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

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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. 

Resources:

http://www.tennessean.com/story/opinion/2016/05/01/how-many-people-really-moving-nashville-every-day/83100468/

http://www.hospitalcareers.com/blog/10-best-places-to-live-for-healthcare-jobs/

http://www.cnbc.com/2015/09/29/from-music-to-health-care-nashvilles-thriving-start-up-scene.html

http://www.census.gov/newsroom/press-releases/2015/cb15-113.html

http://time.com/money/3398229/where-millennials-are-moving-for-jobs/

https://www.entrepreneur.com/slideshow/248148

http://www.pewresearch.org/fact-tank/2016/04/25/millennials-overtake-baby-boomers/

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Communicating in the New Millennium

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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.

Millennials

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.

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http://www.golfdigest.com/story/a-baby-boomers-9-step-guide-to-millennial-golfers