In 1964, Phil Knight and his former track coach, Bill Bowerman, shook hands on a partnership. Knight was just 26 years old.

He'd borrowed $50 from his father to travel to Japan and secure a distribution deal for Tiger running shoes. By day, he worked as an accountant. By night and on weekends, he sold shoes out of his trunk at track meets across the Pacific Northwest.

The odds seemed long, and few believed he was going to make it.

The Battle

Most startups struggle with product-market fit or finding customers. Knight had the opposite problem: too much demand and no cash to fund it.

Sales doubled every year, but supplier payment terms devastated cash flow. Knight kept selling out of inventory, paying off his growing line of credit just in time, then placing an order for twice as many shoes.

In 1975, during a particularly difficult cash-flow crisis, the Bank of California called in Nike's $1 million line of credit. The company should have died.

But Knight had made an unconventional decision: he'd formed a secondary funding relationship with a Japanese trading company, Nissho. When the bank walked away, Nissho analyzed the business, saw the potential, and stepped up with additional money to bridge the gap.

The Transformation

Today, Nike is the world's largest footwear maker. The iconic Swoosh logo - now one of the most valuable logos in the world - was commissioned for $35 from a graphic design student in 1971. Knight said at the time: "I don't love it, but it will grow on me.”

Knight wrote the business plan for Nike in a class at Stanford, where he asked whether Japanese sports shoes could do to German sports shoes what Japanese cameras did to German cameras. That paper became the blueprint for a company that redefined athletic footwear.

Knight reflected: "I've had a lot of people tell me, 'We think he's not going to make it.' But the team had a cause, and they believed they would succeed. Any adversity that was thrown at them, they knew they could overcome.”

The Lesson

As a founder, I know we face hard choices: take the safer path with one reliable partner, or build redundancy even when it feels inefficient?

Knight succeeded not because he avoided risk, but because he understood which risks could kill the company and built alternatives instead.

That foresight - knowing that a single funding source meant a single point of failure - is what separated survival from collapse.

The biggest risk isn't taking chances, but putting all your chances in one basket.

After years of working alongside healthcare entrepreneurs and founding startups myself, I've seen well-run businesses fail. Often, it’s not because of the usual concerns about slower sales or higher burn, but because insurance companies didn’t pay on time, or the services rendered weren’t reimbursed.

Most business education teaches founders to monitor burn rate, manage runway, and tighten expenses when growth slows. That's the right instinct in most industries. 

But in healthcare, you can do everything right - grow steadily, serve patients well, build a loyal base - and still find yourself in a cash crisis because a payer's back office is backed up.

In other words, many startups fail not because they ran their business poorly, but because their payer partners did. Your customer’s dysfunction often becomes YOUR cash crisis.

So what can you do to prepare? Three tips:

1. Treat cash reserves as mandatory. In most businesses, reserves are a cushion for unexpected downturns. In healthcare, they are an operating requirement. Budget for the lag between service delivery and actual collection. If your reserves can't carry you through a 60- to 90-day reimbursement delay, you are already undercapitalized.

2. Know your payers. Track which partners pay on time and which ones don't. What are their common processing timelines? The payer mix you accept shapes your cash flow as much as your pricing model does.

3. Build financial resilience before you need it. The worst time to shore up your reserves is when reimbursements slow down. The best time is when business is strong and the pressure is off. Prepare during the good stretches for the inevitable slow ones.

In healthcare, running a good business is necessary. It is not sufficient. You have to build for the environment you're actually in, not the one you wish existed.

Investing in relationships pays dividends.

I have business partners who keep me focused and push me to revisit our goals and keep growing.

I have a personal trainer who keeps me on track with my body.

I have a mental fitness system that helps me manage emotions and build empathy every day.

I keep a shared note with my cousins to account for the alcoholic drinks we consume weekly. It has reduced consumption, but more importantly for me, it has brought awareness to any beverage I consume, and that’s been great to apply to anything I ingest.

My wife and kids keep me accountable to our family when I start drifting too far into the business lane.

I have friends who check up on me and also have the peace of mind that they will be checked on.

I have golf buddies who are exactly that. They remind me of laughing, having fun, and discussing life… outdoors! (Ok, I put this one in for fun, but it’s true.)

The point?

Have people around you who keep you accountable to what matters most.

If you need someone to help keep you accountable as you grow your business, LOUD Collective can help. Reach out here.