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CloudView blog

Ideas and insights to help health care providers stay informed and profitable in today's challenging health care environment.

Plenty to Say: Behind the Scenes with Jonathan Bush, Part II

by Jonathan Bush, President & CEO

Back in March, CEO Jonathan Bush sat down with the gracious staff of to talk about everything from his experience as a young entrepreneur trying to ‘fix’ the birthing process, to the inception of athenahealth, to his five, beautiful kids. In honor of this standout interview, we’ll be continuing to share (see Part I here) excerpts over the course of the next couple of weeks in four parts. Today, in Part II, the conversation focuses around innovation and entrepreneurialism. Check it out! Oh, and don’t forget to read the interview in its entirety here. – Michelle, Social Media Manager

Question: What's missing in our country today to encourage innovation?


Culture is a function of underlying assumptions. It's the unspoken reality and I heard a beautiful moment from President Barack Obama during the election when he was talking about taxes and capital gains taxes and someone said, what about these CEOs who start these businesses? What do you think this will do to them? And he says there's nobody who starts businesses. And I was like, oh my God, he genuinely believes that we're not a nation of people that start businesses.

I believe it’s biodiversity that allows for sustainability. In a pond, in an economy, in a family, in a school, it's biodiversity. Probably the most important leading indicator of our economy and our national strength would be an economic biodiversity index and I've never seen anyone track it but it's the most important number.

You have the established players that are sort of ironically the very regulation that keeps entrepreneurs out and keeps the established players in. And I'm sitting here crossing through that. I'm experiencing this journey from one side of the looking glass to the other where I go to Washington and people actually ask me what laws I'd like and I have the opportunity to make laws that make it impossible for other companies to come do what I do.

It's this weirdest thing and I'm looking at all the laws that have been created and I'm like, how did this happen? There have been a million athenahealths that came before me that were some congressmen or legislator or executive branch guys trying to respond to some event that's happened that's bad and all these guys with access snuggle up to them and say, I have a way of protecting the interest of the people. Then they propose some new law that's going to be curated and maintained and chased down for decades to come.

Question: How do you feel about that and why?


It makes me miserable because it deafens our humanity. To survive we need to be able to express ourselves in a wide range of ways. Humanity comes from being able to fly your freak flag or being able to struggle with whether you want to go at it on your own and do it your own way.

That Washington is protecting people by protecting some minority and in turn forbidding a giant majority from acting on their own… it’s the fundamental debate of government. It's the Nietzsche... the bird of prey versus the lambs.

Question: What is needed for entrepreneurialism to stay alive in America?


You have to act locally. But I think what we need to do is foment our own destruction voluntarily and figure out a way to benefit from that.

I've devoted a chunk of my time and athenahealth's time toward a thing called More Disruption Please, or MDP, and it's a support group for entrepreneurial ventures in health care.

There is next to no entrepreneurship in health care delivery. It's virtually illegal. Corporate practice of medicine is illegal. In many states, it's illegal to build a clinic, hospital or a health care delivering institution without a certificate of need from the governor.

athenahealth should sponsor new ventures, disruptive ventures entering health care, and offer access to our sales channel, access to our regulatory team. We want a group that represents the interests of new entrants in health care because only the established players in health care are represented in Washington.

Question: Did your midwife business make much money?


It went out of business.

But I do believe it's the right business model for society. If I was starting over today, I would do the exact same business model but I would use athenaNet, (athenahealth's suite of cloud-based services which includes an electronic medical records, practice management and care coordination services.) The reason it didn't work is that there wasn't enough information liquidity. It was so complicated. You couldn’t pull all the threads and expense and care together, and see them in one place as a doctor or a business person and today that's possible and fifteen years ago it just wasn't.

Question: I read that a VC offered you $11 million for athenaNet. Was that the catalyst for athenahealth?


That was the catalyst for closing out of the birth center (Athena Women’s Health, the precursor to athenahealth that Jonathan founded with Todd Park). We had the largest free-standing birth center in the United States and he made me that offer, and I quickly realized that was where we were going next.

Follow Jonathan on Twitter: @Jonathan_Bush.

Jonathan Bush is the President and CEO of athenahealth.

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