An internist, who goes by the pen name of “a boy who does not play football during lunch”, explained the origin of his pen name that during his secondary school years, his friends always invited him to play football during lunch. He, himself, wanted to join them on the field but he was not good at playing football, so he could only wait at the sideline. Until he graduated from secondary school, life after that does not consist of playing football at lunch anymore. He, thus, uses this pen name to remind himself of what he once wanted to do, but he did not and let that one moment in life slipped through his fingers.

Now, Dr. Kanapon Phumratprapin or Dr. Tum, who has the above-mentioned pen name, chooses not to hesitate to do whatever he wants to do. He opens a start-up company despite having a stable job as a physician in the hospital. He chooses to follow his heart when the opportunity appears before his eyes. It was a decision made at the right situation and time that brings about a start-up business called “Health at Home” to drive the future of healthcare forward and create more options for the nation’s healthcare.

The beginning of Health at Home
 

Dr. Tum likes taking care of patients’ overall health. When he graduated as a physician, he was on his quest to be specialized in overall health. At that time, there was a new specialty which is “geriatric medicine” that goes hand in hand with the aging society that Thailand is now facing. Also, there was a scholarship to study in the United States of America offered. Dr. Tum, thus, chose to be a specialist in this field that focuses on the healthcare of the elderly of 60 years old or above. After he graduated, he became a resident at a community hospital in other cities. At those hospitals, physicians will visit patients at their houses to know their lifestyle and get a better understanding of the patients. That experience sparks the idea of looking after patients’ health at their homes in Dr. Tum’s mind. Besides, when he was in America, Dr. Tum got to visit patients at their houses and witnessed the high-technology medical equipment. Physicians and nurses can examine patients just like how they do in the hospital. All patients’ information can be monitored through the electronic system like patients are hospitalized at home. Nurses will visit them every day till they recovered. Patients do not have to go to the hospital or stay in the nursing home which is highly favorable for them.

After Dr. Tum has returned to Thailand, start-up business has become trendy. Many fundraising happened. Dr. Tum, in his 32 at that time and was about to have his first child, challenged himself by joining the start-up business field. Because if he did not try, this would surely stick to him. If that very moment had passed, he might not get a chance to do it anymore. And if he was older, he would not want to tell his children about things that he could only think about, but never get his hands on them. However, if he succeeded, he would look super cool in his children’s eyes. Even if he did not succeed, he would still have a fun experience to tell his children.

Dr. Tum then set his foot in the path of a start-up business. He became a start-up doctor whose dream is to see Thai people being healthy at home. He wanted various medical services to be easily accessed from homes without people having to go to the hospital even though this dream would take time. Eventually, in 2015, he established Health at Home Company on the same month his child was born. If anyone were to ask how long his company has established, Dr. Tum can instantly tell them the age of his child.

Tips to start business and conquer challenges
 

The dream to bring medical service to the home is the big picture in Dr. Tum’s mind. He began by checking the market demand by creating a website. He listed the domain under the name “health at home.in.th”. On the website, there is a short message for people who are interested to contact. After that, he bought an advertisement on Google. The price is around 400 baht to see if there is anyone interested, clicked, and contacted. When there is a demand, someone will have to take care of it. Dr. Tum’s friend, who is also a co-founder, knows one good senior that used to take care of their cousin that was just passed away. Dr. Tum, thus, invited them to join the team. When there is anyone contacted, the company will send this senior to do the job. At that time, there was no proper system, so the company asked customers to fill up their medical record on Google Form and made reports by Photoshop and sent to the customers. If customers had questions, they could enquire. The payment was done via normal transactions. The very first case finished with everybody feeling happy. He then started to recruit more caretakers. When there are more caretakers, he began to look into other factors. For example, building up a team or setting up the system. Apart from that, Dr. Tum joined “dtac accelerator” which was a project supporting Thai start-ups at that time. This gave him the capital to develop the platform and website. It was a moderate start from what he could do at that moment.

