Could tugboats be the answer for Nashville’s Growing Healthcare Industry?


Nashville is growing at more than double the national rate and, as with any city experiencing the influx of new residents, there are issues. Sure, there’s traffic, and trust me, you can’t go anywhere in Nashville without that being brought into the conversation. However, in this case, the intersection of growth and the existing infrastructure of Nashville is good, very good. In fact, when you take into account the very strong and evolving shift in how we must do healthcare, the growth in Nashville, paired with the existing large companies, makes it a perfect place for where healthcare is headed.  We need out-of-the-box thinking (especially from Millennials) in this conversation to push this shift into being. 

Nashville is known for many things…the generous welcome to visitors who can partake in the arts, music, history, food, culture and nature which presents itself at every turn. Nashville is also known for access to higher education, having some of the nation’s best Universities within walking distance to our city center. But most important for this discussion is that Nashville has a fantastic healthcare presence. CNBC stated, ‘healthcare is a major part of the Nashville ecosystem, with a $38.8 billion impact on the regional economy in 2014.’ It is that very large presence which helps employ, and care for our growing population, which is no short order. On top of healthcare’s help sustaining the local economy it is also a major powerhouse with implications far reaching beyond our city alone, having 18 publicly traded healthcare companies operating out of the city. So that’s one piece of the puzzle and a very major factor in why Nashville is the perfect place to pivot healthcare.

As stated earlier, the next important factor, is that Nashville is growing, and the growth is most noteworthy in that it has a bit of the ‘Benjamin Button effect’. Nashville’s population is growing younger as it is growing larger. Millennials make up 25% of the US population but are over-represented in Nashville, with more Millennials present here than in the general population. This increasingly young demographic is pushing us to think and accommodate differently. Millennials are simply ‘different’ but that’s what makes Nashville a perfect place to watch what happens next in the healthcare space. This is the piece to the puzzle which makes for the perfect intersection for the future of healthcare; “healthcare” is one road. “Millennials” is the other.

The Millennial generation is a unique cohort in that they are connected to each other. They want things delivered in a way which suits them; their needs, their value perceptions and,very often, their space. They choose not to go to products, services or experiences but to have them available to themselves when and where they want. This is as far from a push economy as it gets. This is all pull, so best be ready because healthcare is in for a bumpy ride if  the powers that be don’t take note now before it’s too late to right the ship. The great news is that this generation is an incredibly innovative and forward thinking group. They are willing to put ideas out there to address their needs and desires differently than ever before. They are the engine in innovation.

Here’s where the problem of this most perfect union presents itself. The current model of healthcare is not quick enough to address this shift. It is much like a large ship, and it takes an effort to make that turn and change processes and deliverables in a way which reflects the needs of a burgeoning subset. This lack of agility is what could lead to the crumbling of the monoliths of healthcare and a significant shake-up as we adjust to the new way of moving forward in this space. But it doesn’t have to be that way. We can visualize and implement change, yet still lean on the old guard. We can get what we want, how we want it, but still be able to rely on the experience and stability of the current model.

I grew up in Western New York where the waterways were ever present. There were ships aplenty coming down our rivers and traveling about the Great Lakes. It was not uncommon to see an itty bitty (comparatively speaking) tug boat tethered to a great ship in order to help them navigate the waters with a bit more ease than they themselves could muster. It is this analogy which helps shed some light on what  needs to be done and how Nashville is the perfect testing grounds, and potential model, for the new way of executing healthcare.

Innovation is key and fostered quite beautifully in the landscape of Nashville. Yet the issue is that the innovation is being done in a relative vacuum without much consideration for the existing structure in healthcare. Mind you, this is not by design.  Quite simply, validating and executing grand shifting methods of doing healthcare without the financial backing of the giants that dot the healthcare landscape makes it a bit like a tug boat without its ship. It is in this moment, the time when the Goliaths realize they need David as much as David will come to rely on the Goliaths that all could be right in the healthcare world.The ship will be turned because of the help of the tugboat which will, with far more flexibility and agility, navigate the waterway that is healthcare in and beyond 2016.

So here lies the perfect intersection. When Goliaths extend their hands and David is afforded the bandwidth to continue to innovate, we will see the shift happen faster and more effectively than if these two powers don’t meet. As it stands, when they remain staunch and ‘siloed’ little gets done, or at least gets done quickly. The ‘bigs’ are too large to affect change in the near future and the ‘littles’ often lack the funds or validation to move their innovations efficiently and effectively forward. We are in ‘that moment.’ A paradigm shift is upon us and we need to have processes in place that tether the tugboat to the barge in order to get to a more patient-centric, better, faster, more innovative way to distribute and attend to our healthcare needs. 


Angels Everywhere

By Lorac
It was awkward, driving with tear-filled eyes and overwhelmed by my thoughts about a current crisis in my family. The recurring illness of one of my family members was taking its toll. Nonetheless, a woman caught my eye—or was it her passenger?

I saw him reclining, relatively motionless, in the front seat of the car. He was handsome, thirty-something; she attractive, together-looking —I’m guessing it was his mother. Easing into traffic, I snapped a mental picture, even though my mind was still preoccupied with my problem. Her gray hair and powder blue sweater gave an added maternal softness to her already gentle, smiling face.

She seemed to be talking to him; his face was quizzically turned toward her, ever so slightly. He appeared to be trying to comprehend what she was saying, or perhaps who she even was. Quite suddenly, I found myself stepping out of the depths of my own anguish, and feeling hers. I have worked and cared for mentally handicapped persons and the association was, truly, not only one of sadness but also the prevailing feeling I related to at that moment.

Spend a few hours, or a day, with a person – loving every precious moment and looking forward to the next time together. Surely, the bond will be built on this ever increasing knowledge of each other. The joy will be greater, the relationship will grow. We do that with new born babies, neighbors, friends, lovers and pets. Now, imagine that mother building a relationship with her son, over and over, on a daily basis. Perhaps he looks upon her face today wondering who she is, not realizing that this was the face he learned to love yesterday (or ten minutes ago).


