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Ameera Shah of Metropolis Healthcare: How To Take Your Company From Good To Great

An Interview With Jerome Knyszewski

A great company is made by great teams. People make a company great. An organization that constantly invests in the well-being of its employees, truly taking care of their needs and making the workplace a stimulating environment and giving a sense of purpose and fulfilment through their work is very important. Today, Metropolis is a 4500-member strong and happy family. The true test for all of us at Metropolis was when the pandemic hit, and our teams had to work from the frontlines putting their own lives and that of their families at work. It is of utmost pride to me that our teams really put their best foot forward with a strong sense of purpose to alleviate patient fear and anxiety. Our brand purpose has truly shone in this pandemic more than ever.

As part of my series about the “How To Take Your Company From Good To Great”, I had the pleasure of interviewing Ameera Shah. She is the Promoter & Managing Director of Metropolis Healthcare Ltd., a leading chain of pathology labs with a large network of patient service centers in India and Africa. A finance graduate from the University of Texas, she is also an alumnus of the Harvard Business School, (OPM Program).

For the last 20 years, she has built Metropolis into a leading and reputed chain of laboratories with a wide network of over 2900 laboratories and patient service centers. Due to its unique operating model and competitive advantage, Metropolis has attracted three rounds of investment by reputed private equity investors. Under her leadership, Metropolis had a successful listing at the Stock Exchanges in April 2019. She has played an instrumental role in changing the pathology industry landscape in the country, from being a doctor-led-practice to a professionally led industry in an extremely unregulated, competitive, and fragmented market.

Ms. Shah has been named amongst Asia’s Power Businesswomen List by Forbes Asia 2020, Most Powerful Women in Business by Fortune India (2017, 2018, 2019, 2020) and by Business Today (2018, 2019). She launched Empoweress in October 2017, which is a peer-to-peer mentoring and networking ecosystem for women entrepreneurs.

Ms. Shah is an independent director on the board of reputed Indian companies (Kaya, Torrent Pharma, Shoppers Stop) and is also an advisor to Baylor College of Medicine, Texas. She is also on the global advisory board of AXA, a Paris headquartered company with 700 Billion $ under asset management.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

In the year 1981, my father, a renowned pathologist in Mumbai set up Dr. Sushil Shah’s path lab in Gamdevi, Mumbai. The lab was well known in South Bombay and other parts of the city for its quality services, customer orientation, and its specialized test menu. It was a single lab operating as a doctor’s practice with a small team of over 30–35 people (technical team for sample collection and conducting tests). Growing up with doctor-parents and seeing them always walking the extra mile for patients meant that from early on I was constantly aware of the impact that they were having on people’s lives. So, the idea of wanting to make a positive difference was imbibed from early on.

Return to India: Driven by a sense of patriotism, purpose and the desire to build something meaningful.

In 2001, after completing a business degree in finance from the university of Texas, I had the choice of either pursuing a corporate career in the United states or to return to India to build my father’s pathology lab in to a sustainable business. Personally, I have been hugely inspired by Muhammed Yunus, the Nobel Peace Prize Winner who changed the lives of thousands of people through his idea of Grameen Bank. In my own way, I wanted to do something for my country and thus started my journey with Metropolis in the year 2001. It was a sense of patriotism that brought me back to the country and the sense of purpose in healthcare where there is a huge opportunity to positively impact the lives of people.

Can you tell us a story about the hard times that you faced when you first started your journey? Did you ever consider giving up? Where did you get the drive to continue even though things were so hard?

In India, navigating the complex intricacies of the healthcare industry that is still rooted in the traditional way of functioning posed several challenges. In addition, being a young women entrepreneur with no medical background added to the complexities. Access to capital had been a challenge as investors would ask ‘’but how long would you run the company, what about when you get married.?” In India, it was difficult for investors to fathom that a woman may continue to run her businesses in the same way irrespective of whether she got married or had babies. Of course, as we built scale and demonstrated growth, we had marquee private equity investors (ICICI India Venture Fund, Warburg Pincus, Carlyle) investing in our growth story and making 3–4x return on their capital.

