April 27, 2024

Corner Office: Rakesh Kapoor on Accepting Bitter Pills

Q. What were some important early lessons for you?

A. I was born in a very small town in India, and the literacy rate at the time was just one in six. Thankfully, one of the biggest things my parents could do for me is to recognize that if I stayed in that town it would be very difficult to get out. And I remember learning how my parents decided that I had to leave. I was playing marbles, and I had an exam the next day. My mother said, “Why aren’t you studying for your exam?” And I said: “What’s the point? I’ll be first anyway.”

I wasn’t that bright, but in that small town, I would have been first. So my parents sent me to the No. 1 school in India, which happened to be a boarding school in New Delhi. It immediately changed the game for me. I went from somebody who had never been second in class to the middle of the class. The bar was immediately raised, and I had to work really hard.

The lesson for me is that a very important part of leadership is to set a bar for people and to constantly keep them out of their comfort zone. I think status quo is a real enemy for progress. And getting out of my own comfort zone is just as important.

Q. Any other influences from your parents?

A. I asked my mom recently if she saw anything in my early childhood years that would tell her that there was something greater in store for me. She told a story of when I was pretty young, and I had some medical problem. She took me to an ayurvedic doctor, and he gave me a concoction that I had to put on my tongue, rather than swallowing, every day. I would do it every day and not complain.

One day, my mom tried the medicine to see what it tasted like. And she said it was the most bitter, awful medicine. When she was telling me about this recently, she said, “I think one of the things about you is that you don’t complain about something you have to do.” And I think this is a leadership lesson, too. You have to swallow many bitter pills in your life. You just can’t keep complaining about how life should be. You’ve got to accept the way you have to run your life and then do the very best you can.

Q. Tell me about your first career job.

A. I come from a background of entrepreneurs, and after I got my M.B.A., I joined a start-up rather than a big company. I found that to be a much more exciting way of learning.

I became an area sales manager for an electric typewriter company, and I was sent to a state called Gujarat. We went there and there was nothing. I said to my boss: “Can you even tell me where’s the office? Which way do you want me to go?” He said: “There’s no office address. That’s why we hired you, to build our business.” And for the next couple of years I recruited a huge number of people and we created the second-largest business of that company. So I tell people that when you choose your first job, choose one where you can really make a difference from Day 1, rather than getting submerged in a big-company mind-set.

It also taught me that if you are going to be successful, you’ve got to treat your company like your very own. Because, as an entrepreneur, you are depending on yourself to create the value, not anyone else. You cannot rely on other people to tell you what to do. You’ve got to take the initiative yourself. And if you do that, you know, you are going to have a great chance of success.

Q. Important lessons you’ve learned from mentors over the years?

A. My previous boss was a very successful C.E.O. He ran the company for over a decade and we achieved fantastic results. He taught me many things, but he was immensely focused. Time is the only one clear constraint in life, and if you focus on a few things, you have a great chance of achieving something interesting. He taught people — like me and others who have this burning desire to achieve more and more — to prioritize and to be very consistent with the priorities. He never changed the strategy in 12 years. He focused on a few big things and went after them.

Q. You said you came from a family of entrepreneurs, but now you’re running a big company. How do you try to foster an entrepreneurial culture?

A. You have to take risks. Entrepreneurship also means that we need more ideas than we have money for. I keep telling people, you think we are working for a big company, but I’m going to starve you of resources. Only then will I have the best ideas. Scarcity gives rise to more ideas than abundance does. Scarcity is the mother of invention. I’ve grown up like that.

Scale is also the enemy of speed. As you become bigger, you’re going to get slower and slower. So you have to create small teams, because they are more effective and more efficient than big teams. You also have to be careful about how many layers you’re creating.

Q. How do you hire? What qualities are you looking for?

A. One is how bright they are. You’ve got to have a level of intellectual agility. The second thing I look for is hunger for success. Is the person hungry or have they had enough? If there’s hunger for success, the person will, by and large, outperform those who don’t.

