The Health Haven (a)

Abstract

The financial manager at the medical devices start-up Health Haven had to develop a revenue forecast that was aggressive enough to meet required performance targets but realistic enough to be honest and achievable given a reduced budget. He wanted to "lead from the middle" of his organization by providing an acceptable performance forecast on which Haven could deliver. This case is supported by a teaching note for instructors which contains links to supplemental video for students.

Excerpt

UVA-OB-1062

Rev. Jan. 26, 2016

The Health Haven (A)

Eric Hunt had a great deal to accomplish in very little time. He had only recently transitioned to his new role as senior finance manager of the Health Haven (Haven) from a more junior finance- and business-operations support position. Although he had been with the company for nearly four years, the level of responsibility he now faced was new to him. Not only was the experience of leadership new, but the challenge of preparing this year's budget was far more complex than he had ever thought possible. His predecessor, Steve Knight, had acted in ways that had eroded the trust his associates had in his company's leadership—including Hunt. The circumstances were dicey, there were multiple parties to please, and much was at stake.

Company History

Knight founded Haven in Durham, North Carolina. He was an emergency department physician who had discovered several useful, low-tech ideas for improving patient care in the course of his work. Because his improvement ideas were not owned outright as the intellectual property of his employer, Knight was able to explore the commercial viability of nine of his ideas using $ 100,000 in start-up capital from family and friends. Eventually, one of his ideas seemed destined to be a hit. His most promising product, the ShoulderBand, was an innovative harness system for supporting a shoulder joint, so it could heal without limiting mobility. It was especially useful to those with mild-to-moderate shoulder pain who also had hypermobile joints, which tended to hyperextend. The hyperextension could delay the healing process. Because the ShoulderBand was classified as a device and not a drug, it did not have to go through a lengthy FDA approval process. Instead, it required laboratory testing and a clearance process that was less expensive and cumbersome to obtain than FDA drug approval. Knight employed two part-time researchers to explore the commercial viability of this and his eight other medical-device ideas.

Knight was close, but he had not yet been able to raise the money necessary to scale operations and secure accounts with key customers such as hospital systems and other providers. Although a true philanthropist and decorated physician in his own right, Knight was also modest. He did not have the personality for the external advocacy required to grow the company and had distaste for what he thought was incessant self-promotion. Two years in, he crossed paths with Ray McDonald, a physician from his days at medical school. McDonald's career had paradoxically wound its way into the world of medical-related corporate management, and Knight thought he had the connections, the financial acumen, and the salesman-like personality to take ShoulderBand to the next level as Haven's CEO.

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Keywords: trust, leading from the middle, lead from the middle, middle management, building trust, building trust in a crisis, crisis management, medical devices, startup, scale-up, scale up, lifecycle, mergers and acquisitions, rounds of funding, private equity, budgeting, forecasting, organizational behavior, leadership, stakeholder management, communications, new manager, interpersonal relationships, calculative trust, relational trust, institutional trust, distrust, rebuilding trust, honesty in reporting, multiple reporting lines, change, middle manager