Author: Kathy Marshack

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Women entrepreneurs: Are they different from men?


By Kathy J. Marshack, Ph.D., P.S.

All entrepreneurs face barriers to achievement; in fact, this is probably a major defining characteristic of entrepreneurs. Entrepreneurs by their very nature thrive on a challenging, even inhospitable environment. Still the challenges faced by entrepreneurial women are different from those faced by men, and further shape their destinies.

For example, a male entrepreneur often has not only the emotional support of his wife but her unpaid help in the business as well. A female entrepreneur on the other hand, does not have the benefit of her husband’s unpaid help.

Typically, the husband is emotionally supportive, but it is up to the wife to manage her business as well as her child-care and household duties, while he works outside the business. Debbie Fields of “Mrs. Field’s Cookies” fame had such a marriage. Although her husband was remarkably supportive of his wife’s enterprise for many years, he acknowledged that he would withdraw his support if she failed to meet her obligations as a wife and mother.

In spite of this barrier, women entrepreneurs are starting businesses at ever-increasing rates — and are succeeding, too. But they are using unconventional methods of business management.

For example, women entrepreneurs rarely have formal operational policies, formal planning processes, or formal job descriptions. These relaxed standards may be a result of their lack of formal business management education; however, they are not interfering with their success. Women entrepreneurs are obviously making an impact on the American economy.

The relaxed style of management can also be seen in how women entrepreneurs treat their employees, suppliers, and customers. They seem to prefer a more people-oriented style.

According to a 1993 study of entrepreneurial women in Oregon, women entrepreneurs blend their personal and their business identities. They base their management of the business on relationships rather than on the development of business plans. Employees are considered friends. Family and spouse supports are elements without which the woman would not consider an entrepreneurial venture.

Rather than network within the traditional business organizations, entrepreneurial women rely on strong personal relationships with their customers and vendors. These findings led behavioralists to describe the business orientation of entrepreneurial women as a “web of interconnected relationships.” This web philosophy shows up in the problems common to women entrepreneurs, such as how to deal with the differences between themselves and their husbands, and to how to balance home life and work life.

For example, Sarah came up to me after a presentation I had made on entrepreneurial couples, and she complained that her marriage and business had been suffering since her husband, Buck, quit his job and came to work for her. Sarah started her business in her home as a way to supplement the family income. She made gourmet popcorn. As demand for her popcorn increased, she branched out and started selling other gourmet treats (gift baskets of nuts, popcorn, and chocolates, cookie bouquets, and so on).

Soon the business required her efforts full-time. She hired staff and rented a professional kitchen, warehouse, and office space.

Although Sarah did not ask her husband to join her, he quit his job in order to do so. She gladly accepted his offer at first, but all too soon the trouble started. Buck continued to think of Sarah’s business as a part-time endeavor. He worked short hours, leaving most afternoons to go fishing with his friends. In spite of his lack of commitment, he would make major decisions for the business without consulting Sarah.

It was clear that Buck had been unhappy in his career in agricultural sales and saw Sarah’s business as a way out. He wasn’t really committed to the business, although he supported his wife emotionally. Instead, he saw the business as a way to support his own early semi-retirement. When Sarah realized that Buck was not really an entrepreneur, she needed to make a decision about how to take the business back and still save her marriage.

Sarah represents only one style of entrepreneurship for women and only one way that women entrepreneurs are affecting the ones they love. As women gain in confidence, as they encounter career barriers such as the glass ceiling in corporate life, and as their husbands adopt a more egalitarian attitude and approach in marriage, we are seeing more and more women embarking on entrepreneurial careers either as solo entrepreneurs, as dual entrepreneurs, or as copreneurs.

Regardless of entrepreneurial style, these women are reporting that they are highly satisfied with their lives and wouldn’t arrange them any other way. In other words, working from a web of interconnected relationships, entrepreneurial women want personal achievement just as entrepreneurial men do.

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Five must-answer questions for passing on the family-owned business


By Kathy J. Marshack, Ph.D., P.S.