You see, maybe he can’t remember. And maybe, just maybe, every day, Mom secures her heart, ready to put a lifetime of love into one day, one moment of awareness, because tomorrow, well, who knows. Through it all, she smiled! She looked at peace! Gracious, how does she do it? In thirty-some years, how many tears has she cried? Surely, there were the joy-filled ones at his birth. And, today, did she cry, or blame herself for the hopelessness of his condition?

And yet, I observed joy and peace on her face. Could it be that she has come to the realization that every day is a new beginning? That every day brings new discoveries? Think back… take a moment and remember the first time your own child said “mama’ or “papa.” Today, would you trade the joy you felt that very moments when your child knew she was yours? Or the first time he looked at you with that special child-parent bonding? Have any victories since been sweeter? Different, yes. Sweeter? Close your eyes and think about it.


You know, every now and then, life freezes a vignette in time from which we can learn; to catch angels flitting about, tapping us on the shoulder, showing the loving finger of God pointing toward a lesson. I’m not quite sure I heard flapping, and certainly saw no parting of the veil by a holy hand yet, in my mind’s eye, I did. In that brief breath of time I saw her story, your story, my story; the human drama in which my family’s time onstage is but a cameo appearance.

In that heartbeat of time, I was able to step away from “The Problem” and gain perspective – to acknowledge the positive moments within my situation and to invite happiness back in. I decided that I prefer peace to turmoil, joy to sorrow, contentment to frustration, and of course, an openness to love. It was only one moment in time. I never saw them again. Were they real? Don’t know. Doesn’t matter. The lesson was. I arrived home with a smile on my face and genuine joy and peace in my heart. The situation there hadn’t changed one iota… the change was within me. I realized that life truly is good, if we will but look for the good in every day. It’s there. Look for it. Listen! Are those beating wings I hear? Angels truly are never far away.

5 Essentials for Creating Culture

Essentials for Creating Culture

The new buzzword for start-ups in healthcare is without a doubt the word culture. A quick look at Harvard Business Review finds 7,153 articles that center around culture in the subject of managing organizations alone. There’s all kinds of culture-talk happening. There’s:

• corporate culture
• data-driven culture
• culture of originality
• emotional culture
• continuous improvement culture

When a word is presented at every event or tossed back easily at lunch with a taco and a mojito, it’s easy for it to lose its intended meaning. However, culture is more than a buzzword. It’s actually a crucial component to customer satisfaction and specifically in the healthcare space, to peoples outcomes and quality of life. Culture is far more than a box that needs to be checked off when you’re building, or redesigning, a company, it is the key to how effectively you’ll not only reach your target audience but in the end how loyal they’ll be to you. And, considering it takes far less to retain a patient than to attract new ones wouldn’t this be a great goal to have?

1. What do people mean when they say culture?

As per culture is…”social heritage of a group… It is a pattern of responses discovered, developed, or invented during the group’s history of handling problems which arise from interactions among its members…”
As per Wikipedia, “culture is a central concept in anthropology, encompassing the range of phenomena that are transmitted through social learning…”
Key in these definitions is that culture is intimately tied to ones’ audience. There is no way to build, refine or transmit culture without looking to the perception of ones’ members. You can not build an effective culture in an ivory tower. There is most definitely a back and forth. Culture works only when built (or tweaked) to address previous experiences (social learnings) with members.
And, a successful culture only comes into being if the following four things are taken into account.

2. Culture isn’t created in a Vacuum.

Screen Shot 2016-05-05 at 4.30.58 PM
Here’s the thing, you can’t just start listing your vision and values in an office meeting and call that your culture. And you certainly can’t duplicate another company’s culture and call it your own. Culture is created over time and you need one crucial element that ignites the entire process: Your consumers. Your target audience.

Who are your consumers and what do they need, want and expect from you? Before any corporate culture is built, you must know your audience. Culture isn’t created in a  vacuum.
Business, in general, is no longer a function of push it out and have people accept what you’re selling (that may have worked with past generations but that is no longer true now that fresh generations are at the forefront in our society) now it’s truly a matter of pull from them: what do they need, what will they respond to, how do you reach them, how do you keep them? Until you know these things, set your culture aside, it may be your ‘ideal’ but that doesn’t mean anything unless it is also the ideal of your audience.

3. Talk to Your Intended Target.

If you are in the Health Care space, consumer research is absolutely necessary to determine the following answers:
What information do your patients need prior to choosing you as a healthcare partner? What information do they need before stepping foot into your practice? What do they expect once they arrive? What does a patient require as they leave, and beyond, your care?
Once you hear from them, build processes that meet said needs. Consequently, patient experience and satisfaction will correlate positively. If you develop a mission that doesn’t align with the needs of the intended recipients, it will fall on deaf ears. You must find out the following:

• Expectations
• Needs
• Wants
• Pain points

From the answers to these questions, build your mission, processes and internal culture accordingly to hit each and every one of them head on. If you do this successfully not only will your practice flourish but the loyalty to your practice will be second to none.

4.  Build Your Culture from the Outside In.

Once you know who your target demographic is and what their needs are, you can hire based on who can accomplish the tasks needed to meet the clients’ needs. Only after this happens people, practices, processes, and place can be determined.
If you choose to hire before your culture is fully formulated and put it into action it is likely the training you’ll need to do with your employees, so that they can better convey the culture will take away from any benefit you thought you had in filling your work force early.
Take the time first to know who is needed to best fit your culture, who will transmit authentically all that is intended, and then hire accordingly. Once your internal culture matches that of what is expected from your external audience you have the recipe for success, efficiencies, positive outcomes and loyalty.

