I run a rehabilitation-services business whose financial choices must leave clinical judgement with clinicians and make its commitments understandable to the people using it.
Leadership paper / 01
Growth and service economics5 min read
Growth has to honour the service already promised
Abstract
Why a regional service business should compare expansion with the unresolved commitments inside its existing network.
An executive perspective on prepaid balances, service completion and the importance of keeping a commercial question separate from a clinical decision.
I am chief executive of Orthevani Rehabilitation Services in Hubballi, with responsibility for nine outpatient centres and 410 colleagues. Our centres work across four Karnataka cities. For the year ended March 2026, the business recorded ₹74 crore revenue and ₹6.8 crore operating profit. I lead seven executives and serve as an executive director on our seven-member board. My background is in commerce and service administration, so I am explicit about the boundary of that responsibility: clinical standards and individual care decisions belong to our medical director and qualified teams.
The business brings together a clinician-shareholder trust, a regional founding family and a patient-capital investor. Their different perspectives can be useful if the board receives a clear account of the choices in front of it. I want that account to connect investment, staff terms, the meaning of a patient payment and the obligations created when a centre changes. A revenue forecast alone will not explain whether we can responsibly make the next commitment, and a good intention alone will not fund the service needed to keep it.
I began in healthcare administration in 1991 and became CEO in January 2021 after centre and regional operating roles. The cases here concern postponing two proposed openings while existing centres needed attention, returning unused prepaid balances, changing a visit-linked staff incentive and managing the relocation of two centres. None is presented as evidence that a particular treatment worked. They are accounts of business decisions, including what we spent, what remained unresolved and which clinical judgements were deliberately kept outside a commercial instruction.
Two openings waited while three centres needed repair
We deferred a proposed ₹9.6 crore expansion and funded a separate ₹2.2 crore programme for access and staffing at three existing centres. Their combined operating loss narrowed from ₹1.8 crore in FY 2025 to ₹0.9 crore in FY 2026; they had not become profitable.
Unused balances were not earned service revenue
A review of 186 closed accounts found twenty-four with unused prepaid balances totalling ₹18.6 lakh. We returned those balances and revised the review process, keeping clinical decisions about care separate from the commercial preference to retain a payment.
An incentive deserved examination before an outcome claim
We changed the remuneration structure for eighty-two therapists, removing the paid-visit-linked component and increasing annual compensation expense by ₹1.35 crore. The decision addressed an incentive conflict; it did not establish a measured improvement in patient outcomes.
Current focus
I am strengthening the account the board receives when a commercial choice affects continuity of service. It should identify the people already relying on us, the clinical authority needed and the cost of making a change responsibly, including cases where the financially convenient action is not yet ready to proceed.
Conversations I welcome
I am considering one external non-executive appointment alongside my current executive directorship. I can provisionally allow twenty-two days a year, subject to our board's consent, relationship review and the actual preparation required by the prospective company.
Beyond the page
The record behind the perspective.
In the boardroom
Orthevani Rehabilitation ServicesExecutive Director · January 2021 – Present
Formation
BComZelvitha Commerce College · 1991
MBA in Service Management, evening programmeNerthavi Management Institute · 2001
Revathi kept the clinical decision separate from the question about unused balances. She asked the business to resolve what it held without asking clinicians to justify retaining a payment through additional visits.
Bhavana ZervaliMedical Director, Orthevani Rehabilitation ServicesThe full record ↗
Contact
I am considering one external non-executive appointment alongside my current executive directorship. I can provisionally allow twenty-two days a year, subject to our board's consent, relationship review and the actual preparation required by the prospective company.
