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How a medic used an EMBA to scale up her impact

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How a medic used an EMBA to scale up her impact

Joan LaRovere’s CV is complicated, spanning medic, non-profit co-founder, investor, start-up adviser and teacher.

Fundamentally, she is a doctor who specialises in paediatric cardiac intensive care. But LaRovere is not focused only on the transformative power of medicine — she is now using data and technology to get help to where it is needed most. That scaling up of impact was fuelled by a return to study, at business school.

LaRovere’s work has spanned continents. With dual American and British citizenship, she studied for her undergraduate degree at Harvard University, before taking a masters at the University of St Andrews in Scotland, then returning to the US for medical school.

A fellowship took her to Great Ormond Street Hospital for Children in London before moving across the capital to the Royal Brompton, where she eventually became the director of the paediatric intensive care unit, in 2008.

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“They really invested in me,” she says of the Brompton. Alongside her medical role, she enjoyed other opportunities including the Windsor Leadership programme for emerging leaders from a range of sectors and embarking on “a kind of mini MBA” at Imperial College London.

In 2002, while on maternity leave with her first child, LaRovere helped to co-found Virtue Foundation, a non-profit that delivers healthcare to underserved populations and uses data science to address global health challenges.

Joan LaRovere at work in northern Ghana with oculofacial surgeon Ebby Elahi of the Icahn School of Medicine at Mount Sinai, New York

LaRovere realised that to create change, build new opportunities and deliver what patients need, “you have to understand the finance structure, the go-to-market, the product, the build,” she says. “There’s all these other things that go into it besides the science and the medicine.”

Her awareness of the broader picture may have formed as she was growing up — “I’m a businessman’s daughter,” she notes — but it was germinated by her time at the Brompton and Virtue Foundation. So, when Boston Children’s Hospital, where she had started her career, asked her to re-join the team in 2011, she was ready with a deal: she wanted support — in funding and time — to study for an Executive MBA.

In 2014, she started the course at MIT Sloan School of Management, across the Charles River in Cambridge, Massachusetts. LaRovere applied to just one school. It was a good fit — from the healthcare, tech and entrepreneur elements to the university’s motto, mens et manus (mind and hand), and that of the school: “Ideas made to matter”.

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“It really is embedded [that] you should be looking at big ideas, things that are important for the world, things that add value to people,” she says. “And you also have to know how to build it.”

Joan LaRovere: ‘You can see how an EMBA would be something that helped bring all the right skills and partners and just so much [else together].’ © Brian Fitzgerald, for the FT

The other reason she chose MIT was data science and AI. She had seen “how healthcare was becoming a data business”. But she also had a project at Virtue Foundation that would lead her deep into the sector. More than a decade ago, Dr Ebby Elahi, an oculofacial surgeon and professor at the Icahn School of Medicine at Mount Sinai, New York, had an idea. It was only when doctors got on the ground at medical missions that they really understood the situation. That creates challenges and inefficiencies.

Elahi wanted Virtue Foundation to use data science and AI to get a more accurate picture of healthcare needs on the ground in low- and middle-income countries, so that volunteer surgeons and doctors could make better decisions about where to go to help the most people.

“And that started us on this whole journey of granular data and the use of machine learning to make the invisible visible,” explains LaRovere.

After much work, a product is set to launch in early 2025. It is an AI platform that shows the global health ecosystem — such as healthcare facilities and NGOs — in 72 low- and middle-income countries. Alongside that, the tool overlays other information such as population or road networks, including the ability to see a street-level view.

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“You can start to see things more clearly on the ground,” she says, for example locating “medical deserts” where there is a concentration of people without access to care.

The tool also uses AI as a “lens over the web”. Models collate data (such as information from social media, blogs or news articles), tagging it so users can build a picture of a situation, and keeping the data refreshed. “Oftentimes, that information is hidden in plain sight,” says LaRovere.

The platform will be free to use, and will initially be available to physicians and other healthcare practitioners to help them find where they can best use their skills. It will allow searching by speciality or volunteer opportunities.