5. Patient Driven Culture vs. Doctor Driven Culture

Right now the health care space is seeing the beginning of a paradigm shift. Patient-driven culture is growing because the doctor-driven culture has shown itself to be lacking.  In the past patients were apt to take a doctor fully at their word, never question a diagnosis or a set protocol for recovery. Now, not only have the times changed but the generations with it and they demand more; they demand a voice, they demand a partnership, they demand a seat at the proverbial table of their own healthcare.
As we are in the midst of this shift we’re finding not all practices are getting the memo. Until such time that we are all speaking the same language practices will find patients will look elsewhere for care. Now care is literally only a click away and the newly empowered generations are quick to go that route or to use easily accessibly walk-in-clinics and they don’t feel history with a practitioner is as important as convenience. Once healthcare providers and healthcare recipients align the efficacies of our system will greatly improve. The current burdens, such as wait time, costs, and even (re)occurrences of diagnoses will decrease.
A patient-driven culture creates the empowered patient which encourages ownership of their own health. Healthcare is no longer a ‘silver bullet’ directed by doctor but, better yet, decided upon, analyzed by and bought into by the patient. Study after study proves that the more the patient is empowered the more committed they’ll be to their own care and the more committed they are will lead to better outcomes and lower healthcare costs and a higher quality of life.
Here’s to health. Here’s to happiness.

The Team Approach to Caregiving



A dear friend is completing her life’s final journey…at home.  Strong in her faith and experiencing joy with friends and family, she is at peace. At this stage her care is straightforward: Manage her pain, uphold her wishes, keep her comfortable, celebrate her moments of joy, and keep her safe. This is done through the loving care of friends and family who share in her days and nights, and the visiting hospice nurse who stops by a few times a week. Together, they are her care giving team.

This is the second time in as many years that I’ve shared in this sacred part of a friend’s final journey; winding down, buttoning things up and preparing for what comes next. 

I’ve learned that seeing someone through the process at home adds extra challenges, but if it is important to them, it is worth the effort. People are more likely to visit and linger, and there is levity generally not found in a hospital or hospice.  

So, how does a team of mostly inexperienced care givers do this and maintain their sanity as they help another through this final stage of living?  Home hardly provides a controlled environment. There are issues with personal care, feeding, safety, and, of course, the cultivation of joy.  The team that works best here consists of a Ringleader, a Researcher, a Social Media Manager, Doers, an Uber-Organizer, a Cheerleader and an Advocate.

The Ringleader knows the person journeying through (the Journeyer), all team members, and their roles. They need people to research, release information, gather food and supplies, or visit and offer joy to the Journeyer (or the team). They are the one that, when/if anything falls through, they must step in and take the reins and responsibility. This is the care giver who most needs support and encouragement. 

The Researcher brings options for care, updated processes and opportunities and new insights. The Researcher is objective, yet thorough. There are multiple confusing choices available from doctors and facilities, to treatment and nutrition. Several people need to fill this role as it’s quite complex. One can focus on the traditional options, and the other on the alternatives. Remember, because something is proven to extend life, it doesn’t mean that’s the acceptable choice. It is up to the Journeyer and/or their loved ones to determine quantity or quality, and how they’d like to balance those to generate peace.  Empowering the patient to make choices at this time can give comfort and control to one who is at the point of saying their goodbyes. 

The Social Media Manager is the glue…the person who disperses information regarding the Journeyer. The key strategy here is to build a large team. There is heavy turnover since it is both mentally and physically draining. Time being unpredictable, one must be prepared to loop in others to keep moving forward with as few interruptions as possible.  The Social Media Manager will frequently post updates and photos on various sites (e.g. Caring Bridge, Lotsa Helping Hands, Meal Train, GoFundMe, Face Book, Twitter, Instagram, etc).  This keeps the journey at the forefront for those who will want to lend a hand.

The Doer(s) are the muscle and the heart. They are ‘boots on the ground’ and the lifeline for the Journeyer. This is the group with the highest turnover. It’s a lot to ask people to cut the grass, clean the house, cook meals, or drive for a few days let alone for weeks or months.  Even loved ones reach their limits. It’s OK.  Be prepared and have new people ready. Manage the Doers in a way that best fills vital roles but still speaks to their core capabilities. You may find some suited to cooking but uncomfortable with visiting. If you need something more than another, focus on that and let the rest fall into place. It will.  The Doers need a leader. This Uber-Organizer is the person that takes the lead for all Doers. She/he utilizes resources wisely so as to not over-extend any one Doer. Tools are Voxer, Meal Train, Face book, or Lotsa Helping Hands. 

The Cheerleader is the person who enters smiling. Their role is to lighten the mood for the Journeyer. This journey is stressful: it’s heart wrenching, it’s beautiful, it’s loving, it’s life and it’s death. We will all pass through this journey; some of us suddenly, and some will wish to wind down in as peaceful and loving a way as possible. It is this final option to which I speak.  The Cheerleader helps the Journeyer to reminisce, share laughter and stories, and talk of joyful things. The Journeyer’s role is to absorb the good and put forth whatever they choose to leave behind. A great tool is Voxer. 

The Advocate is similar to the Ringleader but may not have previously known the Journeyer. The Advocate is a professional  touch point for the care team,  objectively managing ‘the system’ and offering options that fall ‘within coverage,’ financial abilities or time constraints.  

There are so many nuances at life’s end: constantly changing issues with healthcare, alternative offerings that need to be carefully vetted,  managing the dynamics of the family; how  to keep everyone in the loop and who has authority to do what and when? Conversations need to be held with the Journeyer regarding living will and their chosen course of care, who to connect to for a spiritual advisor, and discuss funeral arrangements and wishes for disbursement of specific mementos. Working closely with the Ringleader the Advocate is there to tend to wishes and alleviate any stressors along the way, helping to move toward joy in living and peace with passing. The Advocate is also there to lend support, a shoulder to cry on, an ear to listen and a caring heart for all those who are on the care giving team during and after the journey is over.

