Written by Jay Turo on Monday, June 3, 2013
Every time I moderate a strategic planning retreat, I learn something.
About the investment of life force necessary to build and sustain a successful organization in the modern business day.
About the importance of heartfelt and mutually supportive communication among and between an effective executive team.
About how there is no more efficient use of business time than to step away from the day-to-day, to reset, and to talk about the big “whys “of an enterprise.
And from this talk, to refresh, refine and define the best, most strategic, and highest ROI use of executives’ time and of an organization’s capital.
I have the great, good fortune to moderate 1 - 2 of these “big” strategic planning retreats each month.
This past week, the group was the eight person executive leadership team of one of the larger and more prestigious hospitals here in Los Angeles.
A dynamic and highly experienced group, these eight executives have management and leadership responsibilities for over 1,500 hospital employees - providing care to over 17,000 patients, including 4,000 deliveries and 8,000 surgeries annually.
Yes, these executives have their strategic and tactical hands full to the highest degree.
In addition to the sheer scale and breadth of their organization and of the truly life and death impacts of their decisions, they also must grapple with and adapt to the sea changes beyond their control in our brave, new healthcare world.
The Affordable Care Act.
Payor consolidation, driving down reimbursements.
An increasingly Byzantine thicket of regulatory, liability, and organizational complexity that can easily make a hospital executive feel that even their best work will and cannot “tilt the windmill” toward high quality and cost effective care.
But here’s the inspirational rub of it all…
The bigger the challenge, the more engaged does become the effective executive.
And in this hospital executive team that I had the privilege of working with this past week, well they were engaged and committed at the highest level.
Well, how about this - in spite of having a more than a century of collective experience, and having to travel from their homes an average of more than 50 miles through Los Angeles rush hour traffic, all eight members of the team arrived at the retreat 30 minutes before its scheduled 9:00 am start!
Or, how about the fact that the organization’s CEO, in spite of being on the job for 17 years and being honored as one of the nation's top hospital CEOs, seeking critical feedback from a staff member on the job less than 90 days?
How about a willingness to, in spite of leading a wildly successful and highly respected 100 year old+ organization, to in an afternoon agree to scrap the team's existing meeting structure and try something completely new?
And my favorite, how about a willingness to take on the challenge of fundamentally rethinking the performance review structures of their vast and complex organization, knowing that yes, doing so will result in far more work on their already stretched plates, but committing to it as it is in the profound interest of the organization's mission and reflective of its values to do so?
And that is all that matters.
These kinds of discussions, and of course many more of the highly confidential, and often heated and pointed type, resulted in a high emotion and results-packed retreat day.
Undertake this work like our fair and fine hospital executives did this past week and watch the magic happen.
And, of course, ignore it at your peril.
Because, as Thoreau once famously said an unexamined life is not worth living.
And an unreflecting organization will, in the end, almost always turn into one not worth having.
Written by Jay Turo on Saturday, May 25, 2013
Compared to its original intent, Memorial Day has become an overly “leisure” - focused day.
Rather, it is a day where we can and should take pause and remember those that gave the ultimate sacrifice so that we may enjoy our blessed, modern lives.
Along with President's Day, the 4th of July, and Thanksgiving, Memorial Day is one of the Big Four quintessentially “American” holidays.
Yes, days to step aside from our normal work routines and responsibilities, to relax, to have fun, to spend time with friends and family.
But also days to "pay forward" the sacrifices of those that gave their lives, in the immortal words of Abraham Lincoln, “so that that nation might live.”
And a great way to pay it forward is to stand strong for freedom.
Freedom is a word that too often has become stripped of much of its inherently spiritual meaning by politicians and others seeking to further narrow agendas.
And, also too often, a distracted (and distraction-seeking) populace has let them get away with just that.
But freedom stands alone as the highest of all of the great “American” virtues - this country’s revolutionary gift to the cultures and economies of the world.
Now, to the degree that the success of the American experience has inspired freedom worldwide - such that economies and cultures and lives of people in places like China, India, Brazil, Mexico, the Philippines, Poland, parts of Africa - that until recently have been clothed in medieval darkness, poverty, and rigidity...
... well then if freedom perishes here in the years to come, it will go on living elsewhere to a degree and on a scale many, many multiples greater than on these shores.
And yes, that is inspirational in its own right.
BUT it would not make it any less discouraging and dare I say sinful for those us blessed to be born and living in the cradle of freedom to let it perish here.
Or, as badly, to not take full advantage of the opportunities for self-expression, self-actualization, contribution, and prosperity this freedom affords.
And, of course, on this Memorial Day it would also be highly dishonorable to those who gave the ultimate sacrifices to preserve and protect it.
So how can one rightfully honor this gift of freedom?
Well first from that simple, profound place of gratitude and thanks.
But build on that.
Stand up for justice.
For good, limited, effective and neighborly government.
But stridently and ever vigilantly against corrupted, self-serving, expanding, "celebrity" and far away government.
And when it comes to work, knowing that freedom’s truest modern, civic expression is in the realm of private enterprise.
