Bio-Hacking, Lasers & Lifestyle – The Future of Interventional Orthopedics in India With Dr. Praveen

Introduction to Elyra and Dr. Praveen 0:00

This conversation will change the way you think about specialty clinics. Today's guest is an orthopedic surgeon who walked away from a thriving career in Canada to rebuild everything from scratch in Calicut, Kerala. But what he created isn't just a clinic, it feels like the future. From biohacking blueprints and IV trip launches to advanced laser robotics, he's pioneering the field of interventional orthopedics in India. Why choose the harder path? The answer is powerful. Let's dive in. Dr. Praveen, welcome to the show.

Thank you, Rakesh. Nice to see you again. Yeah. When I met you in Hospix Expo, the one thing that got fascinated me is your vision. Like, you know, it has a sparkle. I can see that the way you were explaining your mission on that day to me and to You know, that's what made me to come back and meet you again in your clinic in Calicut. And that was all a whole different experience for me. Before getting into that, I just want to talk about a pre-story of Elyra. So you built a successful medical career in Canada, a country now with some of the best healthcare infrastructure in the world.

Then you decided to go back home to Calico to start from the scratch. Many people dream of going abroad to find an opportunity. You did exactly the opposite, you came back to create it. So tell me what drove that decision? Was there a moment when you knew this was bigger than just a professional move? Thank you, Aakash. I get asked that question all the time. But I think it's important to understand why I left in the first place, to why it came back.

Returning from Canada to Build in Calicut 2:00

In 2019, I went to Canada to learn what was out there. And I firmly believe in power of perspective. You can only have perspective if you have diverse experiences. I have healthcare experience in India, Qatar and Canada, and I wanted to know what the West was doing. Typically, there is a 15 to 20 year gap in technology between the Western India. And I believe that in order to what that gap is, I need to go outside of the country and experience what it was like. I came back to Calicut, of course, because it's a city that I love.

I started working in Calikit after my graduation. And I loved the people, the place, so I bought a home here. When I got back from Canada, it was a no-brainer for me to come back. And of course, we also had personal reasons to come back. Our family are based in and around India, and we wanted to be close to family. Life is made meaningful by the relationships you have. So on the personal front, also it was an easy decision to make. Well, that's powerful. You just didn't move back, you brought back the future.

As you said, in the West, most of the times is almost 15, 20 years ahead in terms of technology. Another thing what I find incredible is that you didn' compromise when you build Elyra. It can be, as I said the technology or the architectural, the design, it all feels international. When I stepped into Elysra in Calicut, I was mesmerized looking at just the architecture, like the moment you open the door, I hear the subtle music coming in in your reception and the fragrance. I still smell it. Okay, it was like for me stepping into a different world.

It was not expecting a clinic to give such an experience, especially in India. So I just want to hear a story behind it, You know, thank you for your feedback, and that's exactly what I live for, to hear that people loved coming to my center and had a really good experience. I can't take any credit for how beautiful my Center looks. My architect is also my sister. Her name is Anisha Samuel. We can follow her work on Instagram on CalCock Design Studio. And I told her, I want clients who walk into Alira to feel like they're not in a hospital.

They have to feel like they're at home, comforted, cared for, and loved. And I believe that healthcare is a multi-dimensional experience. It should be more than just your typical transactional experience with your doctor.

Designing a Clinic That Feels Like Home 5:00

Every frame must be beautiful. There must good music playing. The touch of the doctor, the therapist, nurses must all feel good and comforting. There should be a fragrance, there should refreshments. So the whole experience of healthcare, I wanted it to be sublime, conventional. That's the story behind why this centre looks the way it does. Because healing is not one-dimensional, it's multi- dimensional, and you must have all five of your senses aroused. and you shouldn't feel like, oh, I need to get back home as soon as possible.