Nowadays, the platform of Health at Home has expanded into LINE Application. Caretakers and service recipients can select work and service according to their demands. There are both going back and forth and staying with patients at home and hospitals. For patients who have a limitation in staying at home, for example, they stay in the condominium with limited space or there is an abuse of patient within the family, there is a care center that is designed to give an environment similar to home for this group of customers.

“Caretaker” –A career that practices science and arts
 

Caretakers play an important role in Thai society. Dr. Tum, thus, wants people who work in this field to be proud. When they take pride in their job, they will be able to do their job well. He then calls the caretakers, “Care Pro”. In order to be caretakers or Care Pro under Health at Home, candidates will undergo an interview to see their attitude. After that, they will have to attend the training to sharpen their hard skills and soft skills simultaneously.

The job of the caretakers includes basic physical therapy, bedridden patients care, body position shifting to prevent bedsores, bathing and rubbing the body dry as well as room cleaning. Caretakers will work in a team. They can change shifts or work for one another in the same standard. They understand patients and take care of patients like their own family members. If caretakers do not meet the standard such as they are irresponsible, move patients wrongly or give patients the wrong medicine, harm could be brought upon patients, caretakers as well as the company. Therefore, the company will have to recruit individuals with high quality and positive attitudes towards the job.

Opportunity from the outbreak of Covid-19

During the outbreak of the Covid-19 pandemic in Thailand, many organizations implemented a new working system, letting their employees work from home and many businesses have to temporarily close. The demand for short-term caretakers, thus, decreased. However, there are many more families that are in need of long-term caretakers. The problem of scarcity of caretakers then happened because many caretakers are staying in different cities and were unable to travel to Bangkok and attend the training. So, online interviews and training are brought forth for new caretakers to study about their job. For caretakers who want to revise their skills, courses are created for them to further improve their skills with both courses instructed by Dr. Tum and courses instructed by the nurse team.

For patients’ house visits, this is a chance to test the technology of both Virtual Visits and Telemedicine. Since patients’ families have an idea of using the technology, physicians and nurses can advise and monitor patients’ condition easily. As for caretakers’ visit, video call is being used instead. Besides, online collaboration is being used within the organization and it allows the team to work more swiftly.

Getting ready for an aging society

Even though the pandemic situation in Thailand is getting better, an aging society still remains for Thai people to consider. Dr. Tum then left advice to prepare for retirement with quality, money, time, and power as followed:

1. Invest in money: Come up with the financial plan for the entire retirement years.
   
2. Invest in health: Monitor diet and regular exercise. The earlier, the better because a healthy body depends on long-term commitment. On the retirement days, individuals can still have the strength to go on a trip or do whatever they like.
   
3. Invest in society: Retirement years should be valuable and meaningful moments. If one has retired and is able to keep their circle of friends to dine together and talk together, Dr. Tum recommended them to keep in touch. As for couples, they have to maintain healthy relationships too.

From his robust experience with the elderly, what Dr. Tum wanted the elderly or those with children to prepare beforehand is to “make a future plan in a time of emergency”. If they fall sick, what they would want their children to do. They have to think about medical treatment and financial management to prevent possible family problems that occurred from not planning for unexpected situations or unclear talk.

Keys to success for start-up business

Becoming a start-up business is like running a marathon. There are not many runners registered, but everyone wants to get to the finishing line. They need another push to run into that line which is similar to a start-up business.

• Start: Start immediately. Do not hesitate. However, start small. Take things to step by step.
• Stop: Stop doing the unnecessary and focus on work and goal. 
• Continue: Continue to do and learn. At the same time, reflect on whatever is done and improve from there.

Being a geriatrician is like spending the sunset years with patients. Dr. Tum discovered that elderly gives importance to “valuable relationship” because, the meaning of life, eventually, is about being together with people they love and seeing that they are happy. Dr. Tum also applied the maintaining of quality relationships into his family life and work. He tried to lead a life to meet a “Happy Ending” from experiences that he encountered. The last moments of life are not complicated and not required much. So, do not forget to give importance to people who mean a lot to us while they are still alive.

Citation: SCB TV Series "START NEVER GIVE UP", Episode: “Health at Home” by Dr. Kanapon Phumratprapin on Friday 10 July 2020