Our world is a bundle of contradictions. The other day I read that the American Heart Association will not allow its healthy heart logo to be placed on Post Grapenuts cereal because the company is owned by Phillip Morris, a tobacco company. Grapenuts cereal has relatively no sugar and no fat. On the other hand, the healthy heart logo is on Kellogg’s Fruit Loops cereal, which is 50% sugar, because Kellogg’s pays the American Heart Association for the privilege. With these kinds of mixed values going on, it’s very important that you recognize the only one who can take care of you is you. Not even a private non-profit organization can be relied upon to guide your eating habits. While it may be easier in the moment to focus on only those pleasant uncomplicated things in life (such as the taste of Fruit Loops) in the long run ignoring the contradictions may prove quite hazardous.

People are often surprised to find out that I can have negative, suspicious, even paranoid thoughts, and that I waste my time researching things like the contractions of the American Heart Association. After all, I am a psychologist and professionally I encourage entrepreneurs and their families to find healthy constructive solutions to the problems that life dishes out. So if I am professionally supposed to look on the bright side, why then do I point out everything that is or could go wrong?

The simple answer is balance. We live in a world of duality … positive/negative, good/bad, male/female … and balance is the act of giving each side attention and respect. Having a positive outlook on life is just fine, but looking only on the bright side is like the proverbial ostrich with his or her head stuck in the sand. You also need to look at what is going wrong, or not working, or not even in the ballpark of reality. If you fail to account for the negative side of things, you fail to plan and live your life fully. How can you correct your mistakes, if you never sort through your flaws and problems? To sum it up, my motto is : HOPE FOR THE BEST, but PLAN FOR THE WORST. That way you’ve got everything covered.

For entrepreneurial couples and families in business, there are two unpleasant areas which are regularly ignored and therefore never planned for … death and divorce. Some of the juiciest scandals come from family firms that failed to plan for the succession of the business after death or divorce. Because the founder never thought he or she would die, they never developed a plan for whom to pass the business on to. Even if they had a successor in mind, they may never have told this person, let alone trained them. Furthermore, the founder usually has no plans for employees, customers, vendors or even their files or inventory. If you ask these founders what they would like upon their deaths, they often have very specific wishes, but they have no plan to carry them out.

Still there are more entrepreneurs planning for business succession than planning for divorce. Planning for the possibility of divorce of an entrepreneurial couple is a real taboo, apparently. Most couples fear that if you plan ahead for the possibility of divorce, you are setting yourself up to create a divorce.

Matt and Kristen were a happily married young couple when they started their modem manufacturing business in their garage. They had a toddler and one school age child at the time. Kristen’s Dad loaned them the startup capital. Both Matt and Kristen had the technical expertise for the business, since they each had a degree in engineering and had originally met while working at a high-tech company in the Silicon Forest. It all seemed perfect and it was for awhile. But business started booming and employees were required. Then the garage got too small and a warehouse was rented. Then a third baby came along and Kristen was fatigued trying to cover the home front as well as the business. Soon she opted for staying at home and Matt ran the business.

Even this set up worked for awhile because Matt was a capable business manager and had hired excellent help. He did not have to work excessive hours because he and Kristen had designed an excellent product that practically sold itself, especially with their combined contacts in the industry. So Matt was able to be available to his family almost as much as when he had worked a 9 to 5 job. The problems emerged, however, when Kristen became resentful that she was no longer at the helm of the thriving business. After all, she had prepared herself through education and training for a career that she thrived on before the marriage and children. Although she loved her children and Matt, she felt a great loss at not being able to use her education and intellectual talents too.

Eventually Kristen’s resentments grew to the level that she and Matt couldn’t talk anymore without a fight. Matt started working longer hours at the office. The children were stressed and scared because Mommy and Daddy weren’t happy. When the baby came down with a serious illness requiring hours of Kristen’s time and emotional energy, she brought up the topic of divorce. As clear as their thinking had been about how to develop the business, how to use their combined talents and resources to secure a financially successful future, Matt and Kristen had never considered divorce and therefore had no plan for parting … as marriage partners nor as business partners.

But let’s back up and take a look at what might have happened had Matt and Kristen built into their life/business plan the possibility of divorce, right from the start.