Q. And your career advice?

A. In my whole life, I’ve never worried about my next job. I never did. I never thought, “Since I’m doing so well, what will come next?” I always thought the job I was doing was the very best job of my life. So I tell people, don’t worry about what somebody else is doing and when they are getting promoted and how much money they’re making. We look around a bit too much. None of that is going to help you do a better job. So do the very best you can of the job that is given to you. It’s like swallowing the bitter pill. Stop complaining. I hate complaining. Put heart and emotion into it. That’s it.

Article source: http://www.nytimes.com/2013/09/22/business/rakesh-kapoor-of-reckitt-benckiser-on-accepting-bitter-pills.html?partner=rss&emc=rss

Wealth Matters: Dealing With Doctors Who Accept Only Cash

The next day, he drove an hour from Brooklyn to our house. He then spent an hour and a half talking to us and examining our daughter in her nursery. He prescribed some medicine for her and suggested some changes to my wife’s diet. Within two days, our baby was sleeping through the night and we were all feeling better.

The only catch was this pediatrician did not accept insurance. He had taken our credit card information before his visit and given us a form to submit to our insurance company as he left, saying insurance usually paid a portion of his fee, which was $650.

A couple of weeks later, our insurance company said it wouldn’t pay anything. Here’s how the company figured it: First, it said a fair price for our doctor’s fee was $285, about 60 percent less, because that was the going rate for our town. Then, it said the lower fee was not enough to meet our out-of-network deductible.

While we were none too happy with the insurance company, we remained impressed by the doctor: he had made our baby better and was compensated for it, all the while avoiding the hassle of dealing with insurance.

Last year, I wrote about doctors who catered only to the richest of the rich and charged accordingly. But after my experience, I became interested in doctors for the average person who take only cash. What pushes a doctor to go this route, often called concierge medicine? And how hard is it to make a living?

As to why doctors decide to switch to a concierge practice, the answer is almost always frustration.

“About four years ago, one insurance company was driving me crazy saying I had to fax documents to show I had done a visit,” said Stanford Owen, an internal medical doctor in Gulfport, Miss. “At 2 a.m., I woke up and said, ‘This is it.’ ”

Dr. Owen stopped accepting all insurance and now charges his 1,000 patients $38 a month.

“When I decided to abandon insurance, I didn’t want to lose my patient base and make it unaffordable,” he said. “I have everything from waitresses and shrimpers to international businessmen. It’s a concierge model, but it’s also the personal doctor model.”

Dr. Owen, who once had three nurses and 10 examining rooms, said it was now just him and a receptionist. He has become obsessed with keeping overhead low, but he said that, for the first time since the 1990s, his income was going up.

At the other end of the spectrum is David Edelson, who runs a practice called HealthBridge in Great Neck, N.Y. In addition to five doctors, the practice has a full fitness center and provides the services of a personal trainer, nutritionist, acupuncturist, sleep expert and stress-management consultant.

“The current model for primary care is broken,” Dr. Edelson told me. “Either I can go down with the ship, sell my practice to a hospital or take my practice in the wrong direction. Or I can develop a better mousetrap, which is more time dealing with patients and their care.”

Dr. Edelson has reduced his own practice to 300 patients, from more than 3,000. Of those, 250 pay $1,800 a year for concierge services and 50 others receive scholarships. He estimated that from the combination of the membership fee for the extra services and what gets billed to insurance for typical care, he will make $600,000, and more of that will end up in his pocket.

“We’re bringing in the same fees but we’re reducing our overhead,” he said. Fewer patients means fewer medical assistants, receptionists and staff members to deal with insurance.

But of the five doctors in the practice, he is the only one to go fully concierge. Another, William Klein, is testing the model, with 15 percent of his patients in the concierge program. Dr. Klein said he was hedging his bets because he was not sure what the new federal health care law would mean for primary care physicians.

Weren’t some patients getting shortchanged by this hybrid model? He said he saw no difference in care.

“It’s like paying for first class and not coach,” Dr. Klein said. “Everyone is getting to the same destination, but some people have a better seat.”

This approach to medicine is not without risks for the doctors and downsides for patients.

This article has been revised to reflect the following correction:

Correction: November 23, 2012

An earlier version of this column gave an incorrect middle initial for Mr. Harris. It is M., not V.

Article source: http://www.nytimes.com/2012/11/24/your-money/dealing-with-doctors-who-accept-only-cash.html?partner=rss&emc=rss