Chief Executive Officer / India
What we funded before calling the work complete
- Healthcare administration and leadership
- 35 years
- Career begins July 1991
- Outpatient centres
- 9
- Across four Karnataka cities
- FY 2026 revenue
- ₹74 crore
- ₹6.8 crore operating profit
Decisions & consequences
01Postponing two openings while three centres remained in loss
Three of our existing centres recorded a combined ₹1.8 crore operating loss in FY 2025. At the same time, management was considering two new locations with proposed expenditure of ₹9.6 crore. I asked the board to examine the existing service before approving a larger footprint. The three centres faced access and staffing difficulties that a new opening would not resolve. Their problems were specific enough to investigate, and important enough that expansion should not distract us from the people already relying on them.
We deferred the two openings and approved a separate ₹2.2 crore programme covering access arrangements and staffing. Clinical leaders decided the requirements within their remit; finance and operations examined the cost and implementation. I was responsible for bringing those views into a decision the board could understand. We did not describe the unspent ₹9.6 crore as a realised saving, because the proposed expansion and its possible returns had also been postponed.
In FY 2026 the three centres' combined operating loss was ₹0.9 crore. That was an improvement on the previous year, but they remained loss-making. Other changes in activity and cost also affected the result, so I did not attribute the whole movement to the programme. The board continued to receive the centre-level account alongside the group's ₹6.8 crore operating profit. A positive group result should not make an unresolved local service problem disappear.
This decision taught me to distinguish a larger network from a more dependable business. Expansion may be appropriate, but it should compete openly with the work required to fulfil existing commitments. I would return to the postponed openings with evidence about staffing, access and economics, rather than treat the passage of time as sufficient reason to restart. The outcome I can describe is a deliberate sequencing decision and a narrower loss, not a completed turnaround or a claim about treatment quality.
Returning ₹18.6 lakh that closed accounts still held
Finance and centre teams reviewed 186 accounts whose service episode had closed. Twenty-four retained unused prepaid balances totalling ₹18.6 lakh. The accounts were no longer active, but their commercial position had not been resolved clearly. I asked for the balances to be examined and returned through the appropriate process. The question was what service had actually been provided and what money remained due back, rather than whether an inactive account could be left undisturbed because nobody had recently asked about it.
We returned the identified balances and introduced a weekly review of newly closed accounts. Clinical teams retained responsibility for decisions about care, and the payment review did not instruct them to continue or shorten a plan. Finance worked with centre staff to explain the amount and communicate with the person concerned. Where an account required clarification, it remained visible as an unresolved case rather than being treated as completed administration.
The ₹18.6 lakh was a return of unused balances, not a promotional discount or an investment in customer acquisition. I wanted that distinction reflected in the executive account. We did not claim that the review established the position of every historical account or that one process change removed the need for legal and accounting judgement in disputed cases. The scope was the 186 accounts examined and the continuing review introduced for subsequent closures.
The result was a resolved set of identified balances and a named responsibility for examining the next ones. I learned that service businesses can confuse the absence of activity with the absence of an obligation. A person may have stopped attending while the company still needs to explain what it holds on their behalf. Chief executive oversight should make that question part of performance, even when returning the money makes the short-term cash position less comfortable.
Removing a visit-linked incentive without inventing an outcome study
Our remuneration structure for eighty-two therapists included a component linked to paid visits. I asked the medical director, people team and finance to examine whether that commercial signal sat comfortably beside the clinical responsibility to decide appropriate care. We did not begin with a claim that individual clinicians had acted improperly. The concern was the design of the incentive and the pressure it could create, particularly when business performance was discussed through activity and revenue measures.
We removed the paid-visit-linked component and revised the fixed remuneration structure, increasing annual compensation expense by ₹1.35 crore. The people team managed the staff discussions and implementation, while the medical director retained authority over clinical standards and professional review. I brought the financial consequence to the board as an explicit choice. It was not presented as a cost-neutral policy improvement or something that could be absorbed without affecting the business plan.
We did not use a reduction in visits as a success measure, because fewer visits would not by itself establish appropriate care. Nor did we claim that clinical outcomes improved after the change; we had not conducted an examination capable of supporting that conclusion. The immediate result was a different remuneration signal and a clearer separation between commercial performance and individual clinical decisions. Any later assessment of clinical effects would require the proper expertise and evidence.
The lesson was that management can act on a recognised incentive conflict without accusing staff or inventing a result. The decision still needs a clear rationale, cost and implementation account. I would want a board to ask how remuneration interacts with the service obligation and who has authority to evaluate its effects. It should not reward an executive for an attractive outcome statement that the organisation has not established, especially where the people affected depend on specialist judgement outside that executive's competence.
Keeping sixteen unresolved arrangements visible during relocation
Two centre leases required relocation, affecting 112 people actively using the services. A completed property plan would not by itself establish where each person would receive care next. I asked operations and clinical leadership to prepare a transition account before we treated the lease move as complete. It needed to show the options discussed, the people responsible and the arrangements still requiring attention. The commercial timetable mattered, but it could not answer those questions on its own.
We funded ₹46 lakh for a ninety-day transition. Clinical teams and the people concerned considered appropriate options. At the checkpoint, seventy-two had agreed an arrangement at a nearby Orthevani centre, twenty-four had chosen an outside provider and sixteen remained unresolved. Those categories totalled the 112 people in the transition population. We did not describe the sixteen as transferred merely because a letter had been sent or an alternative address had been offered.
The figures represented agreed arrangements at that time. They did not establish completed attendance, continuity of a particular treatment or a clinical outcome. The medical director remained responsible for the clinical process, and I remained accountable for funding, coordination and the way the board understood the unresolved work. Where an outside provider was chosen, the company did not assume that its own commercial preference should determine the person's decision.
The outcome was a funded transition with named responsibility and a visible unresolved group. I make no claim that every arrangement had been completed at the point described. The case changed how I review service changes: a property milestone, a system update or an announcement can be finished while an obligation to people remains open. I want the executive account to preserve that difference until the responsible teams can explain what has actually happened, including the cases that are harder to fit into a reassuring completion summary.