If they planned for an amicable divorce or dissolution of the partnership, they not only would have a legal document to follow (such as a prenuptial or partnership agreement), but they also would have had to look at what could go wrong and make contingency plans so the worst may not happen. In other words, in planning for the worst, they would look at these things among many others:

  • What if the business grew so big it moved out of the garage?
  • What if there was more to handle at home requiring one or the other partner to quit working the business and focus more on home management?
  • What are the desires of each partner with regard to career and business?
  • What are the desires of each partner with regard to the children and family development?
  • What are the desires of each partner for their marriage?

Paradoxically, by planning for the possibility of divorce right from the start of a marriage and business venture, the entrepreneurial couple has to focus on those things that actually will help strengthen their marriage/partnership. By digging deeply into who you are, and what you want, you have the opportunity to negotiate with each other to make your desires come true. Instead of resentments building, the trouble spots are planned for. Therefore the entrepreneurial couple has a better chance of facing the problems head on, learning from them, or even avoiding them. Planning for the worst in this case isn’t a prescription for divorce, but insurance against it.

Remember the question isn’t “What do I do with my business or marriage/family if I die?” The question is “What do I do with my business or marriage/family when I die?” And the question isn’t “What do I do with my business and marriage/family when we divorce?” The question is “What do I do with my business and marriage/family if we divorce?” Death is inevitable and those who don’t face this one are avoiding their responsibilities to others and courting a miserable demise for themselves. Divorce on the other hand is not inevitable, but avoiding thinking and talking about the possibility is just as foolish as ignoring the inevitability of death. If you want to get started planning for the worst but hoping for the best with regard to creating a healthy, long-term, successful marriage/business partnership with your spouse, try asking yourselves this question:

If one or the other of us wants a divorce in the future, why would that be and what can we do now to prevent this.

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Family Business / Risky Business


By Kathy J. Marshack, Ph.D., P.S.

Todd looked at me bewildered, as if to ask, “Can’t you make her see reason?” The tension in my office had been mounting between the couple as they discussed the likelihood of divorce. They had been at odds for years and everyone including friends, family, employees and business associates knew it. This couple never kept their disagreements secret. In fact, they openly fought in front of employees, just like Mom and Dad in front of the kids.

When the discussion got even more heated, I stepped in and tried to offer help to the husband who seemed so confused about his wife’s request for a divorce. “It’s simply that your wife doesn’t want to be your business partner any longer if she files for divorce.” “She doesn’t trust you anymore,” I said, “as a husband or a business partner.” This couple had built a successful business over many years of hard work. But as the business had grown successful, the marriage had foundered. Now the wife wanted out … out of the marriage and out of business.

Todd again looked at me as if I were speaking in riddles. “What’s trust got to do with it? I know that she wants a divorce. I am OK with that. But can’t she learn to be civil and still be my business partner? We stand to lose a lot of money if we have to split up the partnership.”

Unfortunately this scenario is all too common among couples and families who work together. The focus is so much on the business, so much on business success, so much on financial profit, that the family fails to keep tabs on the loving relationships that made the business partnership possible in the first place. As they ignore the signals that their personal life is sinking into oblivion, these couples and families seem to put even more energy into the business. It’s as if they are trying to save the sinking ship by putting on a new coat of paint.

Entrepreneurial families and couples are starting businesses at a phenomenal rate right now. There are powerful incentives to do so.

Not only are there terrific financial and ego rewards from self employment, but couples find that there is great joy in working with the ones you love. Where else can you find a more trustworthy, reliable, confidential business partner than your spouse or close family member? Todd and his wife started out this way. They had a dream and worked hard to make it a reality. They wanted to provide a quality of life for their children that would enable them to achieve even more than their parents had. They wanted freedom to create something out of nothing. They wanted to go beyond the limits employers always placed on them. They wanted to help each other grow as individuals and in their business/professional lives. At first Todd and his wife Laura were ecstatic with their new lives. They looked forward to each new day. They worked long hard hours but they were doing it together. This “togetherness” was inspiring. Somehow, their combined effort was synergistic and they created even more than they dreamed they could alone. Then something happened. It didn’t happen with a bang, but snuck up on them. Inch by insidious inch, Todd and Laura lost track of themselves as individuals and as a married couple. Instead they were business partners only. The business consumed them. Vendors, customers, employees, business associates, the CPA, their attorneys … all came before Todd and Laura and their love and friendship.

