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How to Navigate Your Career with Passion & Persistence: An Interview with Laura Francis, CFO & COO at SI-BONE


Despite her humble beginnings, Laura Francis never stopped advocating for herself and her career. 

As the first person in her family to attend college, she paid her way through the University of Wisconsin and achieved her MBA at Stanford. When we recorded this interview just a few weeks ago, Laura was serving as the CFO/COO of medical device company, SI-BONE. She was recently announced as their next CEO – a well-deserved promotion! – which makes her story even more inspiring.

During our interview, Laura shares the most challenging parts of her career, how she made it to the CFO & CEO levels, and what she wishes the younger version of herself had known. I hope our conversation encourages you to navigate your own career with passion, diligence, and persistence.

Leslie Boudreaux: Thanks for being here. I was hoping you could start by telling us a little about your role at SI-BONE. 

Laura Francis: I’d be happy to. I’ve been with SI-BONE for almost six years. I would say it’s been the best job of my career. 

LauraFrancis
Follow Laura on LinkedIn.

When I started with the company in 2015, I was brought on as the CFO to take the company public. The company had some issues on the reimbursement side, and it took a lot longer for us to get to where we expected to be, compared to when they hired me initially. We did not get public until the end of 2018. 

You can gauge success in a number of different ways. For a CFO, I was able to take the company public. That’s an event in and of itself, but it’s not necessarily a success. In our case, as a medical device company, our mission is to help people who are in pain. 

We just surpassed a milestone of 50,000 patients who have received our procedure. That is the impact that makes you come to work every day as a financial person. I see my job as moving the company forward in order to reach our mission. The mission is to help these patients who otherwise would be debilitated from SI joint dysfunction or degeneration. 

I am at the point in my career where it’s really more about who I’m surrounded by, and whether I feel like I’m making a difference. That’s really what drives me. 

That’s an amazing success story for you and SI-BONE! It can be hard to get to the CFO level; When you look back on your career, what decision did you make that enabled you this success? 

I have always been a goal-oriented person, professionally and personally. I really do say, “Here’s what I want,” and then I figure out how to achieve those things. 

I certainly didn’t start out that way. I was the first person in my family to go to college. Neither of my parents graduated high school – which they didn’t tell me until I was an adult because they thought maybe I wouldn’t go to college. 

I went to the University of Wisconsin because I lived in Wisconsin, and I had to pay my own way. It was the best place that I could afford, but at a large, public university it’s a little bit of survival mode. You have to advocate for yourself, and you have to know how to navigate your success very early on in a large institution like that.

I didn’t know what career I should be targeting. I was debating between engineering and accounting because I looked at things from a financial perspective. I came from a working class family, and even when I was 17 years old I was doing the math of how much I’m paying for my education and what’s the average starting salary. So, I went into accounting. 

I would not say the study of accounting was particularly scintillating to me. I saw it as a way to establish a career for myself early on. I almost felt like I learned things as I went, “Okay, I’m going to study accounting, that’s a good career, whatever that means.” 

I still remember my mother saying, ‘Those schools aren’t for people like us, those are for rich people.’ I had this little chip on my shoulder, so going to Stanford was really just my way of saying, ‘Hey, I think I can do that.’

Then I got to the point of where I was supposed to interview for positions, and everybody was interviewing with these large public accounting firms. So, okay, I’ll interview with large public accounting firms. There were eight of them at the time, and I got offers from five of them. I chose the one that paid me $1,000 more a year. That’s how I made the decision with Coopers & Lybrand, which is now PwC. 

I was establishing goals for myself, but I was a little behind because I didn’t have anybody to mentor me and say, “Here’s how you manage your career. You can go into this field or that field and here are the things you need to do.” 

My story is very similar to that. It’s really interesting. 

Isn’t that crazy? When I was growing up, I remember looking at different schools for undergrad, and I was looking at private East Coast-type universities. I still remember my mother saying, “Those schools aren’t for people like us, those are for rich people.” I had this little chip on my shoulder, so going to Stanford was really just my way of saying, “Hey, I think I can do that.” 

It was odd that I got in – they don’t tend to admit a lot of people in accounting. They look for more broad skills. Only 2% of my class had a background in accounting, but I believe I was so unusual for Stanford Business School—public undergrad, first generation college and accounting—that they went, “Okay, this is what we’ll do.”

Once I got there, I had this idea of, “Okay, I’m going to really figure out what I want to do with my career.” A month later, they started interviewing for internships. Literally a month. I started school in September, and in October interviews started.

