Why the Affordable Care Act isn't Affordable

I will be first to say healthcare is too expensive for consumers. When I had to go searching for a plan in November because my prior insurer stopped covering individuals, I was angered, frustrated and nearly brought to tears at the reality of my options. The plan I have is more expensive each month than my mortgage and that excludes the deductible of $6,000.

In my lifetime, I have participated in many forms of healthcare coverage or lack of coverage. As I child I was covered under AFDC or Aid For Dependent Children (welfare). I experienced the embarrassment of having two ugly eyeglass frames to choose from at age 12 when I needed glasses because those were the only ones covered and my single mom couldn’t afford anything else. Braces? No way, but the orthodontist was so concerned about how badly my teeth were configured he wrote a letter of appeal to the powers that be and got partial coverage. He generously offered the rest of the service gratis. I was grateful, but embarrassment and guilt left a sting that made me determined to work hard to be dependent on myself, rather than the generosity of others.

As a college student, I had no insurance and used Planned Parenthood for any care I needed because they took payment on a sliding scale. This amounted to yearly exams, birth control pills and treatment for an occasional sore throat or sinus infection. I was so grateful to have basic care that I could afford as I struggled to get the education that would make me independent. I had insurance coverage as soon as I began working in the hospital and it was reasonably affordable because I was always very healthy.  Fast forward to 2016 and I am self employed and have a cancer diagnosis. The fact that I even have coverage is because of the Affordable Care Act.  Before it, insurance companies could reject me because I had a condition that could get very costly to cover.  This would have meant $250,000 for initial treatment and my basic maintenance every year costs between $30-50,000.  As it is, I am stretching out the length of time between my basic follow and looking for other options because my deductible is so high that a significant amount comes out of my pocket. $2,000 every three months is not affordable to me or my family.  No, The Affordable Care Act, isn’t affordable but let’s take a look at the reasons why. 

Insuring more people costs more money.  The Affordable Care Act, or Obama Care as fellow Minnesota native Michele Bachmann re-titled it, mandated insurance companies could no longer reject people with pre-existing conditions. They had to cover the kid with cancer, the mom with failing kidneys, the priest with Cystic Fibrosis and yes, the smoking COPD patient on a fixed income.  20 million people were suddenly offered insurance coverage that didn't have access to it before, which was great in that the incidence of massive medical debt plummeted and sick people are able to get care before they are critically ill and most expensive to treat.  President Obama was not able to pass legislation to cap profits made by insurance companies because, to my understanding, that violates the free market economy we are so proud of.  This isn’t rocket science, more people getting care means more money going to hospital and healthcare systems who provide that care.

Why the mandates and penalties?  In order to have enough money to cover everyone, the young healthy people (who I used to be), need to be paying the insurance companies too.  It’s not so different from the Social Security System in that the people who are young and strong are supporting the ones who need help and when the young strong ones get old and sick, it is essential there are more young strong ones in the pipeline paying in and so on.  While it may seem wrong or even in opposition to American principles to try to force people to have health insurance coverage, it is the only way to support the huge amount of money that is needed to cover everyone. The money has to come from somewhere. Even these measures weren’t enough to make monthly premiums affordable for everyone so the government added money in the form of subsidies for people within certain income limits.  So, more people who need care are getting care and the majority of American’s are getting help with their monthly premiums.  I think most would agree these are positive outcomes, but wait….

Insurance companies like and are used to, big profits.  The cost to insure all of the sick Americans who they could reject coverage to prior, was higher than even they anticipated so they started rejecting in a way that was allowed, by pulling out of the healthcare exchanges.  I recall many of them stating things like continuing in the exchanges “is not sustainable.” This was especially true when they were covering individuals, like myself, rather than people who received coverage from their employer. With large groups like employers, insurance companies negotiate prices with healthcare providers and systems, that is why there are limitations on seeing physicians “out of network.” That is code for the insurance company hasn’t negotiated prices with those physicians.  They negotiate reduced prices with medical groups in exchange for the large volume of patients or “customers” they provide to that group, a volume discount, so to speak.  This is also why we don’t see anymore small family practice doctors like in the good old days.  I know many physicians who also long to provide that personal kind of care but they can’t compete with large systems and payers. But, I digress, that is another topic for another day. 