The realm of business.
So go for it.
Think. Plan. Act. Do.
To the fullest of our ability and with all of our effort.
In the service of noble missions and visions that call to us.
And when done to the fullest of our ability and with all of our effort…
…well on this Memorial Day then, we are honoring the sacrifices of those so they truly did not die in vain.
Written by Jay Turo on Monday, May 20, 2013
I had the great good fortune this past weekend to co-host Growthink's Business Blueprint Live event at the LAX Sheraton Hotel, next door to our Company’s Los Angeles offices.
At it, 53 entrepreneurs and business owners gathered for two days and nights with the Growthink team to dream, plan, and network as to how to best grow the revenues, increase the profits and better fulfill the missions of their businesses.
What is really neat is that because of its longer group and in-person format, there is time and space to really listen and, correspondingly, to share best business practices, ideas, and inspirations.
Golly - what a weekend!
The attendees that ventured from near and far and from the comforts of their homes and regular routines took a chance.
The chance that by "mixing it up a bit," that breakthroughs would follow.
And they did.
From the aerospace engineer developing new quality assurance processes that make the engines that fly our planes safer and more efficient, to the software entrepreneur helping community banks better manage their loan portfolios (and by so doing freeing up more capital to lend to entrepreneurs and small businesses to grow their companies and create jobs), to the doctor re-designing the nature of care to focus more on prevention than cure, new and powerful business ideas and tactics were hatched and committed to.
And I was reminded of an old wisdom that I forget way too often.
It goes like this: when there is something “nutritious” in my life and business that I am resisting, it is that thing that above all else I need and should be doing.
It could be getting up early and doing that workout.
Or not having that second glass of wine.
Or taking that vacation.
Or, in business, making that call, writing that plan.
Going to that meeting, that conference.
And when you do, hold nothing back.
Don’t let any nagging doubts about whether this strategy, this decision, this job is the right one.
Just dive in.
What is brought to mind is Joseph Campbell, author of a “Hero of a Thousand Faces,” and the world’s great scholar on mythology and the foundational stories of humanity.
He famously said that what we all seek is not “so much meaning in life, as we do the experience of being alive.”
Well, this weekend what I and very many of the attendees that participated and shared with that full-on entrepreneurial commitment experienced this weekend was very much that of being fully “business alive.”
And from it and because of it, new business and conceptual breakthroughs and lovely relationships naturally flowed.
And when I reflect on these amazing outcomes, and then when I think back to the resistance I felt of not wanting to organize, not wanting to go to the event…
Well, it hits home that so important wisdom that when I really don't want to do something that I know in my heart that I should…
…well that is the exact thing that I must do.
And then let the magic happen.
Written by Jay Turo on Monday, April 8, 2013
You’re invited to attend a webinar on Tuesday, April 16th at 1pm Eastern / 10am Pacific about opportunities in the Healthcare Information Technology sector.
To register, click here.
Over $200 billion MORE was spent on healthcare in 2012 than in 2011.
Let's put that number in perspective - the increase in healthcare spending last year was greater than the revenues of Microsoft, Cisco, Google, and Apple.
And with the Affordable Care Act slowly but surely becoming the law of the land and the Baby Boomer generation retiring and hitting their “peak” healthcare spending years, there is no end in sight to the growth.
You Can Cry About It or You Can Seek Opportunities In It
While out-of-control healthcare costs and bureaucratic systems remain one of our most vexing societal challenges, private sector entrepreneurs are moving fast and smart to address various aspects of the problem.
And are building dynamic growth companies while so doing.
Healthcare Information Technology – A $30 Billion Business
Healthcare Information Technology (HIT) is one of the great and growing bright spots in the U.S. economy – it’s a $30 billion+ a year industry growing at over 14%/year.
It is comprised of big sectors:
• Practice Management Systems (PMS) - a $4 billion/year business growing at 11%/year
• Electronic Health Records (EHR) - a $1.5 billion/year business growing at 22%/year
• Revenue Cycle Management (RCM) - a $1 billion /year business growing at 15%/year
• And last but certainly not least - Transcription, Billing, and IT services, clocking in at $24 billion/year and growing at 12%/year
Within each of these sectors are dozens of under-the-radar companies experiencing strong revenue and profitability growth, developing dynamic and cost-saving technological innovations, and are being courted by financial and strategic acquirers.
Companies like Castlight Health, Practice Fusion, Kissner Software, and Strategic Solutions Management.
Meet An Industry Leader
I would like to invite you to an exclusive opportunity to meet, via web conference, the principals of one of the most innovative medical billing companies in the country.
Combined, they have over 40 years of experience in successfully overcoming and profiting from some of the most vexing challenges in medical billing and information technology, and are well-versed on the regulatory and technological changes sweeping the industry.
