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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Guest Blog: How Do You Start a Bank?

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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.

 

Guest Blog: It’s All About Passion!

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By Gina Butler, Founder and Chief Brand Officer of Gigi’s Cupcakes

Im passionate about baking and that allowed me to found Gigis Cupcakes. My entire family loved to cook and bake, so I grew up around it. My Aunt Bennie owned a bakery and catering business and I would spend summers with her. I’d help her bake, cater events, and read her cake decorating books. I loved to bake and had a passion for it at an early age, but my dream was to be a country singer. In 1994, I packed up and moved to Nashville with less than $500 in my pocket. I decided to pursue a country music career instead of going to college. During the day, I operated my small cleaning business and at night, I would sing at the bars and honky tonks near music row. In my early thirties, I realized that my music career was unlikely to take off so I decided to focus entirely on my cleaning business. A few years went by and then my brother called me while I was cleaning a home and told me that he had waited in line at a cupcake bakery in New York for hours. He said, “Your cupcakes are better than these. You should open up a bakery.” I looked at myself in the bathroom mirror and decided to go for it. I opened my first cupcake shop in February 2008 with only $33 left in my bank account. Now, seven years later and against the odds, Gigi’s Cupcakes has grown to be the largest cupcake franchise company in the nation. We just opened our first international location in early 2015 in South Korea and hope to continue to expand in other countries. summer4-600x660I think back fondly on those summer afternoons with Aunt Bennie, who is now part of the Gigi’s team, working on product development in the kitchen with me. We have over 300 recipes at Gigi’s Cupcakes and many of them have a rich personal family history originating from my grandmother, great aunts, my mother and other relatives, many of whom are bakers.

Im passionate about my company and how we do business, so when the opportunity to be on Undercover Boss came along, it was an easy YES! It was a once in a lifetime opportunity that I just couldn’t turn it down. We were one of the few small companies that they have ever highlighted. I had to do it and I’m so glad I did.

People often ask me what I was most surprised by during my experience. Two things that surprised me most were: 1) I was surprised by how many passionate and wonderful people work for us. It’s not just a job to them, they truly care about the business and the brand. 2) I was also surprised that we were consistently inconsistent. We didn’t have the exact same procedures from one store to the next. I knew we needed to address that immediately. The experience greatly benefited us! We learned a lot during my journey and we haven’t been the same since. Filming Undercover Boss was a gift that I will always be grateful for.