An eye surgeon in southern India sits between two operating tables. She finishes one cataract operation, turns ninety degrees, and starts the next on a patient who is already prepped and waiting. Six to eight operations an hour, against a conventional norm closer to one. They did not make the surgery faster. They removed the waiting. That single design choice is the seed of an operating system that now performs three quarters of a million procedures a year, gives away roughly half of them, funds itself without donors, and records infection rates of two per ten thousand cases. In this episode, Gautam examines Aravind Eye Care System: the constraint analysis Dr. G. Venkataswamy ran in 1976, the lens factory they built when a supplier's price capped the mission rather than the margin, the three-tier price list with no means test, the workforce they had to manufacture because the market didn't supply it, and the decision to teach the entire model to their competitors. Plus the question this show keeps returning to: does the operating system survive its architect? Aravind is the one case with twenty years of data on the other side of the founder's death.
Le HG, Ehrlich JR, Venkatesh R, et al. "A Sustainable Model For Delivering High-Quality, Efficient Cataract Surgery In Southern India." Health Affairs, 2016 https://pubmed.ncbi.nlm.nih.gov/27702949/
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