All through the 15 years he practised medicine in the USA — in New York, Chicago, Houston, and finally at the medical school at the University of Louisiana at Lafayette, where he was chief of emergency medicine — Prabhakara Reddy never gave up the idea of coming back to India. Every year he would come down to his hometown of Bangalore, visit his extended family, check out the city’s hospitals, survey property prices, and go back promising himself that he would soon return for good.

Last year, he finally made the break. Now he’s a consultant at Wockhardt Hospital, Bangalore, in charge of the facility’s emergency care unit and says “The concept of emergency medicine didn’t exist in India when I left. Our medical infrastructure is developing and for those who want to come back, this is a good time.”

Indian doctors are ubiquitous in the USA, so much so that they’ve come to be fixtures in every other American television serial. But the script’s changing and the drama may soon have the occasional American television patient in distress as his doctor declares he’s going off to settle in Hyderabad.

At Wockhardt Hospitals, CEO Vishal Bali has made it his mission to reverse the medical brain drain, recruiting 28 superspecialist physicians from the USA, UK, Australia and Canada over the past three years. “India may have been a exporter of medical talent in the past, but now the technology gaps have reduced and more doctors want to come back. We’re taking a lead in bringing back doctors in areas of clinical excellence where talent is not readily available in India.”

One of Bali’s prize catches is Ravindra Mehta, who heads the 90-bed critical centre unit in Bangalore. Mehta was a star of the Big Apple’s medical establishment, a faculty member at State University of New York, with triple specialisation in critical care, pulmonary medicine and sleep medicine, all hot areas. “Coming back is not an easy decision,” he says. “Doctors grow roots wherever we practice — with colleagues, with patients — so we don’t usually move easily.”

Mehta initially wanted to move to Mumbai, but for wife Hetal, who is a paediatric cardiologist, Bangalore offered better career prospects. Today, the couple live in South City, Bangalore’s NRI haven, where their neighbours are mostly US-returned IT professionals. “Property in Bangalore is as expensive as New York,” grumbles Mehta. “Remuneration is certainly an issue for doctors coming back. Right now my salary is what I used to make as a resident in New York.”

Working full time on salaries ranging from Rs 2.5 to 5 lakh a month, Workhardt’s NRI doctors — average age, 40 — have certainly not been drawn by the love of lucre. But with 1,200 doctors on its rolls across ten hospitals, the company can ill afford to distort its salary structure for the sake of its NRI recruits. “They know that multiplying dollar salaries by 45 is not going to happen — the business wouldn’t be able to take it,” says Wockhardt Hospitals group HRD head Kumar Krishnaswamy. “The doctors have to be primarily motivated by a desire to come back to India. There’s no knowing what triggers the desire, but we want to be there when it happens.”

For laparoscopic surgeon Shabeer Ahmed, who returned after working 20 years in the UK, the trigger was racism. “Despite my advanced training under one of Britain’s best surgeons, the white establishment would only give me routine surgeries. I was bored and fed up with my work there,” he says.

Ahmed now works with a team of specialists at Wockhardt Hospital, Bangalore, offering keyhole surgery as an alternative to open surgery. And he’s now set to sell the two homes he owns in Birmingham and Dublin and settle in India for good. “I really enjoy working here,” he says. “The patients are my own people and there’s a bond. Over there, they don’t even thank you.”

Many of the doctors who have returned bring with them rare experience that opens up whole new avenues of treatment. Kaushal Malhan, who returned to India after seven years in the UK, specialises in hip resurfacing, a procedure that’s performed in lieu of hip replacement, that has only recently been approved by the US FDA. He’s performed 400 operations at the Workhardt Hospital in Mulund, Mumbai, over the past three years, and says, “I wanted to return to a ready set-up where the equipment and materials I need would be available. If there are more quality hospitals in India, of course doctors will come back.” For medical professionals, the main draw of corporate hospitals like Wockhardt is the infrastructure they promise to provide. For doctors trained in the use of the most advanced equipment abroad, the biggest disincentive to returning in the past has been the lack of these facilities in India. Prakash Vemugul worked for eight years in Australia and Canada and his last stint was at one of t he world’s best children’s hospitals in Toronto, Canada, before he returned to head the paediatric ICU at the Wockhardt Hospital, Bangalore. “My field requires a trained team and a lot of infrastructure,” he says. “When I left India, paediatric units didn’t even have respirators. Now we have it all.”

Vemugul is known to spend days at a stretch in the hospital and he’s taken on the added administrative responsibility of training the nurses assigned to his unit on the best practices in paediatric care. Even as they introduce best practices from their experience in hospitals abroad, the NRI doctors have to make adjustments in their practice to suit the Indian reality.

Malhan, for example, observes that patients come to him when their problems are far more advanced, which is challenging, especially since they expect to cured faster so that they can go back to work (“they can’t go on welfare, like in the UK”). Since most patients in India don’t have insurance, Mehta ensures that there’s minimal wastage and costs are kept down (“you can’t splurge on random investigation like they do in the US”). In the absence of paramedics and fast moving ambulances, Reddy is creating a system where patients are rushed to the nearest of the four Wockhardt hospitals in Bangalore for emergency care. Says CEO Vishal Bali, “We consider our doctors to be group resources. They work as a team and their expertise will be available to all our hospitals, including those in smaller cities like Rajkot, Surat, Gauhati.”

Bali expects the number of NRI doctors working in Workhardt Hospitals to cross 100 over the next three years and the company is advertising in medical journals and on the web in a bid to attract talent. It also networks with organisations like the American Association Of Physicians Of Indian Origin and its long standing affiliation with Harvard Medical International has helped gained it visibility.

S h a n t e s h Kaushik, the first NRI doctor to join the company, was a surgeon at the hospital attached to Boston University and got in touch with Workhardt through the Harvard route. He came back to India with his wife Aparna (who is an anaesthetist) and three children because he has “roots” here. “My parents are here and we own property in Pune and Mumbai. It might be a difficult decision for those who don’t have such ties, but it was easy for me,” he says.

Kaushik is of the view that the medical facilities in India today are much better than those in the USA. “It’s an eyewash that Americans have the best facilities,” he says. “Unless they’re in the top bracket of private insurance, patients in America don’t have access to doctors — they’re constantly stonewalled. It’s so much better in India, where even the poorest have access to doctors. There’s a personal touch here, with patients actually becoming friends with their doctors.”

Though he has no regrets about coming back, Kaushik does miss one thing about his career in the USA — the teaching and research. It’s a feeling many NRI doctors share and Wockhardt is trying to do something about it by offering fellowships to young doctors under the Indian Medical Council’s Diplomat of National Board programme. Ravindra Mehta, for example, currently supervises eight postgraduate students training in emergency care at Wockhardt, Bangalore.

Wockhardt has much riding on the success and happiness of its current crop of NRI doctors — for they are the ones who will bring in others in the future. “We hope to create a ripple effect,” says Bali. “Coming back is a tough decision and in the healthcare, referrals have always played a big role.”