When Todd and Laura came to my office it appeared that all was lost for the marriage. The business was thriving and would carry on under the capable leadership of either one of them. There would be some financial loss, a few employees would quit, perhaps a contract would be lost, but ultimately, Todd and Laura had created a business that produced a quality service and customers were pleased and faithful. Even a divorce would not really threaten the business. Financial problems were not their worry. Rather, it was the value placed upon each of them as individuals and the value placed on their relationship that was suffering. This kind of problem erupts when entrepreneurs focus all of their attention on the competitive world of business and away from the nurturing world of family life and marriage.

When Laura asked Todd for a divorce, she made a bid for freedom from the tyranny of a one-track life. Better to get a divorce than go on living for nothing more than financial profit. Laura felt dead inside, something money could not heal, but love could. If Todd could no longer love her because the business had become his obsession, then she would seek love elsewhere. Laura was willing to admit that she had made the business her obsession too. It was not all Todd’s fault. She ignored the early warning signs just as he did. She too was thrilled with the status of achievement that came with self employment success. She even felt guilty for not doing something sooner so that she wouldn’t have to cause Todd such pain by asking for a divorce. “If only she had put her foot down sooner,” she thought.

The problem that Todd and Laura created for themselves is brought on by two major errors. The first error is building your life around the business. Remember the business is there to serve you, not the other way around. The business is a result of your creative energy, your vision. It reflects your personality, but it is not the master. Todd and Laura’s business was a success because it reflected the synergy of their collective talents and energies. Without them the business would have never been.

The second error is failing to confront problems head on when they first appear. Todd and Laura knew that they were spending too much time on the business. They justified it in those start up years as a necessity to get the business going. They justified it as years went by to stay ahead of the competition. They continued to justify it in later years because work is all they knew. But as the business grew under their careful and committed hands, their relationship was left untended and shriveling into a shadow of what it had been when they started the business.

Is it so hard to turn off your pager or cell phone and take a walk with your sweetheart? Couldn’t you squeeze in a little time to read a novel if you put down the trade journal? How about joining an adult soccer league instead of attending more business after-hours meetings? In other words, attend to your life, your whole life, just as carefully and mindfully as you do your business. If you have it in your power to create a successful thriving financial enterprise, can’t you put similar energy toward your emotional- spiritual-relationship enterprises?

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Dual – ing Entrepreneurs

By Kathy J. Marshack, Ph.D., P.S.

When I returned to the office a few months ago I found a phone message from Dick Wilsdon indicating he wanted to talk with me about a recent column I had written. He was especially interested in the topic of competition among spouses who work together. Being somewhat of an expert on this topic, having researched the area for years, consulted with many entrepreneurial couples, and written not only countless Vancouver Business Journal articles, but recently published a book on the subject, I felt confident that I could answer Dick’s questions and give him a few pointers to boot! But with his first question I was stumped. “I was just wondering,” he said, “if you knew anything about couples who operate competing businesses?”

Dick and Linda Wilsdon are such a couple, believe it or not. Dick owns Western Nugget Transportation and Linda owns All Americas. Both are transportation brokers and quite successful at it. Each has had the honor of being among the INC. 500, an annual award given by INC. Magazine to American companies who have distinguished themselves. The following is a run down on just how Linda and Dick do it.

There is an interesting story behind how this couple found themselves in competition. Certainly they didn’t plan this outcome. It was a natural progression of events. Entrepreneurs are like that. The successful ones allow nature to take it’s course and capitalize on it. Dick has always been an entrepreneur. He has owned several businesses, so it was a natural to move from being a trucker to being a transportation broker.

Linda on the other hand never thought of herself as an entrepreneur. Like so many women, entrepreneurship came as a result of helping out the family. In order to bring their son into the business, Linda started All Americas as a way to prepare their son for taking over Dick’s business someday. Mom and son were to work the business together. As it turned out, the son wasn’t interested after all, so Linda was left with the decision of letting the business go, joining forces with Dick and Western Nugget, or continuing on her own. With her husband’s encouragement and blessing, she took on the task of running All Americas on her own.

