Friday, April 11, 2025

Foundations First: Quietly Building the Future of Dental Healthcare. Reflections on purpose, partnership, and the making of something meaningful

It was nearly 18 years ago that I first met Dr Ramakrishna, the visionary behind Smiline Dental Hospitals in Hyderabad. From the very outset, it was clear he was not merely building a dental clinic — he was crafting an entire ecosystem. His ambitions extended far beyond clinical practice: training academies, structured internship programmes, robust operational protocols, cutting-edge technology adoption, and, above all, assembling a high-performing team.

During one of our early meetings, Dr Ramakrishna requested a short break to travel to Mahbubnagar. Curious, I asked what drew him there. His answer was both simple and telling: he was teaching at a dental college, and dentistry was his passion — a commitment he wasn’t willing to compromise.

Having observed large healthcare networks, especially in ophthalmology, I gave him my honest view — that he would eventually need to choose between two distinct paths. One could either remain a great clinician or evolve into a healthcare entrepreneur managing a growing enterprise. The two, in my mind, required fundamentally different perspectives and mindsets.

He was clear, even then. He told me that both he and his wife were, first and foremost, committed to excellence in dentistry. If building a business meant letting go of that identity, he would willingly pass on the business opportunity.

Yesterday, I was delighted to realise that my advice — however well-meaning — was not taken.

In hindsight, I had underestimated several critical factors. Dr Ramakrishna’s entrepreneurial spirit has proven to be as relentless as his clinical commitment. Over the years, he has consistently explored new models in dental care while maintaining his standing as a top-class dentist.

Equally instrumental to this journey has been his life partner, who brings a level of discipline and attention to detail that complements his expansive vision. Her meticulous nature — likely honed through years of clinical training and mentoring — ensures that no detail is overlooked. Together, they have struck a rare balance: big-picture thinking grounded in process-driven execution.

They have built a team culture where quality is non-negotiable, protocols are sacrosanct, and patients — or should we say, customers — receive consistently high standards of care. The results speak for themselves: Smiline today delivers both scale and excellence, a combination that eludes many.

Yesterday, I visited their new facility in Nanakramguda — the first visible step in a broader and bolder blueprint. What stood out wasn’t just the impressive infrastructure or state-of-the-art equipment; it was the sense of purpose. This is more than an expansion — it’s the beginning of a new to the world, innovative business and care model, one that could potentially reshape how dental health is perceived and delivered in the future. 




It is telling that even at this stage, the focus remains on the foundation — the systems, the people, the philosophy. There is no fanfare, no rush to claim innovation for its own sake. It is being built quietly, but with clarity. Dr Ramakrishna was even hesitant to the expression 'institution' even as he has built a great one! 

Wishing Dr Ramakrishna, his family, and the entire Smiline team every success as they embark on this exciting new chapter. The journey that began nearly two decades ago now rests on a foundation stronger than ever, built on passion, perseverance, and precision.

In a world where founders are often forced to choose between passion and scale, Smiline reminds us that — with the right partnership, discipline, and clarity of purpose — it is possible to do both. vision needs discipline, and dreams need systems!


Wednesday, April 2, 2025

Organizational leukemia !

My grandfather Sri G A Acharya (1900 -1972), for whom 'self-made' would be a euphemism as would rags to riches, was not 'educated' in the certificates/degrees definition of educated. He was highly educated in the school of hard knocks at the university of life. In 1943, he set up the Acharya High School in his birthplace Gauribidanur, about 80KM from Bangalore. The schools and colleges that had grown from this institution over the last 80 years were down on their knees, facing a Lokayukta case and other issues about 10 years ago, when my uncle and the then secretary of the society approached me to join the school, even offering to pay me a salary if required. I knew it was a tough call and told my uncle to find me a partner. For the first five years as president, I had my efficient cousin as secretary. He quit a couple of years ago, having found a better use for his time and effort.

My grandfather, a silent philanthropist, was deeply involved in the freedom movement and many cultural, business, and social organizations after independence, making sizable donations. As this post is not about him, I will stop the introduction here and perhaps share his profile later. In short, I became 'President' of the association that ran seven institutions.

I will share some events and happenings—not in any specific order, but from my memory—that should indicate to the reader the various symptoms and diagnostic parameters that led to my diagnosis!

The trigger for this catharsis was our executive committee meeting last week, where a few EC members were hand-signaling to each other based on a pre-planned effort, ultimately leading to the following decisions:

  1. Retirement benefits and all papers should be processed for employees who have pending inquiries against them because it is a bother to fight with them in court.

  2. Retirement benefits and all papers should be processed for employees who have been proven and have confessed to misusing money meant for feeding poor children as they may go to court.

  3. While I tried to resist these two decisions, I was myself part of another decision where the district administration and education officials suggested (you know what that means!) that we promote an employee who absented himself for 200 days without notice and was involved in various other issues. The officials felt we were being too harsh and that a simple letter should suffice for each of the 'mistakes.'

