Decision Maker: Can you please introduce yourself, Mrs. Sonali?
Sonali Srungaram: I did my B.Tech. in computer systems engineering, with an artificial intelligence background. I’m not a doctor. I’m an engineer by training and by profession. I did my MBA from the Indian School of Business, the batch of 2004. This was all quite some time ago. My initial background was that I had worked with Accenture for 12 years across New Zealand, Singapore, India, and the UK. And to be honest, the intent at that time was that I would probably have become a lifelong consultant as I used to work in their strategy practice.
But in 2011, I actually moved from London and came back to India. It had been a long time—almost 17 years—since I had come back home. I moved back here because I had a young family. I had two children, and we had to make a decision, my husband and I, as to where we would want them to grow up.
Decision Maker: What challenges did you encounter when you moved back to India?
Sonali Srungaram: When I moved back to India in 2011, I encountered challenges related to corporate India’s readiness to accommodate working parents, especially senior female staff. The traditional corporate structure didn’t have well-established work-from-home or flexible work options, which was particularly challenging for working mothers like myself. This was during the period of 2011–2012.
These challenges made me realize that I needed to work, and I was always passionate about having a career. However, with corporate India not offering suitable options, I began contemplating the idea of creating my own career path. This was a significant shift for me because I come from a traditional South Indian professional family with no background or history in entrepreneurship. There was no one to mentor or guide me in this direction. So it was a little challenging at first.
Decision Maker: What motivated you to start your venture?
Sonali Srungaram: I think it was a combination of me trying to come back into corporate India and what was happening in my personal life at that time. There was a shift in the kind of policies we had for working women. Because I was actually in Europe for a very long time in the UK, and there were a lot more parent-friendly policies out there than I had noticed in India. So my story started almost 11 years ago, when I could not find that same accommodation. My oldest child was five, and my youngest was a year and a half. So I was struggling to try and find the right kind of care for them.
And if work and policies don’t allow senior women to come back, we will lose a very large segment of talent. I thought I’d branch off on my own. So while the idea of entrepreneurship started brewing, actually very unfortunately, I had three cancer cases in my family between 2012 and 2014.
As I dealt with what was happening to my family, this really brought me to sense that I was now a carer for patients running around across hospitals trying to figure out what was happening to them. Nobody would give me transparency. I did not understand what treatment was going to be involved. The fact that cancer treatment was very complicated, involved a multidisciplinary team and was a long chronic condition was difficult to understand. For an individual coming at it from a very layman’s perspective, it was very hard to navigate.
And I think what happened with my family and the fact that cancer cases were increasing created a confluence of events that began my journey.
Decision Maker: Can you tell us more about the structure of the CION Cancer Clinics and how it differs from traditional cancer care providers?
Sonali Srungaram: Absolutely! CION Cancer Clinics was founded in 2019, under the company CIPHER Oncology Private Limited. CION Cancer Clinics is an amalgamation of everything we have learned in the field of oncology. Today, we are a distributed cancer hospital. So, while most traditional hospitals cater to patients within a 10 to 15-kilometer radius, we are the first ones to say that from the epicenter of Hyderabad, we can treat patients within a 100-kilometer radius. So what we have fundamentally done is taken the traditional hospital model and turned it onto its head.
We take up space inside existing multi-specialty hospitals, so we are an asset-like model. We don’t build huge infrastructure. We will rent or hire when needed. So, we go to existing multi-specialty hospitals, which don’t have oncology as a department, and create an oncology department for them. We have a 10-member team stationed at the hospital with three doctors visiting.
We offer all three modalities of care, medical, surgical, and radiation oncology in the city center. In the periphery, we do medium-sized surgeries and chemotherapy. In the district, we do smaller surgeries and smaller chemotherapy infusions. So, without altering the clinical protocols, we are pushing the envelope in terms of the operating model of how to deliver quality cancer care.
Decision Maker: Can you provide insights into the core offerings of your company and how these offerings support individuals?
Sonali Srungaram: Our primary offering is cancer treatment, medical, surgical and radiation oncology including cancer screening and various allied services that support both cancer patients and their families. What sets us apart is our commitment to making the entire process as seamless and straightforward as possible. For instance, if someone cannot afford to visit us physically, we provide services online. Additionally, for those who need family support to proceed with treatment, we offer family-based counseling. Our goal is not just to provide a service but to ensure its implementation.
