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Operations - BLOG

India’s Free Specialty Hospitals Combine Medicine With Mindfulness

Sunil Shenoy, (INSEAD EMBA 2015D) |

How a pair of Indian hospitals have made no-cost surgery a sustainable healthcare paradigm.

In 2015, as I was in the midst of completing my INSEAD EMBA, I had an experience that I consider nothing short of a miracle. Racked by debilitating back pain, I reluctantly consulted a neurosurgeon, who told me that I required prompt surgery to address a seriously prolapsed disc. As is wise practice in my home country of India, where private doctors sometimes recommend procedures out of pecuniary motives, I sought out second and third opinions. All three doctors said the same thing: Either have the operation or risk paralysis.

Then I remembered my friend, a neurosurgeon employed at the Sri Sathya Sai Super Specialty Hospital in Bangalore. Choosing to have my procedure done there made perfect sense, as I have been a spiritual follower of the hospital’s founder and namesake since 2009. “Just come here and let’s do it,” my friend urged.

Set in a sprawling 52-acre complex, the hospital is like no healthcare facility I had ever been to. The placid, contemplative atmosphere pervading the place is akin to that of a temple. Patients are greeted not by harried and underpaid reception staff but by volunteers who come to the hospital in the spirit of “seva”, or selfless service, one of the central values extolled by Sri Sathya Sai Baba. Here, medicine is practiced as pure healing with no profit motive. Patients pay nothing for the world-class services received – including procedures that would easily cost tens of thousands of dollars at a hospital in the United States – regardless of their nationality, religious affiliation or financial circumstances.

Perhaps most impressively, the hospital is not scrambling to survive from month to month but has kept its costs tightly controlled since it opened its doors. In other words, it presents a sustainable and replicable alternative to the deeply troubled healthcare paradigms currently in use in both the developed and developing worlds.

Historical background

Established in 2001, the Bangalore hospital is the newer of two surgical facilities under the Sri Sathya Sai Institute of Higher Medical Sciences (SSSIHMS). The first opened in Sathya Sai Baba’s birthplace of Puttaparthi in 1991. Both specialty hospitals exist in a sort of hub-and-spoke network with the Institute’s two general hospitals and two mobile hospitals, which also conform to the Institute’s mandate of providing free healthcare for all. Together, the two hospitals offer cardiology, cardio-thoracic and vascular surgery, neurology and neurosurgery, urology, ophthalmology, plastic surgery, orthopaedics and gastroenterology services.

As of March 2015, 46,535 cardiology procedures and 20,720 neurology procedures had been performed at the Bangalore facility, with a mortality rate (0.87%) lower than the average for a hospital in the developed world, and far better than the dismal average rate for hospitals in India.

How it adds up

Of course, readers will want to know how an organisation can dispense tertiary care at no cost to the patient for 15 years without committing financial suicide. Crucially, the land for the super-specialty hospital for Bangalore was donated by the state government. Beyond that, however, the public-sector contribution is minimal. The Bangalore facility draws its operating budget from the interest income generated from the Sathya Sai Central Trust’s corpus fund that, at its inception in 1990, comprised USD$55 million in unsolicited donations received from individuals and institutions across the world.

Amazingly, despite a strict fundraising ban set down by the Sri Sathya Sai Central Trust, the corpus has steadily expanded over the last quarter-century.

Sathya Sai Baba’s ambitious project has been sustained by innovative and effective cost management; accordingly, at SSSIHMS, major medical decisions, including the length of post-operative stay for a given patient, are made based on evidence-based standards of care and are not biased by cost or insurance status. I experienced it first-hand during my time at the hospital. Had I undergone the exact same procedure in a Western hospital, I would likely have been held for up to five days of observation. At Sri Sathya Sai, I was discharged less than 24 hours after leaving the operating room. Hospital staff were in touch with me by telephone throughout my recovery. Not once did I feel my care had been compromised.

Costs are assessed at three levels: at point-of-service delivery (OR, ICU, ward, outpatient clinic); average per-episode cost (intervention and stay) computed by surgery type; and on a per-consultation basis at the outpatient clinic. Equipment and materials expenses are controlled by a centralised procurement system which all SSSIHMS facilities are plugged into. Additionally, the organisation is continually developing its own innovations, such as a custom-built inventory management system. In his spare time, the surgeon who performed my procedure is working on a machine-learning algorithm to make surgeries more cost-effective.

Incentives also play a significant role in holding down costs. In place of the volume-based incentives staff are often subject to in for-profit hospitals, SSSIHMS applies a fixed-salary approach (pegged to industry norms) across the board.

