Metropolis to Deepen North India Push, Open to Acquiring Quality Labs: Promoter Ameera Shah

It's been a very interesting year for us. As we said, our focus on North India is very high, and that was really the focus last year. We did four acquisitions last year, three of which were in North India, which clearly signifies our focus and attention on the region. Earlier, North India contributed about 8% of our revenue, and now it accounts for about 17–18% of the group’s revenue. That is a very significant jump for us because we believe North India is a very large and opportune territory. There is a significant lack of access in many markets, and people often travel to bigger cities for tertiary and specialty care.

We wanted to make sure that we are able to provide the kind of diagnostics and services that people across the region need. With that in mind, we have set up many labs across the region.

Doctors are now beginning to recognise Metropolis as a super-specialty player in North India across areas such as genomics, neurology, oncology and multiple specialty segments. I think it has been a good move for us. There is still a lot more for us to do in the North, so this is not the end—it is very much the beginning, and an exciting one.

It's a mix of both. If you look at markets in North India where Metropolis does not yet have a presence, the idea is to establish collection centres and expand deeper into the region. Currently, we are present in metros as well as tier 1, tier 2 and tier 3 towns.

The plan is to go further into smaller markets and establish a physical presence there. In markets where we are already present, the focus is on reaching more doctors and more customers, growing the business and serving more patients. So it is a combination of the two. This is the organic route.

Along the way, if we find good-quality labs that share our ethics and way of working, are focused on the B2C segment, and are available at the right price, and if they are leaders in their markets where we do not have a B2C presence, we would certainly be interested in acquiring them and using them as a base to grow in that region.

Not really. The hospital space is certainly growing fast and is also consolidating, but there is not a very direct connection with the diagnostics industry. The doctors who refer patients to us may be based inside hospitals or outside hospitals, and both are our customers.

So I would not say that the growth in hospitals has been a direct inspiration for us.

In fact, in some ways the hospital industry has taken inspiration from the diagnostics industry in terms of consolidation. Earlier, most hospital chains were very small or regional.

Now you are beginning to see more pan-India players. Even then, there are only a few truly national players, perhaps Apollo, Fortis, and Manipal. Most others remain regional chain.

Definitely. As people understand the difference between high-quality results and poor-quality results, they prefer to choose trusted brands like ours that offer precision and reliability. As diseases become more complex, the need for accurate diagnostics becomes even more important.

Over time, I think three things will happen.

First, more people will move toward branded labs that are known for quality.

Second, preventive testing will increase as people become more conscious about maintaining their health.

Third, as insurance starts covering more diagnostic testing, larger diagnostic chains are likely to grow further because insurance companies prefer to partner with organised networks rather than individual labs.

So if you look at the next 10–15 years, there will be significant change in the industry.

It is not really just a perception, it is the reality. Private equity firms invest with the objective of generating returns for their investors. That is the basic premise of the business. They invest in companies where they believe they can create value and earn profits.

Companies, on the other hand, take private equity investment when they need capital to accelerate growth. If the capital available within the business is not sufficient, and the company either cannot raise enough from banks or prefers not to take on debt, private equity becomes an option to fund expansion.

So as long as the arrangement works for both sides—the investor and the company—it makes sense.

The real question is how that growth impacts the consumer. As companies become larger, are services improving? Is the quality of treatment improving? Are offerings becoming better? And importantly, are prices becoming too expensive for consumers?

There is often a perception that because private equity capital is expensive, companies will continuously raise prices. However, in the diagnostics industry, this has not really been the case. Diagnostic price inflation has remained relatively low even in markets where private equity has played a role.

That said, the situation may differ in other healthcare segments. For example, insurance companies often raise concerns about rising hospital costs.

Ultimately, patients usually choose hospitals based on the doctor they trust the most for their treatment. They do not typically consider whether the hospital is backed by private equity or not.

Prices do matter, but they are not the only factor. In many cases, especially for insured patients, the insurance company is paying the bill. This means the negotiation over pricing often happens between insurance companies and hospitals rather than with the patient.

Patients still focus primarily on finding the best doctor and the best treatment available.

Yes, definitely. I have been building Metropolis for about 25 years, and I have seen significant change over this time. One important step was the government mandate requiring at least one female director on company boards.

Initially, many people criticised this move, calling it a form of reservation. But the regulation pushed the ecosystem to develop more qualified women directors.

Even today, India remains quite diverse in this regard. In smaller companies, sometimes a woman director is appointed simply to fulfil the requirement, without truly involving her in decision-making.

However, in most of the top 500 companies, the quality of women directors has improved significantly. There are many organisations that are now working to train and prepare women to participate meaningfully in boardrooms.

That said, the pool of experienced women directors is still quite small. When boards need to replace a female director, it can be challenging to find the right candidate because many experienced women already serve on multiple boards.

At the senior management level as well, we are seeing more capable and ambitious women. But one challenge remains, the home ecosystem has not changed at the same pace.

Women are still expected to be the primary caregivers in their families. This additional responsibility often becomes a barrier to career progression.

While women’s aspirations and capabilities have certainly grown, the expectations at home have not evolved as much.

Yes, absolutely. I have often been in situations where I held a different view from most of the men in the room. When you raise that point, sometimes others may dismiss it quickly.

If you are the only person expressing that perspective, it can be easier for the group to move past it.

However, when there are two or three women in the room who share a similar perspective, the discussion changes. It becomes harder to dismiss the viewpoint because it is no longer coming from just one individual.

In those situations, the argument can be presented more strongly, and it often encourages others in the room to reconsider their stance.

Sometimes, one of the men in the group may then say, “Yes, that makes sense,” and the conversation shifts.

Ultimately, it is not just about gender. It is about having different perspectives and having others who are open-minded enough to listen and engage with them.