Although Linda had no business experience before starting All Americas, she took on the challenge and soon gave Dick a run for his money. While Dick was nominated to the prestigious INC. 500 in 1987, Linda was nominated just six years later because her business was booming. Linda talks about how scared she was to take over All Americas when her son left, but Dick had every confidence. He mentored her during those early years, but acknowledges that she has abilities that he lacks. He says, “This woman is the most fantastic people motivator I know. Watching her motivate people is like a symphony!”

Herein lies the key to the Wilsdon’s success as a competing dual-entrepreneurial couple. They have tremendous love and respect for each other. They consider each other best friends. Although they may disagree heartily about things, they make a point to work the arguments out. And they don’t take things personally. When I asked Dick and Linda what advice they would give to other competing dual-entrepreneurial couples, they offered these three nuggets:

  • “Talk a lot.”
  • “Be willing to give.”
  • “Think of your spouse as a 60% partner … 10% better than an equal partner.”

Over the years the Wilsdons have demonstrated in their behavior that they really believe in this advice. They are early risers and in the morning over coffee the two of them discuss the business, their lives, the kids, etc. Because they enjoy each other’s company they do spend a lot of time together, so talking comes easily. They grocery shop and run errands together too, rather than allow efficiency to divide them up. And they love to travel, so they incorporate lots of play time together. Talking a lot doesn’t just mean discussing business. It’s a time to reconnect with your spouse/partner … to let each other know that you love and respect the other person.

Being willing to give takes on another meaning for the Wilsdon’s too. Because Dick had already proven himself in business before Linda started her enterprise, he was in a position to mentor her.

He wasn’t really giving up anything by encouraging her to develop a competing business. His business is strong and profitable. Rather he views it as helping his wife be the best she can be. Dick loves having a strong, assertive, capable wife who keeps him on his toes. He admires her strengths and feels that he benefits from them too. After all if Western Nugget loses a bid to All Americas, he still reaps the financial rewards. And the friendly competition spurs his staff on to improve their performance.

The Wilsdon’s do have some rules about competing however. They never go after each other’s existing business. They only compete for new work. Everything is out in the open … no secrets between them. Although they may enjoy rubbing it in once in awhile when one company has the edge over the other, they really enjoy helping each other win. In other words, I don’t really think they are in competition at all. Rather each has the goal of being the best they can be and encouraging that in their spouse.

The proof of all of this is right there at their company offices. Western Nugget and All Americas are side by side in a Hazel Dell office complex. Each business has it’s own legal identity and separate staff, but employees do cross over sometimes. Once the Wilsdon’s daughter worked for Dad and now she works for Mom. Interestingly Dick has a woman office manager and woman bookkeeper, while Linda has a man office manager and a man bookkeeper. They laugh and tell me that this is just a coincidence, but I wonder if it is just another way the Wilsdon’s keep things balanced.

The Wilsdon’s may be a unique couple in that they operate competing businesses, however, all entrepreneurial couples can benefit by the principles that they live by. It takes a lot of maturity to put your egos aside and encourage your partner’s talents, especially when they might show you up. It takes courage to accept criticisms from your spouse/partner and really hear these criticisms as helpful feedback from one who knows you well. It takes patience to listen and work through problems. Communicating regularly with your spouse/partner is often the last thing busy entrepreneurial couples do, but it is essential to a healthy business and a loving marriage.


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Why can’t we Communicate now that we live and work together?


By Kathy J. Marshack, Ph.D., P.S.

“She’s so busy I hardly see her at the office anyway.”

“I just let him handle things his way.”

“We’re not very good at resolving problems, so I let it go.”

“I just hate confrontation!”

Listening, talking, communicating, resolving problems, making joint decisions… these are requirements for all business owners, not just entrepreneurial couples. Yet entrepreneurial couples often complain that communicating effectively with each other is the last thing they do. Without good communication skills and quality time dedicated to communicating, relationships (business and personal) soon flounder and fail, especially among couples with the stress of two careers, or a joint enterprise, and a full family life. Moreover, the potential for a breakdown in communication grows as the complexity of the family/business system increases.

