By Evan Flaxman, JD, MBA
I started working in my father’s medical-equipment company when I was about 11 years old.
My first job wasn’t analyzing financial statements or deciding where the company should expand. I cleaned and disinfected used commodes, walkers, wheelchairs, hospital beds, and mattresses. I learned how oxygen concentrators worked and helped clean out sieve beds.
That was how I started.
My father was an orthopedic surgeon who, after retiring from practicing medicine, started a durable medical equipment company in Miami Beach, Florida. The business supplied everything from wheelchairs and hospital beds to mobility scooters, oxygen equipment, and other medical supplies.
At 11 years old, I began learning the business from the equipment room up.
Learning a Business From the Ground Up
Over time, I learned inventory, the computer system, and the cashier system. By 16, I was driving myself to the store after school and working Saturdays. Before I turned 17, I sold my first mobility scooter entirely in Spanish.
There is something valuable about learning a business from its least glamorous parts.
Before I ever analyzed a profit margin, I knew what the equipment looked like, how it worked, how it was maintained, and how it moved through the business. Inventory wasn’t simply a number on a financial statement. It was actual equipment that had to be purchased, stored, tracked, delivered, and ultimately paid for.
As I got older, my responsibilities changed. Throughout college, I helped with the accounting and bookkeeping and came home during some summers to work.
Eventually, my father entrusted me with the company’s books and financial records. He believed I was capable of performing the financial analysis myself rather than hiring an outside business adviser.
That gave me an opportunity to study the economics of a real operating company—with actual employees, patients, expenses, and financial consequences.
By the time I graduated from the University of Florida, I had helped my father grow the company from one location to nine.
But the most important conclusion I reached wasn’t simply about opening additional locations. It was about understanding where we were actually making our money.
Finding the Business Within the Business
Our company carried an enormous range of medical equipment and supplies. We served customers with very different needs and generated revenue from numerous product categories.
I went through the company’s computer system and analyzed every line item.
What I discovered was that, under the Medicare reimbursement structure at that time, the oxygen side of the business generated our highest returns.
That changed how I looked at the entire company.
I recommended that my father stop thinking of the operation primarily as a durable medical equipment company that also supplied oxygen. Instead, I believed we should build the business around oxygen, with the broader medical-equipment operation supporting it.
That became our strategy.
The underlying financial lesson was straightforward: not all revenue is created equal.
A company can be extremely busy selling hundreds of products while one particular segment accounts for a disproportionate share of its financial success.
The important question wasn’t simply how much we were selling.
It was where we were generating our best returns—and what we should do once we knew the answer.
What the Numbers Actually Tell You
There is a difference between looking at financial statements and understanding what they are trying to tell you.
Numbers don’t make decisions. They provide information. The challenge is determining which information matters, what it means, and what decisions should follow.
In our case, analyzing every line item led to a strategic conclusion. Oxygen wasn’t merely another product category. Its economics were strong enough that I believed it should become the center of the company’s strategy, with the broader medical-equipment operation supporting it.
That experience taught me something I’ve carried into other business and financial decisions: understanding how a company operates is only part of the equation. You also have to understand what drives its financial performance.
I started by cleaning wheelchairs and learning how medical equipment worked.
Years later, I was examining every line item in the company’s financial records and using that information to help change its direction.
Both experiences mattered.
Learning the business from the ground up helped me understand what the numbers actually represented. Learning to analyze those numbers helped me understand what the business could become.
Related reading: What Teaching Thousands of Students Taught Me About How People Actually Learn
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