A Business Model of Infinite Vision

By: Jess Sand | June 5, 2012

Pavithra Mehta was born into a family of ophthalmologists - 21 of them, to be precise. But she did not go to medical school like the rest of her family. Instead, she studied literature and journalism. In 2002, Pavithra began interviewing her granduncle Dr. G. Venkataswamy (Dr. V), a retired ophthalmologist (of course), and founder of Aravind, a highly profitable eye care practice that performs hundreds of thousands of eye surgeries every year. Approximately 70% of these are subsidized or provided free of charge to the poor.

That's right: 70% of Aravind's services are given away, yet the hospital turns a profit. As Pavithra spent time with Dr. V, she was struck by the sensibility at the heart of his business. In a recent email exchange, she explored with us how her experience of bearing witness - truly seeing others - can serve an organization that helps others see.

Net Impact: Even as social responsibility becomes more commonplace in American business, compassion rarely makes it onto the top list of company values. What's so important about this characteristic - why should companies be paying attention to it?

Pavithra: It's odd in a sad, wry kind of way, isn't it, that businesses need to be reminded of why it's good to be good? Somewhere between kindergarten and the boardroom we begin our long abandonment of the Golden Rule, and are now trying to rationalize our way back to it (may we be so lucky). So why is compassion important?

Because it is a deep, cellular level wisdom that knows our well-being is ultimately and intimately bound up in the welfare of others. Intelligently channeled compassion can drive and dictate productivity, efficiency, excellence, sustainability and scale, and it can do so in such a way that each of these aspects reinforces each of the others and strengthens the whole. It's important because there is a famine of purpose in workplaces across the world. An environment fueled by compassion charges the work with meaning. It taps into an intrinsic motivational force that mere money can't buy.

When we practice compassion at the individual and institutional level it can put us in touch with a consciousness that has an organizing capacity that breaks the barriers of traditional business sense. You see this over and over and over again in the story of Aravind. It's one of the most valuable lessons its success has to teach the world; it is fiercely triumphant proof that compassion works - and works not just for the 1% - it works for the 100%. And our world needs, more sorely than ever now, solutions that work for the 100%.

Your granduncle founded Aravind, putting a new spin on the idea of working for the family business. Tell us a little about your involvement over the years, particularly as a documentarian. What's the importance of your role as storyteller?

In 2003 I began work on a documentary, Infinite Vision. In many ways the film was my doorway into the heart of the story. Audiences that saw it spring-boarded into a sea of questions all beginning with: But how...? I wanted to be able to offer up answers, but I didn't know that I had them myself. It was at this point that I joined Aravind's communications department. In many ways I saw my chief role as just simply bearing witness.

I founded Aravind's story archive and began to do a series of interviews as well as writing up descriptions of everyday happenings, milestone events, interesting conversations and meetings. I was, in some sense, the fly on the wall of a luminous corridor of organizational history - and I was very aware of this privilege. The memory of individuals and institutions is short and fallible.

The way I see it stories can be a timeless vehicle for values, they can help shape and reinforce core beliefs about how we do what we do, and why. Because aware of it or not, the stories we tell ourselves about the world subconsciously dictate how we live and work in it. If possible I wanted to tell Dr. V and Aravind's story in a way that allowed its deepest truths to be passed on.

How does storytelling serve Aravind's business model?

It doesn't have an explicitly defined place in the organizational scheme of things, but I and several others do see it as playing an increasingly crucial role in spreading and replicating Aravind's approach in other parts of the country and the world, and not just in eye care or healthcare but other fields of service delivery as well.

Aravind is steadily being viewed as a thought-leader across so many diverse fields, and right now, outside of eye care, the organization approaches this role in a rather ad hoc manner. But there is more and more discussion these days of having the leadership more consciously inhabit its realm of influence. In translating the model across geography, culture and specialties, stories become key.

Oftentimes business models and strategy discussions tend to be reductive. While there's a helpful aspect to that kind of drastic simplification of storylines there's a lot of significance that's sacrificed or that falls to the wayside with that kind of approach. When you are trying to get to the bottom of why something works you have to look at it in all its intricate, messy, layered and hard to categorize reality. Life rarely fits into a neat set of bullet points or takeaways. And the insights are gained by an irreplaceable alchemy of experiences, ideas, intentions, intuitions, beliefs, hopes, dreams, struggles, and hidden victories and defeats.

