Building a company from scratch: 23andMe, athenahealth and Evolent Health CEOs on entrepreneurship

Shocker, shocker — healthcare is challenging. At HLTH, CEOs Anne Wojcicki, Jonathan Bush and Frank Williams discussed how they persevered and made their companies succeed in a difficult sector.

“Healthcare is hard” is emerging as a mantra of this year’s HLTH conference in Las Vegas.

During a May 8 general session, athenahealth cofounder and CEO Jonathan Bush said part of the difficulty is that healthcare startup leaders have to run two companies. On the one hand, they have to follow specific guidelines and “pray at the FDA temple” a certain way. On top of that, they “must create something that is unique.”

Anne Wojcicki, cofounder and CEO of 23andMe, seconded these thoughts.

“It’s hard to do anything in healthcare,” she said. “It’s hard and it’s slow.”

There are reimbursement issues and plenty of risks that impede interested parties from moving in and operating. Plus, Wojcicki noted there’s often a lack of cohesion between entities — tech experts don’t always understand healthcare, while healthcare experts don’t always understand tech.

Frank Williams, cofounder and CEO of value-based care software company Evolent Health, added that he sees numerous healthcare startups coming in with an idea in search of a problem.

Despite the natural challenges of building within the medical landscape, Bush, Wojcicki and Williams all persisted in crafting their businesses.

The journey to success was far from easy. When asked how they cope with flops and disappointments, the panelists shared different answers.

“It’s fun to problem solve,” Wojcicki said. “Every day is a challenge. But the fun of it is that it can always get better.”

Bush put it bluntly: “All we do, all of us, is fail. And then we die.” Perseverance is about learning from past mistakes and the failures of yesterday. Bush added that he feels ashamed when he lets people down in the same way twice.

“This is an ongoing battle,” Williams said. He noted that great entrepreneurs are always evolving, taking insight from every interaction with a customer to improve their solution. A startup’s end product is rarely an exact replica of the founder’s original idea.

“The number one lesson I push on entrepreneurs is not to be afraid of failure at all,” Wojcicki added. “You’re constantly making mistakes.” Within a company’s culture, it’s key to recognize that making errors is OK.

Though the session narrowed in on the creation of all three companies, moderators Stephen Kraus (partner at Bessemer Venture Partners) and Trevor Price (founder and CEO of Oxeon Partners) didn’t ask Bush about the hottest athenahealth news: Activist investor Elliott Management made a $6.9 billion unsolicited offer for the company.

Photo: triloks, Getty Images

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