Dr. Smith has worked as a health financing consultant for the World Bank and a public health consultant for the United Nations High Commissioner for Refugees in the former Soviet republics of Georgia and South Ossetia respectively. She served as the Corporate Medical Director for Highmark Life & Casualty, a national employer stop-loss, disability, life, Medicare supplemental and a regional workers' compensation carrier. She was also the Regional Medical Director for Disability & Workers' Compensation for Delphi Automotive, a former General Motors subsidiary. While working as the Chief Medical Officer for International Medical Group, she reengineered the medical evacuation process for her company's global health and travel customers, getting them to First World care in the most expedient manner possible. Dr. Smith was the Chief Medical Officer for Kentucky Health Cooperative in Louisville, Kentucky, a start-up insurer under the Affordable Care Act.

Dr. Smith envisioned and proposed the formation of the Osteopathic International Alliance (OIA) in speeches she made at the 1999 and 2000 American Osteopathic Association's National conventions and which were reprinted in the Journal of Osteopathic Medicine; from 2003 to 2007, she served on the founding Board of Directors. The OIA represents over 75 national professional organizations & universities from 30 countries. On multiple occasions she has served as a Delegate for the American Osteopathic Association [AOA] and the Global Health Council to the World Health Organization’s Annual Assembly in Geneva, Switzerland. For many years, Dr. Smith has served on the AOA’s Bureau of International Osteopathic Medicine (BIOM), representing the profession before various agencies of the United Nations and other international organizations. In 2015, the American Osteopathic Association honored her as one of the Guardians of the Profession.   

On June 11, 2013, Governor David Paterson of New York quoted Dr. Smith's writings in his keynote address to the New York State Osteopathic Medical Society. Her biography has been profiled in the book The Feminine Touch: History of Women in Osteopathic Medicine.

Dr. Smith received her Doctorate in Osteopathic Medicine from the Nova Southeastern University, College of Osteopathic Medicine in Ft. Lauderdale, FL. She has a Masters in Business Administration and a Masters of International Health Management from Thunderbird School of Global Management, and a Bachelor degree in Economics with a specialization in International Trade from Youngstown State University. She served her residency in Public Health & General Preventive Medicine at the Emory University School of Medicine in Atlanta GA. She has trained at the Centers for Disease Control & Prevention and completed the summer program in Tropical Medicine and Public Health at the Johns Hopkins University, School of Hygiene and Public Health. 

Dr. Smith is board-certified in Public Health & General Preventive Medicine, as well as Occupational Medicine. She is also certified by the American Board of Quality Assurance & Utilization Review Physicians and the American Board of Independent Medical Examiners. Dr. Smith is a fellow of the American Osteopathic College of Occupational & Preventive Medicine, the American College of Preventive Medicine and the American Board of Quality Assurance and Utilization Review Physicians. She is an adjunct clinical assistant professor at Marian University College of Osteopathic Medicine, and has previously held an academic appointment at the University of North Texas Health Sciences Center, Texas College of Osteopathic Medicine. She is president emeritus of the American Osteopathic College of Occupational & Preventive Medicine and Kentucky Osteopathic Medical Association.