“I do believe that the magic happens when you move out of your comfort zone.”


Dr. Manisha Karmarkar, an MBA in Health Care from Manipal University, and an M.D in Anaesthesia, from Nanavati Hospital, Mumbai, is a leader in positive transformational changes, and currently heads Ruby Hall Clinic, Wanowarie, Pune’s first boutique multi-speciality tertiary care hospital as COO (Chief Operating Officer). A perfectionist, with her far-sighted understanding of the nature of healthcare and administration, she is single-handedly transforming it, while partnering with the CEO on a full range of operational and strategic issues.
Here she is in conversation with A.Radhakrishnan.

How would you describe yourself?

Always a go-getter, seeking to overcome challenges life throws at me, I go into work putting my best foot forward every day. It’s always been about adopting the right mindset – especially in the field of healthcare — because only positive attitudes bring about positive outcomes.

Nutrition, wellness, and prevention should always be part of medicine, but it wasn’t until I stepped in as COO, whilst being a practicing anesthetist, that I had an opportunity to use my background and medical skills to create a brand, community, and platform as well as an actual health care service to bring a different perspective of medicine to everyone. I have since revamped the concept of luxurious, yet affordable healing at the hospital.

On the personal front, I’m also a daughter, wife and mother, and do everything in my stride to show my daughter that a woman can achieve all that she sets out to do!

Why did you choose medicine as your field?

For many individuals who decide to become a doctor, it takes years of personal realisation. And for others, it’s always been their life’s calling to pursue medical school and ultimately don the iconic white coat.

For me though, it’s always been a very personal one. My passion and curiosity to understand the human body, while being the most compelling reason, I had also grown up first seeing my father work as a doctor, and then eventually my brother, and it’s perhaps these events which inspired me the most.

I always enjoy a good challenge, and see it through successfully. Being a focused student motivated me to undertake the long gruelling hours of study required. In medicine, overcoming the long work-hours and rigorous academic training is just the beginning. Post my MBBS, it was my husband who motivated me to pursue anaesthesia as a specialisation. With him being a surgeon and me an anaesthetist, I thought we’d make a perfect match in the operating theatre!

How passionate are you about your career?

For me, passion is the fuel behind a successful career. Do what you love and success will always follow suit. After all, one does spend a majority of one’s adult life at work, and how terrible it would be if you dreaded going to work each day!

Healthcare fascinated me and I knew it was the path I was destined for. The satisfaction I get after a long day at work, the smile on the face of a patient or their family members, and the longing to continuously learn and upgrade my skills, are what keep me going.

Where do you draw motivation from? Who’s your role model?

Innovation isn’t an option; it is a necessity. For most effective medical care, in-depth understanding of the patient is key, and recent advances in technology have allowed us medical professionals to gain a deeper insight, and re-align our goals both as a healthcare system and as individuals.

For years together, my role model has been our CEO Bomi Bhote, who saw potential in me as a leader. His willingness to take calculated risks and the ability to read people and adapt management styles, helped me shape my dream of managing a tertiary care hospital with women leading from the front, where the bottom line is not solely profit, but one where the stakes have a human face.
How well have you been able to leverage your leadership skills and strengths?

True leaders have the capacity to develop a big vision – one that inspires and motivates their team – and turn it into reality. Clarity to communicate and the intelligence and experience necessary to execute it, is paramount.

As COO, I have had the incredibly demanding yet fulfilling responsibility of a large, complex organisation, with a diverse workforce in a strict, regulatory environment. Integrating my medical experience with my managerial skills has helped me not just transform the financial prowess of the hospital, but also make it home to a driven and passionate workforce – right from doctors and nurses, to even front line managers and support staff.

With the majority of our workforce women driven, we encourage working women with innovative policies such as work from home, and evening OPDs. Through a combination of hospital affiliations, outpatient specialty care centres, health care accreditations and corporate partnerships, we have redefined healthcare while taking it to the next level.

What’s your decision making style?

All business activity really comes down to two simple things; making decisions and executing them. Your success depends on your ability to develop speed as a habit in both. I’m highly impressed with arguments supported by data. I gather as much information as possible, including market research, customer surveys, case studies, and cost-benefit analysis. Though absolutely enthralled by new ideas, experience has taught me to make final decisions based on balanced information, not just emotions.
At a hospital, every call we take is not only crucial, but has to be quick. Whether I’m in the OT or handling any aspect of patient care, I know my decision has the potential to change the continuum of care.
What’s the biggest challenge you’ve faced so far?