Here’s to health. Here’s to happiness. Here’s to finding one’s joy during each and every part of the journey.

Healthcare is a Grassroots Effort

I am fortunate enough to have the opportunity to talk to people about their experiences in healthcare all the time. Be they a patient or a caregiver there is a great degree of discourse out there. Maybe it’s because I’m a Market/Consumer Researcher? Maybe it’s because I’m a Sociologist? Maybe it’s because I listen? Maybe it’s just because I care. That being said maybe we all need to care just a little bit more because we’re in the midst of a significant shift and the writing is not only ‘on the wall’ but in the hearts of so many. I say it all the time that Millennials are teaching us how to live and the Baby Boomers are teaching us how to die and their wishes, their needs, their ways of doing things will alter how we do healthcare, whether or not the healthcare system is ready.

If you’ll come along and be a ‘fly on the wall’ for a couple examples of what I hear.

Caregiver/granddaughter: I just don’t know what to believe anymore. Hospice tells me one thing, the facility another, and the doctors a third, not to mention the in-fighting and competition between the sitters.

Caregiver/daughter: We never had a close relationship and now I’m the one in charge of her well-being. I just don’t know her wishes? We never talked about it? I want to do what’s right for her, she is my mother, after all, but I don’t know where to start.

Patient: I can’t get my doctor to listen to me. They’re in and out in no time and I just need more information. I feel like I’m being led instead of having a say in my treatment. This is my health after-all, right?

Caregiver/spouse: It’s my job, my obligation, to care for him. I don’t need help. This is the least I can do. I’m exhausted but I want to do everything myself. It’s the right thing to do.

Caregiver/daughter: It’s expensive! We’re talking $8-$11,000 a month for basic care and the facility. We’ll be out of money in three months. How do people do this?

Caregiver/daughter: We’re just living too long. When my day comes I say just give me something and let me drift away. You know there are states that allow that?

Caregiver/son: I think we’re regretting the decision that a few years ago, when mother was 90, we used heroic measures to save her and now she has dementia and what quality of life does she have? Maybe she wasn’t meant to still be here?

There are so many unknowns regarding healthcare and especially end-of-life, and that’s why we are where we are right now. This part of the journey is not scripted. There is no ‘So you’re expecting …’ manual for the end-of life like there is for the beginning. The multitude of the unknowns teamed up with various opinions, life experiences and technical know how bring us to the point where we are needing to strip down the system to its most basic and build it up again to suit the needs of the ‘new consumer’.

The younger generation is full of ‘want it now’ and ‘want it my way’ types. This is a good thing when you learn to adjust and listen well to their voices as you do so. Build in tools which bring healthcare to them where they are, when they want it and complete enough to offer them the options to choose the best course of action for them. Give them treatment options, pros/cons, costs, timing…give them the information they would have at the ready when purchasing any other good/service. They are fully aware they are capable and they insist on being empowered to make their own decisions.

The older generations have seen their share of grief and hardship. They were the children who witnessed the greatest generation fight in wars, as did they themselves. They were the generation who saw their loved ones through death in their own homes when they were children. They were the generation that came to adulthood as the boom of nursing homes took hold and we started the great shift toward ‘institutionalizing’ our elderly. There were scars left on their hearts when they saw their parents through end-of-life out of their homes and away from loved ones. This generation is opting out of that for themselves. This generation is of the belief that quality trumps quantity and they want to ensure when they have lived their lives that they can finish their journey with as much dignity and pride as the current state of healthcare will offer.

What’s happening now is ‘the great conversation’. Sometimes behind closed doors because people still don’t know where they (or others) stand in this new way of navigating the system, but often being had none the less. People are hungry for information. People are thirsting for support. People are desperate for insight on how to manage not only their own health but that of loved ones in a way which is dignified and affordable.

Enter Go-Fund-Me and other such tools which offer a platform to raise funds to help in many ways but more and more specifically for healthcare and end-of-life. With the restrictions of insurance and the limitations within traditional healthcare people are expanding their net and looking elsewhere and paying out of pocket.

Enter Caring Bridge and other such tools which offer an outlet to disseminate information to the masses to encourage group participation in your loved ones care. Caregiving is exhausting work and even those with the best intentions are due to burn out. Having people in the loop and ‘at the ready’ ensures that your loved one will always have someone to take them here or there or sit with them and hold their hand or, at the very least, offer them moral support or send lovely cards or gifts to brighten their day.

Enter Meal Train and other such tools which offers support to feed not only the bellies of those in needs but hopefully their souls as well. When people know there are others who care enough to build and deliver a meal for them it offers them hope and a certainly a glimpse of the good in humanity.

Enter Support Groups which give caregivers or patients an outlet to vent and realize their not alone, share advice and offer hugs. These groups also offer them insight that there are many ways to walk through this amazing thing called life and often there are options available they simply never knew existed.

Healthcare is a grassroots effort. We are using more and more tools to aid us as we journey forward. We are bringing more voices into the conversation, sifting through more information and building our own protocols that fit our wishes and beliefs. We are shifting away from an organized system with a set entry point, protocols which serve the masses and relatively predictable end-points. The script is being muddled, we’re living longer and people are taking their own lives into their own hands and all they ask is for support and access to information along the way. We find that the more one is empowered the better their quality of life. We have learned that the more say one has in their care the less of a burden they are on the system. We have studies that show us lower healthcare costs if only we can come to weave into our current system new ways, new processes, new opportunities, and, in the end, less heroic measures.

At the end of the day if you ask a patient it’s about quality. If you ask a caregiver it’s about quantity. Our loyalty to those we love leaves us fighting for more as that’s how we believe we show our love and devotion. It’s beautiful, it really is, but before we fight for someone else let them have a say before they lose their voice. Have the conversation. Keep your fight on task…fight to abide by your loved ones wishes not simply for more days. These are tough conversations to have but necessary and loving at their very core.

