It's picking up hospitals like they were going out of fashion. In four years, it has built, acquired or taken management control of 12 of them (see Shivinder's Growing Empire). Result: Fortis Healthcare, promoted by Malvinder and Shivinder Singh of Ranbaxy Laboratories, now has about 2,000 beds and is already the second largest healthcare provider in the country in revenue terms; it may, in fact, run current numero uno Apollo Hospitals very close when results for 2005-06 are declared.

Shivinder Singh, who is the group Managing Director of the company, is tight-lipped about financials, but says he plans to expand capacity to over 5,500 beds across 35-40 hospitals all over the country by 2010. He is, however, seldom directly involved in negotiations to buy or take over hospitals. "My senior colleagues don't allow me to go," laughs Singh.

It was the high profile, if controversial, Rs 585-crore leveraged buyout of Escorts Hospital in 2005, that announced Fortis' arrival in the big league. The takeover is now caught in litigation, but Singh still believes he got value for money. "We got a trusted brand name and great intellectual property through Dr Naresh Trehan, who is also a shareholder in the company," he says. Another obvious benefit: Escorts allows Singh to tap the lucrative medical tourism market from Day 1.

Fortis now plans to spend Rs 2,250 crore over four years on expanding capacity. There is talk that it will raise this amount through a private placement or a public issue. Singh says he will consider the latter only after 12-18 months.

Hospital-based healthcare has traditionally been considered a capital-intensive business. The payback time is typically seven to eight years. But Fortis is changing the rules of the game with management contracts. This model, very popular with hotels, is still in its infancy in the Indian healthcare sector, but begins paying for itself from Day 1.

The question, then, is: will such a feverish expansion affect the quality of services Fortis provides? "Top most on my agenda, as we expand, is to maintain the excellent levels of services that Fortis has come to be known for," Singh says. How he deals with this issue may ultimately hold the key to its future.