When I was first offered the role of COO, there were a lot of people who assumed it was the end of my career as a practicing anaesthetist, as the hospital was fairly new and needed to break even to be financially successful, and that would require all my attention and time. I knew it was going to be a very different hat to don, and would definitely be a struggle. But isn’t that what life is all about? Taking risks, accepting challenges and proving to yourself that you can surpass it all. I decided to take it up with full force, whilst continuing my anaesthesia practice. 

It was in my hands to understand the continuum of care across all departments, right from inpatient to outpatient, to ancillary services, to technology, pharmacy and nursing. I first focused on clinical programme development, including bolstering the hospital’s quality management and clinical support services. I began focussing on employee relationships following an open door policy where they could come and talk to me about anything.

Yes, I took a big risk while taking up this role, but the challenge proved to be an eye-opener. I do believe that the magic happens when you move out of your comfort zone. 

Do you think outside of the box?

This piece of business advice has become pure cliché over the past few decades. Although overuse has run it into the ground, the intent has merit, the lesson remains valid; don’t let your preconceptions, habits, lack of information, and narrow-mindedness keep you from considering all possible aspects of a problem. As a hospital, we have issued bold reforms to increase access to care, while decreasing health care spending.

What are the essential skills a COO requires to be a successful administrator?

Being at the helm of affairs is daunting. Much of the operations lean on our shoulders, necessitating consummate trust in our abilities. As a professional, we have to be in touch with customers as well as employees on a humane level. A successful administrator /COO should balance out a visionary tendency with practical follow-through, i.e., they should be able to cross the t’s and dot the i’s.  As guardians of some of the world’s key pieces of infrastructure, they have a tremendous impact on the lives of their constituents.

It also means being part business leader and part politician, requiring a blend of diplomacy, advocacy, business management, and financial sense. The stakes of this role aren’t just profit and loss, but life and death.
What role do you play in the hospital organisation? 

In the Ruby Hall environment, leadership has always been about promoting change —- and only change from within can bring about external changes. It my duty to look at all perspectives from the bottom-line right up to the top, keeping everyone in sync with each other.
I assume responsibility not just for myself and my work, but for the work, attitude, and accomplishments of my team too. Every single day, I lead the team in the operating theatre, taking decisions that are related to people’s lives and deaths. I not only show my team where to go and what to do, but also encourage them to answer questions, track progress, and provide motivation. With the economics of health care shifting from growth-mode to achievement of efficiencies and value creation, I am leading the commitment to patient-centric holistic and compassionate healthcare. 

What awards have you won and what do they mean to you?

Winning awards for what I do is great validation of what I’ve achieved to date, and it’s an honour to be recognised among a high level of successful business women. Personally, I feel very proud to be able to set an example for my daughter that hard work and being passionate about what you do leads to success.

I am extremely humbled and honoured to have received the Healthcare Woman Icon Award at Singapore for my leadership skills making me the only doctor in the APAC region to have received this prestigious honour, the Navbharat Healthcare Excellence Award – Woman CEO of the Year 2018, the Times Power Woman – West, and the Times Business Woman of the Year.

Our hospital is a LEED Gold Certified structure – Pune’s first hospital to receive the rating that incorporates natural light, energy efficient rooms for patients, families and hospital staff. It is also Pune’s only hospital with six NABH certifications, and its Accident and Emergency Medical Services is the first in the city and Western Maharashtra to be accredited by the NABH, and the Green Hospital Award by the AHPI for our eco-friendly practices.

What are your hobbies?

As an early riser, I start my day with exercise. I like to get moving first thing in the morning – it keeps me stress free and motivated throughout my daily hectic schedule. I also really enjoy listening to music. Melodic instrumental music after a long day is my escape, and it just clears my head and lifts my spirit.

A voracious reader, the pleasure and perks of picking up a book in your free time is just something else. When I’m with a book, it just opens a whole new world in front of me, gives wings to my imagination, while providing me with an abundance of knowledge.


A.RADHAKRISHNAN is a Pune based freelance journalist, short story writer and poet, who loves to make friends and share humour.