These are interesting times and I am honored to have been a part of loved ones lives and end-of -life journeys and I am empowered by the knowledge I gained during those days and months of care and constant researching to find the best ways to handle whatever was, and is, at hand. I am hopeful that when we step aside and set ego and greed on the back burner we’ll find a way to enrich the quality of our lives from start to finish. It’s not always about more test, additional surgeries and more days.  Of course, sometimes it is…and that too is a choice and one which ought to be respected. It is after all a journey and every journey must end.IMG_7610






Communicating in the New Millennium


Strauss and Howe’s categorization of the Millennial puts the birth range from 1982-2004.

As the world spins faster and faster into the digital age, companies need to know that they are communicating with two distinctly different consumers and workers. Baby Boomers and Millennials find themselves trapped in lockdown of miscommunication. They may speak the same language, but a translator is needed to bridge the gap of understanding. Particularly in marketing to these consumers and in hiring boomers and millennials, businesses must approach each group with the care and uniqueness that sets them apart.

I’ve made it easier for you to find the distinctions that drive each generation and then how to communicate, motivate, and cooperate with these two groups of people.

baby boomers-6Baby Boomers

Born approximately between the years 1946-1964, these 52-70 year olds came into the world during a time of conflict. World WarII was barely in the rear view mirror, and many of their parents, those of our Greatest Generation, fought in that war so it was never far from conversation. The Vietnam War — a highly contested and volatile war —trailed closely behind, while the Civil Rights Movement and Martin Luther King, Jr. dominated the news. These boomers experienced social changes in women’s rights, birth control, and abortion. During their formative years, the Berlin Wall was built and the Cuban missile crisis kept them practicing drills at school.

They were also born during a time of expansion. The world saw the 1st man on the moon,
Televisions became more widespread and available to the masses, and
suburbs were created. Boomers lived during the time where the adage of work hard and reap the benefits was never more true. The economy was booming and people were living well after the war, up until the early 70’s. This set of kids saw their parents going to college and working in ‘traditional roles’ in traditional fields, for them it was unlikely their parents were entrepreneurs.

This is a generation that:

Is patient and not at all entitled – They saw their parents work for all they got, and they had those same expectations instilled in them. They were raised by the Greatest Generation who lived as though at any moment the bottom may fall out again. They were conscientious spenders and hard workers.

Had a voice – This is the generation of marchers/protesters and flower children. They saw great conflicts in their life times, and the pump was primed for them to jump in and lend a voice and a hand.

Are collaborative workers – They learned when you join forces through their marches and protests that there is more strength in numbers and that followed them into the workforce. They were happy to work as a team and leave their own interests at the door for the greater good.

Put themselves last – this generation was far from coddled as their parents were busy re-establishing their families, getting educations and making a new life for themselves. These kids were independent and were expected to step up and help the family as a whole. These kids are also the ‘sandwich generation’ – carrying for both their kids as well as their parents, this, in and of itself, left little place for ‘me’ time.

Experienced death differently and less ‘intimately’ than generations past:  Aging in America became a business during this time. While the process started in the mid-50’s to establish elderly homes it was really in the 60’s – 70’s that this business model burgeoned and started to take in great numbers of our older population. Baby Boomers watched their parents…their heros…die in homes and institutions unlike any generation prior. For example when Boomers were children they likely saw their parents tend to their grand-parents through the end-of-life in their own homes. It was not unusual to see Grandpa take up residence in what used to be the family living room. Therefore this new ‘outsourcing’ of end-of life put both an emotional stressor on their shoulders, as they felt as though they were abandoning their parents, and a fiscal stressor on their pocketbooks. Now, with life extended they had to cover costs for nursing homes and/or they had to build in travel expenses to visit their continually aging parents possibly across many states. This was far from an intimate was to die, this was death in the age of commercialism and capitalism.

Are fiscally aware but not necessarily prepared – this generation saw great growth in the economy and for some time tremendous strength in a growing middle class but if they didn’t, or weren’t able to, prepare accordingly for a rainy day, this generation also saw the dramatic shrinking of that very middle class with the passing years. Boomers also experienced a significant shift in power and the reality of our dependence on other countries for things so important to our everyday lives as oil. This generation remembers quite vividly the gas shortages and the lines at the pumps with their babies in tow, during the 70’s. They also had the aforementioned hardships of carrying for multiple generations which often depleted their savings and the likelihood that they would over commit to savings such as 401Ks, according to The Fiscal Times (October 2015), ‘the average retirement portfolio… has just $136,200 in it.’ This severe shortfall has led this strong and capable generation to rely heavily on the promise of social security.

How they need to be reached and communicated to:

  • They still read newspapers and rely on the TV for their news.
  • They prefer face-to-face interactions over being buffered by forms of technology
  • They are happy to make due and while they have proven themselves to have a voice; they also believe in the greater good and tend to not want to make waves.
    • This tends to keep this generation a bit quieter than the millennial and more likely to ‘do as they’re told’.
  • They tend to have have more scattered families therefore are more likely to feel the need to maintain their independence and not have to rely on others for their well-being.
  • They tend to choose quality over quantity of life as they saw the harm done to their own psyche as well as the well-being of their parents due to the options and institutionalization of the end of life (noted above).
  • They are not quite as adept at researching their options and tend to lean on others who are ‘at the helm’ be it in commerce or healthcare. They want to be involved in decisions which keep them healthy and capable but are overwhelmed by the vast amount of information available to them.
  • Offer a support team to help in major healthcare decisions and the ability to decide how they’d like to proceed.


Born approximately between the years of 1982-2004, Millenials are between the ages of 12-34 years. There is a great discrepancy on the range for this generation but for the sake of defining the borders of the generation we’ll ascribe to the categorization as set by Strauss and Howe. They were born during a time of connectivity. The internet was growing…exponentially. The Berlin Wall came down, unifying Germany and offering hope to the world.