Probably the number one reason entrepreneurial couples don’t talk is that they let the business run their lives. In my research and consultation work I have found that these couples are more willing to take time from home for work activities than they are willing to take time from work for home activities. In general these couples are rarely willing to leave for work late; very occasionally they may be late not more than fifteen minutes. However, they are willing to be late getting home one to four times a week by more than an hour each time. As well, these couples are willing to leave home for work more than thirty minutes early one to two times per week. On the other hand, they are willing to leave work early for home only once a month. As long as these tendencies prevail, entrepreneurial couples are giving themselves very little quality time to devote to confront and solve the inevitable conflicts that will arise in their personal relationship.

Work is a major source of satisfaction for adults. There are immediate payoffs with work, unlike with relationships. Likewise, there are problems and crises at work that draw our attention away from relationship responsibilities. Most career-minded Americans admit that their families are more important to them than their work, but that they derive more personal satisfaction from work (i.e., their creative side). This obviously poses a serious dilemma, and one that most entrepreneurial couples ignore, because everyone else does.

The second major reason entrepreneurial couples don’t talk is that they are avoiding conflict and confrontation. There is a common misconception that conflict and confrontation are bad. One of the major reasons entrepreneurial couples have problems is their failure to confront issues head-on. They may fight openly or quietly seethe, but they have a terrible time confronting the real conflict respectfully and honestly. It’s as if confrontation and conflict are impolite. However, conflict and confrontation are natural and healthy components of any relationship. You are neither bad nor wrong for causing a conflict or identifying one. Conflict is an opportunity to open up communication on a difficult subject.

You are neither bad nor wrong for causing a conflict or identifying one. Conflict is an opportunity to open up communication on a difficult subject.

As a member of an entrepreneurial couple you are under more stress and potential conflict than others. The worlds of your personal life and work life overlap considerably, creating more intersecting points. This creates a highly complex system of constantly changing roles and rules. Because you cannot really separate home and work, you must learn how to integrate these two worlds better. The tools you used for communicating and resolving conflicts before you worked together may just not be good enough anymore. As an entrepreneurial couple you and your spouse face dilemmas that may have never surfaced before to give you worry. This means you need to enhance your communication and problem solving skills beyond simple linear cause and effect (i.e. blame).

The first place to start is to actually make time to communicate with your partner/spouse. Make time for personal, marital, family and work communication. Give each equal time or at least what they need. Don’t leave this to when you have the time. Make it part of your daily and weekly routine. Informing and clarifying with each other on a daily basis is vital in our crazy, fast-paced lives. Memos and e-mails are OK, but a good face-to-face conversation does more than convey the facts; it keeps the good feelings alive.

Second, practice good communication skills. It wouldn’t hurt to take a class, or read a book on communication. I offer some communication advice in Chapter 3 of my book, ENTREPRENEURIAL COUPLES: Making It Work at Work and at Home. You really may not have to look far for those communication skills, though. You probably already use them in your work, with employees, colleagues, business associates. It’s just that you never thought to use those same successful methods with your spouse. Certainly you realize that communications go more smoothly and solutions are arrived at more readily, when you listen respectfully, establish rapport, and move toward win-win solutions. Why not try this same approach with your business partner/spouse?

Third, do not fear conflict and confrontation. Because of the highly complex and interactive, multi-level system you have created as an entrepreneurial couple and family, conflicts are inevitable and actually a sign of growth. Therefore, avoiding conflict is not the goal. Rather you want to develop the tools to “lean into” conflicts and resolve them early on, so that you can reorganize your lives to include the new learning. Because entrepreneurial couples have a lot at stake when it comes to their business and their relationship, they are prone to avoid conflict or to use ineffective tools to solve the conflict too quickly. Compromising and acquiescing are two of these ineffective tools.

Most couples are shocked when I advise them to avoid compromises at all costs. After all, isn’t compromise a requirement of partnership, both personal and business? The reality is that decisions that are arrived at through compromise usually lack creativity and seldom last. Sure, a compromise now and then may be necessary for the sake of expediency, but if a decision is important, a compromise may cause anger and resistance. Because compromises are usually a result of both people giving up something in order to get an agreement, the decision is a watered-down version of two stronger opinions. While it may be satisfactory to accept compromise decisions for things like choosing a restaurant for dinner, where neither of you gets your first choice but both must accept a third alternative, accepting a third, less-threatening alternative for your business may sabotage your competitive edge.

