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. 


Techniques – Honor Diversity (#3 of 3)

Suggestion Three – honor the diversity

Groups are as different as the folks who sit around those oblong tables.  Don’t jump to conclusions just because you’re sitting around the table with a group of teachers (typically more friendly than others), anesthesiologists (typically more guarded than most), or banking customers (typically more hostile than others) because even though there are those generalities or even stereotypes, those can be quickly blown when you realize each and every one of those anesthesiologists, teachers or customers are just people:  people who live their lives above and beyond their interaction with your clients’ products or services;  people who deal with family happiness’s and challenges;  people who come from different races, religions, creeds, genders, cohorts, etc.  Sure, package them into subsets, draw enough assumptions to build your guide and frame the discussion, but once you sit down with 8-10 strangers sitting around you, take off the gloves, heck, if you have to, take off your shoes too, and look at them as individuals who need to be treated as such.  And, never forget, the guide is just a guide.  A moderators’ guide is a fantastic jumping off point but it’s the nooks and crannies that you explore, while you’re in the group, learning about your respondents as people that will bring you those gems that every client will be pleased to have gotten.


Last, but hardly least – reap the rewards and the surprising extras!

So, all the very best to you as you moderate a group, or hire a moderator to tend to your project.  But as you’re doing so, take a moment to remember that people are just people and they all come to your table with aback story.  The job of the moderator is to decipher where these folks are coming from as effectively and efficiently as possible.  Thus informed, you can then get down to brass tacks.   Dig into the guide and make sure you come out of there having answered the clients’ objectives and, in a perfect world, even gleaned insights well beyond the barriers of the guide.  Of course, for me, my biggest reward isn’t hearing from the client how thrilled they are with the groups (now, dear clients, don’t get me wrong…I love making you happy but my responsibility to you is to get unguarded information from your customers/clients/employees and that’s what I’m bound to do) but from the respondents themselves.  When you have respondents walking out of your groups thanking your for having invited them, there simply isn’t much that is more rewarding.  You know when respondents say ‘thank you,’ they trusted you enough to open themselves up and share their honest opinions.  You know you mined those gems which will serve your client well, and that, dear reader, is the key, no, it’s the technique of all techniques, that puts you heads above the rest.  Know your project, understand the objectives, learn the clients’ product or industry but, above all, moderate a group which will leave the respondents leaving happy having been there.

It’s not just about getting them in the door…

Foot traffic is good.  No, foot traffic is GREAT!  Who wouldn’t agree with this?  You’ve probably said these very words: My business couldn’t exist without it.  I need people through my doors.   Ah…all absolutely valid comments, but if that’s the end of our business plan, then I disagree. Now, don’t get mad – I propose further discussion before we both can agree.  Let’s do a little “they say/she says” and see if we can’t sort this out.

They say (yep, you might likely include yourself in ‘they’) that traffic is vital.  Here’s what I hear:  My business would perish without it.  Warm bodies circulating throughout my establishment make it all work.  I will do anything, absolutely anything I can in order to make this happen.  I tweet, I post, I bargain, I grovel, I beg, I pray, I wait.  I’ve done everything I can do, right?

SHE says:  great thinking and superb effort.  Kudos!  But, now let’s talk about what you’re not doing and see if that disconnect is forcing you to continue to have to tweet, post, bargain, grovel, beg, pray, and wait.

Here are a few questions you might want to ask yourself.  Now be honest!

  • Are you focusing on your customer?
  • Are you focusing attention on what you sell, how you sell it, and if your customers even want it?
  • Have you asked your customers if they value you; if they would choose you over another, even if the other was lower priced, or closer?
  • Have you built a relationship with your customer?  Do you have their loyalty?  Or, are you a magnet for the bargain shopper who just spotted you on their last check of their e-mail inbox or social media wall?

Oh, wait a minute; before you get upset let me continue with the social media discussion.  Truth is I’m really not that insensitive.  Heck, I like a tasty daily offer presented to me via my e-mail or my social media network as much as the next.  Yep, gotta admit it … I love a deal!  Who doesn’t?  Offering opportunities via social media is a GREAT idea.  Really, it is, even though every other article out there tells you it isn’t.  Seriously, just google it.  You’ll find A LOAD of naysayers absolutely, resolutely, undeniably against working social media which discounts their product/services to drive foot traffic.  But (now here’s where you listen carefully to what SHE says), if done right, with reasonable limits and a follow-up plan (while never losing sight of your current customers) you’re good to go.  Sure, continue to tweet, post, bargain, grovel (it never hurts), beg, pray, and wait … but be proactive at the same time.  Think through your campaign and take it to the next level.  You know, that’s the one where you ask – What do we do once our customer arrives?

