands at approximately 30 percent. The attrition rate for senior clinicians is around 2 percent.

Notably, at Max Healthcare, the average length of stay of employees has moved up from 4 years to 6-and-half years over the last few years.

“As far as hiring is concerned, in the past year, our hiring activities focused heavily on recruiting doctors and nurses to support the opening of new hospitals. Given the continuous need for skilled professionals in these areas, we faced significant challenges, particularly with nurse recruitment. To address this, we plan to establish two new recruitment offices in regions with a high supply of nursing talent, specifically in the South and Northeast India,” Gupta says.

The strategy includes forming partnerships with nursing schools to facilitate the hiring process. Additionally, they will create a simulation lab at these locations to provide hands-on training for new recruits. This approach will allow the organisation to maintain a “bench” of trained nurses ready for deployment as new hospital requirements arise, similar to practices in the IT industry.

Healthcare Industry Challenges

Gupta also shares some of the major challenges that the healthcare industry faces. Firstly, the sector operates 24/7, which presents unique challenges for HR, particularly concerning staffing and employee retention.

Secondly, there is a significant shortage of healthcare professionals, especially nurses and technicians, which complicates talent acquisition efforts. This shortage means that HR must be innovative in attracting and retaining qualified candidates.

Also, while competitive compensation is essential to attract and retain staff, HR costs can be a substantial portion of overall expenses – approximately 40 percent in some cases. This necessitates a balance between providing attractive salaries and managing labour costs effectively.

Additionally, the need for continuous training and upskilling of the staff is paramount. Developing a robust learning and development programme does not only help in retaining talent but also ensures that employees are well-equipped to provide quality patient care.

Changes and AI Shifts

As Artificial intelligence (AI) is becoming an integral part of almost every industry, Max Healthcare is also investing significantly in AI and digitization, developing in-house applications that provide convenience for both patients and doctors, thereby reducing turnaround times.

“While there is a concern about AI potentially displacing jobs, I believe it will not eliminate healthcare roles; instead, it will necessitate upskilling and training our workforce to adapt to new technologies,” Gupta says.

For instance, a newly developed nursing app is designed to alleviate the administrative burden on nurses. Currently, nurses spend a considerable amount of time on documentation, which detracts them from patient care.

With AI-driven systems, such as those using RFID technology, vital signs can be automatically recorded, allowing nurses to focus more on direct patient interaction rather than paperwork. This shift does not only enhance efficiency but also improves patient safety and care quality by minimising medical errors.

As far as changes in the industry are concerned, post Covid, there have been some shifts. For example, healthcare organisations have recognized the necessity of maintaining a buffer of staff, particularly nurses, to respond swiftly to unexpected surges in demand. This proactive approach ensures that facilities are better prepared for crises.

Safety and security have also become paramount, leading to enhanced safety programmes and a strong emphasis on vaccination initiatives.

Flexibility in work arrangements have improved, even though work-from-home models may not apply to many healthcare roles. Employees now have more options for extended leaves or pursuing higher education, reflecting a commitment to their wellbeing and career development.

Compensation packages have also been re-evaluated, aiming to position salaries competitively within the market, alongside the establishment of benevolent funds to support staff during difficult times.

  • Published On Nov 29, 2024 at 07:30 AM IST

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