How many hours you spent here in Elyra, you should feel good and welcomed. I think you nailed it. My personal experience was like the moment when I stepped in, when i looked at the walls and in the lighting. Overall, the calmness, for me, it was more of like I came here to heal, not just to be treated by an ortho doctor for my I personally felt it. That's why I just wanted you tell the story of why it was an intentional for you to build it in such a way because it costs a lot to built that kind of an infrastructure to give that that experience.

And another thing that I want to ask you is the photography. I heard that you yourself is a photographer and then you like to take photos and you travel as well. So what was the story behind that? I love photography. Photography is my creative outlet. It's how I unwind after a busy day or busy week. I loved travel as well. My philosophy on perspective extends across everything I do in my personal life and professional life. And I like talking to different people, meeting new people seeing new places and most certainly freezing those snapshots in time.

And for me, photography must always tell us stories. If you visit my home or my clinic, you'll see the walls are adorned by some of my work, and every frame has a story to tell you. And the idea behind it was, if you're spending a few moments looking at my photographs, I want you to be able to think of the story behind each frame. I need, want to you be in the same mental space that I was in when I took that photo. So that's the whole purpose of photography for me, a creative outlet and also a window into my perspective on the world.

guarded. Now the creative eye for a doctor is a great combination to have, right? I think that's where the whole LIDAR shaped out with your vision. So on the same lines, I just want to ask you more on how you want a redefine the orthopedics. In general, common people like me think orthopaedics mostly like a surgery or a bed rest kind of a thing but you created a different path which is now the intervention orthopedics and it is very new term even for me to hear and for a common man, I think it's a new time to here.

Let's say, how do you explain this to a patient who walks in limping and then says that I've been suffering about this limbing chronically and do I need a surgery? How do explain these to your patient? That's great question. It strikes at the core of what I'm trying to do here, Interventional orthopedics, fundamentally, it's non-surgical orthopaedics that's more effective than medications and less invasive and riskier than surgeries. Now, of course, as a surgeon, I will always value the importance of surgery where necessary.

Photography, Travel, and Perspective 9:00

It is essential. In cases of accidents, for example, surgery is often the best option. But in conditions that are chronic or lifestyle conditions, occupational conditions where you can use non-surgical solutions, effective non surgical solutions. You must always consider them. A very relatable example will be osteoarthritis of the knee joint, which many individuals have once they're over the age of 50. It has four grades, grades one, two, three, and four. Four is definitive surgery, grade three is almost always surgery.

But in grades 1 and 2, you can still do interventional procedures or services. to relieve yourself of pain and to improve your quality of life. Now the problem I've identified in India is that there is little cultural awareness of what interventional solutions are available. And that's the gap I'm trying to fill. So I am running into two headwinds. One is a lack of cultural awareness. Second is because there is lack culture awareness, most people don't know that spending money on interventional procedures or intervention solutions is worth it.

They're all familiar with the concept of the idea that you have to spend a lakh and a half for a knee replacement, but few people will shell out 20,000 or 30,00 for an interventional program that lasts over two or three months. So eventually you spend less money, you have less morbidity because you're not getting operated on, but you don't have to recover from surgery after being admitted in the hospital, and you are back on your feet quicker and more painlessly compared to surgical options. Well, that is really good.

I just want to ask you a little bit, like, you know, I don't say, maybe it's a controversial question, but when you said surgery versus the interventional way of treating maybe the grade one, grade two that you discussed, so, at least as far as I know if I go for a surgery, can claim my insurance, option, I cannot claim my insurance, even though it is 10,000, 20, 000 or whatever it, is right?

What Interventional Orthopedics Means 11:30

Like, you know, for someone who is looking through the lens of insurance right, not through, the length of how well I get treated through interventional methods. So can you just shed more light on like, why the intervention orthopedics is much more safer and much, more effective than thinking of just a surgery? I wouldn't say it's more effective. I would say that in situations where you don't need surgery or you can wait or delay surgery, it is just as effective in alleviating your pain or in regaining good functional outcomes.