A business case analysis of Aravind is going to by definition strip out most of these aspects. And as a result what you're left with is an accurate but sterile and incomplete version of what makes it work. The advantages of narrative are manifold. Narrative is nuanced. It acknowledges the gaps, the complexity and the mystery in our lives and work. It doesn't answer easy questions, but instead seeks to surface the right questions.

So how can a business model that treats the majority of its patients for free and does not accept donations possibly be self-sustaining?

That's the million-dollar question right there! Aravind's financial self-reliance baffles people - the fact that it's not just profitable but spectacularly so, despite the fact that it is service oriented. In some ways that way of framing yields limited answers. In truth this is a model that succeeds not in spite of its service-heartedness, but because of it.

On the surface, it comes down to a whole host of systems that are geared to operationalize compassion and to create the high volume, high quality, low cost model that is Aravind's tri-part mantra of sorts. This includes a highly sophisticated outreach program (arguably the largest in the world for eye care) that sends thousands of medical teams into the villages each year to identify patients in need of services - creating volume that allows for economies of scale.

It encompasses a flabbergasting range of quality improvement measures that ensure that service range and surgical outcomes are among the best in the world - thus attracting and driving paying patient volumes up and allowing for cross-subsidy. It includes a series of assembly line processes, streamlining of tasks, and delegation amongst an expertly trained paraprofessional work force that enable its phenomenal productivity.

And all this is, of course, the tip of the iceberg. Because what enables Aravind's self-sustainability is not just one thing but a slew of dynamic and interrelated components constantly monitored, measured and adjusted, against the backdrop of an unchanging set of core values.

What about those of us who might not be in a position to directly influence our organization's business model - how might employees working within conventional businesses apply some of Aravind's principles to make their work more compassionate?

That's a beautiful question. One of the most humbling things about Dr. V's story is the fact that he started Aravind at the age of 58 - this was his retirement project. At the time he had no money, business plan or safety net. His fingers had been devastated, permanently crippled by rheumatoid arthritis - the odds were stacked so high against him - he wasn't really in any kind of reasonable position to influence anything. And yet - look what he did with that set of circumstances. Not because he was gifted with some extraordinary brilliance or supernatural powers. If he had special powers they were just these:

Starting Power: He showed up 100% to begin the work that he was meant to do. Whatever you can do, or dream you can do, begin it. Boldness has genius, power and magic in it. Begin it now. Instead of waiting for the perfect circumstances to arise, Dr. V jumped and the net appeared. When you take that leap of faith into your calling the universe rearranges itself in tremendous ways to support you.

Staying Power: He and his team worked diligently, patiently and persistently day after day, month after month, decade after decade. In an era of instant gratification we often forget what it means to commit to the long haul. When you cultivate the soil where you are, you nurture the conditions for things to burst into bloom. You build relationships based on trust and respect, you create a network of goodwill that serves you in turn, and you create a strong foundation on which you can exponentially build.

Subtle Power: When you acknowledge the presence and significance of the invisible in our lives, rather than being herded by the obvious, you tune into underlying forces. Qualities like generosity, compassion, selflessness, transparency, simplicity, and integrity become the pillars of your work - they become the means and the end. One of the most humbling things about Dr. V was that he never took his compassion for granted - he knew in every bone of his body that he had to practice it - daily, in a moment-to-moment way with every patient, doctor, and partner that he encountered. This conviction that clarity in thought and action arise only from a certain discipline of mind and heart was part of his gift to the world. He believed that when you work at the boundaries of your compassion and strive to put your life at the service of the greater good, then you slowly live into your highest potential.

All these three aspects of his and Aravind's life can be put into practice by each of us, in the here and now. So much of it depends more on an internal shift in perspective and approach than on tweaking the external environment. Which, when you think about it is quite a liberating thing!

Our warm thanks to Pavithra for sharing her insights both here and during our recent Issues in Depth call, Infinite Vision: The World's Greatest Business Case for Compassion.

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