“An incredible amount of work from so many people has gone into the building of this,” she says. “But you can see how an EMBA would be something that helped bring all the right skills and partners and just so much [else together].”

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Part of that was studying AI, big data and machine learning. But it was also the connections she made with classmates and professors. For example, she was able to use the MIT network to create partnerships with companies such as Databricks, DataRobot and Carto — which have all helped bring the platform to life.

A close-up view of a woman working on a laptop displaying a detailed geographical map, with two colleagues in the background seated at a conference table
Focus on health: the platform developed by LaRovere uses AI to reveal areas with poor access to healthcare © Brian Fitzgerald, for the FT

The EMBA has given LaRovere a “broad skillset”, adding knowledge about topics including entrepreneurship, healthcare finance and systems thinking. Indeed, the ability to impact someone’s life as a doctor is “unparalleled”, she says. “But what I think MIT has allowed me to do is both do that at the individual level, but also do it at scale.”

That ability to scale will continue with the foundation and her latest role as the associate chief medical officer for transformation at Boston Children’s Hospital. She is the clinical lead looking at a range of challenges such as the future workforce, embedding AI into workflows, and translating research into clinical products.

The role brings together all the strings to her bow, while keeping true to the original caring mission. “Healthcare is in so much transition, you need to be able to think in a different way — and I think MIT really gave me the skillset to be able to think in a different way,” she says. 

CV

2011-present Boston Children’s Hospital. Currently associate chief medical officer for transformation, and a senior staff physician in cardiac intensive care

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2023-present Board member, LifeMD

2021-present Healthcare operating partner, iSelect Fund

2016-present Various roles at the Martin Trust Center for MIT Entrepreneurship including professional adviser at the Delta V Summer Accelerator

2016-present Instructor, course director, visiting lecturer, and mentor on courses at MIT Sloan and the MIT Media Lab on healthcare, biotech, finance and AI

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2011-present Assistant professor of paediatrics at Harvard Medical School

2002-present Co-founder, president and board member, Virtue Foundation

2000-2011 Consulting physician, Bupa Cromwell Hospital

1999-2011 Various roles at Royal Brompton Hospital including chief of the paediatric intensive care unit

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1997-1999 Fellow of paediatric intensive care and cardiac intensive care, Great Ormond Street Hospital

1993-1996 Resident physician, Boston Children’s Hospital

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Are directors of founder-led companies being set up to fail?

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The story is familiar — the visionary founder builds a successful company from scratch but as the business matures, they obstruct effective oversight. Time and again, as another boardroom drama breaks out, independent directors wonder: can a founder-led company ever truly be governed?

The drive and boldness of these leaders is essential in the early stages of growing a business. But without proper checks and balances, an over-reliance on one individual can lead to more risk taking and poor decisions. Failure is often praised as a lesson for success but there can be huge costs. Recent turmoil at OpenAI, Tesla and WeWork highlights the complexities of balancing founder influence with the structures needed to safeguard a company’s future.

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“All founder CEOs need to think about evolving their company from founder-led to founder-inspired,” says Jason Baumgarten at headhunter Spencer Stuart. “By establishing a strong board of directors, having clear boundaries to their own roles and being aware of their outsized influence, founders have a better chance at ensuring their company can grow . . . beyond their leadership.”

Success depends on whether the founder wants this shift, rather than being forced into it by investors or regulators, he adds. Even then, they may retain control over key decisions and leadership appointments through voting rights that in effect mean they have not ceded much power at all.

Other founders may leave but still hold shares or meddle from the sidelines. Howard Schultz, who did not start Starbucks but led the aggressive expansion of the coffee chain, returned to the helm twice after stepping down and has had huge sway over the board. Peter Hargreaves, the co-founder of UK financial services firm Hargreaves Lansdown and its largest shareholder, has publicly criticised the former management for presiding over “a shambles” that hit the share price. Were their actions in the interest of the company, preserving their own legacy or about financial security?

