Elefant family in front of the Mirage.
Ronen Elefant, MD, MBA, FACS, has a unique way of combining two of his greatest passions, aviation and medicine. The Hartford, Connecticut-based physician regularly flies across the eastern half of the United States to perform ambulatory surgeries for patients, who are billed directly by the providers for their services rather than through insurance.
“I have always been fascinated by aviation. My earliest memory is being three years old and playing with Fisher-Price airplanes and just being in awe of them,” Elefant said, noting that his first airplane ride was six years later, when his family moved from Israel to Florida. Four years after that, he asked his father if flying lessons were something that he could pursue.
“I went out to what is now Fort Lauderdale International (KFLL) and took a couple of lessons, but was too short to even reach the pedals. And we actually had an incident on my second flight, where we had some engine trouble and the instructor called mayday,” he recalled.
“I called my dad to pick me up from a different airport and was surprised by his reaction, because I thought he would never let me fly again after that. But he was very supportive and said I should schedule another lesson because that helped me learn how to handle an emergency and stay calm under pressure.”
If acting cool under pressure isn’t a learned skill, then perhaps it’s something that Elefant is naturally inclined toward. He ultimately wound up pursuing a career as a trauma surgeon over being a professional aviator, which requires similar attention to detail and intentionality found in the cockpit.
Elefant had earned his private pilot certificate before completing his undergraduate degree and earned his instrument and commercial ratings before the third year of medical school, knowing he would never have as much time again as he did then.
“Fast forward, I maybe flew not even ten hours during residency and fellowship. I wanted to get back into flying. It worked out that my fellowship ended at the beginning of July, and I didn’t start my full-time job until September. But in the interim, to make money but not work full-time, I was moonlighting at a hospital in Pennsylvania. It was a nine-hour train ride from Connecticut, and it was awful.”
Before making the long trip again, Elefant stopped by the local flight school to see about renting a plane. He brought an instructor with him and began making the commute via air, and quickly became current once again. Flying enabled Elefant to continue seeking other part-time opportunities once employed full-time, and added Florida, New York, and South Carolina as frequent logbook entries.
A Cirrus SR22 was the first plane that he owned, which was replaced several years later by a Piper Mirage. A larger cabin, pressurization, and speed were some of the top reasons for stepping up. And as Elefant explained, “I wanted more complexity and to move my flying [skills] along. I never even thought that I would even own an airplane. So, every single airplane that came along was a dream come true.”
The Mirage was replaced by a JetPROP, which was the first plane that Elefant customized. A formerly red and white exterior was replaced by a fresh, blue paint job, and the tail was adorned with N8RL. ‘November’ was for his daughter Nava, ‘8’ was for his wife Brooke, ‘Romeo’ stands in place of himself, and the tail number is bookended by ‘Lima’ for his son Liav.
What I built my company around was that foundation. The economic and philosophical foundation of bringing autonomy back to surgeons and bringing top-notch healthcare to places that otherwise would not get it.”
“I love the JetPROP, and it was the perfect plane for my mission, which is fairly short – usually between Connecticut and Central Pennsylvania,” he said. “My mission has expanded since then, and you always think about what’s next. I wanted to fly a jet my whole life.”
After years of careful consideration, an abundance of spreadsheet analyses, and conversations with trusted advisors, Elefant determined that he was ready to pursue jet ownership.
“It was a hard decision because my mission doesn’t warrant a jet, but I felt like I was at a point in my flying that I just wasn’t satisfied and wanted to fly something bigger and better. I would rather pay more for fuel and have jet time than continue to fly something that I’m ready to move out of. So, I pulled the trigger on a [Cessna Citation]CJ1 and immediately regretted it.”
On paper, the transition to jet ownership didn’t seem that daunting. But reality set in even before the ink on the contract dried. Elefant explained that he learned a lot about himself and refined personal goals in the months following the dream purchase.