BULLETIN!!!!! Sociologist Turns Market Researcher…and why that’s important to you

It’s wild out there!  Enticements for consumers are everywhere in the form of promos, TV ads, radio sound bites, billboards, magazine slicks, newspaper announcements, etc.  Trouble is there is so much out there that today’s consumers are not listening.  They are tired of the clamor.  They are tired of too many pages of advertising in every newspaper and magazine they pick up.   They are looking for substance – they are looking for what THEY need, not for what you want them to need.  They’re waiting for you to catch their interest so they can discover that you provide the very item and/or service they need.  So, how do you do that?

Well, you start with a researcher who knows about people and how to discover their needs and satisfy them.  The folks who try to sell you services based on their slick advertising/marketing experience but who haven’t an idea how to glean the clues to their customer needs from the very people they hope to serve simply sell you short.  You need a people person to learn about people – those individuals who translate into your customers once you fill their needs.

Would you hire a butcher to cut the fabric for your most important business suit?  The butcher wields a mean knife and can cut with the best of them.  Oh, that’s right, he cuts meat, but hey, cutting is cutting, right?  Your researcher or, worse yet, your staff person, might be the butcher you’ve hired instead of the well-trained human observer who has the tools in his/her workbag to discover what your potential clients want.  Sure, your butcher might even run a focus group, but does he/she know enough about human nature to ask the right questions? 

Let me explain:  I share this from Wikipedia:  “Quantitative designs approach social phenomena through quantifiable evidence, and often rely on statistical analysis of many cases (or across intentionally designed treatments in an experiment) to create valid and reliable general claims Qualitative designs emphasize understanding of social phenomena through direct observation, communication with participants, or analysis of texts, and may stress contextual and subjective accuracy over generality.”  Sociologists tend to divide in their chosen approach here, but a researcher who uses both techniques, starting by understanding your potential clients’ personal needs can offer your company so much more than just slick ads.

Do you want monkeys?

 Imagine yourself as a contestant in a game show where you can actually choose your prize, then design a plan to capture it.  You are given a limited bankroll to finance the venture and a group of people to whom you must answer.  With each decision you make you must convince them that you are spending your bankroll carefully and wisely. 

Life in the business world is kind of like that, isn’t it?  You have your eye on the goal and you must use every available means to achieve it.  Trouble is, an unlimited budget is a luxury in today’s business climate, so the reasonable goal is to wring every last penny of value out of each precious dollar spent.  Now that sounds like the right thing to do, but sadly, the first impulse is to tighten the purse strings at every portion of the project without taking the long-range view.  The end result is this … you get what you pay for.  Warren Buffet, Bill Gates, Henry Ford, W. Clement Stone and others of their ilk have created their own version of James Goldsmith’s quote, “if you pay peanuts, you get monkeys.”   Although it’s an amusing statement, it’s sobering in a business setting.  Yet, time after time, companies will choose to pay peanuts (or cut corners) and still expect high rewards.    

Here’s an example: 

‘THE’ Company has decided to launch a new product.  However, they are uncertain whether their product will resonate with their customers and prospects.  They interview two research and marketing consultants (Company A and Company B) and hire the one which offers focus groups for less (B), knowing they will need several to cover every possible scenario.  Bear in mind, however, that Company A had guaranteed ‘THE’ Company that the results could be generated from four focus groups.  ‘B’ Company did not.  For the sake of a visual, let’s say that Company A charges $1000 per group to moderate (4 guaranteed groups = $4000).  Company B charges $700.   Oh, what a savings, right?  Only $2,800 with Company B.

Once hired, Company B finds that they need five or six groups to glean the information ‘THE’ Company is looking for = $3500-$4200.  On the surface, it appears that $3500 for 5 or even $4200 for 6 groups can be reported to your overseeing group as more value, as Company B was at $4000 for JUST four groups. 

Let’s dive deeper and see if it is.  Every focus group requires secondary expenses … room and equipment rental, travel expenses for the moderator, time spent by ‘THE’ Company to sit in on groups, group costs – recruiting, incentives, meals, etc., adding up to possibly another $2500+ per group.  Company A – 4 groups $4000 + $10,000 = $14,000.  Company B – 6 groups $4200 + $15,000 = $19,200.  Suddenly the perceived value (not to mention the typically tight timeline) vaporizes into thin air.   It is far better to review the track record of the competing companies, get referrals, and analyze where the true value lies.  A talented moderator gets results and it’s not the letters behind the name, or even all the training courses completed, that generates the value it’s the moderator themselves.  This comes through a mix of experience and personality.  Know who you’re getting and what they bring to the table.  Don’t be afraid to follow up on references, it could, afterall, save you many peanuts in the end.

Bottom line question … do you want monkeys or practical results?

Progress – It’s a process.