Insurance companies are still able to make considerable profits, just not to the degree they could prior to the Affordable Care Act. So, they started to raise monthly premiums, deductibles and co-pays.  A typical deductible (amount our of your pocket before insurance starts paying) for a family used to be between $500-1,000 per year and now have climbed to $6,000-20,000.  That is in a addition to monthly premiums of anywhere from $700-2,500 and co-insurance (percentage not covered by insurance) of 20-50%. While insurance companies complain about higher costs to cover members, their CEO’s are still getting paid multi-million dollar salaries.  I am not saying they shouldn’t be, I am just the kind of person who likes to know the facts when drawing conclusions. 

It is a dilemma to be sure and I agree the current state of healthcare is not sustainable for a variety of reasons. But what is the answer? Do we create a new system where there aren’t penalties and the government kicks in more money so the cost of insurance is more affordable to everyone? This increases our deficit tremendously.  Do reimbursements to healthcare systems diminish and there are staffing shortages and it takes months to get important procedures or treatment? Maybe the government gives money to the insurance companies in the form of massive tax credits but that would essentially be a government supported system and a precursor to the much demonized term “socialized medicine.” What I do know is, the costs of covering sick people in this country are going to sky rocket over the next 20 years and it’s really just a matter of who is going to foot the bill. 

What Carrie Fisher Taught me About Kindness and Authenticity

I have been fortunate in my life to have had experiences and opportunities that are rare and unique. To have landed in some enviable situations, not because I had a plan to be there or even the imagination to consider it a possibility but more because I had an open call out to the universe. A call to show me things I was certain I missed having grown up in rural Minnesota. To be certain, one of the finest examples of these moments of dumb luck, is meeting Carrie Fisher.

I had just moved to Los Angeles and contacted a local nanny agency looking for a position for the summer, before signing up for classes in the fall. I had experience teaching preschool and had been babysitting everyone in the neighborhood since I was about 12 years old. I had heard that nannies from the midwest were highly sought after so it seemed like the most logical job to try and land. The first interview I was sent on was in Beverly Hills and I was hired on the spot. I was plopped in the midst of A list celebrities and Hollywood producers literally overnight and meeting new ones on almost a daily basis. While this was initially exciting, it quickly became clear that this was not a world I was familiar with or could easily conform to. The starlet I worked for had a habit of instructing me to “get the baby ready” and get in the car without notice or any indication of where we were going. Sometimes it was to buy shoes for “the baby” on Rodeo drive 10 pairs at a time in different sizes, sometimes we traveled to Malibu for a barbecue where television icons from my childhood were gathered about discussing their latest film or television project. There were moments that seemed surreal and I tried to blend in or disappear as best I could but I usually felt very uncomfortable. Never particularly starstruck, just awkward. Then one day we went to Carrie Fisher’s house.

I remember the first time we drove up Cold Water Canyon and turned to climb up the twisty hill that lead to her estate. Colorful Holiday lawn ornaments with phrases from “Twas the Night Before Christmas” lined the drive on that summer morning. I couldn’t imagine who lived there as everything about the place was so different from the impeccably manicured, gated nirvana where I then resided and searched daily for glimpses of something familiar or conventional. We parked the car and walked up to the door where we were greeted by a demure woman who invited us in. I began inconspicuously scanning the room for clues such as framed family photos, movie posters, awards with name plates or gigantic self portraits but I wasn’t seeing any of the typical items I came to depend on to orient me or prepare me for what to expect. A portrait of Teddy Roosevelt hung over the mantle. There were stuffed animals, the real kind and everything was bright, interesting and begging to be explored. There were stacks of books by the door, not assorted books but multiple copies of the same book wearing a brightly colored jacket. Suddenly, she appeared, fresh out of the shower wearing a robe, her hair still wet. She extended her hand as we were introduced and apologized for making us wait. She asked if we were hungry and offered pancakes as she escorted us to a back patio that ran the length of the house. I was first struck by how tiny she was (I am 5'9") and the fact that she would host any gathering of Hollywood moms in that non-coiffed state, immediately put me at ease. This was behavior I understood, the glimpse of bare humanity that I had been looking for to ease the gnawing feeling, I had slipped down the rabbit hole. 