In India, only a few people have private insurance, so our doctors have even modified treatment plans to align with insurance policy renewals, allowing patients to afford the care they need. This level of customization can be challenging, but it’s part of our culture. Selecting the right team members is crucial. Empathy, which cannot be taught, is essential. We are very particular about recruiting individuals who are both intelligent and empathetic. Empathy plays a significant role in delivering patient-centric care.
Ultimately, our offerings are centered around a commitment to providing consistent and personalized care to our patients. This, I believe, is our unique selling proposition (USP) and defines our offerings in the healthcare space.
Decision Maker: Can you walk us through the journey of starting an oncology business and how you overcame initial challenges, especially when convincing doctors to join your venture?
Sonali Srungaram: Certainly! My journey in oncology spans 11 years, but the initial seven years were dedicated to doing groundwork. During this period, we conducted outreach programs, collaborated with the government of Telangana on various initiatives, and even set up helplines. These efforts inadvertently turned into primary market research. We uncovered essential insights about cancer care in India.
Contrary to the myth that all cancer patients flock to cities for treatment, we discovered a substantial population residing in districts who couldn’t access city hospitals. Even those who managed to reach cities faced financial and logistical hurdles, with a significant portion abandoning treatment due to these challenges—this abandonment ratio reached a staggering 75% in India. Interestingly, our helpline received around 70% of its calls from districts and tier-two cities rather than metropolitan areas. This diverse demographic included daily wage workers, transport professionals, and high-tech job holders. It became apparent that cancer knows no boundaries; it affects people from all walks of life.
Understanding these challenges made it clear that our solution needed to cater to those who could afford treatment and those on the brink of affordability. While we currently can’t provide free treatment like government schemes such as Ayushman Bharat, it remains a future goal. Our new treatment model, initiated three years ago, falls under the brand of CION Cancer Clinics.
Decision Maker: The landscape of digital health has undergone substantial transformation in recent years. How has this evolution impacted your company?
Sonali Srungaram: Cancer care traditionally relied on face-to-face interactions due to the high mortality rates and the need for direct consultations. However, the advent of COVID-19 triggered a significant shift. Cancer patients, often immuno-suppressed, became wary of visiting hospitals where COVID cases were being treated.
This situation acted as a catalyst for embracing digital health solutions. Patients and their families began opting for online consultations, a trend that continued even after the initial COVID surge abated. The newfound acceptance of online interactions provided patients with convenience and reduced potential health risks.
While in-person consultations remain essential, our approach has evolved. Presently, around 20% to 30% of our consultations occur face-to-face, with the remainder conducted online. Services such as feedback, dietary guidance, psychological counseling, and family support are now seamlessly delivered over the phone. This transformation in patient care, driven by the unique circumstances of COVID-19, has proven beneficial for our organization and patients alike.
Decision Maker: What, in your opinion, should healthcare providers prioritize when seeking patient engagement solutions?
Sonali Srungaram: The most crucial aspect providers should consider is making patient-centric programs. It’s no longer about focusing solely on service providers’ needs. Patients and their families want transparency, access to information, and a comprehensive understanding of their medical journey. It’s not just the patients; family members also seek clarity. To meet these expectations, providers must allocate time, facilitate access, and be patient enough to explain the intricacies.
Gone are the days when a patient would enter a hospital, remain anonymous, receive treatment, and depart. Today, people demand more value for their healthcare expenditures across all sectors. When healthcare models prioritize patient-centricity, they revolve their processes, services, and operating models around the patient’s needs.
This shift also influences staff training. Teams need to learn how to handle distressed patients, deliver difficult news sensitively, and guide individuals in adjusting to life after a diagnosis. For instance, informing someone that they have cancer is a life-altering moment, and we must provide appropriate support. Similarly, when patients aren’t responding to treatment or when they are making progress but their lives are forever altered, healthcare providers must step in to guide and rehabilitate them.
Our services reflect this patient-centric approach. For every patient undergoing treatment, we offer free nutrition counseling, psychological support, and genetic counseling. Providing patients with knowledge about familial cancer risks empowers them to take precautionary measures. For example, breast cancer can run in families, so educating daughters of patients about early detection becomes crucial.
