Healthcare in the U.S. is costly, confusing, inconsistent, and poorly organized. The patient suffers. It is notoriously not consumer friendly, yet we all entrust our lives to it. At its best, it is the best in the world. But on average, it’s inefficient, chaotic, and uneven. But we can change that. We can by listening to others.
Nashville, frequently referred to the nation’s Silicon Valley of health services because of its current cluster of 17 publicly held healthcare companies and its unique 60-year history of innovating care delivery, has been inundated the past few years with an influx of health conferences. Nashville today is the place to be for gatherings to solve the sector’s biggest challenges. But almost all these conferences are cut from the same cloth, health experts talking to health experts. So we at Frist Cressey Ventures endeavored to try something radically different.
We set out to engage the best and smartest and most experienced problem solvers from outside healthcare with some of the smartest operators and innovators within. And to do so in a natural setting that inspires. The central organizing theme: “Great minds think differently: Colliding spaces to inspire better health.”
On a picturesque farm setting 40 minutes south of Nashville, we brought together a carefully curated group of innovative healthcare CEOs, dynamic thought leaders, disrupters and entrepreneurs to engage directly with the pioneering titans of information technology, distribution, food, and entertainment. We drew directly from the founders and leaders of transformative companies such as FedEx for logistics, Oracle for connectivity, and NVIDIA for generative AI. We explored the creative process and adapting to change with the music industry. We collided spaces to inspire.
I’ve found from my careers in the operating room, in the U.S. Senate, and in business, that the most powerful and life altering ideas seem often to emerge from the collision of ideas across different lived experiences, different geographies, and different industries.
Here is what we learned.
Lesson 1: Passion
We kicked off the first day with former Johnson & Johnson Chairman and CEO Alex Gorsky, who set the stage and provided a framework that guided our next 36 hours. His ability to grow, successfully manage and innovate in a 137-year old company is legendary. The scale is breathtaking; he “estimated we’d touch about 1.5 to 2 billion people a day with J&J products globally.”
We spent time discussing the vital importance of company mission, but then an audience member asked if Gorsky had a personal mission statement. You could hear the emotion in his voice when he encouraged us to double down on passion: “I love seeing people who really care and give a damn about what they’re doing,” those who loudly proclaim, “I will bet my career on this! … Don’t be afraid to take a stake.” He said this energy is a sign of great leaders, underscoring that passion isn’t something you can fake.
“When you’ve got a passion about whatever you’re doing … you’re willing to do your homework, you’re willing to go the extra mile. The people around you are going to smell it in what you’re doing,” he emphasized. “More and more, people want to be part of something bigger than themselves.” Creating that environment in your team, in your company, creates success.
His charisma was electric, and it carried over into the next panel when Ellie Rubenstein, co-founder and managing partner of Manna Tree, took the stage to share how a near death experience inspired her relentless mission today to institutionalize food investment to transform health.
After a skiing accident caused a traumatic brain injury, Rubenstein movingly detailed how it was her mother’s commitment to holistic, natural foods that restored her gut health and ultimately made the difference in Ellie being able to fully recover. This experience infused Rubenstein’s approach to building Manna Tree and investing with a passion to transform the food supply chain for healthier outcomes. She opened up to the audience about the world of food as medicine and the concept that health is more than healthcare.
We also heard passion in the voice of Larry Ellison, co-founder, Chairman and Chief Technology Officer of Oracle. Keynoting the event, Ellison’s presence left the room awestruck as he painted a powerful vision for the future convergence of technology, artificial intelligence, machine learning, and healthcare. Ellison was deeply moved by his intimate experience in the pandemic – as many don’t realize the integral, life-changing role Oracle played in creating in a record five-weeks time the technological foundation that supported so much of our nation’s Covid-19 response. But this work was also a lightbulb moment for Ellison: “Covid was such an eye-opener. I knew healthcare was not perfect in managing information. And for years I’d been giving the speech about having more information about our retail purchases than our health. But I wasn’t doing anything about it.”
The pandemic laid bare to Ellison and the Oracle team how little we knew about our own health, including how many people had Covid and whether we had enough hospital beds, ventilators, and other equipment to treat those who did. We were flying blind at the mercy of this unknown virus.
“The science of healthcare is more complicated, but the data management of healthcare isn’t more complicated. There’s no excuse we prioritize credit cards or shopping over health,” Ellison said, crisply explaining the fragmented experience all of us as patients have with siloed medical data. “We have not applied that same rigor to electronic medical records.”
