Summary: This is a case study published by Wishup about how a virtual assistant helped a healthcare practice modernise its operations, improve patient experience, and free its founder to focus on care.
When Dr. Aleksandra Gajer acquired her practice, she inherited more than 20 years of operational history — including the systems, habits, and staffing that came with it. A highly paid admin who had been with the practice for seven years was still in place, but disengaged and resistant to change. Automations were minimal. Processes were manual. The practice was running, but it wasn’t growing. Twenty-five months ago, Hariharan Anandan joined through Wishup. What followed was a systematic rebuild of how the practice operated — from its online presence and email marketing to its social media, payroll, and patient experience.
The situation before the VA joined
The Gajer Practice had been operating for over 20 years when Dr. Gajer took ownership. Longevity, in this case, had come at a cost: the systems were old, automations were nearly absent, and the experienced admin who had managed operations for seven years was not interested in implementing new technologies or taking on new responsibilities.
Dr. Gajer couldn’t afford to keep a highly paid admin who wasn’t growing with the business. But replacing that person meant finding someone who could come in, learn a complex operational environment quickly, and actually move things forward — not just maintain the status quo.
Without change, the trajectory was clear: growth would have stalled or declined. The practice needed someone who could modernise operations, not just manage them.
Onboarding and getting started
Hariharan came in with no prior experience in healthcare — almost everything about the industry, the tools, and the workflows was new. The outgoing admin provided one week of training. From day five, Hariharan was working independently. By the third week, the impact was already visible.
The approach during onboarding was straightforward: ask the right questions, never let a doubt sit unanswered, and use every available resource — the trainer, the team, and daily 30-minute check-ins with Dr. Gajer herself. Dr. Gajer was highly supportive in those early weeks, and that accessibility made the learning curve significantly shorter.
Several tools had to be learned from scratch:
- Shopify — 6 days
- Kajabi — 4 days
- Typeform — 5 days
- Acuity — 3 days
- Linktree — 1 day
Two of these — Linktree and Shopify — were tools the practice had not been using at all. Hariharan introduced and implemented both.
Core responsibilities
Hariharan’s responsibilities spanned operations, marketing, communications, and finance:
- Email management — the single biggest time-saver for Dr. Gajer
- Email marketing via Constant Contact
- Calendar management via Acuity
- Payroll processing via Paychex and time tracking via On The Clock
- Social media management (taken over from an external 1099 worker)
- Online store management via Shopify
- Patient review automation via Zapier
- Website management via Elementor
- Patient communication via Textline and VideoAsk
- Linktree management and YouTube Studio updates
- Google Admin Console and Zoom administration
- Yelp profile management
- SOP creation across multiple operational areas
Across email management, email marketing, and calendar management alone, Hariharan freed approximately 9–12 hours per week for Dr. Gajer — time that now goes toward patient care.
Tools used
Acuity • On The Clock • Paychex • Typeform • Kajabi • Constant Contact • Linktree • Shopify • Textline • VideoAsk • YouTube Studio • Google Admin Console • Elementor • Zoom • Yelp • Zapier
Building what didn't exist before
One of the most impactful contributions was an automation Hariharan built to collect patient reviews. Before this system existed, getting Google reviews was a persistent struggle. The automation changed that: the practice now holds a 4.9/5 rating with over 200 reviews, strengthening its authority in the local market against competitors.
Beyond the review system, Hariharan created multiple SOPs that didn’t exist before — documenting processes that had previously lived only in habit and memory. Transaction journal entries, which had not been updated on a daily basis, were brought under consistent management, reducing errors and backlogs.
The practice also got a new online store, a revamped website, and a switch to a new email marketing platform — all of which contributed to a meaningfully improved patient experience.
Social media management
Social media had been handled by an external 1099 contractor when Hariharan joined. Over time, as he took on that responsibility too, the results improved noticeably. The growth was sufficient for Dr. Gajer to part ways with the contractor entirely — consolidating social media management in-house with Hariharan.
What the healthcare practice is able to achieve now
Dr. Gajer is now able to focus on patient care in a way she couldn’t before. The operational load — email, marketing, scheduling, payroll, social media, the online store — runs without requiring her direct involvement in the day-to-day.
If Hariharan were removed from the engagement today, day-to-day operations, payroll, and email marketing would all require immediate attention from Dr. Gajer herself. The trust built over 25 months is reflected in a simple but telling moment: when Dr. Gajer went on vacation, she handed Hariharan access to her personal email.
The VA partnership
The engagement has run for over two years and remains ongoing. The relationship is built on daily communication, clear accountability, and a working style that has become increasingly self-directed over time — with Hariharan operating more behind the scenes without requiring Dr. Gajer’s direct involvement in routine decisions.
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