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Her interest in pursuing an MBA began when RIC asked her to serve as a medical consultant for the University of Chicago Hospitals, where she saw that leading physicians in acute “cure-based” medicine did not always understand the rehabilitation work of the post-acute sector.

In 2006, she was named CEO, the first woman to hold the post at RIC, where she has expanded services beyond Illinois and convinced the Pentagon to grant soldiers access to care at civilian facilities. Smith's success earned her recognition from Chicago Magazine as one of Chicago's top doctors and from Crain's Chicago Business as a "woman to watch."