Promisingly, the pandemic converged with “a lot of fabulous technology was coming to maturity,” Ellison remarked. “For the first time, we think we have the technology where we really can address this problem. And if we can, we must.” And when Larry Ellison says he will, you believe him.
Lesson 2: Discipline
With passion, must also come discipline. That was the central lesson HCA Healthcare CEO Sam Hazen emphasized when he took the stage. “We are super disciplined in our mindset, in our execution,” said Hazen. A storied leader in my own hometown of Nashville, Hazen is known for his relentless commitment to monitoring and analyzing data, a focus that saw him rise through the ranks over four decades at HCA Healthcare, one of the nation’s leading healthcare providers and the company which initially put Nashville on the map as a major player in health service innovation.
Hazen also cautioned the room against mission creep, noting that HCA Healthcare is now responsible for between six to seven percent of all hospital services nationwide. “Moving away from your core competency, your core service offering, creates confusion in the mission and how we use our resources and capabilities to make your journey as an individual in our company successful.” Stay focused and true.
We heard this same message from FedEx founder and executive chairman, Fredrick W. Smith. “Be careful about adjacencies that are outside your core competencies,” he warned the room.
He, too, credits discipline as central to his company’s success, noting there were about eight other competitors in the market, but those all failed with the exception of FedEx and UPS. FedEx’s discipline was rooted in their “No tolerance for loss” philosophy. FedEx was substituting fast transportation for inventory, replacing the need for a warehouse, a radical concept at the time. But in many cases it was the most important inventory in the world, Smith added when describing some of the sensitive, life-saving cargo that our health systems rely on FedEx to quickly and reliably ship.
This weighty responsibility meant FedEx had to stop trying to manage retroactively by audit, and instead, Smith explains, “We invented the ability to track and trace.” This was the transformational game changer. This highly accurate, real-time tracking system is why FedEx was trusted with the cold storage shipping of the Covid-19 vaccine and could tell hospitals and clinics down to the hour when the vaccine shipment would be arriving. That’s discipline.
The healthcare audience, so aware of the miserable ways patients are forced to navigate the system today, engaged: let’s figure out now how to bring that logistical precision, timeliness, and seamlessness to the patient journey.
Lesson 3: Culture
Listening to these pivotal leaders, we could feel the culture that each had imbued in their organizations. “Culture will trump strategy every day of the week,” Gorsky reminded us.
This lesson really hit home when Todd Park, co-founder of Devoted Health and Athenahealth and the former U.S. Chief Technology Officer, took the stage. Park motivated us to care for our patients as if they were the people we love most. He explained at Devoted Health, their mission is to “Dramatically improve the health and wellbeing of older Americans by caring for every person like they are literally our own family.” They direct their caregivers and patient navigators to “visualize in your mind the faces of members of your own family whom you love desperately…. Then ask yourself, what would you do for them? Then, go do that thing.” It’s empathy in action. His irrepressible energy and commitment shook the room as he spoke.
It was a powerful moment, as all of us in healthcare thought about the way we wanted our loved ones to be cared for, and tried to reconcile it with the way we know so much of the fragmented healthcare system works. It’s why, Park explained, Devoted Health has been uniquely insulated from the workforce shortage that has handicapped so much of the industry.
Devoted is scaling rapidly, yet they have hundreds of applications for every open spot – nurses, nurse practitioners, doctors, clinicians of all kinds. Why? Park said the applicants tell them: “In this job, I can actually practice the way I always thought I was going to … I’d given up hope until I came here.”
He then challenged us to think about what success truly looks like in healthcare: “If people cannot find fulfillment in their heart in many clinical roles” and many clinicians across the country don’t feel like they’re fulfilling their destiny, “I don’t think we as a healthcare industry have succeeded.”
Lesson 4: Personal Health
The casual, farm-like setting encouraged creative ideas to emerge. For example, surprising to some to surface so early in the conversation was the necessity of taking care of our own health and well-being. Alex Gorsky delineated this theme in his opening remarks, telling our gathering: “The best thing we can do long term in healthcare is to take care of ourselves.”
He continued, if we’re in this space taking care of others, we’ve got to carve out time to take care of ourselves. Gorsky poignantly reminded us that you don’t want to hit that financial goal and then have a health event that prevents you from enjoying the fruits of your hard work because you didn’t invest 15 minutes a day in your own well-being.
