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

by Jonathan Bush, President & CEO

In this fourth and final post (see Parts I, II and III) on Jonathan Bush’ in-depth interview with, we focus less on innovation and health care, and more on the eccentric entrepreneur behind the curtain—Jonathan himself. Read on to learn what it’s like to grow up a Bush, who gave Jonathan a break when he needed it, and a day in the life of JB (one of my personal favorites from the series).

Be sure to catch the full interview here. – Michelle, Social Media Manager

Was it more interesting to be in a startup in your basement than riding a booming $2.7 billion-market-cap company?

I don't feel remotely less engaged than I did then. The motivation there was survival. Not biological death, but the death of athenahealth. I would hire someone and I’d say, ‘Here's how it's going to work. We're going to pay you enough to cover your Visa, so you don’t roll over your Visa. We're going to give you stock and if it works, you're going to be rich and if it doesn't, you're going to have a great resume item and story for what you were doing for the last three years.’ I did a startup. I tried to revolutionize birth.

Today I rarely think about whether athenahealth will go under, but what I think about all the time is will it matter? Will we get enough steam built up and is our nose hard enough that we can make a dent in this amorphous, numb sort of Orwellian system? And that's motivating because it's so much bigger than us. I mean, we're big compared to where we were but compared to health care, we're like if ticks could get ticks.

Is there someone who gave you a break when you needed a chance?

Fred Frigoletto. Then chairman of OB-GYN at Mass General called me back when I was a business school student and helped me work on my midwife model. I wasn't even a med student...that was cool. And Mitch Besser and Bill Schwartz and Cindy Dickinson in San Diego, who basically joint ventured on the first women's center. That was huge.

The other one would be my uncle George. We had all these elaborate models that showed how the midwifery thing would work and I met with his financial advisor, a guy named Tony Duke from Bessemer, and Uncle George called me and he wanted to know one thing. ‘What I couldn't tell from all this excellent work is, do you believe in it? In your heart, do you really believe in this thing?’ And I said I really believed in it. And he said, ‘I think that's the most important thing and Bar and I are in. Goodbye! Love you.' That was it.

You come from a very powerful American family. How does that affect you on your path as an entrepreneur?

I think my party line is that the wind is sometimes at my back as a result of that name and sometimes in my face as a result of that name, and that it averages out. I have so many cousins and uncles and grandparents who have established themselves and have done really good work at games that were already well played, that I was scared away from even trying to play the familiar.

I had a lot of love and a lot of unconditional positive regard from my parents, which clashed dramatically with the practical reality of the battlefield which is that every job, investment bank, political sphere, golf, tennis, had been done way better than I could ever do it and so how did I reconcile. I think that forced me further out into the ecosystem. I had to be an outlier.

Describe a typical day.

It depends on the day of the week, but on a day like today, I wake up at six. I do my breathing for fifteen minutes. I am here now in this. 'I' on the inhale, 'am' on the exhale. And then read a couple pages of The Presence Process. Michael Brown recommended it. I wake the first kids, get them started and then the second kids at 7:00. I leave at 7:25 with the two kids that need to go far and the other two kids walk. My fifth child is in college. Today is admin day so I work until 3:00 when I pick up my youngest. I try to get one on one with each kid in some way. It’s my chance to be a father.

Today is one of two days each week committed to administration of the company: writing for the internal audience, meeting one-on-one with members of my team and helping them with their journeys. It's meeting with my wife, Mandy. On Monday or Friday, we have lunch and we go through our calendar. Fridays, I spend three hours with my team and we go through everything that they're working on, a day a month on PR, a day a quarter on investor relations, a day a week on client and operations experience. We have town meetings at different offices. We have six offices. (From India to Belfast, Maine to the headquarters in Watertown, and it’s 900+ employees.)

You have five kids. Where is your favorite place to take them in Cambridge?

I love the Cambridge Skating and Tennis Club and with one daughter, we do gymnastics every Sunday. That's like a highlight of my week.

Is there a quote you live by?

Blank or die trying. Doesn't matter what.

Follow Jonathan on Twitter at @Jonathan_Bush.

Jonathan Bush is the President and CEO of athenahealth.

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