The power of mindfulness

Underlying the hospitals’ guiding principle is Sathya Sai Baba’s dictum of “Love All, Serve All.” Baba taught that proper healthcare is a human right that professionals should deliver without concern for anything but the patient’s needs. All other factors – such as profit or passing trends in medical technology – have no place in a hospital.

You could call this mindfulness – full mental immersion in what really matters, with no room for distractions. Just as easily, you could relate it to Michael Porter’s call for the industry to move from a “supply-driven model organised around what physicians do [to a system] organised around what patients need.”

Either way, Sathya Sai Baba’s message helps attract leading physicians and surgeons from around the globe to spend part of their year working as volunteer consultants at the hospital. Some are followers of the guru; some are not. What they have in common, I think, is the recognition that in order to live extraordinary lives, we need extraordinary values. The volunteers – doctors and non-doctors alike – cherish the opportunity to work in an environment that allows for the disinterested pursuit of excellence and the realization of human-focused values.

Wherever such an opportunity exists, standout talents will seize it. That is the main reason why (though it may not be the sole paradigm needed for healthcare reform) the Sathya Sai Baba model could be replicated in other contexts, serving as part of the solution to our current crisis.

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Basanti ,

I congratulate the team for their good work day in and day out.
I have a concern regarding use of term "mindfulness". The terminology associated with the Indian things and places should be deliberately indic. It retains our adhikara and authenticity of narrative.


At a time when medical treatment is costing crores and most hospitals have become money spindling institutions the work done by Sri sathy sai hospital is legendary.Thanks to Sree Sai for helping the Poorest of poor.No wonder people see the GOD in Him:)


The experience of Sri Sathya Sai hospital proves with authority that service rendered with a pure and dedicated mind can withstand the shallow cravings and support will be forthcoming from all quarters. That is divinity in action!


Unless you go and see for yourself it's difficult to beleive. I was so fortunate to be part of swamis mission for some years. I know this service will continue till the world exists! . sairam!

Dr s madurai,

Only God can do this...our Beloved Sai God himself

Rajiv Magal,

At a time when running an organisation for pure Profits encounters several hurdles, one need not imagine what happens if it is free for all. But SSSSH in Whitefield or elsewhere is successful not because it has donors, but it is the will of God in Human form, Sri. Sathya Sai Baba. When God wills, no devil can even think of obstructing his Goals

Sri Latchoumane,

This is really interesting that this article is written from in a business school blog!
It means a lot as it different from what they teach you!
This shows that our society has been in the wrong direction and actual/future world leaders need to think people's welfare and not personal one and not to increase even more the wealth of those who can sustain the entire world with what they already have.
I hope this will inspire many to achieve this type of "business"

Akella Sastry,

pleasantly surprised to see the article. I have myself been there many times. A very unique business model sustained by teachings of Sathya Sai Baba. You have also beautifully brought out the importance of humanitarian values and ethics in business and how that is actually making viable business model. Sairam....

vivek shekar,

My son had recently undergone a spine treatment at SBS Hospital. All of the nurses were wonderful with our son and also very much dedicated.

Vaidy Bala,

Sathya Sai Hospitals, one in Parthi, second in Bangaluru and a third Gen. Hospital (Parthi). Love All Serve All, that is all the operating principle. All kinds of specialty are given free to anyone ill. Of course, somebody determines priority. Least infection rate and a massive dose of Loving Care is administered. Buildings look like more like huge palaces emerging out from nowhere, must be seen to appreciate, something like this is going on Planet Earth! Who owns them, God!

Ramana Prasad,

Service in its purest form! Hope the other hospitals emulate this model in the service of humanity.


I would like to send my tithes for this noble services that this hospital is providing for the poorest of the poor.
Please advise
Thank you

Punya Upadhyaya,

Thanks for bringing this one to my attention - I would also like to share the story of AIIMS set up by Amritananadmayi Ma that offers millions in free treatments every year (with cutting edge therapies -e.g. hand transplants) Soon they will opening a similar hospital in Delhi where the need is great and options for low cost or free care are limited - very encouraging. Also look at the great work by Arvind Netralaya that has been a pioneer in reshaping eye surgery processes and practices - and many more - be a good area for research or a case study

Ortho Nova,

Its a good step taken in right way.
Looking forward to having more in the future.

Nav Jeevan Hospital,

Its good initiative in helping people in better way.
Looking forward to having more such steps in the future.

Mann Mediciti,

Thanks for going in so much detail.
Looking forward to having more in the future.

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