Dr. Marc Watkins, Chief Medical Officer of Kroger Health, put our nation’s personal health problems into context. From his perspective as the medical lead for the healthcare arm of The Kroger Co., which comprises more than 2,200 pharmacies in 37 states and more than 225 locations of The Little Clinic across the country, Dr. Watkins shared that it’s the health of our population that keeps him up at night. In fact, it’s a national security threat. “Right now we have about 6 out of 10 Americans with chronic illness,” and he cited concerning data that show nearly one in three young people will be disqualified from serving in the military because they are not physically qualified, either due to being overweight, obese, or having serious mental health issues.
Dr. Watkins encouraged corporate leaders to prioritize consumer health in their business models, explaining it’s a natural, financially savvy decision for Kroger since healthy individuals are more active retail consumers. And it’s a growth opportunity: “90% of Americans want to eat better,” he told us, but only about 50% are willing or able to pay more for food. How can we help them make that change? According to Watkins, Kroger is leading by reformulating its own brands, with a goal of adding 15,000 healthier stock keeping units (SKUs – the unique barcodes on products) to live on their shelves, without inflation.
Lesson 5: Embrace Change
Finally, the most consistent lesson these titans of industry shared at our Forum was to embrace change. And that requires a trained receptiveness and openness to the ideas of others, as well as a commitment to lifelong learning. And we all know, with accelerating scientific and knowledge advances, healthcare delivery will rapidly and continually change.
Ellison, a legend in his own right, who could comfortably rest on his laurels, instead is motivated to take on the next big challenge. “The most important thing Oracle is doing right now is working in healthcare,” he told us. He’s adapting the unparalleled cloud and computing and security technology at Oracle to solve our healthcare data challenges on a grand scale. Spurred on by his close friend Elon Musk who is tackling space and transportation, he joked: “I asked Elon, are you going to do healthcare? He said no. I said, I got it.”
Fred Smith said, “Change is really hard. And if you’ve got an organization that doesn’t know you’ve got to continuously change, you’re going to fail.” He said the reason they stayed ahead of competitors and are still standing today is because FedEx was “a child of the technology and we really embraced the technology.” Even now, Smith is looking to the future: “Robotics are a huge opportunity for us, if we don’t embrace them, someone will get ahead of us.”
Arguably the most captivating and nostalgic speaker we heard from was Joe Galante, a man responsible for developing the careers of award-winning artists including Waylon Jennings, Dolly Parton, Alabama, Kenny Chesney, Brad Paisley, Martina McBride, Vince Gill, Miranda Lambert, and more. As the former President of RCA Records and Chairman of Sony Music Nashville, Galante gave us a fascinating, inside look at the major disruption in the music industry as it moved from records to cassettes to CDs to digital. He explained how the breaking apart of the album, a change spurred not within the industry but instead by outsider Steve Jobs who decided you could buy a single song for 99 cents, turned their business model on its head. Because the industry was so hesitant to change at that time, hoping to continue business as usual, they’ve spent a painful two decades playing catchup. Galante said the music industry’s peak year was in 2000. Then came iTunes, Spotify and streaming, and “We dropped every year up until 2022.”
Galante shared that in 1999, if the music industry had bought Napster and at least had partial control of what became iTunes, it would have meant they could have had a hand in controlling their digital music destiny. “But we didn’t do that. We closed ranks,” he said. “Technology came to us and caused the change; we didn’t go there.” His story painted a vivid picture for those of us in healthcare as we considered what changes and advances we had our blinders on to, as a legacy industry that is notably behind in adopting technology and other advances.
And Dr. Mona Flores, global head of medical AI at artificial intelligence giant NVIDIA, captured quickly why their company has come to dominate the AI space: “When we see an opportunity, we jump on it. Jensen [Huang, NVIDIA founder & CEO] is the king of pivoting.” That is why today, NVIDIA is integral to healthcare in ways we don’t realize: “We are not at the patient’s bedside, but we are underneath every application that is at the patient’s bedside.” She advised us to “stand on the shoulders” of others, and concentrate on building on that foundation with the unique talents our organizations bring to the table.
After colliding the greatest thought leaders from diverse disciplines outside of health with insider healthcare innovators, we left with an unanticipated unity of guiding lessons in mind: Lead with passion and discipline; Build a culture that is truly baked-in and not just words on the wall; Remember to take time to take care of ourselves physically, mentally, emotionally, spiritually; and always Embrace change.
At FCV, we are also taking to heart the lesson of putting the patient first always, treating them like you’d treat your own family.