The merits of being in “founder mode” rather than “manager mode” have gained traction online after an essay by tech investor Paul Graham. Many in this industry have celebrated founders who make quick-fire decisions and push through their vision with little room for dissent. These individuals may be inspiring and innovative but their style can make for workplaces that are toxic and often dysfunctional.

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Companies require independent boards that support and motivate founders but are willing to challenge decisions. At earlier stages this may just be a chair role and down the line a full suite of directors.

“Lots of founders are concerned the chair is going to come in and fire them,” says Rachel Ingram at Cadmium Partners, a board services firm that specialises in tech companies. “But finding a skilled chair who can support them and help scale a business can be a game-changer.” She says chairs that succeed “understand the mindset of an entrepreneur”. Those taking a more corporate view might “struggle”.

One director who sits on public and private company boards in the UK says he would think twice about joining a founder-led business, partly because egos often “limit the ability to listen to advice”.

Pippa Begg, co-chief executive of Board Intelligence, a technology and advisory firm, suggests directors do their due diligence properly and ensure their interests are aligned before joining a founder-led board. They should consider issues such as where voting rights lie and what powers directors have. For example, if a company wants to change a product line or regional focus, does it go to the board?

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Looking for clues as to how a founder has worked with the board in the past can help directors understand how their relationship might unfold. “One should be wary of a board with lots of non-executive director turnover,” says Begg. “It can be the sign of a problem in a founder-led business where the only control you have is to vote with your feet.”

She adds that staff reviews of the way a founder interacts with their team on sites such as Glassdoor can give a sense of how they will work with directors. “Do they appear curious, like to empower and delegate, or is it [a] more hierarchical ruling of the roost. The former will probably welcome input, the latter could be allergic to it”.

Spencer Stuart’s Baumgarten agrees potential directors must probe why the founder wants them. “One of the most famous founders in modern history said to us of his board, ‘I want people who are generous — someone who thinks about my company when they don’t have to, when they aren’t in a board meeting, I want their best thinking time and ideas.’” But he noted another founder had a more self-serving perspective — they wanted “mostly decent people who will not make [their] job more difficult”. “Understanding which you are potentially joining is incredibly helpful,” adds Baumgarten.

This will allow directors to decide whether it is worth entering the fray or prioritising self-preservation if they think they are being set up to fail.

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$10mn? $30mn? $100mn? The redefinition of the super-rich

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Three young men look at artworks mounted on a purple wallin a darkened room

Talk to 10 different wealth industry professionals about when you become super-rich (an ultra-high-net worth individual, or UHNW, in industry parlance) and you will get 10 different answers. For a law firm, it can mean having investable assets — spare cash not tied up in property — of $10mn; for a wealth manager, it can mean having at least $30mn; for an exclusive private members’ club, the hurdle can be as high as $100mn.

What they do agree on, however, is that the base figure is rising, and quickly. The monetary definition has shifted significantly, reflecting not just the growth in wealth globally, but also the changing expectations of what it takes to be considered part of this elite group.

David Gibson-Moore, president of consultancy Gulf Analytica, says the traditional $30mn level “allows for significant investments across multiple asset classes — stocks, bonds, real estate, private equity” — while also furnishing luxuries such as private-jet travel. But, over time, as the financial world has expanded and the accumulation of wealth has accelerated in certain sectors, particularly technology, “the bar for what it means to be ultra-wealthy has risen” he observes. “The $30mn threshold . . . doesn’t carry the same weight or exclusivity it once did. In today’s world, $30mn might secure you a luxurious lifestyle but, in the realms of the ultra-rich, it’s increasingly viewed as just the starting point,” Gibson-Moore adds.

“The ultra-rich today are being measured by new standards, with some financial commentators now suggesting $100mn is the new yardstick for anyone who wants to keep their head held high at private equity parties.”

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Charlie Wells, managing director of high-end property buying agency Prime Purchase, agrees: “The dial keeps ticking upwards when it comes to defining ‘UHNW’. Forty years ago, a millionaire with a Rolls-Royce may have been the epitome of wealth. But, thanks to inflation, the numbers are constantly growing. Only recently, someone worth £20mn-plus would have been considered very wealthy but now you need £50mn-plus to be truly UHNW.”