Everybody was interviewing for consulting positions. I didn’t even know what consulting was at the time. But everybody was talking about this firm McKinsey and how they’re such a great firm, everybody wants to work for them, etc. 

I ended up interviewing and getting an internship with McKinsey. If I think about building my career, a lot of it was working really hard, doing the right things, and then being opportunistic at different points in time in my career. 

Now, I’m at the point in my career where I’m trying to give back to people. I’m mentoring people, and every day in my work life I’m thinking about how I can help whoever it is that I’m on the phone or a Zoom call with. Am I connecting with people or is there an opportunity to connect other people? 

Ultimately, my job is to drive my business forward. There are a lot of ways I can do that, and they are ways that I find very rewarding.

I’m curious: career wise, has there ever been a time that you’ve been challenged or struggled? 

There have been a couple of different points in time. I envy those people who made all the right career decisions, and everything seemed to be done in an elegant fashion. 

There were points in my career where I was “hanging on by my fingernails”. For me, it was having two children. After I left McKinsey, I became a CFO by going to a small company, because in a small company, sure, we’ll call you the CFO. If you want to get the CFO title, the easiest way is in a small company. 

Next, I jumped to a company that had just gone public. It was a tools instrumentation company in the life sciences. I loved the job. At the time, I was living in Madison, Wisconsin, and the business was in Madison. But we merged with another company in the Boston area. 

I became the CFO of the combined public company. I literally was never home, I was in Boston, I was in New York. We had most of our operations in Germany. I loved the people, the dynamic company and dynamic industry, but I had two small children at home, and it was really difficult. 

Then they wanted me to move to Boston, but my husband had his own career as well. So that was a challenge in and of itself. I ended up going to work with another company at that point in time. 

If there’s one message I would give to women who are out there trying to do this, it’s just figure out how to stay in the game.

I had another opportunity at the time to go work for a company that was in its infancy and is now a massive company, as their CFO. I didn’t even consider it, because I was trying to get my professional and personal life in balance.

So, I joined a private company that had hundreds of millions of dollars in revenue and was growing nicely. But I probably was not really utilizing all the skills that I had, and not necessarily meeting all of my ambitions. It also took me off track a little. 

I was in the Midwest, I wasn’t necessarily in an epicenter, and then I was trying to work more normal hours, and not to travel all the time. I spent a number of years working with that company and raising my children. It was hard for somebody that’s really ambitious to do that. But now, I’m on the other side of it. My kids are grown, I have a great relationship with them, and I caused minimal damage (we always cause a little bit!) What’s really cool for me at this stage of my career is I’m at the point where my children are old enough where I could go, you know what, I can travel again, I can be away, and people don’t need me all the time. 

I revved up my career again. It takes time because you’ve been out of the loop – what’s happened to your network, what’s happened to your skill set, all of those things. I had to do some rebuilding. 

If there’s one message I would give to women who are out there trying to do this, it’s just figure out how to stay in the game. There are different stages of your life, so try to figure out what’s really important at different points in time, and embrace all of those things. Everything in hindsight makes perfect sense. I look back and I think I’ve made the right decisions, even not going to that large company.

Did you regret that or not?

I did for a long time. I was like, oh my gosh, I would have made this amount of money. Doing the math just like I did when I was 17 and going, “Oh, shoot, what did I do there? Why did I not even consider that? What was I thinking?” But I couldn’t imagine being more fulfilled in my life today, so no regrets.

Is there anything that you know now, that you wish the younger version of yourself had known? 

To not worry so much about all of this stuff. Also, don’t be afraid of failure. 

I was terrified of failure. What it does is it limits your ability to do interesting things. Working with smaller, growth-oriented companies, your odds of failing are a lot higher than in larger, more defined companies. I was made the COO of my company around 18 months ago. The truth is, I have been running operations since I started, but it was not necessarily my strongest skill set. 

I had a spike in the finance area, and I did a good job of managing people and understanding processes and so on, and that helped me to drive the operations. But I would have rated myself at a B- when I first started heading up operations. 

At the point where I was made the Chief Operating Officer, I had probably reached an A-. Now, I’m working with our Operations team to move toward operational excellence and improvement. The only way you can do that is by taking on things that might feel uncomfortable to you, and enlist people to help too. There’s a lot of people who know a lot more than you do. That’s how you grow, but it’s uncomfortable to grow. 

Absolutely, most people are comfortable being comfortable. What challenges do you think women face in leadership?