Additionally, India faces a high prevalence of cervical cancer, but simple steps like administering the HPV vaccine can help eradicate it, as demonstrated in countries like Australia. We must educate families on these preventive measures. Our services extend beyond treatment to encompass the entire family’s well-being. These personalized services represent a significant departure from traditional healthcare processes.
Decision Maker: How do you envision the impact your company will have on the Indian healthcare landscape?
Sonali Srungaram: Our primary objective is to make cancer care accessible and affordable for middle-class Indians. If we continue to limit services to urban areas, the costs will remain prohibitively high and continue to rise. By extending our reach to districts, we can significantly reduce the price of services.
For instance, performing the same surgery in a district hospital rather than a city hospital can reduce costs by up to 40%. This financial flexibility allows patients to allocate more resources to their treatment. Our goal is to transform cancer from a potentially life-threatening illness into a manageable one.
Ideally, we aim for cancer to become just a chapter in one’s life story, not the defining narrative. Patients suffering from diabetes, for example, learn to manage their condition with regular check-ups, and it doesn’t dominate their lives. We hope to achieve a similar outcome with cancer.
Cancer should no longer be an insurmountable obstacle. Instead, it should become a challenge that individuals overcome, allowing them to return to pursue their life goals and aspirations. While we cannot prevent cancer from occurring, we can equip people to manage it effectively. Ultimately, our vision is to make a substantial impact on reducing cancer mortality in India and to improve overall quality of life for cancer survivors and their families.
Decision Maker: Expanding on this, what keeps you up at night? Can you provide further insight into this?
Sonali Srungaram: Certainly, one of the foremost issues is the sheer scale of the problem we’re addressing. Cancer is a massive issue, and addressing it comprehensively requires collective efforts. While we’re playing our part, it’s essential that this becomes a broader movement involving many stakeholders.
A specific challenge that we face is that our model is relatively new in the healthcare landscape. We have numerous existing players who take a “wait-and-see” approach. They’ve already invested in their established methods of cancer treatment and might be skeptical about our approach. It’s almost amusing in a way, considering that I, as a non-medical outsider, dare to question the status quo.
Over the past three years, we’ve managed to make them somewhat uncomfortable with our approach, which I find quite satisfying. Our objective isn’t to make existing players feel comfortable; it’s to provide the best possible care for our patients. Each day, we ask ourselves how we can deliver cancer treatment closer to the patient without compromising quality, making it more affordable, or ensuring that every patient who starts treatment can complete it with us.
The complexity of these challenges keeps me awake at night, but I’m fortunate to have an incredible team that shares my vision and is willing to push boundaries. Approximately half of our time is spent brainstorming solutions for emerging problems that haven’t been addressed elsewhere. While it’s unfortunate that some new players might try to copy our model without truly understanding it, the responsibility of solving these challenges falls squarely on us. We are pioneers in many ways, and being on the forefront can indeed feel isolating.
Decision Maker: Can you elaborate on the major milestones your organization has achieved in its development path?
Sonali Srungaram: While we officially established ourselves as a treatment center in 2019, the journey began seven years earlier. During this period, we engaged in government programs, outreach initiatives, and extensive research. These experiences laid the groundwork for our current operations.
In 2019, we took a significant step by establishing our treatment centers. By 2020, we had initiated our first units in Hyderabad, followed by further expansion within the city in 2021. Towards the end of 2021, we extended our reach to Visakhapatnam.
As of May 2023, our organization comprises nearly 120 dedicated professionals, including 15 oncologists. Our vision for the future is ambitious. We aim to double the size of our team while quadrupling our impact. By January 2025, we aspire to have handled four times the number of cases we’ve handled thus far.
This growth plan includes expanding our team to around 250 individuals and significantly increasing the number of patients we serve. Our journey has been marked by steady progress, and we are committed to making a substantial impact on cancer care in India.
Decision Maker: How do you plan to enhance healthcare services without increasing costs?
Sonali Srungaram: It’s indeed a multifaceted challenge, but we’re tackling it through a range of strategic approaches. Firstly, we’re leveraging cutting-edge technology, such as AI-based screening tools, to ensure our care remains consistent and efficient. This not only enhances accuracy but also streamlines processes.
Secondly, we’re deeply committed to process re-engineering. We’re meticulously optimizing our existing processes to make them more efficient, thereby reducing unnecessary expenses without compromising on quality.