“What did I get myself into? I literally called the broker the day I picked it up and said to put it back on the market. It was just so much. This is expensive and is a lot to learn, with a type rating and maintenance tracking. Do I have the time to do all of this? It took me about four months of driving, instead of flying, and thinking, to understand more about myself. It wasn’t even about the airplane.”
With Elefant’s busy work schedule, a concern was how to best approach earning his type certificate while simultaneously feeling confident in the aircraft. Just as he had when re-entering the cockpit after becoming a physician, what wound up being the most efficient approach was flying with an instructor while travelling for work and family commitments. The 40 hours he spent in the plane before getting a type rating provided a level of comfort that was missing at the outset of the transition.
“My first solo in the CJ1 was the first time that I finally was like, ‘Okay, I like this airplane, and I’m going to keep it. This is fun, and I really enjoy this type of flying.”
Now, about a year and a half into ownership, Elefant only has good things to say about the CJ1. His mission has grown since acquiring the plane, and its main use is in support of his company, ACES National Surgical Team.
This company was born out of Elefant’s passion for healthcare economics. He believes that aviation has the potential to bridge the gap between inadequate patient care and poor doctor satisfaction, especially in underserved communities.
“I think that one of the things [causing] the demise of American healthcare is the insurance model. A lot of doctors are burnt out, not because of the work that they are doing, but because they are working for the insurance company more than the patient. If they did just patient care, they would love what they do,” he said.
“What I built my company around was that foundation. The economic and philosophical foundation of bringing autonomy back to surgeons and bringing top-notch healthcare to places that otherwise would not get it.”
Elefant flies himself to visit medical centers in support of ACES’ work, which currently takes him between Pennsylvania, Wisconsin, and South Carolina. They consult with patients before their surgery and typically spend two days at local ambulatory surgery centers performing operations before flying back to Connecticut.
“I am flying to South Carolina tomorrow, to Charleston International Airport (KCHS), and the flight will be about two hours long [from Hartford]. There is a 27-knot headwind, and we will be flying at 38,000 feet, and I can realistically get .62 Mach at altitude. The ceiling is 41,000 feet, and we can maybe go a little faster, a little lower, but then you’re talking a lot more fuel burn,” he explained, noting that the CJ1 typically burns about 100 gallons per hour when cruising at FL380.
“The CJ1 was designed as an entry-level single-pilot jet, and it shows. The cockpit flow layout, as well as start sequence and emergency procedures, are very thought out and involve very few required inputs, which are intuitive once you learn the systems. The speed envelope is really amazing as well, cruising at 380 knots but landing slower than 100 knots – and it handles like a classic Cessna 172.”
As the organization grows, he believes that aviation will continue serving an integral role – whether other surgeons supporting the mission fly themselves to their cases, or they are flown by someone else aboard a company aircraft.
“Wisconsin and South Carolina are both about two-hour flights in the CJ1. Part of me wants to expand to Florida, but I feel like I would only do that when I can bump up to the CJ3 because I want to make it non-stop. But the truth is that it is still fun when flying a jet, even if you have to make a stop. But the places I am choosing initially, I will try to keep it at the radius that I can get to myself. However, there has been interest from surgeons and surgery centers on the West Coast, so we might partner with some people there.”
And when looking further into the future, Elefant sometimes thinks about what plane he may have next. He explained that he initially wanted a Phenom 100 over a CJ1, but it was a little pricier and I needed better runway performance.. The CJ1’s takeoff numbers looked more favorable at his home base, Hartford-Brainard Airport (KHFD), which has a 4,417-foot-long runway.
“I am very analytical and made spreadsheets initially to see if I could even own a jet. I research the heck out of every airplane and know a lot about every one of these platforms I’ve considered. What are the benefits? What are the flaws? Where could things go wrong? What is the right choice?”
“My dream airplane, when talking about where I want to be one day, is a Phenom 300. That’s the ultimate single-pilot jet to me.”
