Ameera Shah took her father’s pathology lab from his garage and kitchen and turned it into a “global pathology empire” and an “INR 2000 crore company.” After working at Goldman Sachs in New York, she realized that her true passion lay elsewhere, and she quit to return home. Her father’s lab, Dr. Sushil Shah’s Laboratory, was already a thriving organization in South Mumbai, with a steady clientele and an excellent reputation built up over 25 years. However, nobody outside of South Mumbai had heard of the company. Dr. Shah envisioned establishing a chain of labs across India, but according to her, “there was no clarity on how to go about achieving this…there was no bandwidth for growth.”
With expansion in mind, Ameera Shah started work. She rose to her position from working at the customer care counter, while putting the building blocks in place, and identifying the issues that needed to be solved. After two years, she began her efforts to grow the company. In 2004, Metropolis Healthcare signed its first partnership, Over the years, the company has signed 25 partnerships.
In just 13 years, Ameera Shah grew the company from one lab with 40-50 employees to “800 centres and 125 laboratories in seven countries.” Her leadership has earned her a spot in Forbes Asia’s “Asia’s Most Powerful Women in Business,” and Fortune India’s “Fifty Most Powerful Women in Business.” She has also been recognized as a “global thought leader in the healthcare industry.”
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Jerome Knyszewski: What do you think makes your company stand out?
Firmly established in Science and Innovation
Metropolis has been driven scientifically every step of the way; be it adopting reflex testing policies, customizing reference range for Indian Population, building a digital library of case studies or providing smart reports to patients with trend analysis, Metropolis has always been leading the industry with new innovations.
Metropolis: Pioneers in new tests and technology
One of the key differentiators and USP of Metropolis is its wide range of specialized and super specialized tests. Right from introducing radioimmunoassay as early as in 1981 to introducing molecular diagnostic tests for Tuberculosis, HIV and Hepatitis, taking strides in immunohistochemistry, surgical pathology and cytogenetics, Metropolis has been at the forefront of pioneering the most advanced tests and technology. Our test menu comprises of over 4000 tests which is comparable to global reputed labs like Quest Diagnostics in US. Over the years, we have provided access to specialized tests that are available globally. These tests need skilled manpower and experienced doctors to make a diagnosis. Our wealth of experience over the last 4 decades enables us to offer these high-end tests which improve our revenue diversification and profitability.
Metropolis amongst the top 1% labs worldwide for quality testing
Metropolis was awarded the NABL accreditation (National Accreditation Board for testing and Calibration Laboratories run by the Department of Science & Technology) in 2004 and CAP (The College of American Pathologists) Accreditation in 2005, the global gold standard in laboratory accreditation and the CLIA certification. Ever since, Metropolis has been rated amongst the top 1% labs worldwide for quality in laboratory operations and processes.
Jerome Knyszewski: Which tips would you recommend to your colleagues in your industry to help them to thrive and not “burn out”?
Ameera Shah: 1. Healthcare is an industry that has a long gestation period and building a reputation in healthcare takes years and years of cementing a position of trust with all stakeholders. Therefore, we are not in for a sprint but a marathon. Trying to scale up the business quickly will force one to take shortcuts or build business in a manner that is not sustainable in the long run. Getting into healthcare means you are in for the long haul and fully realizing this is important to avoid anxiety and a burnout.
2. Healthcare especially in India is a complicated industry, where a leader needs to have the ability to micro-manage and macro-manage multiple times in the same hour. Unless you have a passion for taking care of others or have a nurturing side in yourself, it would be very difficult to sustain in healthcare for the longer run.
Jerome Knyszewski: None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story?
Ameera Shah: While growing up, I saw both my parents who are both successful and reputed doctors work hard for the sake of patients. In a country that is still rooted in patriarchal traditions, both my sister and I were empowered to make decisions, find our path and we were given the freedom of choice. I was financially independent at the age of 18, I had travelled internationally alone at a young age and this really helped my levels of confidence while growing up.
Seeing my mother (Dr. Duru Shah, a reputed Obstetrician and Gynecologist in Mumbai for over 4 decades) work late nights, always walking the extra miles for patients, pursuing a strong academic work and also contributing a lot of her skills and time for charity was inspiring. We really had an example of the kind of qualities one needs to imbibe to traverse the healthcare industry. The freedom that my parents gave me, the values that I imbibed from them while growing up has helped me in my own journey of building Metropolis.