We made the trip weekly to Carrie Fisher’s house that summer for playgroups that she hosted. It was a respite in a routine that was fraught with a constant barrage of chefs being fired, measuring bath water temperature to the precise degree and impromptu requests to dress up “the baby” and parade her in front of dinner party guests at any hour of the day or night. In stark contrast, Carrie Fisher sat on the floor next to me, her chin perched on her knees and asked my opinion on things like music lessons and optimal toddler nutrition. She asked about how my mom did things and if I went to church as a child. She talked openly about normal things like her mother judging her choice in cribs or her father’s most recent visit and while, yes, there was a life size Princess Leia cut out in her court yard, she never treated anyone like they were invisible or any less important than she was. I can’t express how rare that was there or any place. There was an ease in the way she interacted with her daughter that was consistent to what I knew growing up but that I hadn’t witnessed in awhile. The world didn’t end if there was a scrape or scuffle and she beamed as she watched Billie play, oblivious to the frivolous gossip being strewn about by the other Hollywood moms. Of all the people I met in Hollywood, she had the pedigree to be the most pretentious and dismissive but she was exactly the opposite. She seemed curious about how things were done outside of what she knew directly and didn’t assume a life of privilege meant she had all the answers. She was real, flawed and didn’t seem to have the slightest interest in wasting energy on a facade of anything to the contrary. I looked forward to this weekly escape as it was a kind of life line to something normal and good that I saw as sorely lacking in most everything else I encountered. I imagine that’s what many others loved about her too, the realness and vulnerability. 

The stacks of books, I would learn, were copies of “Surrender the Pink.” She signed one for me and I have it to this day. She will live on as an icon, celebrated author, crusader and much more to those who were closest to her. To me, she was consistently kind when I was trying to feel okay in what seemed like a foreign land. This may seem a small accomplishment in comparison to all she is rightfully celebrated for but it meant the world to me at the time. She was a class act and she will be missed.

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Finding the Silver Lining-Can There Be Strength in Vulnerability?

I find it more than a little ironic that the same day I was named one of Linkedin’s top voices on healthcare, I was told by my doctor that I have ovarian cancer. In addition to reeling with how this will impact my personal life, I thought about the impact it will have on my professional life and my business. I knew I had to share it with those most closely involved with the day to day development and management of my software but how would it impact potential and current investors and advisors? I am actively preparing for a second round of funding and worry that the fear the news stirs in me may also be a deterrent to those I will depend on for the future success of my business? Will they view me differently? Will they still trust my ability to lead my company? Will I be seen as strong and competent? I have been told numerous times by supporters that what engages them is the passion I have for supporting patients and their caregivers and that it is my unwavering ability to overcome obstacles that has played such a crucial role in the success I have had to date.  But, to date, I have been physically healthy and able to move at a whirlwind pace.  No matter how strong my will or resolve, I am not delusional.  This will impact things in a way that is yet to be seen but an impact is undeniable. So, I have decided a few things for now:

I will be honest. I firmly believe that one of the most important things a founder does is to set a culture for his or her company. Though my company is young, I have made efforts to have full transparency with those who have supported me and I will continue to do so.  I am blessed to have people who have taken risks because they believe in my vision.  To most highly honor that, I have to be truthful with them at every turn and that includes sharing the truth that I am human and sometimes vulnerable to things outside of my control.  I will be strong and positive when I feel strong and positive and when I feel otherwise, I will call on those I trust to be strong for me and represent and nurture my company.  There may be days that all I can do is reinforce this culture but hopefully it will become an important cornerstone of my company and something every future employee embraces.

