Welcome to the first 2024 episode of First Principles! Though we’re only 15 months old, we’re also technically into our third calendar year, after our first episode in August 2022. A happy new year to you. Here’s to many more years of wonderful conversations, learning and growing. Our guest today is Viren Shetty, the executive vice chairman of Narayana Health—the publicly listed healthcare group that operates over two dozen hospitals across India.  Refreshingly, Viren thinks about healthcare…as an assembly line.  And there are many, many steps in this line. Many of these are very small...they seem unimportant. Even forgettable. Like scheduling an annual healthcare checkup. Or filling out a feedback form at your clinic. Or just waiting in line for your doctor's appointment.  When I asked Viren how healthcare can be fixed in India, he pointed to this assembly line.  Basically, what if you tweak every small step of this line a little bit? Small, unnoticeable changes at every step? He’s confident that the result will be a smooth, well-oiled machine that takes care of your health end-to-end.  This is what, Viren says, Narayana Health is trying to do.  It reminded me of Apple. Take existing technologies and make improvements while putting the user at the centre of the experience.  Narayana Health is a name you might have heard, especially if you’re from Bangalore. It was founded in 2000 by Dr. Devi Shetty. It went public in 2016 and is valued at over US$1 billion. But what we know as Narayana Health today began as Narayana Hrudayalaya, a super speciality hospital with a laser-sharp focus on cardiac health. Twenty years on, however, it's changed a lot. In addition to its numerous hospitals across India, it's also venturing into health insurance policies, partnering with clinics and pharmacies, and building an ambitious bundled subscription plan for its customers.  This episode is a first in more ways than one. It’s not just our first episode of 2024. It’s also the first episode with a guest from the healthcare sector.  And it’s the first episode which may sound a little different to you.  In this episode, I ask Viren: Why are health checkups such a hassle?Is the answer to better healthcare in hardware or software?What are the health tech startups doing right?And then there is the unshakable mistrust that the Indian population holds against hospitals and doctors. Can this even be solved? Patiently and confidently, Viren answers every one of my questions. He talks about building sticky habits in customers, changing the messaging in healthcare, and becoming “worse” as an insurance company to be better as a healthcare one. In this episode, we truly get down to the first principles of healthcare in India. Check out the First Principles Newsletter, a weekly Sunday read on entrepreneurship, mental models, leadership and reflection here. Send in submissions for book recommendations, interesting reads, Silent Sunday pictures or songs for the First Principles newsletter here. This is Episode 34 of First Principles, Viren Shetty—The Ken’s fortnightly leadership podcast. The Ken is India’s first subscriber-only business journalism platform. Check out our deeply reported long-form stories, insightful newsletters, original podcasts and much more here.