Now, you mentioned something about insurance and that's absolutely true. Many of these treatments are new to this country. Most insurance providers may not cover them. But again, that stems out of a lack of cultural awareness. In the West, many rehabilitation programs are covered by insurance. But any health care intervention, I think, needs to reach a certain critical mass of awareness before insurance companies take notice. So we will eventually get there in India. Interventional orthopedics will not replace orthopaedics.

It will supplement surgical orthopoethics, right? So surgical will always be necessary and essential in life saving. For example, grade four osteoarthritis, the best procedure for you to get done, is in fact right now a knee replacement. But if you have grade one or grade two, You can have interventional treatments that will definitely lower your pain, improve your quality of life and give you more smiles. Definitely, definitely. Got it. So on the same lines, I can know what blows my mind is the infrastructure in terms of that technology, like the laser technology that you bought back and then the focus shockwave.

I heard this, and I'm aware of these things because we help another orthopedic who is a podiatrist who focuses more on foot and ankle in New York. He exclusively provides these kind of laser services, the shockwave services. And that's how I came to know about these services and then I never heard anyone from India talking about them. You are the first doctor that I met. The first orthopaedician was just talking all these high tech laser, shock wave therapies and that really blown my mind. So, what gave you the conviction to bring all this to Calicut?

Well, first of all, I think the people of Calikit gave me that confidence. Maybe it's a cultural thing about Calicate. People here are extremely receptive to innovation, technology, and anything that's new. If you give them good service, they will try anything. And if it is effective, then if its new, that they can experience here. And for me, my mission is to change the face of healthcare in this country. I want to the change culture. Typically, Indians wait for something to happen before seeing their doctor.

I believe prevention is better than the cure, always. So if you know how to prevent something, if know to how prevent the progression of something that you already have, the burden of healthcare on yourself, on society, and the country is much lower. But in order to achieve all that, you definitely have to take make a bet and take a risk on bringing the best that the world has to offer here in this country. So it was a no-brainer for me to bring these technologies here, to invest in these technology.

And so far the response has been excellent. I love that. You bought the international experience back to India here in Calicut. I think whoever nearby are very lucky to have this kind of a clinic who is providing international level experience to them.

Laser, Shockwave, and New Treatment Technologies 16:00

So on the same line, you created your own signature programs based on lifestyle. It can be an athlete or it can for men, it could be the biohacker blueprint that you have. Can you shed some light on what made you create these programs and what is the message you want to give to the people? Great question. I am a fitness enthusiast myself. Have been involved in bodybuilding for the past 15 years. And these programs that you mentioned came out of a personal realization. When I started body building, I was quite young.

There were many things I didn't know that I wouldn't have benefited from knowing back then. I would have prevented a lot of injuries. How to manage certain injuries better than I had. So I started bodybuilding much before I became an orthopedic surgeon. The gap back than was not knowing. and not finding the right help. The athlete's advantage, for example, if you're a weightlifter and you are doing certain exercises, deadlift for examples, you'll more likely to have certain injuries. If you a powerlifter and your doing deadlifts or you doing prone to having certain kinds of injuries, So if you're coming in for the Athletes Advantage program, what you will receive is customization.

Customization to the extent that we will look at the cause of what's happened to you by studying your routine, the kind of sport you are in, and the industry you in. And based on what do you need, we customize your diagnostics and your solutions and that'll work for you and I really believe that that's the only way healthcare should work because every individual is different and so the athletes advantage program is customized to the individual to be athlete and you don't have to an athlete you could be a physically active person who likes fitness or not.

It's just a way for you to customize your healthcare to yourself. And you have the right diagnostics and the solutions catered around your need. So these programs make customization possible in health care? Well, I think that's the future. People just don't want the fragmented consultation. Just go and get a medication, come back even for now, especially the athletes. They get injuries and then those injuries might be fatal sometimes. Anyone with all these things, they just wanted a guided journey rather than one just consultation, just go get maybe a painkiller, So, I think that's that what make Elira special.

