David St. Clair retired from Medecision at the end of 2009. By the following summer, he was back in the chief executive’s job. After more than two decades spent building the company, taking it public and selling it, he had acquired one more assignment: keeping it moving while someone else was found to run it. Retirement, in this instance, came with an intermission.
The return is a useful place to begin because it unsettles the usual sequence. Founder stories tend to march toward an exit, then stop at the transaction value. St. Clair’s kept going through appointments, departures and handovers. The business had changed owners. Its founder still had work to do.
That is also what makes his career interesting beyond the milestones. He has been willing to discuss the disappointment alongside the achievement. The enterprise he began in a basement became a public company and then a subsidiary. Other ventures ended badly. None of those outcomes quite disposes of the person who has to turn up for the next decision.
Before the ticker symbol
St. Clair’s route began with a B.A.S. in mechanical engineering at the University of Pennsylvania and an MBA at Harvard. The combination put technical study beside business training, years before his name would appear above a company’s financial statements.
From 1981 to 1985, he worked as a principal in the Strategic Management Group at Hay Associates. From 1985 to 1988, he was a vice president at GMIS, a business subsequently acquired by McKesson. By the time he founded Medecision in 1988, he had already worked inside both consulting and a software business.
The basement beginning was his own description of Medecision’s origin. It is a pleasingly modest address for a company that would eventually need underwriters. More consequential was the financing sequence: he recalled growing profitably with early customers before raising the first venture capital in 1997. There were nine calendar years between the founding and that financing.
Founding to first venture financing, in St. Clair’s account. Customers came before the capital announcement.
He reported another $30 million raised in 2000. Venture money had entered the story, along with the obligations and expectations it brings. The basement had served its purpose. The company now had a financing history substantial enough to make its later public offering part of a longer progression.
A company learns a new calendar
On December 18, 2006, Medecision completed its initial public offering. The offer comprised 4.7 million shares at $10 apiece, including shares sold by existing holders. The company itself sold 3.3 million shares and received approximately $26.4 million after underwriting commissions and offering expenses.
Those distinctions matter. A headline offering amount and the money arriving in a company’s bank account are different figures. Approximately $9.5 million of the proceeds went toward accrued dividends for former preferred shareholders, and about $600,000 repaid a working capital facility. Becoming public also meant settling obligations accumulated along the way.
There was a growing business behind the paperwork. Annual revenue had risen from $16.4 million in 2002 to $44.2 million in 2006. The growth gave the offering a business context; it did not spare management the demands of the next reporting period. A listed company gets a fresh examination every quarter, however long its customers take to decide.
By 2008, St. Clair was publicly confronting that problem. Medecision’s stock had traded between $1 and $2, a long way from the offering price. He considered the business undervalued, while accepting some responsibility for expectations that had been set too high. Customer negotiations, he explained, did not arrange themselves around the reporting calendar.
It is an awkward position for a founder: responsible for the promises made to investors, dependent on decisions made by customers. The same executive has to explain both. St. Clair’s account allows the discomfort to remain visible, rather than smoothing the public-company years into a ceremonial step toward the sale.
Seven dollars, and a different owner
The 2008 agreement with HCSC offered $7 in cash for each outstanding share, valuing the transaction at approximately $121 million. The buyer was already a major customer. A relationship established through doing business would become an ownership relationship.
Set beside the $10 offering price, $7 tells one story. Set beside the depressed trading price, it tells another. Both comparisons are necessary. Neither price, by itself, supplies a complete judgment on the years St. Clair and his colleagues had spent building the enterprise.
For St. Clair, the arrangement also supplied capital to expand the business. That is a practical reason to sell, with consequences for products and employees after the agreement is signed. An acquisition announcement can make a company appear finished just when its next operating chapter is beginning.
The operating work was already under way. In April 2008, Medecision appointed board member Tim Wallace interim president and chief operating officer. St. Clair described a move from product development toward execution and client service. It was an acknowledgment that completing new products creates another set of management jobs.
The previous year’s accounts recorded $4.8 million invested in product development. Money committed to building something eventually has to become a product customers can use, supported by an organization that can deliver it. Wallace’s appointment put an experienced operator into that part of the work.
Recognition had arrived, too. In July 2007, St. Clair accepted a Department of Commerce innovation certificate at the company’s Wayne offices. Under Secretary Robert Cresanti made the presentation; Pennsylvania governor Edward Rendell joined the congratulations by telephone. A founder who had started downstairs was now receiving calls of a rather different sort.
Retirement, with an intermission
In November 2009, Medecision announced that Scott Storrer would succeed St. Clair as chief executive. Storrer had been president and chief operating officer. The handover followed the company’s sale, and St. Clair was scheduled to retire on December 31 after more than twenty years with the business.
Then Storrer resigned in 2010. St. Clair returned as interim CEO, retaining a connection he had already maintained through the board. The arrangement was explicitly temporary, covering the search for a permanent replacement. The founder’s familiarity with the organization had become a resource during a change of leadership.
His stated priority was continuity: carrying forward the company’s momentum and continuing to develop its products and services. There was no need to invent a new origin story. The immediate assignment was to lead an existing organization through the interval between two permanent chief executives.
- 2009Storrer named successor; St. Clair’s retirement scheduled for year end.
- 2010St. Clair returns for an interim assignment.
- 2011Deborah Gage takes over; St. Clair supports the transition.
Deborah Gage was named president and CEO in February 2011. St. Clair continued in a consulting capacity during the transition and remained a director. His departure from daily leadership was therefore a handover with some overlap, allowing the incoming executive to take responsibility while the founder remained available.
There is a less glamorous kind of achievement in that sequence. Starting a company gives a founder a central role almost by definition. Helping it move through a succession requires a different relationship with the job. St. Clair’s history contains both, including the temporary return between them.
The people who still turn up
“I learn from failure as much as I try to learn from success.”David St. Clair
That willingness to keep both sides of the ledger is present in his own account of entrepreneurship. Alongside Medecision, he describes two other companies, one that ended early and another that lasted longer before failing. The successful sale did not induce him to delete the less flattering entries. For someone considering his experience as an investor or advisor, those entries have value: they show that his working knowledge includes businesses that could not be made to last.
His later professional life includes investment and advisory work. Robin Hood Ventures, the Philadelphia angel investment group, lists him among its members. The move brings an operating career into contact with people still making the early decisions of their own businesses.
One of his public remembrances identifies Tom Morse as a friend, mentor and first investor. Company records also place Morse on Medecision’s board. The connection gives a human dimension to a financing history otherwise recorded as dates and amounts: someone supplied capital, and the relationship became more than the transaction.
In 2023, the company’s thirty-fifth anniversary brought another kind of gathering. St. Clair invited the Medecision crew and their partners to Will’s & Bill’s Brewery & Restaurant in Berwyn for October 26. More than ninety people had already responded positively, he wrote. The anniversary arithmetic was simple; keeping that many working relationships alive takes longer.
A reunion invitation makes a fitting last page for this part of his story. The listing had come and gone. The business had another owner and other leaders. St. Clair was still able to send a message to people who had helped build it, and people still wanted to come. After all the financial calendars, there was a date worth putting in the diary.