I will see the silver lining.  Although it wasn’t planned, I get a completely new perspective on being a patient battling a disease. I have been lucky to be in the role of supporter and advocate for patients and their families for many years but have rarely been the patient myself.  I am grateful for my software platform and think of how helpful it will be to my husband when he is trying to keep everyone updated on how I am doing over the next weeks and months.  It will help me keep my healthcare team connected and help me better manage my own care, medications and keep track of important metrics to stay as healthy as I possibly can.  I am certain I will learn a great deal about how to make my product even better for others who are going through what I will be experiencing. I also realize this may push me to seek partners for my business sooner than I would have otherwise and that may turn out to be a good thing.  Maybe there is somebody out there right now who has successfully taken a med tech company to mass markets and is actively seeking a new opportunity. Maybe rather than deter would be investors, I will attract exactly the people I need to make my vision a reality because the need has become more prominent.

I will grow as a human and as an entrepreneur.  I am lucky, the type of cancer I have is slow growing with high curability so I am planning for this to be a bump in the road. I fully intend to get past this and have a healthy, long life but being told you have cancer, changes you forever.  It changes you in a way that is different from working in a field where you see how fragile life is every single day. I thought I understood that very clearly, as most healthcare professionals are very aware of that reality.  It is different when you are the one who is sick and faced with what seems like a daunting path ahead. When it is you who must muster up the strength to face new obstacles and unknowns that change the way you view yourself and that don’t fit in any way into your plans. It gives new meaning to the often overused term “pivot.”  I vow to view this experience as an opportunity to share what I learn and make the process better where it can be improved.  I have already been faced with frustrations in communication gaps between care providers and have been abruptly dismissed when I have had questions. I will put what I suggest for others, to be strong advocates, into practice for myself.  I will undoubtedly have a completely new understanding and response when a fellow colleague, employee, customer or friend is struggling with a potentially fatal disease and I will sincerely be able to say “I know exactly how you feel.”  There is a beautiful strength and overlooked value in that statement.

What Entrepreneurs can learn from Elizabeth Holmes and Theranos

My heart actually sank yesterday as I read the Wall Street Journal article that made several damaging claims about tech entrepreneur Elizabeth Holmes and the California company she founded, Theranos.  I have watched over the past two years as I have started my own tech company, the rise of this young woman who the media has adored and promoted to near rock star status.  She has graced the cover of most every business or tech journal of significance and was one of very few tech entrepreneurs on the billionaire lists who was not a man and who made her fortune rather than inheriting it from a husband or father.  I was proud of her and her accomplishments, even having never met her.

I am holding back judgement and holding out hope until more facts emerge because I want the story to be true. I want a woman to be that successful in a male dominated industry and world. That being said, whether the accusations are true or not I believe some important lessons can be learned.

Do your research and share your research.  I didn’t take the WSJ article as gospel, so I started to dig a little into the accusations. What I found was this, there have been questions into the technology Holmes developed from the scientific community for quite some time. Of course these questions from actual scientists didn’t get any attention and I imagine were ignored because pretty much everyone had jumped on the bandwagon and drank the proverbial Kool-Aid. (more on that later)  From what I found, the minimal research that had been conducted was vague and had it been scrutinized, would have lead to more research and questions into the accuracy of the technology.  The reason’s Holmes camp gave as to why they didn’t want to disclose certain explanations of the actual efficacy of the technology was to protect trade secrets.  I think this was a mistake. It astounds me that so many individuals, investors included, would have given millions of dollars without more evidence this groundbreaking technology actually was effective.  I would have thought before Walgreens or anyone else actually paid huge money for this technology, they would have wanted proof it is at least as accurate as previous laboratory testing. 

A board containing high profile individuals isn’t worth as much as a board made up of people who know your product and market.  I have been told time and time again that what I need is some big name people on my board. I have rejected this notion repeatedly because it is my feeling that what I really need is a great product that solves a real problem and a team of people who have experience getting that product to those people.  Holmes has huge names like Henry Kissinger, Sam Nunn  Senator Bill Frist and George Schultz (who is 94 years old.) on her board.  These are heavy hitters in capital investment and politics but I have to wonder how they could have impacted the efficacy of her product. Maybe she would have been better off having a couple experienced molecular biology researchers or nanotechnologists or even a humanitarian since she seems to talk a great deal about her passion to change the world by making less invasive lab testing cost effective and available to everyone.  Maybe that’s who she wanted on her board but was pushed by investors to choose big name men who have access to money and people who change policy.  There is not one woman on her board and I couldn’t help but notice that she was recently tweeting with Gwyneth Paltrow, Arianna Huffington and Maria Shriver about #ironwomen and celebrating Margaret Thatcher.  Maybe lesser known, more scientifically experienced names of women or men, would have been better.

