The wealthiest people in the healthcare industry prove there's no one way to the top. Companies that now yield billions were built in garages, basements and spare bedrooms, and their founders and CEOs once worked the breakfast shift at McDonald's or were two-time college dropouts.
Here are the trajectories the five wealthiest people in healthcare took to the top of the Forbes 400:
Jeff Bezos (Amazon)
Net worth: $161 billion
The richest man Forbes ranked in the healthcare industry — and the third-richest man in the world — got his start at McDonald's, working as a short-order line cook during his high school years. After graduating as valedictorian, he attended Princeton (N.J.) University, where he received his bachelor's of science in engineering.
Mr. Bezos' first job after college was at Fitel, a fintech telecommunications startup. He served the company for two years, including stints as head of development and director of customer service, before transitioning into the banking industry. He worked another two years as a product manager at Bankers Trust before joining the new hedge fund D.E. Shaw & Co., where he ascended the ranks to become senior vice president in four years' time.
In 1994, Mr. Bezos and MacKenzie Scott, his wife at the time, left their jobs to begin Amazon. The company began as an online bookstore operating out of a rented garage in Bellevue, Wash. Nearly three decades later, the company is an e-commerce giant with a market cap of $1.36 trillion. It's now looking to crack the healthcare space through various outlets, including Amazon Clinic and One Medical.
Larry Ellison (Oracle)
Net worth: $156 billion
Larry Ellison enrolled in the University of Illinois-Urbana Champaign as a premed student, but withdrew his sophomore year after his adoptive mother passed away. He was later accepted to the University of Chicago, where he studied physics and math for one term before dropping out once more.
Mr. Ellison moved to Berkeley, Calif., to work as a computer programmer without a degree. In 1973, he began working for the electronics company Ampex, where he met another programmer, Ed Oates, and his supervisor Bob Miner. He left the company after three years and joined Precision Instruments, a tool manufacturer, as vice president of research and development.
In 1977, Mr. Ellison teamed up with Mr. Oates and Mr. Miner to form Software Development Laboratories, which was intended to provide contract programming — but Mr. Ellison's vision for SDL extended further. Inspired by a research paper, and using a grant from the Central Intelligence Agency, the three developed a commercial relational database using structured query language. Oracle was released in 1979 under the company Relational Software, Inc., and had become the largest database management company in the world by 1987.
Thomas Frist Jr., MD (HCA Healthcare)
Net worth: $22.6 billion
Dr. Frist Jr. was born to a prominent internal medicine specialist in Nashville, Tenn. During college at Nashville-based Vanderbilt University, he created a collegiate advertising company and earned his pilot's license. He went on to medical school at Washington University in St. Louis and then returned to Vanderbilt for his surgical residency.
The Vietnam War interrupted his residency, and Dr. Frist served two years as a flight surgeon in Warner Robins, Ga. During his service, he had the idea for a company that would bring hospitals together to share resources: a health system.
In 1968, he formed Nashville-based HCA Healthcare with his father, Thomas Frist Sr., MD, and Jack Massey, the venture capitalist who acquired Kentucky Fried Chicken four years earlier. The health system was one of the nation's first investor-owned hospital companies.
Carl Cook (Cook Group)
Net worth: $9.8 billion
Mr. Cook was born to William and Gayle Cook in 1962. In the year after his birth, his parents co-founded the Cook Group, a medical devices company, in a spare bedroom of their Bloomington, Ind., home.
Mr. Cook earned his bachelor's degree in engineering from Purdue University in West Lafayette, Ind., and his MBA from the University of Iowa in Iowa City. He traveled to France and Germany after graduation to set up computers for the Cook Group, then held various positions within the company's pacemaker division and Winston Salem, N.C.-based plant.
He took over as CEO of the Cook Group when his father died in 2011.
Judy Faulkner (Epic Systems)
Net worth: $7.4 billion
Ms. Faulkner received her bachelor's degree in mathematics from Carlisle, Penn.-based Dickinson College and her master's degree in computer science from the University of Wisconsin-Madison.
Shortly after graduating, she co-founded Human Services Computing with John Greist, MD, a psychiatrist. The company began in a basement with a $70,000 investment from friends and family, and has remained a privately held business. It later became Epic Systems, which now stores the medical records of more than 200 million people.