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Scott G Winterton, Deseret News
Carine Clark poses for a photo at her home in Orem on Monday, Feb. 13, 2017.

SALT LAKE CITY — Utah's business community is among the most vibrant in the nation, with scores of profitable, locally based companies across a wide range of industries, including technology, life sciences, advanced manufacturing and financial services.

While the leaders of many of these firms are well-regarded for their achievements today, some of their success stories include periods of tragedy, near failure and immense struggle on the journey to business prosperity.

Among the chief lessons learned, some noted entrepreneurs said, were the importance of determination, teamwork and sustaining self-confidence in the face of repeated disappointment.

For three local business leaders, the path to success was paved with numerous pitfalls and unexpected obstacles. But their ability to conquer those hardships is what has made them outstanding examples of courage, perseverance and vision in their respective fields.

Overcome tragedy

Before Carine Clark, 53, became one of the first female chief executives of a Utah technology company or regional Ernst & Young Entrepreneur of the Year or Utah Business magazine CEO of the Year or just the second woman ever inducted into the Utah Technology Council Hall of Fame, she was a survivor — in the most literal sense of the word.

Nearly five years ago, as her professional life was humming along on its perennially upward trajectory, Clark received news that would test every ounce of will, strength and faith she ever had. At 48 years old, she was told she had a 20 percent chance to survive a rare form of stage 3 ovarian cancer.

"I was at the top of my career and I was diagnosed with this horrible disease," recalled Clark, who is on the board of directors of the nonprofit Silicon Slopes. While she never asked, 'Why me?' she did wonder, 'Why now?'"

"I had worked for 20-plus years to build a brand and a presence — something I really enjoyed and was proud of, and I had worked 22 years to (raise) my two kids and now I have to face the possibility that I exit stage left?" she said.

Initially, she was stunned, having had no family history of cancer and little exposure to the disease on a personal level. Almost immediately, she began devising a survival strategy.

"You kind of have to get your brain around that my only option is to fight this and use this opportunity to teach my children and my husband and my family what it means to stand up to something really horrible," Clark said. "You have to look in the mirror and ask, 'What are you going to do? Are you going to cry and feel horrible or are you going to take all the skills that you've learned in your business life and in your education and use that to build a team and a plan with the vision of not dying."

She found the best oncologist with the most experience with her form of cancer and also connected with others who had survived similar diagnoses. Fortunately, she found a local physician who had survived the same form of cancer to help offer advice and personal perspective.

"She became my 'cancer whisperer,'" Clark said. "She was able to tell me what it felt like to have chemotherapy. Whenever I had (questions), I would call her."

After six months of debilitating chemotherapy, along with strong trial medications for a year, she was able to make it through the aggressive treatment schedule and has maintained her recovery path.

"You try no to let the cancer live with you forever, but it does," she said. "You always think, 'What if it comes back?' But it doesn't define me, it refines me. I'm a better person for having gone through it."

She believes surviving cancer has made her a better boss, a better mom, "a better everything" because of the empathy she has gained for others who may be in similar dire straits.

The experience also put into perspective the time she was fired while pregnant with her first child from a company she had worked for 15 years.

"(At the time) you think that you're not going to survive it," Clark explained. "That's why the cancer eclipses everything because what you thought was the worst thing that could happen ended up being a great thing."

After being jobless for a time, she took a position with a tech startup for "a lot less pay, no title, no budget, no staff and no office," and launched what became her Hall of Fame career.

Clark recently left MaritzCX, where she was president and CEO; prior to that she was CEO of software company Allegiance.

"It was an opportunity to take on a lot of work and show that I could do some really cool things," Clark said. "That would have never happened if I hadn't been fired from that job by a woman who didn't know what she was doing. I should send her chocolates and flowers because it put me on a trajectory I would have never been on otherwise. I would never have left."

Overcoming near failure

To be a successful entrepreneur, one has to be resilient because chances are that during the development of your enterprise, there will very likely be failures big and small.

"You just have to be an optimist's optimist," explained Dave Elkington, 43, founder, chairman and CEO of InsideSales.com — a Provo-based sales analytics platform valued at more than $1 billion. "Any possibility of success, you just have to believe it will probably happen — almost to the point of being naive."

Elkington said he has always been a "glass is half full" kind of guy, but when he began his foray into entrepreneurship, his mettle was tested far beyond anything he had previously experienced. He launched InsideSale.com in 2004, bootstrapping the company using his own money and credit. While the notion of funding the company with no outside capital may sound good to some, he said it was exceptionally difficult and often nerve-wracking.

There was period early on in 2006 where he was short on cash necessary to make payroll. He went to his wife, who was also a partner in the business, and said, “I’ve screwed up.”

“We either have to lay some people off or (get second jobs),” he said. As it turned out, they both hired on as janitors cleaning doctors’ offices on the graveyard shift.