Apart from drawing inspiration from my parents, I have always tried to be a sponge in life, trying to learn something good or gain some knowledge from each person I meet.
Jerome Knyszewski: Ok thank you for all that. Now let’s shift to the main focus of this interview. The title of this series is “How to take your company from good to great”. Let’s start with defining our terms. How would you define a “good” company, what does that look like? How would you define a “great” company, what does that look like?
Ameera Shah: A good company is one that provides a good product or service to its customers and is financially creating value for its shareholders. A great company would be the one that transforms the industry, is a thought leader, focused on creating an ecosystem for all its stakeholders and has a role in influencing how industry changes, sets benchmark and leads the way.
Metropolis has set benchmarks in the industry very early when we were one of the first few companies in India to be accredited by CAP (College of American Pathologists, Global Gold Standard for Lab Accreditations), as early as in 2005. In a country and in an industry that is still over 90% unregulated with no minimum standards in place, Metropolis has paved the way for global standards and has adopted the highest standard of quality protocols and is trusted by millions of patients for their diagnostic needs.
Two decades back, it was believed that the pathology industry will always remain fragmented and be largely driven only by doctor-led labs. However, Metropolis has been successfully acquiring and integrating laboratories over the last 20 years and has been one of the first players in the industry to consolidate the unorganized space. Metropolis led the way and has demonstrated successfully how pathology can be institutionalized in a very competitive, regulated, and fragmented market. This has been possible because at Metropolis, acquisitions have been led through engaged partnerships rather than a commercial or a transactional deal.
Jerome Knyszewski: What would you advise to a business leader who initially went through years of successive growth, but has now reached a standstill. From your experience do you have any general advice about how to boost growth and “restart their engines”?
Ameera Shah: When you hit a standstill, it is important to set a goal post and be clear in our mind that the journey to this goal is going to be immersed in highs and lows. When one reaches a low point or a stand-still, it is important to look back at your highs and keep a perspective on the future. Resilience, grit, and a positive mind set is very important to keeping moving forward even when the situation is overwhelming.
From my own journey, in 2015, I was in a challenging position where I could possibly have lost my company that I had worked very hard to build. It was my legacy at stake and what sailed me through the situation is the realization that I had to take the plunge, bet on my own self and my abilities and to prove to myself that I am capable of doing the exact thing that I feared the most.
Jerome Knyszewski: Generating new business, increasing your profits, or at least maintaining your financial stability can be challenging during good times, even more so during turbulent times. Can you share some of the strategies you use to keep forging ahead and not lose growth traction during a difficult economy?
Ameera Shah: Being emotionally balanced and calm: During turbulent times, besides the financial havoc it creates for business, it also takes a huge toll emotionally. The fear of letting down employees, customers, all stakeholders in the ecosystem and your own financial wealth and value creation being at stake may lead to imbalanced decisions and clouded judgements. Being emotionally balanced and calm in turbulent times is important and the following strategies could help stay afloat and forge a path ahead:
Customer value proposition and going back to the basics: Everything beings and ends with the solution that you are offering to customers. It is important to answer the question if your business is still relevant in a turbulent time; whether your business really stands for a purpose and fulfils a need in the world and if you are not facing an existential crisis, the turbulence may be linked to short-term financial crisis or other challenges. These are the times when one needs to decide objectively what the trade-off is going to be. These choices of what you are going to keep and what you are going to let go can be challenging but often turbulent times will force leaders to make these hard choices.
Do not hesitate to seek help: Being upfront in terms of the challenges that you are facing, putting your vulnerabilities on the table makes it easier for people who are in a position to help you to offer as much assistance as possible.
Do not put up a front for family and friends: The anxiety of dealing with any crisis is as it is challenging and if you are not honest with those who are closest to you and if you put up a front for their sake, then it worsens the situation.
Holding on to the best members of your team: It is important to hold on to the good members of your team, keeping them aligned to the larger purpose and working together to the next goal is very important.
Jerome Knyszewski: In your experience, which aspect of running a company tends to be most underestimated? Can you explain or give an example?