Compromise is the easy way out when you are trying to avoid conflict and confrontation. It appears that the compromise will smooth ruffled feathers and that both partners can go away happy. What really happens, however, is that each partner leaves feeling as though they have been had. One person may resent having to compromise and will be looking for ammunition to prove that the decision was a bad one. Another person may feel he or she has done the honorable thing by not pushing his or her opinion on the other, only to feel unappreciated later when the compromise plan is dropped. If you stop and think about it, how long have your compromise decisions really lasted?

Acquiescing or forcing your opinion upon your partner are other ways of avoiding conflict. In seeking to avoid conflict, for example, a persuasive person may push his or her partner to acquiesce to a certain point of view, but this does not mean that the partner agrees. It may mean only that the partner actually does not want to fight and so appears to agree, when he or she has only given in. Don’t make the mistake of pushing to win at all costs or to acquiescing to the persuader, when you don’t agree. In either case, if you are the persuader or the acquiescent partner, the conflict has not been resolved and, what’s worse, may have been driven underground.

“Why can’t we communicate now that we live and work together?” The answer to that question is pretty clear for entrepreneurial couples. If you don’t make time to talk, if you don’t consider nurturing your personal relationship as important as nurturing your business, and if you avoid healthy conflict and confrontation, your partnership/relationship will disintegrate into two uninvolved business associates at the best, and into bitterness and divorce at the worst. So take the time now to evaluate your communication skills and your life/business plan. Invest in the time to develop a meaningful, loving relationship with your spouse that enhances your business relationship.

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Cost Containment or Quality Care? Health Issue


By Kathy J. Marshack, Ph.D., P.S.

Are you a good old-fashioned American Capitalist? Most of you who are reading this article are entrepreneurs or business owners or executive or managerial employees of local businesses. This makes you American capitalists in the truest sense of the word. You believe in working hard, competing for profit, and setting your sights on the American Dream of financial success and security. Is it any surprise then that health insurance companies are American capitalists too? They were founded by visionaries who recognized a market just waiting to be tapped, employers and employees who needed help paying for medical expenses and who were willing to pay in advance for the insurance that the costs would be covered. Being capitalists, they used the existing American system for setting up their businesses and arranged to make a profit. As more people founded insurance companies, the competition began to heat up, which only fueled the enthusiasm of these early entrepreneurs. Competition honed the industry into the incredible, unbeatable American Dream Machine it is today. Don’t some of you secretly wish you could have been in on the ground floor of this multi-billion dollar industry?

Most of you readers were not in on the ground floor, nor do you own a piece of an insurance company. Primarily you have not been looking at the profitability of a particular insurance company, nor the investment potential of the market/insurance industry as a whole. Rather your main interest in the health insurance business is whether you have a fair and cost-effective plan to offer your employees and whether you, yourselves have the type of insurance that will take care of your health needs. However, in making decisions about buying and using health insurance plans, it is important that you understand that health insurance companies are businesses, just like yours. Their goal is to make money by providing a service/product that can be produced as competently and efficiently as possible. The problem is, can insurance business owners make medical decisions that affect your health, without the advice of professionally trained physicians, psychologists, chiropractors, dentists and so on?

The insurance companies of the nineties, and their cost-management sub-contractors, managed care companies, are indeed making medical decisions for each and every member of their plans. And they are doing so without sound medical and/or psychological advice. They are making these decisions based upon actuarial tables, not upon the unique individual needs of each patient. For example if the cost of a mammogram is cheaper than an ultra-sound to detect breast cancer (and it is), your cost-management company may deny the claim for an ultra-sound. If the actuarial tables suggest that most cancer is detected satisfactorily by mammogram and self-exams alone, then to contain costs, they will deny the ultra-sound. However, if you have a history of “breast lumps,” and so far all of them have been benign, but your doctor is concerned that with advancing age there could be an increasing likelihood of cancerous tumors, or that the benign lumps are hiding the tumor, and in your case an ultra-sound is vital, there is still no recourse with the cost-management company. You may still have your claim denied because you do not fit into the range of what is most cost-effective according to the actuarial tables. There just is no room with insurance companies for the exception to the rule.