Media and good PR are powerful.  The media surrounding Holmes and Theranos over the past several years has been a powerful force.  They took the story of the Stanford drop out with a passion to change the world and ran with it and they ran far.  America ate it up, seemingly without question, me included.  Now when I read her story it occurs to me she had very little formal knowledge of science. I am sorry, even if you read science journals all day long and took every advanced placement science class in high school you wouldn’t be prepared to create a product at the technology level Holmes did. Her answers to questions posed in the past by the scientific community should have made everyone reconsider the story that she was a young science genius. I certainly don’t discount her idea and passion and potential ability to rally the right people to fill those gaps but a 19 year old who hasn’t taken Microbiology, Physics and Chemistry at a college level is a different reality than the story the media has presented.  The biggest thing I take away from this is that if a story is pitched and repeated enough times, whether true or not, it can be believed by the masses including influential people that one would think couldn’t be easily swayed. This belief can bring money, respect (deserved or not) and near celebrity status.  Maybe we all want a bandwagon to jump on, maybe we buy in because it makes us believe it can happen to someone else and that means it can happen to us too.  Maybe we honestly want to see someone make a difference and become successful in that process.

Like I said, I still hope she is able to show the hard evidence to refute the damaging allegations she is facing.  I want to think this is a story of an innovative woman who was passionate about a belief to improve a process and worked tirelessly, overcoming obstacles and doubt to achieve success.  I want her and other women to be on the lists of the most successful tech entrepreneurs and I want them to be there because they created something new that changed the world and made things better.  While I wait for that to shake out, I will keep plugging away at my own tech product, research study in progress, with my ever important, brilliant but little known advisory board. We will see how it all turns out.

Rolling the Dice

I saw a quote from Elizabeth Gilbert recently that read

"I fully believe that one of the greatest gifts I have given my children is the example of a mother who pursues her passions like a motherfucker."

I like that quote. That quote momentarily diminished the recurring fear that I have dragged my daughters down a path of unknowns and sacrifices that will leave them scarred, anxious and guaranteed at least two full years of intense therapy at some point in their adult life.  "I have taught them to be brave and to take risks and to be persistent in the face of adversity" I tell myself.  About an hour after reading Ms. Gilbert's profound words, I wondered how the path of an entrepreneur and all the variables and unknowns is different from taking their college savings to a Black Jack table in Vegas.  The truth is, from a pure statistical standpoint, the odds might be better in Vegas.  In my heart of hearts I believe what I am brining to the market is a sure thing, is needed and has been proven.  That is the belief that keeps me moving forward every day, but the fear is still there.  It has just become something I live with and try not to think about too much or it would paralyze me.

The farther I go down this entrepreneurial road, the more intense the roller coaster ride seems to be. The highs are higher which makes the lows seem even lower, the closer I am to that large investor, big contract or high profile advisor, the more time frames matter and the stronger the sting when something doesn't go as planned.  Rolling with the punches is a gross understatement.  Every day I feel as if I'm a circus performer juggling fiery torches while walking a high wire without a safety net.  I don't let myself think too long about the leap I took two months ago when I quit the job I really enjoyed, a government job with amazing benefits, to focus full time on my software.  Now, with diminishing funds, a tech product in transition to a new team that I just met and waiting customers, I spend every day focusing on the success that I can see just around the corner.  It is so very close but dependent on a great deal of factors that I can't completely control.  I am excited but just as equally afraid.  That is all this post is about really, being afraid and questioning the risks. Hopefully it will simply help someone else who is afraid, to know that I am afraid too and I am doing things every day that I have never done before. There are no tips or advice in this installment, just honest self doubt. I have moments of real fear that I will again be picking change from under my floor mats to get money for gas like I did when I was in college, that I will be serving up a big helping of ramen noodles for dinner and have to call AT&T to ask for an extension to pay my cell phone bill.  It's crazy how in my 20's I did those things and it sucked but it didn't seem as scary is it does now.  It seems more unbearable now that I have spent 20 years not doing it and I have people depending on me, family, friends and people I don't even really know who have made significant investments of time and money because they believe in me and my product.

