Healthcare Must Reach The Last Person In The Queue: Dr. Sanjay Maheshwari

For more than four decades, cancer surgeon and telemedicine pioneer Dr. Sanjay Maheshwari, Medical Director and Head of MP Birla Group of Hospitals in Satna, Madhya Pradesh has worked far away from India's metropolitan medical hubs, building what he describes as a healthcare model rooted in compassion, accountability and service.

Working in one of the remotest areas of the country, Dr. Maheshwari has spent much of his career proving that advanced healthcare need not remain confined to Delhi, Mumbai or Chennai or say any metros. His guiding philosophy is inspired by a quote from Apple founder Steve Jobs: "Innovation distinguishes between a leader and a follower."

Yet, for Dr. Maheshwari, who is also CEO (Innovation, Research & International relations) Mahayogi Gorakhnath Medical University, Gorakhpur (UP), innovation is meaningful only when it benefits the most vulnerable.

"The true measure of a healthcare system is not how effectively it serves the privileged, but how successfully it reaches the unreachable," he says in a candid conversation with The Health Outlook.

A journey shaped by service

Unlike many medical professionals, Dr. Maheshwari did not come from a medical family. A high-achieving student who earned distinctions and gold medals throughout his education, he was drawn towards medicine by a desire to contribute to society.

"My parents believed that if I became a doctor, it would not only benefit our family but inspire others around us to pursue education and dream bigger," he recalls.

Over the years, he was trained at some of the world's leading institutions, including programmes in the United States, Sweden and the United Kingdom. While many contemporaries chose careers abroad, he decided to remain in India.

"No matter where I travelled, I remained convinced that meaningful work can be accomplished anywhere if there is commitment and purpose. I wanted my work to reach people in smaller towns and villages."

One of the strongest influences on his life was social reformer Nanaji Deshmukh, whom he had the opportunity to treat years ago.

"He often told me that if you truly want to make a difference, work in the villages. That is where the real India lives."

Those words continue to guide his work today.

Why cancer cases are rising

According to Dr. Maheshwari, a reputed surgical oncologist, the increasing burden of cancer in India is the result of multiple interconnected factors.

"Cancer is not increasing because of one reason. Tobacco use, pollution, unhealthy food habits, obesity, stress and lack of physical activity are all contributing. At the same time, people are living longer, and cancer is naturally more common in older age groups."

However, he believes delayed diagnosis remains one of the country's biggest challenges.

In many villages and smaller towns, symptoms such as persistent ulcers, abnormal bleeding, unexplained weight loss or lumps are often ignored. Patients frequently resort to home remedies or local treatments before seeking professional medical advice.

By the time many reach specialised centres, the disease has already advanced. Fear and stigma further complicate the situation.

"There is still a perception among many people that cancer means certain death. That is no longer true. Many cancers can be treated successfully if diagnosed early."

Women, particularly in conservative communities, often hesitate to discuss symptoms related to breast or cervical cancer, resulting in avoidable delays, he laments.

Technology as an equaliser

As a telemedicine expert, Dr. Maheshwari sees technology as a powerful tool for reducing healthcare disparities.

Over the past decade, teleconsultation services have enabled specialist expertise to reach patients in smaller cities and remote districts without requiring expensive travel.

"Technology can bridge the gap between metropolitan cancer centres and district hospitals. Patients can receive expert opinions, follow-up consultations and treatment guidance without repeatedly travelling hundreds of kilometres."

He is particularly optimistic about the role of artificial intelligence in healthcare.

"AI can analyse disease patterns, identify trends, assist in diagnosis and support treatment planning within seconds. In radiology, for example, AI can learn from thousands of X-rays and help identify tuberculosis, pneumonia and other abnormalities more quickly."

However, he emphasises that technology should support clinicians rather than replace them.

"Artificial intelligence will improve decision-making, but it cannot replace empathy, trust and human judgment."

The irreplaceable role of the family physician

While embracing innovation, Dr. Maheshwari is concerned about the gradual decline of family physicians and traditional clinical medicine.

"The family physician understands not just the patient but the entire family. He knows their history, fears, relationships and social circumstances. No algorithm can replace that."

He argues that modern medicine has become increasingly dependent on investigations and technology, sometimes at the expense of clinical examination.

"Many consultations begin with tests before a proper examination is conducted. Young doctors must remember that touching the patient, listening carefully and performing a thorough clinical examination remain essential."

According to him, technology should enhance clinical science, not substitute it.

Rural healthcare needs grassroots solutions

Having spent most of his professional life in semi-urban and rural India, Dr. Maheshwari believes healthcare reforms must be informed by those who work on the ground.

"If policymakers genuinely want to transform rural healthcare, they must involve people who have spent decades working in villages and district hospitals."

He strongly bats for strengthening district hospitals, expanding telemedicine networks, training local healthcare workers ie allied health force and promoting preventive screening programmes.

Public-private partnerships, he says, can also play an important role, provided accountability mechanisms are robust.

"The PPP model has tremendous potential, but monitoring is critical. Accountability must exist at every level," he points out, stressing that healthcare infrastructure alone is not enough.

"Buildings and machines do not save lives. People do."

Creating the next generation of healthcare leaders

One of Dr. Maheshwari's most ambitious initiatives focuses on identifying talented students from underprivileged rural backgrounds and exposing them to careers in healthcare and science.

Launched in 2019, the programme has already trained more than 8,000 students. "Talent exists everywhere. Opportunity does not."

Students are assessed for communication skills, observation, manual dexterity and problem-solving abilities. Those with specific aptitudes are guided towards appropriate healthcare careers.

Some have gone on to work in genome sequencing, biotechnology and advanced research institutions across India and abroad, he tells you.

"What gives me the greatest satisfaction is seeing rural children discover possibilities they never knew existed."

Trust, compassion and the future of medicine

Despite remarkable advances in robotic surgery, precision oncology and artificial intelligence, Dr. Maheshwari believes the future of healthcare ultimately depends on preserving its human core.

He worries about the growing trust deficit between doctors and patients and believes the solution lies in transparency, ethical practice and communication.

"Trust grows when people feel cared for, respected and heard," he says when asked about the reason for growing violence between patients and medicos

For him, medicine remains far more than a profession.

"A patient is not merely a collection of reports and scans. Every patient carries emotions, fears, dreams and hopes. If we forget that, we lose the very essence of medicine."

"Healthcare begins not in hospitals but in humanity. The stronger our human connections remain, the stronger our healthcare system will become."

"Science is about understanding the truth. It is the responsibility of a scientist and a doctor to seek that truth. Medicine should never become a system driven by commissions, referrals or financial incentives. Society eventually recognises the difference and decides whom it can trust."

When asked whether he still encounters the massive tumours that once brought him national attention nearly two decades ago, Dr. Maheshwari said such cases continue to arrive even today at his hospital offering multispeciality and super speciality facilities to the people in the remote areas. He had gained global recognition after surgically removing a 66-kg tumour, an extraordinary feat that later earned him a place in the Guinness World Records in 2010.

“Even today, we continue to see such advanced cases,” he said, reflecting on the persistence of late-stage disease in underserved regions. “Poverty does not only mean lack of money—it reflects itself in delayed diagnosis, limited awareness, and restricted access to timely healthcare.”

The fact that such advanced cases continue to reach hospitals after so many years tells us that awareness efforts remain inadequate. “Either awareness has not reached everyone, or our systems have not been effective enough. That is precisely why we continue to invest in community outreach and health education."

“If we empower young people with the right knowledge, skills and sensitivity, they will become the real force that changes healthcare at the community level,” he adds, summing up his vision of a system where technology supports care, but humans drive it.