Ameera Shah: I think people management is an underestimated aspect of running a company. However, the most under-valued and most underestimated aspect of running a company is good governance. Founders and entrepreneurs do not like checks and balances and enjoy the freedom of being the leader driving all aspects of the business. They do not necessarily like to be told what to do or what not to do or how to approach things differently. The biggest risk to any entrepreneurial venture is the ego and the inability of the founder to have checks and balances that brings different perspectives to the table. A good governance framework has many aspects and one of it is building a board comprising of people whom you respect, whom you are honest with and are willing to listen. Having people come to you and tell the flaws in your organization, hiring good quality auditors who point out the areas of risks and lack of controls in an organization, listening to investors who bring a lot of objective perspectives and most importantly listening to customer feedback — all these together help in building a much stronger and sustainable long-term institution. An entrepreneur who wants to build a business like a single lion is the biggest risk in a business.
Jerome Knyszewski: Great customer service and great customer experience are essential to build a beloved brand and essential to be successful in general. In your experience what are a few of the most important things a business leader should know in order to create a Wow! Customer Experience?
Ameera Shah: I think keeping the customer at the center of every aspect of your operations will ensure the best possible outcome for the customer and that is something we have successfully done at Metropolis. To give you an example, our hierarchy lines are flat when it comes to solving a problem for a customer. Our teams are empowered and encouraged to communicate across the layers in the organization to ensure patient satisfaction. Foreseeing the customer’s needs, actively seeking feedback, and tweaking your way of functioning to meet customer needs is a good way to stay on top of the game. Additionally, customer centricity is a culture and it always needs to come from the top levels in the company for it to be emulated across the organization.
More importantly, good analytics is at the heart of a great customer experience. Something as basic as measuring the number of calls that you get during a day at your call center, the reasons for these queries and proactively communicating to the customer to prevent these calls leads to a constant improvement in the overall customer experience. Therefore, harnessing data and analytics is core to a Wow! Customer experience.
Jerome Knyszewski: What are your thoughts about how a company should be engaged on Social Media? For example, the advisory firm EisnerAmper conducted 6 yearly surveys of United States corporate boards, and directors reported that one of their most pressing concerns was reputational risk as a result of social media. Do you share this concern? We’d love to hear your thoughts about this.
Ameera Shah: Social media is a two-way sword. Some companies have really resonated with customers when they have been able to align with certain purposes that people’s sentiments are leaning towards. But this needs to be handled deftly to avoid the risk of your campaign backfiring on you. Social media is therefore concerning for brand owners as these lead to a quick change of perceptions in the minds of the audience. Often, we have seen that the response to such incidents come too late from brands or are not communicated in a manner that manages the expectations of those on social media. Therefore, having a ready plan to combat such situations and keeping the top-most executive constantly informed on such issues is very important.
Jerome Knyszewski: What are the most common mistakes you have seen CEOs & founders make when they start a business? What can be done to avoid those errors?
Ameera Shah: The most common mistake that CEOs and founders make is assuming the best possible outcome. Almost all business plans ever made has proven to be incorrect when implemented practically. Without insights from a ground-work and actual customer feedback, a plan is simply a plan on paper. Most founders believe that they will be successful in an optimistic timeline while it may take at the least two more years than the expected timeline. Therefore, having funding for a little more time than your expected timeline is a good step. A good business plan built with actual insights from a pilot, customer feedback, setting a realistic timeline, having the funds to last until you reach a point of scale is very important.
Running a pilot project in different environments to get as much customer feedback as possible and not being over-ambitious but allowing the business plan to evolve to match customer feedback and expectation is one way to avoid all the pitfalls that a founder may face when starting a business.
Jerome Knyszewski: Thank you for all of that. We are nearly done. You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
Ameera Shah: Right to confidence is the biggest asset for a woman. Everything starts with our own self-belief and often women all over the world are conditioned to not have this self-belief and confidence. A movement to get parents to bring up their daughters with more confidence would be a great movement that will give rise to strong — independent women who would be capable of so much more. Bringing up girls with more confidence means allowing them to take risks, enabling them to follow their dreams, setting them free and not limiting them because of their gender.
Over the years I have seen that entrepreneurship can be a lonely journey especially for women entrepreneurs in a country like India where patriarchy is still deeply rooted. In my own way of paying it forward, I started Empoweress in 2017, a peer-to-peer learning, mentoring, and networking ecosystem for women entrepreneurs. We all know that investing in women businesses has a great impact on other women, the economy and in-turn more women come to the fore. This has been an area very close to my own sense of purpose and putting these here so that women business owners can reach out to us in case they are looking for help.
Jerome Knyszewski: This was very inspiring. Thank you so much for the time you spent with this!