While born into a time of unification it was also one of great uncertainty and lack of control of ‘others.’ There were bombings (Olympic Park, Unibomber, 911), and the OJ Simpson’s highly televised ‘chase’ and trial brought a new level of ‘reality TV’ into our homes. Drama was everywhere and now instantly accessible 24 hours a day. AIDS was an epidemic, and school shootings began, starting with the Columbine High Shooting, and continued.

This generation of Americans are technologically versed and fragmented. This was truly the MTV Generation; they never knew a world without music on TV.
The internet was accessible – AOL (1985) and email became a part of their world. Many were never aware of a ‘before the internet’ timeframe. News came predominately from TV and the Web, with Newspapers taking a back seat.

This is a generation that is:
Connected – Millenials are always connected to others and by various devices. “Smart” devices (phones, watches, cars, appliances, etc.) are responsive—or work across platforms or other devices at once— and support the use of multiple use as they thirst for a connection to the world.

Multi-taskers – Due to the multitude of devices at their disposal along with managing their ‘off-line’ existence, they’ve become amazingly adept multi-taskers.

Involved and wanting to give feedback – This generation relies heavily on others who came before and also, a type of a trickle down effect, are more willing to give feedback to those who may follow. They feel their voice has value, and they want to share opinions. This generation was likely raised in a household where things often revolved around them unlike the generations prior which were not nearly as child-centric. The generation proceeding them, Generation X,  was full of ‘latch-key’ kids so the parents for this generation tended to over compensated for this one. I believe the benefit of this is a stronger more confident voice for this generation which is in direct dispute with the other option and misnomer, the ‘Me Generation’.

Community oriented and ones who wish to effect change – As per the reasons above, they have a level of self-confidence not seen in past generations and with that a belief that they truly can change things. Consequently, there is a willingness to try to find opportunities to succeed often in niche ways (entrepreneurial) not seen possibly since our Greatest Generation (Those who grew up during the depression, fought in WWII and went on to build what is ‘modern-day’ America).

Comfortable with self-expression – Again their level of self-confidence leads to their ability and willingness to express themselves how they see fit —whether it be body adornments such as tattoos or piercings or freer expressions of themselves sexually. This freedom extends to other behaviors and groups as well and affords them a higher level of acceptance for people of other faiths, ethnicities and race.  For them, all is permissible within the realm of being true to themselves.

How they need to be reached/communicated with:

  • Meet them on their terms, where and when they want and bring them into the discussion and decisions – Don’t talk to, or sell them.
  • Utilize many avenues of communication from internet/social media, tv and lastly print.
  • Prove how working with, buying from or partnering with you affords them the opportunity to effect change and make a better world.
  • It’s not aways about the bottom line financially for them as much as it is about where the rubber meets the road and what it means for the greater good.
  • Lead them through their options and allow them to mix and match things as they see best suits their needs be it on a purchase or their own well-being/healthcare.
  •  Incentivize them to give positive feedback so others, like them, will follow suit.


If you still aren’t sure how to cross the generational divide, the magazine Gold Digest offers some more specific advice on how to play golf with a boomer versus a millennial.


Bright Cellars Has a Bright Idea

A Word from My New Friends from: Bright Cellars  

A New Way to Drink Wine

Bright Cellars has discovered a new way to sell wine

Bright Cellars has discovered a new way to sell wine

The wine industry can be an intimidating place, especially for millennials. It’s been perceived as pretentious and uppity for so long that it has driven away consumers, even intimidating prospective winos out of the wine aisle altogether. But thanks to two MIT grads with a love for wine and a desire to make the industry more accessible and entertaining, a huge shift has been inspired. It began with two roommates: a vehement business student and a merlot-sipping tech genius. Enter: Bright Cellars.

Monthly Subscriptions Ain’t Just For Magazines


Bright Cellars is a monthly subscription wine experience that matches member with personalized monthly selections. Members take a short quiz to share their taste preferences for food and beverages, which Bright Cellars then uses to design each member’s very own personalized taste profile. Based on this profile, the Bright Cellars algorithm identifies specific wines that are likely to match the member’s tastes. Bright Cellars’ slogan is literally “discover wine you love.” Not only do members get to rate and review four wines a month, but often this results in finding their new favorite wine, usually one they would otherwise never try.

Understanding the
Millennial Demographic

Bright Cellars

Bright Cellars has discovered a new way to sell wine. Wine + Custom Choices + Mail = Happy Millenials.

The subscription component of Bright Cellars is also a major score with the millennial demographic. Millennials as a group are likely to invest in products that feel personalized and reflect their personal style and brand. Bright Cellars promotes this customization through matching each member to each wine specifically. It’s as much of a wine discovery project as it is a wine education experience, with flavor and aroma profiles, and a blog that explores and explains the wide world of wine.

What Wine Can Learn from the Craft Beer Movement

Bright Cellars has discovered a new way to sell wine. Wine + Mail = Happy Customers.

Bright Cellars has discovered a new way to sell wine. Wine + Mail = Happy Customers.

“Other wine subscriptions have focused heavily on discounting and no one has solved the heart of the problem yet: There is a ton of high-quality wine out there that our members will love that they would never otherwise try, learn about, or have access to. Bright Cellars is the fun, interactive way to experience new wine,” says Richard Yau, Bright Cellars CEO. As Yau puts it,

“Millennials are ready for this. Nearly all of our new members learned about us through social media or bloggers. I think we can do for wine what craft beer has done for the beer industry.  We can help wine drinkers discover and learn about the world of wine. Gallo and Constellation Brands are looking at how to engage millennials, and I think we have that solution.”