In psychology and psychotherapy, the picture is even gloomier. If you have a broken arm, the insurance company will authorize treatment. But if you are suffering from anxiety or depression, regardless of the cause or the intensity of the problem, your claim will be challenged by the cost-management company. One reason is that it is not the event per se that is paid for, but your reaction to it. For example, if you are in an automobile accident and your child/passenger loses his or her life, but you survive, you would be expected to be in shock, to be grieving intensely, to be unable to carry on your daily routine for weeks, months or even a year or two. Yet this event may not be allowable under your mental health coverage because you are reacting normally to the stress. In other words, you can only be covered under your mental health coverage if your reaction to the stresses of life are abnormal. But in my experience, even if you are suicidal (which insurance companies do consider abnormal) you will need to get prior authorization from your cost-management company before you can schedule an appointment with a psychologist. Because the psychologist is a specialist, cost-management companies do not make as much money on their services, so they have established a gate to keep the number of referrals to specialists at a minimum. If you are suicidal you must first call your cost-management company for authorization or make an appointment with your primary care physician, who in turn will make a recommendation to the cost-management company to refer you to a psychologist!

What this all amounts to is that psychological and emotional health do not mix very well with health insurance and cost-management companies. It is important to understand the distinctions between the two realms. Health insurance companies and their colleagues, cost-management companies (euphemistically called managed care companies), are in the business of making a profit by containing the costs of health care. While this goal may be needed or even admirable, it has nothing to do with providing the specific medical or psychological care that you or your employee needs today. The kind of mental health treatment that you or your employee needs today should be a decision between the patient and the doctor based upon the specialized needs of one unique human being. While what the patient can afford, either privately or through their insurance plan, should be considered by the doctor and patient, the best medical/psychological treatment that is necessary for this one human being should always be considered first, not secondarily to what the cost-management company will authorize.

Obviously you cannot ignore the costs of health care, even though psychological health care is relatively inexpensive. However, the biggest mistake that patients make is assuming that their cost-management company is making the wisest health care decision for them, when in fact the cost-management company is diagnosing by the actuarial tables. I know of suicidal patients who went untreated because their cost-containment company could not act as quickly as a phone call to the therapist. I know of patients who want a cure for serious clinical depression within the unrealistic five sessions authorized by their cost-containment company.

I know of patients whose personal, confidential medical records are reviewed by the employer’s human resources department before they are reviewed by the cost-containment company clerk, before they are reviewed by the cost-containment supervisor, before they are routed to the insurance company for a similar series of reviews, before the claim is authorized or denied.

Whether the insurance industry needs cost-management or not is not the question here. What is at stake is the quality of your psychological and medical health care. When making these very important decisions about your health care, consider that your insurance company is not the best source of advice on quality of care. They can only advise you on cost of care. For example, if you choose one of their preferred providers the costs may be lower but cost is no guarantee of quality. For quality of care decisions you have more work to do. Searching for a psychologist, for example, requires assessing just what your needs are, what approach would work best for you, what type of professional you can relate to, what credentials and qualifications make this provider better than another and so on. Furthermore, you may wish to work with a psychologist about problems that are perfectly normal, but that you want help with nevertheless, such as a divorce, child behavior problems, career planning, family stresses at work, work stresses at home and so on. Remember, your cost-management company is not under contract to help you with these problems, only those issues that you are handling abnormally.

When it comes to insurance, Americans are soft. We assume that we are entitled to “life, liberty, the pursuit of happiness and health insurance to cover every conceivable medical expense.” Health insurance is an extra. It has its limits. It is time for Americans to build some unused muscle and start making decisions for themselves again. Stop looking for someone to take care of your every health or emotional need. Stop turning these decisions over to cost-management companies. Instead utilize your good old common sense and decide for yourself, with the help of professional advisors such as your trusted doctors, just what is the best psychological or medical treatment for you, your loved ones and your employees.

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