Today, Jonathan Bush is CEO of athenahealth, a pioneering healthcare company with nearly $600 million in revenue but he got his start mowing lawns and pruning shrubs. It sounds like a farfetched trajectory, given the entrepreneur's famous family name (his cousin is George W.) but he learned the value of hard work and entrepreneurship at an early age.
"[Growing up], I was surrounded by people who were much older than I was, and they were doing extraordinary things that appeared to be good for others," Bush explained in a recent sit-down interview. "I got the idea that I wouldn't be loved if I wasn't doing something good for others, too."
That desire to be helpful led to Bush's first venture. At age 15, he started his own landscaping business. His core offering was clearing pesky pricker bushes off of people's lawns. It was an unglamorous service to specialize in but it made Bush's business a success.
"The lesson is to pick a place where no one wants to be [like cleaning pricker bushes]," Bush said. "I never won any head-to-head competitions as a child, so I thought instead I'd pick a place where no one would come for a really long time, and eventually build a position where it'd be just impossible [for other people] to enter the space."
In 2000, Bush, a graduate of Harvard University's MBA program and a former combat medic in the U.S. Army, put that childhood lesson into action once more. Leaving a job at consulting firm Booz Allen Hamilton, he raised more than $10 million in venture capital to found Watertown, Mass.-based athenahealth.
The simple, yet groundbreaking, goal of the company was to make healthcare personal. No one had done that before. In fact, healthcare was a space it seemed no entrepreneur wanted to enter. That is exactly what drew Bush to the industry in the first place.
"The interesting thing about healthcare at that time was that, frankly, the best and the brightest people were not choosing healthcare administration," Bush explained. "They were choosing other things: the Internet, social networks, etc., but not healthcare."
The absence of innovation and entrepreneurship in the healthcare sector meant that Bush was essentially entering an industry with little, if any, direct competition. Finding a niche without entrepreneurial competition was key to the company's success from the get-go, according to Bush. It's also a tactic that he advises other entrepreneurs to employ.
"We're in a space where there is no entrepreneurial energy," he said of the healthcare sector. "In 16 years, we've really only had one company enter the space and try to be like us."
But that doesn't mean the company was an overnight success. Bush is quick to emphasize the role of failure in making athenahealth what it is today. As he put it, "If you don't have the fight and the breakdown and the sadness, you can't have the success."
At athenahealth, failure came in multiple forms. For starters, the company itself changed direction several times, forcing Bush and his colleagues to start over from scratch.
"This was originally a women's health birthing company," Bush noted. "We currently have no birth centers, nor any midwives, nor any OB/GYNS. The entire business was a complete failure that went belly-up. There have been a million things that failed. But we kept figuring it out."
That approach to failure is something Bush advises aspiring entrepreneurs to embrace. He also suggests that entrepreneurs learn to strike a balance between building financial growth and building a socially conscious company that truly benefits consumers.
"You want to build a business model that is philosophically aligned with the financial wellbeing of your clients and the social wellbeing of society at the same time," he said. "There are a lot of ways to make money that doesn't do society good."
Bush acknowledged that it's not obvious how to build such an organization. But the key, he said, is not to be afraid of failure while you "live the corporation you want to be."
"Don't say, 'I can't wait 'til I get there!" Bush advised. "Be there now!"
At athenahealth, "living the corporation they wanted to be" meant holding quarterly reviews when there were only eight employees, and running competency models when there were fewer than 50 people at the company. Bush and his colleagues also wrote down company policies and put them online when athenahealth was just a tiny startup. They had a server when there was fewer than a dozen employees.
"We loved the idea that we were playing house, and that someday there would be a real house around it," he explained. "And it ended up working out that way."