A Christmas Revelation

Screen Shot 2015-12-02 at 3.59.46 PM.png

By: Guest Author, Lorac

While I waited for my ride in the relative comfort and warmth of the historic building’s entry hall, the woman opposite me caught my eye. She stood outside, in the cave of a cold, stone entryway of the shabbier, old building across the street. The icy, unrelenting wind roared around her, swirling up her summer-weight, lavender print, ruffled muumuu revealing mismatched white athletic socks, one edged with a wide band of Christmas red, and the other with Buffalo Bills blue. Only a top button secured her dingy grey jacket, which had long lost its puffy, insulated warmth. Her size did not allow for complete closure of the coat, so she gripped the edges together over her ample chest with her bare cold-cramped, right hand. She covered her straight, grey hair with a bright red, plaid neck scarf, looped securely under her chin against the biting icy gusts. Her left arm held a faux alligator purse which held treasures known only to her … and which she frequently inspected.

My first instinct was to feel sorry this woman. Then, I started to wonder about her. Who was she? How old is she? (Since I am approaching my golden years, I always wonder if a person I meet is younger, or if I am. I have acquired this quirk as a new senior.). On I reflected … where was she going? Is she waiting for someone? What is her life like? What WAS her life like? Is she happy? Is she excited about the coming holiday season? Did she fuss before a mirror to get dressed for this outing?

As I mused, she suddenly turned and opened the streaked glass and tarnished copper door, flashing the bright, silver reflective Nike symbols on her white sneakers as she crossed the threshold into the lobby of the building. I was disappointed to see her leave without any more clues to enlighten my imaginings about her. No sooner did that thought cross my mind when she re-appeared, now with a small change purse in her left hand. With her stiff right hand, she pulled out what appeared to be a large coin, a quarter, perhaps, and flashed it to a young man who crossed the street toward her … possibly a friend. She called a greeting, smiled broadly, revealing a few missing teeth, and spoke a few words to him. Unfortunately, I could not hear what they said from the cocoon of my warm refuge filled with inviting restaurant smells and Christmas music. I could see, however, that he responded; then they both laughed, and he went on his way. She stepped back inside again, only to once again re-appear, this time stuffing something into her side pocket and gripping her change purse close to her chest. She smiled and chatted to yet another passer-by, and I realized that she seemed quite content to “hold court” in this archway. Perhaps these individuals were part of her social circle inside that forbidding (to me) old building.

I noticed heavy drapery from another era in the windows of the building, which served as a hotel of sorts. Perhaps one of the rooms I spotted a few floors up was hers, or a gathering spot for chats, bingo, and games with her family of friends. Perhaps she left this refuge to wait for a bus to take her to a long-awaited destination – a Christmas party, possibly, with a hot, nourishing lunch, treats, candy, and gifts in gaily-wrapped packaging tied with festive bows. I do not know. I can only hope it is so.

I will never see her again, or have the answers to my questions. Nevertheless, this I do know. This woman, shabby and down on her luck, at least in my eyes, has her purpose here on earth, just as we all do. Was she one of those classic Christmas Angels that you read about this time of year, who was earning her wings, like Clarence in It’s a Wonderful Life? Did God send her to stand in front of me to make me aware of the fact that His children come in all sizes, shapes, and from all lifestyles? Did she appear to make me, and perhaps you, determine to make better the lives of the people she represented?

I know what the experience did for me … it gave me a call to action. Perhaps this story will strike a chord with you and you will make something fabulous happen for those less fortunate. After all, Christmas and Hanukkah are the seasons of miracles. Three rich and powerful kings traveled, guided only by a star and a yearning, to worship a newborn baby in a stable, hoping he was the promised Messiah – and he was; and an ancient lamp burned, miraculously, for 8 days on one day’s worth of oil. Our current miracle may have happened on a frigid and blustery day in Downtown Buffalo. What do you think? Oh, listen, I think I hear a bell tinkling somewhere … do you think our lady has earned her wings?


About Lorac:

Our newest guest blogger, Lorac, has been writing since the 80’s when life turned uninteresting. To release the boredom, Lorac dashed off a trilogy of stories and took them to the owner of the local newspaper in their small tourist ski town in the northeast. He liked them. Lorac got the job. Over the years, writings by Lorac became a fixture as the town grew exponentially into the now famous Ellicottville, New York, home to Holiday Valley which has ranked in the top five ski towns in the north east for many years.

Lorac has created tourist materials for the town, and created an annual parade in the middle of winter, on a state highway, at night, which might give you a view into the personality of our blogger. Lorac has managed one of Ellicottville’s top restaurants, written for the top quality Buffalo Magazine through its lifetime, is a part time lay preacher, was involved with establishing the first hospice in the Buffalo NY. area, was one of the first in Buffalo to hold a NYS certified EMT card, and helped to establish the first FAST (First Aid Simulation Team) in NYS.

Lorac says there’s a funny dog story attached to this one. Perhaps we’ll read it someday. One of this writer’s favorite positions was with the Seneca Nation of Indians as a Project Manager in charge of procuring doctors and other medical personnel for the Nation’s two health centers, which involved developing, scripting a first ever video of the Seneca Nation while being taught the ancient Seneca language by one of their revered elders. A parent of 3, grandparent of 4 (tot to teen), Lorac enjoys writing, gardening, DYI projects, cooking, the smell of sawdust, chocolate, fried chicken and gasoline, and is, naturally, a voracious reader.

The Power of Passion

Screen Shot 2015-11-24 at 9.27.29 AM.png

Passion is key to professional success. Without passion, you have nothing worth waking up for and heading into the office to build. A successful business begins with finding something you can throw yourself and your heart into.

When you work passionately with affecting change as your goal, the bottom line will follow.  A passion-based business always has at its core meeting your target market’s need.

Ask The Questions

In order to meet a need, you must first identify it. This process may take time because you cannot meet a need in a void. You need to get into the minds of your target market to understand fully what they need and how they’ll use it.

You cannot sit in an ivory tower, brainstorm what “they” want, and put it out there. The trick is for you to figure out how to discover what “they” need and make that happen. Do this by asking questions, listening to the answers, and then building your business around that gap. Fill the void.