“We’re taking the money that we generated from (these jobs) and paying employees during the day,” Elkington explained. “At one point around 1 (o’clock) in the morning I’m bending down on my knee cleaning a toilet and my wife’s got a mop. She stops and kind of smiles and says, ‘Dave, we’re living the dream!’”

The irony of that moment today brings a smile to his face, but he also recalled that the money made from those part-time jobs made it possible to keep the company afloat.

“It (wouldn’t) be fair to have to fire someone because I screwed up revenue (projections),” he said. Another “battle scare” came in 2008 when the company’s $100,000 line of credit was canceled by the bank, leaving them broke with no way to pay their bills, he said.

“I was sitting with the executive team and we’re (exchanging) hugs and saying, ‘We made a good run,’” Elkington explained. Just as they were about to concede defeat and close up shop, one of the execs suggested going to leadership with a final “Hail Mary.”

He went to each of the top executives and their spouses individually and asked them to defer their compensation for a few months, which they surprisingly agreed to. But, they still were short on the funding required to keep the business going, so he then went to their vendors and customers to ask for their willingness to shift payments for three to six months.

To his surprise, they all agreed and the company was able to forge ahead and begin to generate the revenue almost immediately, he said.

“We were able to pay everybody back in 2 1/2 months,” Elkington said. “That was a point where we (almost) said, ‘We’re done.’”

After coming so perilously close to losing it all a few times, he said the support of his wife, family, business associates and business partners helped him get through all of those major challenges. While Elkington appreciates the success that has followed, he does not think of himself as particularly exceptional.

"It's not like I'm any better than anyone else. I'm really not," he said. "If you outlive your failures, you'll succeed. You have to be insanely resilient and insanely patient."

He noted that confidence combined with humility is critical for entrepreneurial success.

"If you're humble enough, then you'll listen to other people, learn lessons and won't make the same mistakes," he said. Great entrepreneurs are able to pivot and adapt when situations require, he added.

Overcoming immense struggle

When you’ve spent 20 years of your adult life in one profession, taking the leap into a completely new field can be a scary proposition. However, when you have the drive and ambition to change the dynamics of a critical but dysfunctional system like health care, the fear is outweighed by the overpowering need for a better way to improve people’s lives.

By all accounts, Donna Milavetz, 50, was leading a successful life as a board certified internal medicine physician with a master’s degree in public health administration. While she thoroughly enjoyed helping people, about 10 years ago following a long period of seeing 40 patients per day in her position as a medical director at an Ogden area hospital, she decided to make a change and become an entrepreneur.

“That term is really foreign to medicine,” Milavetz said. “That’s part of the challenge with health care transformation.”

She felt like the current health care system was ineffective when it came to providing the kind of care necessary to help patients improve their overall health.

“I was motivated by the ‘pain point’ I saw my patients having and wanted to come to the table with a creative solution,” she explained. “The fee for service model is a broken system.”

“Pain point” is defined as the challenge companies and patients face in affording health care, she explained.

She said that having medical service providers incentivized to create more costs “to make more money off of you” is misaligned with prudent patient care.

“(Doctors) see you as a virtual ATM machine,” she said. “When you set up a payment system that pits me, the doctor, against you, the patient, then you’ve got a problem.”

To mitigate the problem, she developed a business model that focused on providing primary wellness care to patients.

In 2006, she launched OnSite Care, a Utah company that operates workplace medical clinics providing “primary care at work” for employers in Utah and Arizona. Today, she operates 19 clinics with 105 employees across both states.

According to Milavetz, addressing the issue of preventative care is a solution that can drastically reduce the overall cost of health care. Clients of the workplace clinics include company employees and their families who can make visits for free and receive all prescription medication at no cost — both of which relieve a major financial burden for patients by lowering out-of-pockets expenses and employers by lowering the amount they spend on health care, she explained.

When she initially considered the idea and told her colleagues about it, some of their responses were less than encouraging, she said.

“When I started the company, people told me I was committing career suicide,” she said. “They told me that to my face.”

Hearing that refrain from so many respected medical professionals gave her serious concern about whether she was doing the smart thing.

“When everyone is saying this is a really bad idea, it gets a few self doubts,” she admitted. “I had to believe in this (then) hypothetical model so fundamentally that I was willing to overcome overwhelming opposition to the idea from my support group — the medical community.”

Despite the nay-sayers, she forged ahead undeterred and fully aware of the potential consequences.

“What’s the worst that could happen, I could fail and go back to being an employed doc(tor),” she said. “I lose money, but I still have my core skill-set, so there is only upside. And if the upside is transforming health care, then that seemed to me like a pretty easy win so why shouldn’t I try?”

Ten years later, she is more than satisfied with the outcome of her entrepreneurial gamble and the positive impact her company is having on the lives of its patients and clients.

“I’m making that ‘pain point’ go away, and it’s not a ‘heavy lift’ and saving money for the employer (and patient) at the same time,” she said.