While there have been a lot of ups and downs in my journey of building Metropolis, there has never been a question of giving up. From very early on, I have always been comfortable stepping out of my comfort zone, pushing my own boundaries, taking risks, and executing these risks with caution. These personality traits kind of helped me through the difficult and challenging phases of building Metropolis.

My early days were like building a start-up: corporatizing the lab by bringing in people, systems, and protocols. My earliest experience also includes building partnerships with good quality pathology labs across the country. This meant, as a young businesswoman in my early twenties with no medical background, I was sitting across the table with doctor-pathologists to discuss acquisitions. One day, I was the customer facing executive and the next day I was out on the field to study a new market for expansion. Within 3–4 years of my entry, we had all the basics in place, completed a few acquisitions and Metropolis was ready for the next leap of expansion.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or ‘takeaways’ you learned from that?

When I was about 11–12 years old, I used to go to my dad’s lab during the summer holidays (Dr Sushil Shah’s path lab at Gamdevi, Mumbai). I used to be at the lab from eight in the morning to eight in the evening. One of my jobs during that time apart from manning the phone or drawing up customer receipts was to give a lab tour to the guests. At that time, we had a room called the serum collection room. Serum, as we know is a part of blood and is used for certain tests. At that time, these medical words confused me and at one point during a lab tour referred to it as the semen collection room, much to the amusement of everyone in the room.

At 20, when I returned to India to build the business, one thing was clear. If I was going to be in the healthcare space, I needed to understand the medical terminologies, take time to understand laboratory concepts so that it is easier to deal with people around you and also earn their respect.

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.

Which tips would you recommend to your colleagues in your industry to help them to thrive and not “burn out”?

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.

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?

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.

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?

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.

Based on your experience and success, what are the five most important things one should know in order to lead a company from Good to Great? Please share a story or an example for each.

Being aware that the organization is a reflection of its leader:
A company and its people quickly imbibe the values of its leader and therefore it is important to know that you are being watched every step of the way. Therefore, as a leader one needs to be aware of their own personality reflecting on the brand. A bold leader inspires their team to be bold, an honest leader inspires their team to be honest. Great companies are made by great leaders.

As a leader, I have been always conscious of the effect that my leadership, conduct and decisions have on my team. Our brand ethos is built on empathy, integrity, and transparency and this has been possible because from day one I have been clear on how we need the company to be run.

Knowing how to deal with failures:

Often, we are not motivated to take risks because we are too scared of failures and outcomes of a decision that we make. In a great company, there is a lot of trust and open communication at the table so that teams are comfortable with the risks that they take and know how to handle failures.

I have always been bold in my decisions and have taken my fair share of risks while building Metropolis; be it entering markets like Africa, the 22 acquisitions that we have completed in the last 15 years, going public in uncertain market conditions when even the most reputed companies put their listing plans on hold. These risks have been calculated and executed with a lot of caution taking in to considering the worst possible outcome and having a plan to navigate those outcomes. I have learnt to deal with successes and failures and as a leader, have been able to replicate these qualities in my core team.

The best leaders are constant learners

To stay relevant, effective and to adapt to changing times, it is important for leaders to never stop the pursuit of learning. If we are not learning, then we are not keeping up. I have chosen to be on board of other reputed companies (Marico Kaya, Shoppers Stop, Torrent Pharmaceuticals) and get exposure on how companies are governed and implement these learnings in my own company. I also pursued the Harvard Owner President Program to evolve my thinking and my association with YPO since 2013 has helped me bring many new perspectives to the table. Idea of constantly learning and getting exposed to new thoughts and ideas, new ways of doing things is the only way to be a step ahead from the rest.

Transparency at its core

Great organizations are built on good governance and a strong ethical framework. Transparency is a way of functioning at such organizations. Businesses that have integrity at its core will always stay true to all its stakeholders and earn their trust and respect.

Metropolis had a stellar listing in April 2019 and Today, Metropolis is valued at 1.25 billion dollars, up from a valuation of a half a billion dollar at the time of the IPO in April 2019. domestic investors by posting industry leading performance every quarter since listing. Our focused efforts in enhancing operating parameters backed by best in class disclosures and good governance practices have been recognized by capital markets which has resulted in the stock delivering over 100% returns since IPO in April 2019.