Progress and innovation – ordinary expressions loaded with extraordinary potential.  The trick is to bring them back into our everyday business vernacular.

Since the beginning of 2009 many of us have put innovation (hence, progress) on the back burner for the sake of “the bottom line.”  When the pinch came, the first things to go from corporate budgets were advertising, marketing, and research, placing innovation on the endangered list.  Sadly, stagnant companies lose clients and the downward cycle spirals.  So, how do you stop it and restart the wheels of innovation while keeping an eye on the bottom line?

Begin with that project that is small enough to be cost-effective but with enough impact to make a difference.  Remember that project that you were starting right at the end of 2008… the one you pushed to the back burner come 2009?  Pull that out, along with others that have been shelved during the year.  Do a quick gut check, involve your sales force and even ask your customers what they think could make the biggest difference.  Ask questions.  An internal survey to your sales force is a great beginning.  Next consider on-line focus groups and in-facility/home tests. 

Loop in your existing customers with a customer satisfaction survey.  How have they weathered the recession?  How can you help them to meet their bottom line?  Now is a good time to remind your customers that you’re there.  Be the hand up, ready to help.  This investment in empathy will work in your favor when this is all behind us.  Nurtured customers will not forget.  Be the company that cares enough to connect and ask the questions before someone else beats you to it.  And, remember, there are many new ways to do research.  Work with someone who knows these new methodologies and use them to your economical advantage.  Keep in mind that progress takes time but progress is the path that leads to innovation.

Choose to be THAT company which breathes life into innovation and research.  Asking questions indicates that you are competent and will have the ideas to convert answers into solutions.  Remember, when the load feels heavy, it’s really not when broken down into manageable pieces.  Progress is a process … but it needs innovation or it will remain dormant.  None of us can afford that.

Need Market Research? Not just for BIG businesses. You might be surprised to discover your organization needs it. Read on.

Take a minute and check out the questions below…do any of them resonate with you? If they do, or others come to mind, Advocate Market Research can help you reach your objective by finding the answers you seek.   A market research plan that fits your needs can be fashioned using a variety of methodologies, both traditional and progressive, while working within your budget and time constraints.


– Do you need a list of customers or prospects, but are not sure whom you need on that list?   Who’s buying your product?  Who’s buying your competitors’?

– Do you have a new product or service and need to determine its value to your potential customers?

– Are your customer’s satisfied?

– What is motivating your customers to shop elsewhere or consider different products?

– Do you need to know why, or why not, consumers use your business and services, or shop at your store?

– Do you have a new product entering the marketplace, but are not sure in what store or location to place it?

– Do you need customer feedback on a new product, service, or concept?

– Do you need to understand why a customer buys a specific type  (brand or variety) of product?

– Do you need to know how your customers interact with your product, or your competitor’s product?

Did any of these questions hit home? If so, they can provide solid jumping off points to begin a relationship with market research which may well reward you with answers that could fortify your organization’s bottom line.

Remember, market research does not have to be intimidating, time consuming, a hardship on your internal resources, or too costly. What market research can do for you is keep you current, on top of the desires of your customers, in touch with your prospects’ needs, and ahead of your competition. So, maybe you need market research after all. What do you think?


ADVOCATE MARKET RESEARCH provides you with an economically feasible alternative to employing a Market Researcher

Do you find yourself saying the following sentences all too frequently?  “Because of the economy … We can’t hire.”  “We’re cutting our research budget.”  “We’re putting that project on hold … indefinitely.”  Ouch!  In today’s tight market, these simple words can, in fact, hurt your business.  Market research is the key that keeps your business doors open, and the research professionals at Advocate Market Research can provide the keys – at a fraction of the financial outlay for a permanent employee. 

Advocate Market Research has served a variety of companies:  manufacturers of health products, banks, insurance companies, and retail establishments.    We have successfully provided them with qualitative and/or quantitative research both on and off-site, filling their research voids.  Whether you company is faced with budgetary cuts, maternity leave, or, hopefully, an influx of projects that your internal team is too stretched to manage, we come in to support your team on a semi-permanent basis.

Managing the bottom line is always the first goal for any smart company, but the key to that upwardly rising bottom line is to keep on top of your company’s research needs.   If you want to stay on top of your competition, it’s folly to let research slide “because of the economy.”    Shaving costs for the short term can put you at risk for falling behind, not being first to market, or faltering on your current product offerings.

When you bring in out-sourced research professionals who can fill your research needs, you will save the high fixed costs of employing a permanent, or even a part-time researcher.  Turnabout is fair play, so why not turn around your concerns “because of the economy” by saving your green by outsourcing your research projects to Advocate Market Research.  That decision may be just the key to allow you to maintain a competitive edge and successfully manage your bottom line.