As a side note, I recall that two of these three teachers had invited me to inaugurate a science exhibition. After being photographed cutting the ribbon, I discovered there was no such exhibition—except for a signboard outside and the invitation card! The room was filled with broken, dust-covered furniture. A show-cause notice was issued to satisfy me and everything soon forgotten with a knowing smile among everyone connected.

The last time I had noticed this kind of unity among the local EC members was when they pushed for the academic area to be used for a political function. I had suggested the huge sports field instead. However, the organizer, a local strongman, was waiting outside the meeting, and so the members were vociferous in breaking the rules they themselves had created under local pressure.

Back to my first meeting as president—there was a dharna demanding a job for the son of a headmaster who had been caught selling rice meant for the children. His misdeed had even made it to the local papers. I am unsure whether the protestors were unaware of this or if it was a pressure tactic to secure a government job for someone ineligible.

Within my first year, the local MLA stormed into our EC meeting with a group of people, demanding that the school provide them with ownership documents for land they claimed to have purchased decades ago. Upon verification, it was found that a former EC member had donated land to the school under Vinobha Bhave’s Bhoodan scheme, only to take it back and sell it as plots after paying Rs. 25,000. Legally, Bhoodan land cannot be resold or returned, yet the EC had approved this transaction, citing the need for a single classroom.

While going through old EC minutes, I discovered that in 1951, my grandfather had opposed the starting of additional institutions. Over time, what he envisioned as a high school focused on holistic development—with agriculture and carpentry courses—had become a recruitment factory for government jobs, complete with payment under the table. By the time I arrived, the gymnasium, carpentry section, and agriculture field were relics of the past.

In the next few months, my cousin, then Secretary, found during one of his visits that Rs. 2 lakhs was recorded as cash in the books but was physically missing. The headmaster hastily replaced the cash from his personal funds when confronted, as the chairman of the local advisory board had 'borrowed' it from school fees. This same advisor had fixed new tenants for a commission and even appointed a teacher at a meager salary of Rs. 6,000 after taking a Rs. 60,000 bribe. Since he had assisted former office bearers during the Lokayukta case, he wielded considerable influence. We disbanded this advisory board, inviting the wrath of many who continue to create trouble to this day.

Over the years, local politicians, committee members, employees, and others have used the institution as a government employment factory—create a new institution, apply for aid, secure sanctioned positions, expand those positions, and so on. This has led to an interesting mix of government employees on campus who do not care for the management and are confident they can get anything done through government channels. This is the bane of the 'aided' system, which every government understands but favors for its own reasons. Ironically, in my experience, fully government-run institutions fare much better than these aided institutions.

When my cousin and I took charge, our first priority was to protect the institution’s land. Of the 10 acres my grandfather had donated, only eight (or perhaps even less) remain. Some EC members facilitated land occupation by outsiders, using their political clout to have the occupied land acquired by the local government, compensating the school with a pittance. The very people entrusted with safeguarding the institution orchestrated this betrayal.

My uncle, the previous president, attended 67 court hearings to suspend a violent teacher—a decision taken without consulting him under 'local circumstances.' He also spent countless hours navigating various offices over the Lokayukta case. My own record is less impressive, but I have had my share of encounters: two appearances before the SC/ST commission over alleged discrimination in appointments (the case collapsed when it became clear that government-aided jobs were beyond the institution’s control), a visit to a 'human rights' office when an absentee teacher complained of discrimination, and the heartbreaking case of a temporary teacher who committed suicide—an incident that entangled me, despite my having never met him or being involved in his appointment or salary fixation etc. 

This post could go on for pages, but I hope you get the drift. Office bearers, guided by caste, local politics, or personal gains, approve retirement papers without due process, support teachers who incite student strikes to retain temporary staff, hand out civil contracts to preferred contractors without any semblance of transparency, and transfer employees arbitrarily. Even as I try to bring in well-educated and financially independent office bearers, the mindset remains—to exploit this 'public' institution rather than nurture it.

Over the decades, donors have contributed to the institution, but often with ulterior motives. Some merely want their names etched in stone; others use donations as a front to take kickbacks from contractors. A donor might bring in Rs. 10,000 for a classroom while the institution spends Rs. 75,000 from its reserves, yet the room will bear the donor’s name. Of course, not every donation falls into these categories—many have been genuine, made with no expectation of returns.

Organizational Leukemia

Like leukemia, this institution’s ailment is systemic, coursing through its veins, affecting every level. It is not a single malignancy that can be excised, but a slow and steady infiltration of dysfunction. Every attempt at a cure faces resistance—not just from those who profit from the rot, but from the very system that enables them. And just like leukemia, the tragedy is that the institution itself—the body—is still alive, but its ability to heal is constantly under attack from within.