This shift is driven by several factors. First, says Gibson-Moore, is the explosion of new wealth in technology and entrepreneurship. “Over the past two decades, we’ve seen the rise of tech billionaires, cryptocurrency pioneers and venture capitalists who have amassed fortunes at an unprecedented pace,” he says. “The ability to build companies worth billions seemingly overnight has compressed the time it takes to reach UHNW status and these new wealth holders often operate in a different financial universe than the more traditional wealthy class.”

Dominic Volek, group head of private clients at Henley & Partners, which advises wealthy individuals on citizenships and residencies, says: “There has been a jump in wealth creation — and one only needs to look at the tech sector, where billionaires are now common. The diversification into asset classes like cryptocurrencies and NFTs [non-fungible tokens] has also created UHNW individuals almost instantaneously.”

If you take $30mn as the accepted definition for what it takes to be a UHNW, data from consulting group Capgemini shows the number jumped from 157,000 in 2016 to 220,000 last year.

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Three young men look at artworks mounted on a purple wallin a darkened room
Picture this: early price rises for digital asset classes such as NFT artworks has helped create super-rich individuals © Michael Tullberg/Getty Images

The scope of what super-rich individuals invest in has broadened, too. It is no longer just about having a diversified portfolio; today they might have stakes in disruptive tech start-ups, sustainable ventures or even space exploration. This new frontier of investment requires much larger sums of capital and comes with greater risks — but also offers the potential for exponential returns.

Inflation in luxury assets — such as property, fine art and collectibles — also means it takes far more to maintain a lifestyle traditionally associated with super-rich status. Volek says: “$30mn just doesn’t stretch as far as it did a decade ago.”

A painting by Jean-Michel Basquiat, for example, sold for $57.3mn at an auction in 2016 then again for $85mn six years later. Likewise, the price of entry into exclusive property markets such as Monaco, Mayfair or Aspen in Colorado has soared, with the average price of a house in London’s Grosvenor Square, for example, stretching to around £20mn. The costs of maintaining private aircraft, yachts and other luxury assets have similarly grown, making it far costlier to maintain the hallmarks of ultra-wealth. Experts suggest the annual running cost of a $10mn superyacht can now easily be as much as $1.5mn.

For the owners of R360, an invitation-only private members club, it is clear what the number should be to be considered ultra-rich and eligible for membership: $100mn. Barbara Goodstein, managing partner and chair of the New York chapter of R360, which offers members exclusive investment opportunities, confidential support groups and private getaways, says: “We focus on serving centimillionaires.”

She says, at that level, they get people who are “less focused on short-term investment opportunities and more interested in becoming stewards of wealth”. Goodstein notes that the $100mn threshold has been the criteria for membership at R360 since inception in 2021. “While we don’t anticipate an increase in the near future, we recognise that the average wealth of our members has steadily increased over the past few years and is now more than $400mn.”

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The age of members ranges from 28 to 84 but Goodstein adds that R360 is seeing a notable rise in younger members, “with many recently successful entrepreneurs joining in their late twenties and early thirties”.

The question that follows — irrespective of the definition — is why it is so important to the very wealthy to be classified as such. What extra doors does it open?

UHNW individuals receive significantly different treatment because of the scale and complexity of their wealth, Volek adds. “Not only do they have access to better investment opportunities and more diversified portfolios, but they also have dedicated relationship managers who look after them and are available 24/7.”

They often get access to pre-initial public offering deals, private placements and other high-return opportunities that the “broader market doesn’t even know exist”, says Gibson-Moore. For example, Stripe, a fintech payment company, has conducted several rounds of private financing, most notably raising $600mn in 2021 at a valuation of $95bn. This funding round was only available to a select group of institutional investors and the super-rich.

Lifestyle perks can vary. One of the most lavish examples seen by Samuel Wu, chief investment officer of Hong-Kong-based Tridel Capital and co-founder of Chartwell Family Partners, was a European trip given to a super-rich family by a bank in return for their custom.

