Build the access case before adding another address
Expansion in rehabilitation should be built around people who can reach the service and the professional capacity needed to sustain it.
01 / Chief Strategy Officer
Outpatient centres
6
Sikkim and adjoining northern West Bengal; current network
Research and strategy experience
29 years
Service-demand studies to enterprise expansion choices
Strategy colleagues
7
Two leads; ₹2.4 crore annual function expense
＋
Designed for consequence.
An expansion plan should show whose access changes and which resources actually become available. I want to know whether we are counting new people or repeat visits, adding professional capacity or moving it, and bringing a service closer or spending its time on the road. The answer can support a smaller proposal and still be the better strategic decision.
A new address is useful only when the people and capacity behind it are understood.
I lead strategy at Ralqemi Rehabilitation Services in Gangtok. We operate six outpatient centres across Sikkim and adjoining northern West Bengal, with 240 employees in March 2026 and ₹52 crore revenue in FY 2025–26. My team comprises seven colleagues through two leads, with ₹2.4 crore annual strategy-function expense. Founding clinician shareholders own 65% and a private investor 35%. I have neither shares nor a statutory board seat. CEO Pema Selqashi leads the company; CFO Naren Dervqeshi approves financial commitments. Clinical leaders decide what care is appropriate and how it should be delivered.
My career began in market research in 1997. I learned to question what a count represented before using it to recommend an investment. Rehabilitation planning made that habit more important because one person may make several visits and because the service depends on different professional skills. A catchment can look busy without containing the number of new users in a property proposal. A new centre can appear staffed while its roster draws the same colleagues away from existing appointments. Strategy must make those dependencies visible before the organisation commits.
The cases on this site concern a seventh-centre proposal, a recruitment plan and a home-visit option. I had supported assumptions that each review changed. We deferred a lease after distinguishing 1,700 visits from 340 people, replaced a claim of eighteen additional professionals with six recruits and twelve proposed transfers, and narrowed a home-service pilot after including travel in available working time. None of those decisions demonstrates a clinical outcome. They explain how I connect investment choices with access, workforce and the service our operating teams could realistically support.
A repeated visit was not a new person in the catchment
A four-month planning sample contained 1,700 completed visits by 340 distinct people. We withdrew the inference that it represented 1,700 potential new users, deferred the seventh-centre lease and wrote off ₹24 lakh of proposal development.
Eighteen posts did not mean eighteen additions to the network
The expansion roster combined six proposed external recruits with twelve transfers from existing centres. A revised plan separated new capacity from relocation and deferred ₹3.8 crore of fit-out until a smaller staffing option was supported.
Travel changed the economics of a home-service option
A commercial forecast counted all ninety-six paid hours as appointment time, overlooking thirty-six hours of travel and other duties. Reconciliation left sixty appointment hours in the defined weekly scenario and changed the scope of the proposed pilot.
Current focus
I am comparing access options by distinct people, professional availability and realistic travel demands, with the uncertainty of each forecast preserved.
Conversations I welcome
I welcome strategy mandates in regional service networks and a carefully scoped first board contribution involving expansion choices and workforce-dependent delivery.
The leadership record
Trusted with consequential decisions.
Formation
Bachelor of CommerceTervqali Commerce College · 1997
Tashi returned with a proposal that had lost its preferred property and its original demand claim. He explained both consequences and why we still should not proceed on that evidence.
Pema SelqashiChief Executive Officer, Ralqemi Rehabilitation ServicesThe full record ↗
Contact
I welcome strategy mandates in regional service networks and a carefully scoped first board contribution involving expansion choices and workforce-dependent delivery.
