Responsibility grew beyond the centre I knew

Mandate

Build a viable regional service while preserving clinical authority and accounting for existing commitments.

Outcomes

• Deferred two proposed openings while funding existing-centre access and staffing
• Returned identified unused balances on closed accounts
• Changed a paid-visit-linked remuneration component with explicit additional cost
• Funded a centre-relocation transition with unresolved arrangements visible

Decisions in context

Becoming CEO and executive director gave me responsibility for the whole business account, including choices that could not be resolved through an operating measure alone. I lead seven executives and report to a seven-member board whose owners bring different perspectives. The medical director retains authority for clinical standards and decisions, while Sudeep leads finance. I need their accounts to remain distinct enough that a commercial preference does not quietly become a clinical instruction. The recent decisions required the board to see the cost of honouring existing commitments alongside the attraction of expansion. I am accountable for proposing and implementing the approved business course, but major investment and borrowing remain board decisions. Serving as an executive director also means recognising when I am explaining management's recommendation and when I am participating in the board's collective responsibility.

Reason for the move

Current executive appointment; considering one external non-executive contribution with consent.

Concurrent appointment

CEO and executive-director responsibilities are held together in the same company from January 2021.

Mandate

Connect centre-level administration with a consistent group account of service obligations.

Outcomes

• Clarified responsibility for administrative exceptions across centres
• Connected staffing and payment processes with local service needs
• Developed operating managers able to explain unresolved commitments

Decisions in context

I joined Orthevani to build an operating structure that could support a growing regional network. Four managers and 118 administrative and support colleagues worked within my remit, with ₹19 crore annual operating expense. Clinical staff had a separate reporting route through the medical director. The division required regular collaboration, but it also protected decisions that should not be made through an administrative instruction. I focused on whether a centre could explain an exception and obtain the right help rather than simply report that it had followed a group process. Payment queries, staffing gaps and changes in local arrangements could all expose a responsibility that had not been clearly assigned. The move to CEO followed the previous chief executive's retirement and broadened my accountability from the operating structure to the company's overall choices and board relationship.

Reason for the move

Appointed CEO and executive director after the preceding chief executive retired.

Mandate

Make centre administration dependable across locations with different local circumstances.

Outcomes

• Compared the way centres interpreted common service policies
• Developed clearer routes for unresolved administrative decisions
• Linked regional expense planning with actual staffing responsibilities

Decisions in context

The regional role showed me the distance between issuing a policy and knowing how it worked. I led five centre managers and an operating remit of 145 staff, with ₹18 crore annual expense. Each location had its own history and local relationships. A common phrase about closing an account or changing an appointment could therefore produce different actions. I learned to ask managers to explain a real case and the authority they needed, rather than judge consistency solely by whether a form had been completed. Clinical decisions remained with qualified leadership. My responsibility was to make the surrounding administration clearer and better supported. Orthevani offered a chance to apply that learning across a different ownership group and a business preparing for further regional development, with an explicit chief operating officer remit.

Reason for the move

Recruited to lead operations at Orthevani as its network expanded.

Mandate

Coordinate reception, staffing administration and payment queries around the clinical service.

Outcomes

• Progressed from administration into centre management
• Completed an evening MBA alongside full-time work
• Learned to distinguish commercial activity measures from clinical decisions

Decisions in context

I began as a centre administrator and became centre manager in 2000. Thirty-four administrative and support colleagues came within my remit, with a ₹2.4 crore annual operating budget. The appointment taught me that a manager could influence the conditions around care without being qualified to decide the care itself. I worked with clinical leaders when appointments or staffing arrangements needed coordination, and kept the relevant authority visible. I also studied in the evenings, completing the MBA in November 2001 without leaving my job. The combination helped me understand the financial account of a service and the limits of a purely commercial measure. The regional promotion followed as the network needed managers who could compare local practice, explain differences and support colleagues beyond the centre they knew personally.

Reason for the move

Promoted to regional operations head across five centres.

Mandate

Maintain appointment and payment information that staff could explain to service users.

Outcomes

• Worked through appointment and payment queries with frontline colleagues
• Learned how an unresolved administrative question affected the next interaction
• Developed an interest in responsibility beyond completing a record

Decisions in context

My first job began two months after my commerce degree. I worked in a twelve-person office team and had no spending or hiring authority. Appointment records and payment queries seemed like separate administrative tasks until a person needed both explained in the same conversation. I learned to check what another colleague would understand from the record, especially when an earlier discussion had left something unresolved. The role did not involve clinical work. It gave me an appreciation of the responsibility carried by staff who explain a service to someone dealing with uncertainty. I moved to Seranvi because I wanted to understand the administration within a centre, closer to the way staff and service users experienced it, rather than only the supporting office process that recorded what had happened.

Reason for the move

Moved into administration within a rehabilitation-centre network.