If you’re an executive, and let’s say, you’re easily working 60 hours a week, and then you’re trying to parent as well, forget about everything else, forget about friends, forget about taking care of your house, forget about cooking. 

If you just try to do a good job with your work and your children, you are doing 100 plus hours a week. That’s really, really hard. Would I have changed anything? I don’t think so. My husband was very supportive. But the reality was, I wanted to really be there and be doing a lot of these things. 

SI BONE Nov 2018
SI-BONE rings the opening bell in celebration of their IPO, 2018.


The second thing is, don’t be intimidated in an environment with men. I was fortunate here, too. I have an older brother who was a rule breaker. I definitely follow rules, but I also question them. Why can’t a woman do this? I used to like to follow him around, and he tended to get into trouble quite a bit, and I would get into trouble with him. I was used to hanging out with the guys and I feel pretty comfortable walking into a room with all men. Some of my best mentors have been men.  I wouldn’t have gotten to the CEO level without the support of the men at my company.

Another challenge is some of these companies, they’ll talk about cultural fit and how important cultural fit is, but sometimes what cultural fit means is everybody’s like one another. So you’re coming in and you may naturally be a little bit different, but if you embrace that role, and you celebrate it and feel good about it, everybody around you is going to feel comfortable with it too. That has been my experience.

Do you see differences in your company between the way that women and men lead? 

There are different styles. I like doing different personality tests. In Myers Briggs, I fall into the ENTJ category. We use Predictive Index as well, and I fall within a captain or a persuader. What’s interesting about the results of these tests is that my personality tends more toward a typical male leadership personality. 

For example, I mentioned the ENTJ personality.  The T stands for thinker versus feeler. 80% women are feelers, and I’m a thinker in the 20%. There are opportunities and issues with that. First of all, people expect a woman to be a feeler, because the majority of them are. A thinker actually just means you’re more focused on equity and fairness, as opposed to how everybody feels about everything. But if you’re aware of yourself, having EQ is really important and understanding how each person may react a little bit differently to your personality is important. 

I’ve got a pretty big personality, and I’m going to tone it down a little for certain people because I’m not sure they’re going to like the bigger personality. Then there are others where it’s all out there. So, I do tend to change how I interact with people based upon what I think is going to be most effective with people in a professional environment. 

I’m sure that’s probably in part why you’ve been very successful. The ability to read the room and meet people where they are. 

If you’re going to give advice to women specifically, what are some strategies for women who are looking to grow in their organizations and to have a more prominent role? 

There are a couple of things. First of all, to really understand where you add value. I had to do this when I was thinking about a board seat, so I’ll use that as an example. I had to really think about not just what do I want to do, but really, “What would I be good at? Where would I have the most impact? Where would I add the most value?” 

If you can answer that question, I really think a lot of stuff falls in place for people. Start with where you think you can add the most value based on your own skill set or what your interests are, and how you want to grow; those sorts of things. Then, identify what sort of role you’re interested in and figure out how to get from point A to point B. 

This usually encompasses conversations with mentors. Be open about it. 

At times I’ve heard women say, “Well, they should have known I wanted to do that or they should have recognized all of these contributions that I made. I was really upset when nobody noticed it and didn’t give me that promotion, or I didn’t get that increase in pay.” Just assume people don’t know. Just say, “This is what I’m aspiring to,” so that it’s very clear and there’s no confusion about what you’re trying to do. 

“There are different stages of your life, so try to figure out what’s really important at different points in time, and embrace all of those things.”

Sometimes that gets back to this fear factor. If it’s somebody else that’s responsible, if it’s my manager’s job, then if I don’t get that promotion, I don’t feel so bad, because it was somebody else’s fault, not mine. It really is just owning your successes, owning the failures, and being okay with it. 

I really think it’s hard when you’re younger to do that, because emotionally, failure is extremely painful. You get a certain amount of excitement from your successes, but it pales in comparison to the pain you get from a loss or failure of some sort. People are busy trying to protect themselves. But in the process, you don’t get anywhere. 

So true, it gets back to whether people want to grow or not and are willing to take the personal risks to do so 

I want to wrap up with, what are you most excited about right now? 

From a career perspective, I had talked about all the challenges that we had earlier in our business, and we’ve knocked down pretty much all of those challenges. Reimbursement, we have coverage for almost every person in the US. The amount that’s paid for our procedure is adequate for facilities as well as for surgeons. 

Now I’m really looking forward to working with our team to execute on our plan as the CEO of the company, and to see how rapidly we can grow. 

That’s great. Thank you so much. 

You are welcome. Great talking to you.

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