Create your products or round out your concept based on what is missing in the marketplace. Ask yourself:

  • Are you building something to appease an individual, or is it a solitary offering?
  • Is it intended for a patient and a doctor or is it a patient and caregivers (family/friends)?
  • Is your product one that already exists, yet you feel you have a “better mousetrap” to offer?
  • Will your product/service speak to multiple generations? If so, do you need revisions within your product/concept in order to make it that much better of a fit?

Listen to the Answers

Of course beyond asking the questions is listening to the answers. Listen without bias, without editing, and with an open heart. When you listen this way, you’ll be able to push your passion through to fruition in a way that will be well received by those you intend to serve most.

When you’ve begun from a passionate position, asked the right questions, listened to the answers, and responded with a product or service that fills a void, you’re well on the way to securing buy-in from customers and investors alike.

Confirm Buy-in

Always confirm buy-in from your target market by reaching out to early adopters and brand advocates. What do these customers need to know about your business in order to feel comfortable parting with their money? Ask them what they need to ensure their commitment? Today’s savvy consumers are bombarded with purchase options and need assurance your product or service is perfect for them. Having social proof in the form of devoted customers gives that buying confidence.

Whether it’s a new product line in fashion or food, rebranding your existing business, conceptualizing new ways to connect patients to healthcare providers, or something as lofty as launching a bank, having a successful product or service is all about bringing your passion to fruition. You’ll do that through asking and listening and acting in a way that fills a marketplace void and meets your target market’s needs.

So, here’s to passion-based projects and affecting change! Here’s to business done in a way that shifts the power from the bottom line to the bottom of your consumer’s hearts.

Work With Us

Bringing in an objective and unbiased researcher will help you as you get started on your new, or existing, passion-based business. Let us help you with market research, ensuring you’ll ask the right questions, really listen to the answers, and be able to appropriately interpret and implement the results.


Guest Blog: How Do You Start a Bank?

CapStarLogo_PMS303_PMS4515 2014

By Beth Alexander, Private Banker and Communications Director of CapStar Bank

With an ongoing 30-year career in banking, Claire Tucker had a terrific job as state president of a growing bank, doing what she loved and knew well. Then one day in 2007, she got a call from an old friend, a former bank president she had worked with nearly a decade earlier at First American Bank. He had an unusual proposition: Let’s start a bank.

That would mean giving up her secure current job in the upper echelon of her institution and starting to work on…a dream.

The idea for a new bank was confirmed by market research conducted to determine whether middle Tennessee really needed another bank. The research found that while very large institutions were well-served by large banks and mom-and-pops were getting the attention they needed from small community banks, there was a lack of service to the businesses in the middle—mid-size businesses and family businesses that were growing or going through transitions that required both expertise and patient listening on the part of a financial banking partner. This resonated with Claire: She believed it and believed she could sell it.

Working with her old banking friend, the future chairman of the board, they raised more than $88 million in the fall of 2007 from nearly 300 mostly local investors, people who, they hoped, would open accounts and generate buzz about the new bank, CapStar. At that time, the Dow hit an all-time high of 14,164, and prime rate stood at 7.75%.

They worked with the bank’s new board to develop an ambitious but realistic five-year plan and began hiring experts, many of whom came from the core of successful people behind First American, to build the bank—crafting its lending policies, purchasing the latest bank software, building a culture of hard work and a strong team. One of their outside-the-box decisions: hiring me, a magazine editor, to join their sales force of highly experience bankers. Scary? Yes. And exciting. During those early sales meetings before the bank opened, I had a hard time visualizing exactly how it all would come together. But our leadership team was brilliant, far-sighted and working every hour to be prepared for the day when the Fed would issue the letter that allowed us to open.

CapStar opened on July 14, 2008, between the meltdown of Bear Stearns and the bankruptcy of Lehman Brothers, followed the next day by the AIG bailout. By then, prime rate had dipped to 5.0% and only five months later, it sank to 3.25% where it has stayed ever since. On December 16, for the first time in history, the Fed lowered its benchmark interest rate to zero. Did I say it was scary before? What kind of chutzpa did it take to open a bank in this environment? While it seemed as if we were walking a tightrope, our timing was serendipitous. All around us, other banks experienced the softening of their loan portfolios, while we had a clean balance sheet and the capacity to lend. Because of this, CapStar was also an attractive option to those who wanted to take their gains out of the market.

Now I understand what happens when a bank is born. Claire never lost her cool or her sense of humor; she never let us lose sight of the mission to meet the needs of those underserved mid-size businesses, their executives and their workforces. CapStar adopted the tagline, We’re Listening, to reflect our single minded intent to deliver on exactly what the customer needs to fulfill a financial goal—not simply to offer a product but to find a tailored solution.

Within three years, we were operating at a profit, and today CapStar is one of only two billion-dollar banks in the country out of the more than 70 that opened in 2008. In the past seven years, we’ve purchased and integrated a terrific bank in Sumner County along with a mortgage division and added financial planning to our menu of services.

Because of Claire’s leadership and that of the other leaders around her, I’m surrounded by colleagues at every level who are not bound by a 40-hour work week. We’re available to our customers at night and on weekends, and I consider my customers and my coworkers friends. They’re also my inspiration to get a little more done each day, wherever it’s needed. We all perform whatever task is necessary to get the job done for the customer and, as a team, for each other.

It is an inspiration to work with our President and Chief Executive Officer Claire Tucker every day—a woman who is always 100 percent engaged, personally attentive and wise in many ways, not just banking, although that is no small thing. Claire says she’s a late-blooming entrepreneur, but though she may have come late to the start-up party, her years of experience, the respect she wields in the community and her personal integrity give each of us a standard to aspire to every day. I can’t imagine a more effective model for leadership.

And if any of us ever need anything from our CEO, she’s listening.