Saurabh Gupta, Regional Chief Operating Officer (Maharashtra) at Krishna Institute of Medical Sciences (KIMS), talks to The Ortus Club about the logistical challenge of scaling 2,000 hospital beds, the shift from micromanagement to redundancy leadership, and why patient experience is the true differentiator in modern healthcare.
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Executive Summary: Key Takeaways
- The Decentralisation of Care: Healthcare is a local commodity; the goal of modern scaling is to bring high-quality tertiary and quaternary care within a 20–25 km radius of the patient’s home.
- Leadership through Redundancy: True organisational growth requires leaders to make themselves redundant by empowering second- and third-line management rather than micromanaging.
- Experience as the Differentiator: While infrastructure and technology are often standardised across the industry, patient and guest experience will become the core ethos that defines market leaders.
- The Culture Bench Strategy: Scaling culture during rapid expansion is best achieved by building a bench of internal talent trained in the organisation’s specific methodology.
- AI as a Capacity Multiplier: In healthcare, AI serves to prioritise abnormal diagnostic cases and automate routine scheduling, allowing clinicians to focus exclusively on high-stakes decision-making.
Saurabh Gupta is a hospital administrator who views his 22-year career through the lens of human interaction. From a small town in Rajasthan to commissioning five major hospitals across India and consulting for McKinsey and PwC, Saurabh has navigated the highest levels of healthcare operations. Currently, as the Regional COO for Maharashtra at KIMS, he is tasked with a monumental mandate: expanding the group’s presence by 2,000 beds over the next five years.
His philosophy is rooted in the belief that while infrastructure is the skeleton of a hospital, the people and their shared culture are its heart and soul. At this level of scale, Gupta’s approach also reflects a broader reality: the most complex operational challenges are rarely solved in isolation, but shaped through ongoing dialogue with peers facing similar pressures.
How do you scale healthcare as a local commodity?
Saurabh explains the strategic necessity of bringing quaternary care closer to home in the Mumbai Metropolitan Region.
“Healthcare is a local commodity, so patients should not have to travel long distances for quality care. Our aim is to build at least 2,000 beds in the next five years. Our goal is to ensure a good hospital within a 20–25 kilometre radius across the Mumbai Metropolitan Region. We already have a flagship facility, and the mandate is to bring tertiary and quaternary care closer to people’s homes. It’s about accessibility, making sure the highest level of care is available where people live and work.”
Why is satisfying doctors the most challenging part of hospital operations?
Beyond billing and supply chains, Saurabh focuses on eliminating operational noise so clinicians can focus on their patients.
“The most challenging aspect is satisfying doctors. They are highly accomplished, have limited time, and need to focus on patient care. Ensuring they are not burdened by operational issues like billing or supply shortages is critical. We rely on structured systems and checklists. Everything is planned in advance, from surgical lists to emergency readiness. We have just-in-time contracts with suppliers for any urgent needs. The goal is to eliminate surprises and allow doctors to focus entirely on patient care through daily and weekly audits.”
How does a leader make themselves redundant to drive growth?
Saurabh reflects on the transition from controlling every detail to building high-performance leadership layers.
“One key lesson I learned is that if you want to grow, you need to make yourself redundant. Over the past decade, I have shifted from doing everything myself to delegating, empowering teams, and building strong leadership layers. I no longer micromanage. I believe in hiring people who are better than me in specific areas, because that strengthens the organisation. My role is to guide through dashboards and oversight, not to control every detail. If the system can run without my constant intervention, that is a sign of a healthy, scalable organisation.”
Why is Patient Experience the real differentiator over technology?
While many hospitals invest in “star doctors” and digital transformation, Saurabh argues that the guest experience is the true core ethos.
“Many people focus on technology or star doctors, which are important. However, the most overlooked factor is patient experience and guest experience. Most hospitals today have similar infrastructure and capabilities, but experience is the real differentiator. In the next five to eight years, patient experience will not just be a function. It will become the core ethos that defines leading hospitals. Culture is the biggest challenge; as the saying goes, ‘culture eats strategy for breakfast.’ Aligning new teams to a unified culture is difficult, but it’s essential for a consistent experience.”
How can AI multiply human capacity in the diagnostic room?
Rather than replacing professionals, Saurabh sees AI as a tool to prioritise high-risk cases and speed up the diagnostic pipeline.
“AI is here to stay. It is not a fad. The biggest value of AI is in multiplying human capacity. For example, a radiologist may need to review thousands of scans. AI can filter and prioritise abnormal cases, so doctors focus only on what truly needs attention. This significantly improves efficiency, precision, and speed of diagnosis. AI will multiply the capabilities of doctors; those using AI will be more precise and effective than those who do not. However, AI will not replace healthcare professionals. It will augment decision-making and improve outcomes.”
What is the future of the decentralised hospital model?
As healthcare moves out of traditional hospital walls, Saurabh asks if today’s leaders are building for an obsolete future.
“We should ask: Where is healthcare headed, and are we building for that future? There is a rush to invest in infrastructure, but healthcare is also evolving and decentralising, with many services moving out of hospitals into specialised centres. I rely on dashboards and clear accountability structures to maintain standards across these sites. I track non-negotiables like revenue performance and compliance metrics every morning, but I trust my teams to manage day-to-day operations. We must focus on initiatives that maximise current impact while preparing for future models of care.”
Join the Conversation: The Ortus Club’s Executive Network
As Saurabh Gupta’s perspective highlights, scaling healthcare is no longer just an operational challenge. It is a leadership one, shaped by evolving expectations around culture, decentralisation, and technology. These are the kinds of challenges that benefit from a shared perspective. Increasingly, senior leaders are turning to peer-level dialogue to test assumptions, exchange approaches, and navigate complexity that cannot be solved in isolation.
The Ortus Club convenes executive roundtables designed for exactly these conversations. We bring together leaders who are actively building and scaling within their organisations. Join the network to engage in discussions that move beyond surface-level trends and into the operational realities shaping modern healthcare.
Frequently Asked Questions
Q: What is the Hub and Spoke model in healthcare?
A: It is a system where a central hub (a large flagship hospital) provides specialised tertiary care, while smaller spoke facilities provide quaternary and primary care closer to patient communities.
Q: How does a “Just-in-Time” supply chain work in a hospital?
A: It involves contracts with suppliers to deliver medical goods and surgical tools exactly when they are needed for scheduled procedures, reducing the cost of inventory while ensuring no disruptions in care.
Q: What is the difference between Tertiary and Quaternary care?
A: Tertiary care involves specialised consultative care (usually on referral from primary/secondary medical professionals), while Quaternary care is an even more specialised extension of tertiary care involving highly unusual or experimental procedures.
Q: How does AI prioritise diagnostic scans?
A: AI algorithms can pre-screen images (like X-rays or MRIs) to identify immediate red flags or abnormalities. These flagged cases are moved to the top of the radiologist’s queue, ensuring that critical issues are addressed first.
Q: What is Leadership Redundancy?
A: It is a management philosophy where a leader focuses on building systems and training successors so effectively that the organisation can function at a high level without the leader’s direct daily involvement.
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