Do Borders Matter? Lessons in Entrepreneurship

Do business practices differ across regions, longitudes, or languages?

In El Centro Historico de Santiago de Querétaro
In El Centro Historico de Santiago de Querétaro

Well my summer experience with a young, but growing, organization says that overall – yes, business practices vary by region. Setting organizational strategy was a challenge due to uncertainty with México’s political climate and local corruption. As if estimating market demand wasn’t hard enough…

These institutions made it hard for the entrepreneur to accurately forecast when, and if, his business would win contracts to provide critical healthcare to many needy patients. Here was a case where the “free market” failed.

For example, the entrepreneur had recently opened a new facility with enough capacity to perform over 100 high quality dialysis therapies per day. And the lack of capacity was an issue that was preventing several patients from obtaining the lifesaving care they needed, something that local public health officials were well aware of.

However, because special licensing, permits, and contracts are required to serve México’s largest eligible patient pool (IMSS Patients), the power sits in the hands of a few. The adage of “if you build it they will come” made popular by the 1989 film Field of Dreams really seemed to be failing this growing clinic system.

The last I heard was that the clinic will have to wait until November of this year to be evaluated by officials. Something is terribly wrong because patients need care now and cannot afford to prolong lifesaving treatment until November.

Let’s not forget that the facility is up and running with a full complement of staff and equipment that is sitting idly by while the bills for building rent, equipment leases, and employee wages are all piling up!

Such issues are less of a concern in the Unites States as government contracts are awarded with much more transparency. However, regardless of location business leaders should be aware of such challenges and adjust business strategy to overcome such obstacles.

One key takeaway from my work experience in México was that for the most part management practices for internal process are much the same as those in the United States. The business I worked in had a formal organizational structure with directors and departments that mirrored almost any functional structure found in the United States. Within each department were managers and subordinates that had similar roles and responsibilities as their American counterparts.

Where business practices begin to diverge are on processes that deal with external issues; much of which are out of the control of the entrepreneur. Issues endemic to developing regions such as corruption, poor infrastructure, unreliable utilities, lack of transportation for the impoverished, and scarcity of high skilled labor.

One constant challenge at the clinic was with the IT systems and the sparse internet availability which was important for live data capture. The IT director claimed it had to do with bandwidth and service quality coming directly from the internet service provider. To mitigate this obstacle clinic staff was constantly having to return to pen and paper for data capture and re-boot the system in hopes of fixing the internet issue.

I saw this theme in more than one merchant location where store clerks had to re-boot their ATM terminals in hopes of getting the internet to work again and complete a credit card transaction. Now just imagine if you had to restart your computer every few hours. What would that do to your work productivity and employee moral? How would that change the way you manage operations in your business?

I want to thank everyone for following my summer blog and hope that you are all now better business leaders because of it. Please continue to read and follow news on healthcare challenges in México and other developing regions because your help and attention is desperately needed. Good luck with your future endeavors and feel free to reach out with any comments.

Thank you Duke, the Nicholas School of The Environment, the Fuqua School of Business, International Partnerships for Innovative Healthcare Delivery (IPIHD), the Center for the Advancement of Social Entrepreneurship (CASE), and you the readers for following!


Jose Magaña Paredes

Master of Business Administration
Master of Environmental Management
Candidate 2016, Duke University
Fuqua School of Business
Nicholas School of the Environment

One thought on “Do Borders Matter? Lessons in Entrepreneurship

  1. job well done Jose…I hope they get that clinic up and running soon as dialysis is life sustaining procedure for many patients

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