Interview with Lara Francisco, PA-C Founder of Medelita
Today I’m featuring Lara Francisco, PA-C. She is the founder of Medelita, a medical apparel company. Her story is an example of seeing a need and creating a solution. Although it didn’t help her pay off her student loans, it shows how working as a PA inspired her to start a business. It also demonstrates the perseverance it takes to be successful in creating your own opportunities. Thank you to Lara for joining us in this series.
Previous Work Experience and origins of Medelita
I was pre-nursing at Emory but was still exploring other healthcare professions / not 100% on the nursing to nurse practitioner route. In truth I wasn’t ready to enter an intense nursing program my junior year. Working at the university center one summer I was browsing a magazine with the feature article “top up and coming professions.” PA was number one, and I was intrigued.
After doing a ton of research, I realized that if I were to pursue this profession I would need an inordinate amount of patient care hours. I began volunteering at Grady Hospital ER (second highest volume ER in the country) and lead their volunteer program / re-wrote the manuals and training procedures. I became extremely passionate about EM at that point and began to pursue programs in which I could do additional electives in (specifically) inner-city EM.
I matched with a program (previously called) Catholic Medical Centers Physician Assistant Program of Brooklyn & Queens. This program was incredible – as I was taught by some of the very best PA leaders and educators in the country, including JoAnn Deasy, PA-C, MPH, DFAAPA, Larry Herman, MPA, PA-C, DFAAPA (past AAPA President) and Maureen Regan, PA-C, MBA, FACHE (current NYSSPA President). I showed up to the first day of my second rotation in Emergency Medicine, looked Larry Herman straight in the eye – last in a row of 6 PA students – and said “I’m Lara Manchik. I’m from Nebraska. I want to do Emergency Medicine and I want to work here.” And everyone gasped, as Larry’s EM rotation was notoriously known as the most difficult and dreaded.
I started working at Mary Immaculate Hospital ER in August 1999. I moved to California in July 2002 and started work at Mission Hospital / Children’s Hospital of Orange County through June 2006, before transitioning to Urgent Care and launching Medelita in 2008.
Why Start Medelita?
I felt the mandatory unisex style scrub set and lab coat were ill-fitting and embarrassing in presentation. I was working in Emergency Medicine / Pediatric Emergency Medicine and every time the group manager would order scrubs for our MD / PA team, my V-neck would hang too low, my bra strap would easily show when I lifted my arms to do an exam, and my crotch point was brushing mid-thigh as I walked. I could barely keep the pants up with a flimsy drawstring cinched to hold together a huge waist. I tried rolling over the waist and rolling up the sleeves, to no avail. It was really uncomfortable and truly perplexing that we were asked to wear something so uncomfortable for 12-14 hours / day.
I was also flabbergasted by the fact that highly professional individuals with anywhere from 2 – 10 years of post-graduate education were donning (literally) jail uniforms in a different color (orange v. blue) and no one thought much of it. If you think about other professionals with a similar length of education and prestige, they are wearing name brand suits and carrying $3000 designer bags. This discrepancy was hugely motivating.
Also the changes that the big athletic companies were undergoing at the time – Patagonia, Lululemon, Athleta, Nike, etc. were also highly motivating to me. These companies seemed to be transitioning from a ‘sweaty garment in cool colors type brand’, to ‘highly functional, innovative performance fabric designs with interesting, flattering seaming and current technology compatibility.’ I wanted to apply those same principles to medical apparel, in a thoughtful, purposeful way that no one had ever done before.
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Current Work as a PA
Starting a business proved to be way more of a challenge than I was expecting. Although I maintain my certification and licensing, I am still taking a hiatus from clinical practice. I yearn for the patient interaction, challenging cases and complex procedures from the ER as there was nothing more fulfilling in my life to date. I was very well trained and had the gift of working inner-city in Jamaica, Queens NY upon graduation. The PAs at our ER ran the Peds ER, which was known as one of the worst asthma populations and trauma centers in the country. I’ve seen some of the most bizarre cases imaginable, with people from all over the world coming to our hospital from JFK Airport after being told “we cannot help you here (in this country) you should get on a plane and go to America.” Once you get a bit of that excitement and reward (from making an unusual diagnosis or saving a child) it’s hard to back off. I miss it.
Weekly Time Spent Working
I work full time at Medelita and often work at night, as well, as I’m a night owl and our Asia contacts start work as soon as the 5pm ‘time to go home’ hour starts here in California. I’d prefer not to have a lag in emails if I can avoid it. I am holding off on most international travel currently, as our three children are quite young. In addition to my time at the office I do attend some local events, speaking engagements and medical conferences to help spread the word about Medelita.
Barriers to starting a company and working as a PA
About 2006 I was able to transition from EM to Urgent Care. This change was instrumental in allowing me to meet with yarn patent holders, local sewing factories, website developers, copywriters, etc. during normal business hours and then work in UC in the evenings and on weekends. And after working 8 years in EM it’s a pretty easy transition to switch to UC / not nearly as stressful unless I had an unusual patient load.
The greatest barrier, aside from being able to work during normal business hours, was not having any apparel background and / or business background. It was especially daunting to have a clear vision in my head and then be able to correctly execute that vision being dependent on so many other people. Designers, technical designers, patternmakers, sample sewers, production factories…all a new world to me to navigate and with little margin for error because of costs. In addition, I was determined to create our fabrics from yarn concept, combining innovative performance yarns that had never been tried before.
PA School Loans and Starting a Business
I did have student loans from PA school in which I recently received my notice of final payment (19 years later). Starting Medelita absolutely did not help to pay off student loans as we constantly reinvested back into the business to build better products, invest in technology for our web site and fulfilment center, and fueled innovation with new fabrics continually in development. The apparel industry is extremely difficult to enter and to keep afloat, as I’d much rather be in a busy ED than to worry about the thousands of things one must keep track of while running an apparel company.
Also the expenses are endless in apparel manufacturing – fabric, buttons, thread, labels, garment bags, packaging, duties, taxes, marketing, web development, photography, copywriting, accounting, employee expenses, insurance, licensing fees, legal fees, development fees, R&D related expenses, travel, and conference expense outlay, among others.
In summary, we underestimated the resources necessary to fund a rapidly growing e-commerce medical apparel business. But keeping true to our mantra, we didn’t start the company to capitalize on the market but to solve mine and my colleagues’ scrubs and lab coats needs. I didn’t raise huge sums of money via private equity and bombard people with ads. All of our hospital accounts were earned via word of a mouth, not from pushy salespeople. We have too much respect of our industry for that.
We believe in sustainable, responsible growth. Our growth comes from never compromising on quality and letting that quality drive our reputation. The key to our success is our customers, as my colleagues appreciate the thoughtfulness of the product and have helped to spread the word about Medelita.
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