So it's a medicine that restores identity, not just mobility. So the business part, the treatment, your vision, and the passion for care is great, but the economics has to make sense for you, right? It is not viable for us to run this in Calicut. If you have got this, in any other metro city like Bangalore, Mumbai, Chennai, Hyderabad, it might be a different story. So I just want to talk about the bold step that you took and then I want you to tell me your thought process about building a brand in healthcare.

Lifestyle Programs for Athletes and Biohackers 19:30

So what was your thoughts process? Like, you know, this is purely from the entrepreneur in your point of view, not the doctor as a doctor, Praveen. I looked at this from two perspectives. One is as you said, as an entrepreneur and second as doctor. As a Doctor, my product is only one, it's trust. If you ask me, what am I selling? I'm selling trust. Your faith in me is my product. As a healthcare professional, if my clients don't have trust in, me there's no reason for them to see. So they must have faith that I will give them the best solutions possible.

That is the underpinning of all my entrepreneurial ambitions. And from my perspective as an entrepreneur. I believe that healthcare has in the 21st century has to be pillars. One is of course capital we can't do anything without capital. Second is technology. Third is accessibility and expertise. So if health, if the best technology isn't accessible to as many people as possible, it's not worth doing if you ask me, especially in healthcare, because healthcare is such a fundamental need, It must be available and accessible as to many as people possible.

And one thing that technology does is that it democratizes. We live in an age where the push of a button on your phone can tell you your blood sugars or your pressure with wearables and a lot of tech. So for me, as a healthcare entrepreneur, I think my fundamental responsibility is towards my clients, towards patients whose trust I cherish. And I believe that good services based in trust will yield a successful enterprise, if you have those three pillars in mind. Got it. So just on the lines of trust, like for any patient, the moment of truth is not the doctor, but the receptionist.

That's the first person they will be interacting with. And I think the last touch point is you. Before that, the patient has to go through the receptions. Maybe they have to do maybe a diagnostic room to get some tests done. Then finally, they come to you, so there are a lot of touch points that you don't directly control, create the experience. So how do you train your team to give that kind of experience for the patients on the lines of creating trust? Thank you, Aakash. This is such an important point, especially in the service sector.

Health care is, I think, at the top of the food chain when it comes to the services sector, so my process is simple. When I interview potential employees, I look at two things. I tell everybody that of course your experience and educational qualifications matter, but they are secondary to personality, character and integrity. These are the two thing I always tell all my interviewees. So I always screen for people with good character, personality, empathy, integrity, sincerity, because in the service sector,

Building Trust and Training the Care Team 23:00

you need to show all of that for the people to repose their trust in you. And the second thing I do is, I tell everybody, once you're hired at Edira Health and Diagnostics, there is at least a three-month training period where you are taught any technical skills that you lack, but most importantly, any people skills, that your lack. Because care begins not in the doctor's office, it begins at the first point of contact, and it continues throughout follow-up. So anyone who calls into our number is received with the same warmth, and care that they would receive at their doctor's office here.

And that's something that we continuously monitor and evaluate. Whenever we have unhappy clients, we're always empathetic. We do a debriefing at the end of the day to understand why that particular client was unhappy or or felt the service could have been better, and then we make a difference. We make change in our protocols. So we have living protocols, we don't have static protocols we've dynamic protocols that evolve continuously to meet a patient's or client's needs. So for me, care is holistic.

It's not one-dimensional, it's multidimensional, and it never stops. If you look at our logo, do check us out on our Instagram page. You'll see that the Celtic knot symbolizes Allera. And this is a continuous loop. Health care never ends. Once you're a client of mine, you are always a Client of Mine. I don't stop thinking of you. Well, that's truly inspirational for me because you spoke through a marketing lens of branding and the deeper message behind your logo and then your philosophy, getting everything right.