Last week my husband said something to me that hit me at my core. It was one of those lazy statements made just before drifting off to sleep, eyes closed, lying in bed watching TV.  I was giving him the lowdown of the day about some delays in development and he said his usual, reassuring "Everything will work out Love"  but this time he followed with "You take risks I don't think I would have taken."  Now, to put the punch of this statement in perspective, you should know a little bit about my husband.  He was a punk rock teenager who left the comfort of his Minnehaha Parkway home to live in the streets..by choice.  He then traveled all over the world while keeping his few belongings in garbage bags and lived life by the seat of his pants which took him on many dangerous and sometimes unsavory  adventures.  He is an artist for God's sake and embraces every characteristic of that title.  He has lived a most unconventional and envy inducing rich life and experienced things I have only seen portrayed on film.  I took risks he wouldn't have taken? Are you kidding me?! It may not surprise you, he didn't drift off to sleep as planned.  This may be because I immediately jumped squarely on top of him with my face two inches from his, requesting clarification on his statement. "What do you mean?" I demanded.  He replied "Just that I don't think I would have been comfortable with so many variables with people depending on me."  He followed up by assuring me he thinks I am doing all the right things and doesn't think I should change anything but he wouldn't have taken the same risks had he had children (he is a stepfather to my daughters).  I pretended I was satisfied with the clarification, rolled off of him and let him sleep but I kept thinking about it because he's the biggest gambler and lover of the actual living of life I know.  For him to say I took more risk than he would have was profound to me.

My husband's statement was a turning point for me, it changed how I view my commitment to this endeavor and it changed how I see myself in an important way. Am I delusional? Is every entrepreneur delusional? Is it that delusion and persistence that makes the difference, that sets the successes apart from the failures? Sometimes I am truly amazed I have taken this as far as I have, that I continue to overcome obstacles and bring together, through some miracle, the pieces that need to be in place to make this a reality. What if I fail, would I do this again? I tell myself I would not, I tell myself if for some crazy reason I was completely wrong and this ends up going nowhere, I am getting a stable and secure job and maxing out my retirement contributions.  I have to believe that because the thought that I may be crazy enough to go through this all again, and maybe even again after that, makes me more than a passionate motherfucker, it makes me a straight up crazy motherfucker.

Courting a Coder

     A few months ago I was fortunate to get a great piece of advice from Casey Allen, current tribal leader at Health Rising.  I was explaining my pressing need for a great developer to take over my software platform, ideally to continue as a co-founder and lead a growing tech team.  Casey told me that finding a good developer is a lot like dating.  He was right.  Prior to that enlightening moment at Spyhouse Coffee, I thought I would simply make it known I was in the market for a developer to take on maintenance, updates and continued development of my amazing, brilliant, potentially high revenue producing product. I'd probably post it on Linkedin, TECHdotMN, Tweet it out etc..Surely there would be .net coders looking for work and some ownership in a cool new start-up.  Thank God Casey set me straight.

Coders are not all alike. First off, there should be a site, much like a dating site that connects the idea people with the developers because it is a lot like dating.  Just because a developer knows the language your product is coded in doesn't mean you want the same things or you communicate in human language, together, effectively.  It would save a lot of time if you could both really lay out what you're looking for in a technical relationship and list your deal breakers right up front.  Some developers are only interested in a part time gig for hourly pay, they don't want a long term relationship or even a commitment to one project.  Even if you think your product is beautiful and smart and interesting, you won't get them to commit. They like to play the field, jump from project to project and have no desire to settle down with one company or venture.  Some developers are open to a combination so to speak, they will commit a certain percentage of their time to your project but they will still work on other projects on the side as they intrigue them. This is the equivalent to a toothbrush in your medicine cabinet but don't go expecting a sleep over drawer, to use a dating analogy.  Having this information from the beginning would be helpful for both parties involved. Oh, and don't go thinking you can pretty up your product to entice the non-committal coder into a long term relationship. This is highly unlikely as developers, in my experience, are pretty clear about what they are and are not willing to do.  Which brings me to my next point.

