Harvard Business Review on Succeeding as an Entrepreneur

Finding Competitive Advantage in Adversity

by Bhaskar Chakravorti

JONATHAN BUSH SAW THE opportunity to dramatically change how obstetrics practices function. He and his partner set out to build a medical business whose objective was to incorporate both traditional and holistic care options for mothers-to-be. Their aspirations were grand, and demand for their services rapidly grew. But when reliance on slow-paying insurers strapped the practice for cash, Bush’s vision got tangled in red tape.

In this failure, however, Bush envisioned what would ultimately become his truly innovative business idea: a health care IT service that spares its clients bureaucratic purgatory. That service, athenahealth, is now a $189 million business.

Unlike many managers ...