“More commonly, perks include invitations to concerts, meetings with celebrities [and] successful figures as well as economic leaders,’’ says Wu. ‘‘This is a form of marketing, and these costs are often reflected in the prices being charged. One particular Swiss bank is humorously known to run its entertainment programme better than its banking.” Wu says.

On the flipside, Volek at Henley & Partners says that he also knows of banks “off-boarding” private banking clients with less than $5mn in assets because they were deemed not profitable enough to have as customers. He says it shows that size now really matters in the world of the ultra-rich and that, while the definition might still be up for debate, the level at which you can be classified as UHNW is only going one way: up.

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This article is part of FT Wealth, a section providing in-depth coverage of philanthropy, entrepreneurs, family offices, as well as alternative and impact investment

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A bit of Disraeli’s organised hypocrisy is PM’s best bet

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Robert Shrimsley’s ingenious notion of Labour’s three brains (Opinion, October 11) penetrates the paradox in each of our two major parties.

David Hare’s Labour party plays (including Absence of War) suggest the problem for Sir Keir Starmer’s party is that its main thread is social justice but every minister and member has a different view of what that should be and how to get to it. So the thread unravels.

As for the Conservatives, the British sociologist Geoff Whitty, among others, maintained that the Conservative contradiction was between belief in free markets and authoritarian central control. We have been watching this play out in the contest for leader (not to be confused with a leadership contest — one is a title the other is a quality). All of which suggests that the current prime minister’s best bet, if Labour cannot provide earnest pragmatism, is to run an organised hypocrisy; that was Disraeli’s definition of Conservative government.

Simon Crosby
Aysgarth, North Yorkshire, UK

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EGYPTAIR to offer online payments through Amazon and Banque Misr

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EGYPTAIR to offer online payments through Amazon and Banque Misr

Egypt’s national airline, EGYPTAIR, Amazon Payment Services, and Banque Misr, have established a strategic partnership to combine EGYPTAIR’s travel product with Amazon Payment Services’ range of online payment processing services, with the support of Banque Misr, to improve the online payment experience for travellers worldwide

Continue reading EGYPTAIR to offer online payments through Amazon and Banque Misr at Business Traveller.

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Zonal power pricing plan sparks industry ire

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Some of the largest trade groups in the UK have warned the government that its plans to reform electricity prices by introducing zonal or regional pricing would be burdensome to key industries rather than reducing financial pressures as intended (“UK power market reforms pose danger to industry and investment, ministers told”, Report, October 7).

The decision to back zonal pricing is based on evidence showing that such
a policy would reduce costs. The UK’s energy and gas regulator, Ofgem, found that regional pricing could benefit consumers, including industry,
by saving £28bn to £51bn across the period from 2025 to 2040. Octopus Energy has also found that businesses would enjoy a significant reduction in wholesale energy costs, and that consumers would see their bills go down.

But there is still a basic problem at the heart of zonal pricing: many energy-intensive industries have vast factories and infrastructure that cannot simply be relocated. These industries may find themselves in more expensive zones and have to shoulder the burden of high electricity costs through no fault of their own, while other businesses will be able to situate themselves in more favourably priced regions.

This is a critical time for Britain’s energy ecosystem. The UK needs to have a national conversation about its electricity supply, the grid, the nation’s industrial competitiveness and climate change — and in particular about how it can build out the grid quickly and strategically, and reform wholesale power markets.

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Mann Virdee
Senior Research Fellow in Science, Technology and Economics, Council on Geostrategy, London SW1, UK

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Why China may object to N Korea’s Ukraine gambit

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Banker all-nighters create productivity paradox

It is in the interest of both the US and China to prevent North Korean troops supporting the Russian invasion of Ukraine (FT View, October 8).

With China trying to increase its trading and investments with Europe, this “game changer” would damage EU relations while the US would be forced, with Europe, to increase resources to meet the new threat. This issue is common ground for Beijing-Washington-Brussels to prevent North Korea from expanding the war.

Ed Houlihan
Ridgewood, NJ, US

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