Coders are in high demand and great ones are about as hard to find as that 22 year old thoughtful, sweet, monogamous Ben Affleck lookalike you were searching for in college (or now, sorry Ben).  Everyone thinks they have an amazing idea for an application that is going to change the world and make them rich.  Everyone is looking for a kick ass developer to bring their idea to fruition so you better be clear about what makes yours the best and will be the most exciting.  It's not all about money for coders either.  Oh no, some of them will be engaged by the idea and the amount of freedom they will have in creation of the product.  All of them will be assessing what it would be like to work with you and that alone can make or break the potential for a relationship.  Check yourself and act accordingly. Don't act like you know more than you do and be open and respectful.

Coders are special.  One of the most important things I can tell you about courting a coder is that they are unique in every way, some more so than others.  I often wonder what profession the coders I meet would be in if not for our current technology. I met with a coder just this week who, after about an hour long presentation on my product, told me "This is very exciting to me."  I was shocked because he looked about as excited as I look while loading the dishwasher.  They are not always easy to read.  Do not, I repeat do not EVER treat a developer like they are disposable. It is not as if you can just hire any old developer to take what is in your head and make it real or good.  This thought indicates you are, in fact, an idiot and is not what you want to lead with.  Great coders are artistic, superior problem solvers, incredible processors of information, master multi-taskers and the bottom line is, they know how to do something you don't so show some respect. If you are able to find a developer or a team who also communicates well with you and explains things in a way you understand, you have found gold my friend.  I have met some of these rare creatures, Casey Helbling founder of Software for Good is one, John O'Neil at the Nerdery is another.  Treat them right, be gracious and they will try to help you. They may introduce you to people who can help you realize your goals and even people you didn't know you needed to know.  If they choose to collaborate with you and their desires match your own….magic can happen.  I haven't figured the exact dynamics of what that relationship looks like long term.  However, I think I am on the verge of a real committed engagement and I can hardly contain my excitement.  I'll keep you posted.

The Fire Within

The purpose of this blog is primarily to share what I've learned on my entrepreneurial journey and to hopefully create a network of support for female entrepreneurs.  As it turns out, I am currently one of very few women who has decided to develop a software product and found a company based on that product. Who knew?

A little bit about me, I came to this by accident.  I mean, I came to develop software by accident. I think the entrepreneurial part has always been there and is a result of several circumstances. It is hard to say if any one of those circumstances played a bigger role in making me who I am than the other.  I was abandoned by my father and while this didn't destroy me or define who I was or am, it created a core belief that I needed to prove I am worthy. Worthy of what you may wonder? Worthy of anything, love, success, friends, accomplishment, children, water, air etc..etc…I mention this because it is only recently, at 45 years old that I realize I have this constant drive to prove something. Fortunately, in my particular case my perceived value is tied to helping people or solving a problem and doing so in a way that is exceedingly better than anyone has done it before. I won't lie, this can be exhausting and fuels a determination that has been annoying I'm sure to the many individuals I have worked with over the years. An exasperated "That's just the way we've always done it" usually accompanied by a head shake and an eye roll, has come my way more times than I can count. It is typically in response to an in depth line of questioning that I suspect is far to similar to the Spanish Inquisition. I am sorry, I can't help it. I need to know stuff.