I feel very happy. because I'm talking with someone who is building a brand of dress rather than just building clinics and just scaling up. So that's really inspirational Dr. Praveen. I just want to jump on to the future here and then you said it is more of a healing. What could be the feature of healing Maybe, you know, like I don't want to go like, five years or six years. I just now we are changing rapidly, especially in the era of AI. And now maybe I would say in next two years, where do you see the interventional orthopedics heading, both globally and also here in India?

A couple of things. Let me first talk about AI, I do think AI will ever completely replace doctors. But doctors who use AI to augment healthcare delivery will certainly replace doctors, who do not use a AI. So if you don't change with the times, I think you'll be redundant very quickly. Orthopedics like all other surgical branches will become increasingly interventional and minimally invasive. For example, Conventionally, spine surgeries used to be these huge incisions in your back with bones removed and big screws going in.

And now we have the wonder of technology making it minimally invasive with two tiny little ports on either side doing a decompression.

The Future of AI and Minimally Invasive Orthopedics 26:30

That's quite remarkable. Healing times are faster, morbidity is lower. Patients are happier. It becomes a daycare procedure. They can just go back home in the evening So medicine is certainly going to become more automatized, more accurate. If I may, I love this scene in Star Wars where Darth Vader's Anakin Skywalker becomes Darth Vador, where on the planet Mustafar his limbs are burnt off and the Emperor's clones, healthcare clones or robots reconstruct him. I think at the turn of the century that's what we're going to see.

a bit of a reference from pop culture, but right now we are in the journey to that point. And for me as a doctor, it's quite exciting. As also someone who loves and understands technology and its potential in making healthcare more powerful, more effective and less scary. So that's definitely where we're headed. And I think as doctors, we must all embrace technology and not be afraid of it. Got it, so like if I want to put this in structures, you're saying that it is AI guided diagnostics, regenerative medicine and personalized rehab.

Absolutely, absolutely. Very good, Saman. And for Elaira, what's next? Do you envision like research collaborations or even expanding this experience to more cities? All of the above. As my English teacher from high school with whom I have a very strong relationship even today, 18 years after leaving high and Dr. Dipesh Chandrasekhar. He says, all knowledge is for sharing. So I believe that ALIRA's mission in changing the healthcare culture in this country and its process are all for share. And I would like to see myself as a catalyst for change.

India has a lot of potential. Indians should not have to travel abroad to get the best services. Indians shouldn't have choose between feeding themselves and getting the right healthcare. Yeah, Indians also deserve accessible democratic healthcare and the catalyst for that kind of change can only come from doctors, I believe. And that's what we're trying to do. at least be among the first people to do it. And I think eventually you'll see more and more people doing it, more clinics, hospitals doing, and you will gradually witness the transformation of Indian

Expansion Plans and the Vision for Indian Healthcare 29:30

healthcare into much better than it already is. Got it! So Dr. Praveen, when you think of expanding into more cities, my personal request is to think about Hyderabad as one of your options. I certainly want to expand into other cities. We have opened our first branch in Calicut. we will definitely expand to other Cities in Kerala and India and also hopefully the Middle East and other areas of the world in slow and steady. I believe in doing things perfectly. Got it, got it. See, I can't wait to see that.

Okay. So like it's not just now because what you are building isn't just a clinic. It is more of like a blueprint for the next chapter of orthopedic care in India. So that's what I believe in whenever I meet you. So, that is why I requested you to share the story and then you are my first Indian doctor to be as a guest in my show. I thank you, Dr. Praveen, for this great conversation and for showing us that innovation in healthcare doesn't always mean just new machines. Sometimes it means a new mindset.

That's how I felt. So to everyone listening, Elayra is proof that healing can be, you know, intelligent, elegant and deeply human. If you are in healthcare, take note. if you're a patient take heart because the future of healing is already here and it started in Calicut. Thank you, Rakesh. It was nice talking to you.