Today is International Women’s Day (see: http://www.internationalwomensday.com/). Fittingly, with this blog entry, I wrap up (unofficial) Women’s Week here in the Midwest Entrepreneurs class at Monmouth College; the first week of the semester wherein all of our guest speakers have been female entrepreneurs.

Yesterday’s guest was—my cousin—Kathy Gabel, who heads two healthcare service firms in southeast Iowa; Iowa Based Home Services (http://www.iowahomebasedservices.com/) and Advanced Home Health Care (http://advanced-homehealthcare.com/index.html).

Iowa Home Based Services began operations in 2009 with the goal of helping intellectually and developmentally challenged persons, as well as those living with mental illness, live independent and fulfilling lives. Services are provided both in-home and at various locations in the community. Kathy Gabel started the company with one customer and one employee. Today, the company serves approximately 85 customers at any time and has 110 employees (with a payroll of about $2.4 million).

The mission of Advanced Home Health Care is to “enhance the health of our communities by serving as a leader in providing compassionate, comprehensive and cost-effective home health care to individuals of all ages.” It is a home health care firm providing a wide range of in-home nursing services (e.g., skilled care evaluations, pre and post-operative care, diabetic care, patient and care giver education, home tele-monitoring services, medication management and administration, and pain management). It also provides a wide range of rehabilitative, respite, and support services; all customized to the individual needs of clients. The company began operations in 1997. Kathy Gabel acquired it from the original owner in April of 2012 and has nearly doubled the number of clients served since that time.

Kathy’s presentation to the class yesterday was our first journey into the massive, intertwined, complex, heavily regulated, and dynamic world of healthcare and healthcare service provision. The nature of the healthcare landscape and the evolving array of healthcare service options is, in a word, mind-numbing. I can attest to this as someone who has, in the last year or so, tried—with near incessant frustration—to navigate through this landscape in an effort to see that my elderly and ill parents receive proper care (and are not bankrupted in the process of receiving it).

All of this complexity and dynamism made our class presentation yesterday the most difficult to meaningfully understand. It also renders this blog entry the most difficult one of the semester to write; despite knowing the guest speaker well and having experience with one of her two companies.

So, if I had to choose one thing for Midwest Entrepreneurs students to take away from the presentation it would the issue of Where Opportunity Lies and How Best to Take Advantage of It (and the fact that it often lies hidden, waiting to be taken advantage of by courageous entrepreneurs who see opportunity where and when others do not).

Kathy Gabel has found opportunity in several places and in several ways of doing business. First and foremost, as featured in the title to this blog entry, opportunity (a) is to be found in the problems of others, and (b) is to be best taken advantage of by creatively solving those problems better than anyone else. In other words: Be the Answer to the Problem.

As I emphasize in virtually all of my classes, the notion of business success being predicated significantly on one’s ability to be a trusted solver of client problems is true in some way for virtually all businesses. It holds especially true, however, in the healthcare field where those in need of care—and their families—often face a myriad of serious, complex problems. During class yesterday, I asked Kathy how many of her customers would essentially be “completely lost” with regard to their healthcare and payment options without the assistance of her companies. Her answer was “Probably 99%.” In today’s healthcare landscape, problems—let alone the full range of possible answers to them—are fully understood by very few people. The key point of competitive differentiation and advantage for both Iowa Based Home Services and Advanced Home Health Care lies in the fact that Kathy and her dedicated employees strive to understand the unique situations of their clients and to then provide them with the best possible solutions—in terms of type of care and how to pay for it—to their current and possible future problems. The first step here, according to Kathy, is to always listen closely to the client; then know their situation, then present possible solutions, then help them solve their problem. This is how lasting relationships with clients and their families are built. It is also how to generate all-important positive word-of-mouth communication about a service company. Toward this end, Kathy employs a Benefits Coordinator and actually does Medicare, Medicaid, and other paperwork for clients and prospective clients (often at no charge).

Another source of opportunity recognized and exploited by Kathy Gabel involves opportunity hidden within the heavily regulated nature of the healthcare sector. Here, the entrepreneur sees opportunity where others see, in essence, a heavily regulated—and ever-changing—mess. She knows there is great demand for her services yet she knows that healthcare regulations are tedious and burdensome for both service providers and, as suggested above, customers. She sees opportunity, however, in understanding the heavily regulated mess that many today perceive our healthcare system to be. As demonstrated, in heavily regulated and complex fields where there is great consumer demand, there are vast opportunities to be realized by investing the substantial time and effort needed to thoroughly understand the law and its implications for both service providers and customers. I would venture to say that in the healthcare arena today, the ability of the entrepreneur to exist as the go-to source of problem solutions for customers is predicated nearly equally on (a) listening to customers, and (b) knowing and staying current on relevant healthcare law. Neither task is easy but both are absolutely necessary.

Kathy Gabel has also seen and capitalized upon opportunity in an economically depressed area in tough economic times. As a result of originally being from Keokuk, Iowa, one of the two towns southeastern Iowa towns in which Kathy’s companies are based, I can attest to the fact that the area has seen far better times economically. Such a scenario—an economically depressed area in the midst of a persistent regional and national economic downturn—is hardly the ideal scenario for entrepreneurs looking to start and grow businesses. Yet Kathy has done just that; with not one but two companies. She sees opportunity in a community that many would be scared to venture into (and many have fled). Part of the answer lies, no doubt in her love of the community and its people and being driven to help better the lives of area residents. Part of the answer may also lie in her filling of what might be best called a “service void” created by the perceptions of others. I have seen this here and in other small towns manifest in only one or no market entrants in certain service sectors where there is obvious unmet demand. Many potential entrants apparently do not see enough profit potential to merit their investment of time and money. Smart entrepreneurs know that “enough market demand” is not the same for all and that the absence or departure of market entrants means more opportunity for them.

Finally, Kathy Gabel’s ongoing entrepreneurial venture epitomizes the fact that opportunity often lies in wait as one persists and perseveres through less-than-ideal circumstances in pursuit of true passion. As she told the class yesterday, Kathy’s true passion is for nursing and helping people in her community live better lives. This passion led her to earn a nursing degree from Southeastern Community College—in Keokuk, IA—and then to work in a variety of nursing-related jobs for nearly 20 years. These jobs included being a school nurse and, most notably, a nursing home executive administrator. While working these jobs, her entrepreneurial spirit was always lurking; running an antiques business with her husband and looking for an opportunity to herself direct a nursing-related firm. Her opportunity to pursue her passion as an entrepreneur presented itself when she became dissatisfied with the circumstances of position as a nursing home administrator. This dissatisfaction, coupled with both her growing knowledge of healthcare-related law and frequent first-hand exposure to the fact that most nursing home residents would rather be at home with their families, drove Kathy to finally become an entrepreneur in the home health care field.

For the entrepreneur, opportunity is to be found in many forms and in many places and at many times; many of which will not be seen or taken advantage of by others. As exemplified by Kathy Gabel, it is of critical importance to the entrepreneur to know which opportunities are right for you and when to pursue them. Further, in her case, taking full advantage of opportunity ultimately comes down to Being the Answer to the Problem; the serious and otherwise incomprehensible problems faced by many of those in need of healthcare services in the southeast Iowa area.

Thank you Kathy for sharing your fascinating entrepreneurial story with the Midwest Entrepreneurs class yesterday!

No class nor blog posts next week due to Spring Break at Monmouth College. Enjoy the time off but take care not to enjoy it too much.

Regards,

Prof. Gabel