Great company is made by great teams

People make a company great. An organization that constantly invests in the well-being of its employees, truly taking care of their needs and making the workplace a stimulating environment and giving a sense of purpose and fulfilment through their work is very important. Today, Metropolis is a 4500-member strong and happy family. The true test for all of us at Metropolis was when the pandemic hit, and our teams had to work from the frontlines putting their own lives and that of their families at work. It is of utmost pride to me that our teams really put their best foot forward with a strong sense of purpose to alleviate patient fear and anxiety. Our brand purpose has truly shone in this pandemic more than ever.

Extensive research suggests that “purpose driven businesses” are more successful in many areas. Can you help articulate for our readers a few reasons why a business should consider becoming a purpose driven business, or consider having a social impact angle?

Purpose driven businesses stay relevant even as times change. In times of crisis, the single most binding thing is a common purpose, and not a balance sheet or the business product. Especially in healthcare, an industry where the scale is much lower but emotional investment and the sheer number of hours that one puts in is higher compared to other industries.

In healthcare, the ability and desire to want to take care of other people is important. We have also witnessed that when a lot of people in an institution come together and are aligned with a unique purpose, they can together achieve great things because decision making is far more balanced. It is not just about risk taking to create good financial outcome, but decisions are based on creating value for all stakeholders.

Our egos are diluted in comparison to the common greater purpose and this is very important because ego is known to break and crash the largest of institutions.

Therefore, having a business purpose can truly propel a company forward where purpose driven employees become brand ambassadors, there is increased customer loyalty and research also suggests that purpose fuels financial growth too.

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”?

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.

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?

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.

In your experience, which aspect of running a company tends to be most underestimated? Can you explain or give an example?

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.

As you know, “conversion” means to convert a visit into a sale. In your experience what are the best strategies a business should use to increase conversion rates?

Every brand makes a promise to the customer; be it giving a reliable diagnostic report that will decide the treatment outcomes for a patient or something as simple as a box of crayons. Knowing what your customer needs, offering a seamless experience, reassuring your customer that you are always available for any resolution is very important to earn life-long customers. Brand loyalty is not a single visit or a sale but a set of positive experiences and making the customer feel important, cared for and respected and this can be earned only by giving the absolute best experience. Therefore, empathy is a critical quality that every customer facing organization, product and business need to have ingrained in their operations deeply.

Of course, the main way to increase conversion rates is to create a trusted and beloved brand. Can you share a few ways that a business can earn a reputation as a trusted and beloved brand?

There are multiple aspects to becoming a respected, loved and a trusted brand. First and foremost is delivering on your brand promise every single day and being empathetic to your customer’s needs. For example: if one of our patients need an urgent report for their health needs, no matter how challenging the circumstance is, we will figure out a way to do it for the customer. Trusted and loved brands go out of their way and that is what makes them truly stand apart. When you keep doing this day in and out, you become a place that people go to, your customers love you, they recommend you to their family and friends etc. It may be easy to become a trusted brand but to keep that trust and not losing the sense of your purpose as you grow and attain scale is very important.

During the last six months in this pandemic, a lot of customers reached out to me personally out of sheer anxiety of not getting report in a time they anticipated, concern around their report or unable to get a visit because of surge and demand in tests. These complaints may seem miniscule when you look at the myriad challenges that a company may be facing during a difficult time, but for the customer, these complaints were very important because it was the health of their loved ones at stake. Immediately responding to these queries, listening to their problems, and solving these problems truly made Metropolis stand out as a brand that cares even during the most challenging circumstances.

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?

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.

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.

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.

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?

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.

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. :-)

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.

This was very inspiring. Thank you so much for the time you spent with this!

About the interviewer: Jerome Knyszewski (Kenchefski) is the CEO of HeavyShift. Jerome serves as an advisor to CEOs of Fortune 500 companies as well as entrepreneurs who disrupt their industries and therefore tend to be targets of malicious online attacks. His company builds, protects, and repairs the online presence & reputation of many celebrities, products and beloved brands.




In-depth Interviews with Authorities in Business, Pop Culture, Wellness, Social Impact, and Tech. We use interviews to draw out stories that are both empowering and actionable.

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