Moreover, we’re actively exploring collaborative partnerships and outsourcing options. By collaborating with other healthcare entities and outsourcing specific services, we aim to cut costs while maintaining high-quality care. It’s about finding the right balance between efficiency and excellence.
Decision Maker: What advice would you give to women entrepreneurs in male-dominated industries?
Sonali Srungaram: To my fellow women entrepreneurs venturing into male-dominated sectors, I’d offer several pieces of advice. Firstly, hold unwavering belief in your ideas. Trust in your vision and its potential impact, and don’t let skepticism deter you. Secondly, take a practical approach by creating prototypes or minimum viable products to test your concepts. Embrace the learning process that comes with experimentation. Building a strong network of mentors and advisors can provide invaluable guidance and support. Don’t be afraid to ask for help or seek advice from those with more experience.
Additionally, view setbacks and failures as opportunities for growth and learning. Remember that resilience is a key trait for entrepreneurs. Equally important is maintaining a work-life balance. Overworking can lead to burnout and hinder creativity. Challenge conventional norms and embrace your uniqueness as a female entrepreneur. When it comes to funding, seek investment strategically and explore diverse funding sources. Lastly, remain adaptable and never stop learning. Industries evolve, and successful entrepreneurs evolve with them.
Decision Maker: What problems do women entrepreneurs commonly face?
Sonali Srungaram: Women entrepreneurs frequently encounter a range of problems, some of which include navigating biases in the fundraising process. Unfortunately, biases still exist, and women may find it more challenging to secure funding for their ventures. There are also societal expectations and biases that can cast doubt on their leadership capabilities.
Also, balancing family responsibilities with the demands of entrepreneurship can present another hurdle. Women often juggle multiple roles and responsibilities, which can be exhausting and challenging to manage simultaneously. These issues underscore the importance of creating a supportive ecosystem for women entrepreneurs that addresses these issues and provides equal opportunities.
Decision Maker: Can you share your vision for healthcare delivery in 2025?
Sonali Srungaram: Looking ahead to 2025, our vision is centered on a healthcare system that places the patient at its core. We envision a more patient-centric approach where healthcare services are accessible, efficient, and tailored to individual needs. To achieve this vision, we’re planning to expand our presence significantly. By 2025, we aim to establish approximately 50 healthcare centers across Hyderabad and Vizag.
Additionally, we’re committed to creating a central hub, a center of excellence, where we can conduct advanced and specialized medical work in-house. This hub will enable us to offer high-end services while maintaining affordability. In summary, our vision for 2025 revolves around accessible, efficient, and patient-centric healthcare, backed by a substantial expansion of our services.
Decision Maker: What factors contributed to your success as an entrepreneur?
Sonali Srungaram: Several critical factors have contributed to, my success as entrepreneurs. Firstly, the commitment to continuous improvement has been pivotal. We’re constantly seeking ways to enhance our services and processes. Unwavering persistence in the face of challenges has been essential. Building a robust support system, both within our families and our team, has provided the necessary foundation.
We’ve also embraced collaboration as a means of achieving our goals more effectively. Lastly, perhaps the most significant contributor to our success has been our unwavering belief in our vision. Belief in what we do has been the driving force propelling us forward and enabling us to overcome obstacles along the way.
Decision Maker: And what kind of advice would you give to future ‘doctorpreneurs’?
Sonali Srungaram: As someone who isn’t a doctor, I might not have the ideal advice, but I’m genuinely impressed by the emerging generation of young individuals entering the field. What sets them apart, in my opinion, is their inclination to question established norms. My advice to them would be to invest time in their ideas, nurture them, and see where these concepts can lead. Many of them have brilliant ideas but might lack the courage to put them into action due to a fear of failure. It’s crucial to understand that failure is not the end; it’s merely a stepping stone to success.
I’m witnessing a growing trend of collaboration across different sectors within the healthcare industry. My advice to these budding doctorpreneurs would be not to fear collaboration. If you have a groundbreaking idea, try it out. The worst-case scenario is that it doesn’t work out, and you can return to your regular practice. At least you won’t lie awake at night wondering, “What if?” Taking that step, even if it doesn’t pan out, is an achievement in itself. Furthermore, it’s essential to realize that you don’t have to go it alone. There’s absolutely nothing wrong with seeking assistance from others. In fact, it’s often the key to success. Embracing collaboration and acknowledging that you don’t have to be a lone hero can open up incredible opportunities.