One of the other primary components that make me susceptible to entrepreneurship, is that I grew up every day of my childhood living with a female entrepreneur. My grandmother started a ceramic business in our home shortly after I was born and when she was over the age of 50. My mother and I lived with my grandparents who were integral to my upbringing. My grandparents worked together in this home business. My grandmother taught classes in the basement to ladies in the community and my grandpa handled mixing the slip and pouring the molds in the garage.  A few times a week, the noise could be heard all the way upstairs as women laughed, shared stories and created their own version of art in our dust filled basement. Several times per year my grandparents went to local craft festivals and malls to sell their wares and I was expected to help. I spent many a summer weekend at various flea markets all over Minnesota helping my grandparents sell everything from cookie jars to Christmas trees.

  This was my grandparent's sole means of income.  I learned from birth that making something and selling it, is a viable way to make a living. I also saw that my grandmother loved what she did.  I was privy to the variability of the financial aspect of it but my grandparents chose to live a fairly minimal life. There were no vacations or dinners out at restaurants. There were no credit cards or financing things like furniture.  There was certainly talk of how much money needed to be made at the next sale to cover the next installment of property taxes but it was always met and sometimes even exceeded. I saw the immediate sense of accomplishment my grandmother experienced when her sales goals were met. By the time I was 5,  I was painting ceramic Easter eggs and putting them in styrofoam egg containers to carry around the neighborhood to sell door to door.  The indoctrination was complete. Add to that the fact that my grandmother was farming me out to local town folk to clean their homes, iron their husbands shirts and babysit their children so I could earn money for my private school tuition and it became quite clear, I knew you can make things or provide services to earn money.   As I became an adult, I understood this experience is fairly unique and was key to the person I am today.

I went on to college because education was very important to my grandparents and my mother. They felt a college education would give me a life without the financial variability they had experienced and therefore my life would be easier.  What they didn't know was that the deed was done, the veil had been lifted and I saw the possibilities and advantages of entrepreneurship.  Even while working at the career I had been trained for, I always supplemented with things like selling real estate, spa products, high end baskets and whatever else came my way.  I couldn't help myself and I excelled at it mostly because I had that God forsaken drive to do it better than anyone else.  A compulsion to not leave well enough alone when encountering a system that could be better.  About 5 years ago I took my experience in healthcare and the frustration of caregiving for my mother after a stroke and developed a professional patient advocacy model.  This model was solely based on a theory that if someone with medical knowledge was coordinating care and advocating for best delivery of that care, quality of life would be improved and medical errors diminished.  It was just a theory but it proved to be true.  I got my first client, then another and another all by word of mouth.  I helped these families navigate health crisis', chronic illness, end of life decisions and planning and transitions into higher levels of care such as assisted living.  I dealt with complex family dynamics, mental illness and senior citizens who were losing some level of control and were none too happy about it.  What was certain was that I was helping and providing solutions, which I thrived on.

Fairly early into this endeavor, I saw how technology could make the process easier and more efficient.  Surely it would be better if I could communicate in real time with families and care teams rather than sending batch emails giving updates and fielding communication from companions, home health workers and visiting rehabilitation specialists.  Storing medication lists, insurance cards and health records in folders on kitchen cabinets would be much more efficient if held someplace on the web where it was accessible but only to people to whom you chose to give access.  What if I could also measure and trend biometrics like blood sugar, daily weights and oxygen use as well so physicians could monitor these trends and offer guidance preventing a health crisis.  I searched long and hard for such a product but couldn't fine one.  This is how I came to develop software.  I created a prototype to use with my clients and it worked.  It did all I thought it would do and much more than I could have ever anticipated.  From there, it has taken on a life of it's own and I am the nurturer of this ever growing but often fragile, seemingly living thing.  It was an accident like the baby you didn't plan for but now couldn't imagine your life without (yes, I had one of those too).

While the highs and lows are often agonizing and completely time consuming, I find I must see it through.  I will defend it,  fight for it, beg for money to fund it and trample anyone who makes the slightest attempt to damage it in any way.  God help anyone who tries to stop me. Won't you join me on this exciting adventure of courting investors, working with coders, marketing, selling, building a brand all while raising teenage daughters, caring for a disabled mother and building a life with a new husband.  Maybe you too suffer from an unyielding drive to improve a process, outsell anyone and a (semi) delusional belief that you can change the world. Grab a whip, pull up a chair and fasten your seat belt.  It certainly is a bumpy ride.