On the web conference, they will share:
• Who the winners and losers will be when the brave new world of the Affordable Care Act meets the cloud computing and Big Data revolutions
• Why practice areas like obstetrics, surgery, and podiatry are in a unique period of change and consolidation
• How the “dream” of combining billing, practice management, and electronic health records systems into turnkey platform is in fact becoming a reality
• How the emerging world of mHealth – the use of iPads and tablets and mobile devices to deliver care - is and is not transforming modern medicine
• And much, much more
To preserve the intimacy of the presentation, we are limiting the web conference to the first 35 registrants.
So sign up right away to attend via the link below:
Best regards, and look forward to connecting.
Written by Jay Turo on Monday, March 25, 2013
Depending on how you slice it, this is either a golden or a leaden business age.
It is a golden age, as never before in human history has there been so much access to great opportunities as there are right now.
Crowdfunding, private equity and debt secondary markets like Second Market and SharesPost, peer-to-peer lending sites like Prosper.com and Lending Club, and the Big Three social networking giants - Facebook, LinkedIn, and Twitter - have made information and intelligence on, and access to opportunities better and greater than ever before.
Yet, the overall spirit and mindset of business is anything but golden.
Huge and historically unprecedented public sector debt and social safety net obligations in the United States and Europe - layered on an overlapping and inter-connected global banking system cast a pale “macro” of systemic risk over the markets.
Compounding matters, never before has the drumbeat of news and information been louder, mostly shrilling that the financial sky could fall at a moment’s notice.
The overall effect of this both real and perceived angst is a “crowding out” of all of the good stuff that is happening out there.
So what should the growth-seeking, yet sober executive and / or investor do?
Well, first and foremost, get one’s mind and spirit right.
And the best way to accomplish that is to focus on what author Matt Ridley so eloquently describes as what has been since the dawn of Man the guidepost to our better future.
Entrepreneurship lives and grows in the “micro” - in sectors and niches within the overall economy either protected from or aided by the larger current.
And entrepreneurship is the antithesis of sclerotic, bureaucratic, and beyond human scale organizations (see Big Media, Big Government, Big Business) of such complexity and inertia that the application of individual motive force them to far more often than not is ineffective, no matter how good the intention.
Rather, entrepreneurship is undertaken via that finest form of collaboration known to history - small, impassioned teams driving toward an idealistic vision and mission.
To sell some thing or some service of a type, or in a way, or at a price that has never been done before.
And to make money doing it.
And the really good news is that there are more entrepreneurs - far, far more - hundreds of millions worldwide striving to have their brilliance and creations expressed and realized, and to make their futures their own.
And in their multitude, in their collective uniqueness, they are the hope and the light of the world.
Even better, be one of them.
In mindset, in spirit, and in appetite for change and risk and daring.
You’ll feel a lot better.
Written by Jay Turo on Monday, March 11, 2013
When it comes to education, this 21st century of ours is truly both the best and the worst of times.
It is the best of times as never before in human history has more information, more ways of learning, more access to best practices, been available to more people -- regardless of socio-economic condition and geography -- than it is today.
And, with 3 billion more people in the next 10 years coming online and joining the global information exchange, this remarkable and so very inspirational trend will only accelerate and grow.
Now, as anyone that has ever despaired over a never emptying e-mail inbox, over ever distracting and focus eroding text messages, over the always-growing mountain of things to read, listen, and watch, it can quite often feel like the worst of times too.
Yes, it is fair to say that the net sum of human information has grown far faster than that of human wisdom, satisfaction, and even happiness.
Now, the first and obvious point here is that this very well could be simply a distortion of relative versus absolute perception.
For these days, NOTHING grows like information - with every three weeks the aggregate total added to it being greater than that accumulated from the beginning of recorded time through the year 2000
So, of course, the growth of everything/anything else will pale in comparison.
Now, once we recognize this, we should also see that as this mountain of information has grown, so has grown access to and consumption of the world's greatest art, literature, and music.
Which does make us, collectively, far wiser than ever.
And with the percentage of the world's population living in poverty at its lowest level in human history, our collective satisfaction, as measured by freedom from hunger, from premature death, and by access to choice as to one's work, one's mate, one's place to live, is both very good and increasing as well.
And with being wiser and more satisfied, yes we are collectively much happier, too.
This is all well and good, but far more exciting is that we have only begun to scratch the surface of how this “always-on” Internet world of ours might transform for the better our inner lives as it has our external ones.
How this might come to be came into focus for me through a conversation with the President of one of California's most admired colleges of graduate education.
In the process of helping to develop a five year strategic plan for the school, the President and I were discussing the relative merit of enrollment growth of online versus traditional on-campus enrollment.
As we were getting pretty granular into the various modeling approaches and ways to assign value to a “virtual” versus an in-person student, I stopped and noticed a certain pause and quiet in the room.
I looked up, and in the President’s eyes was a faraway look.
He paused, and then quietly said, “values-based education cannot be measured, it just is.”
He then took a sip of water, and more loudly added, “and it is only from this place do we measure our outcomes, not the other way around.”
This inside out approach is where technology can and will lead us.
It will be a slow and bumpy, but very much an upwardly sloping road, towards all of us being truly well educated - online.
Written by Jay Turo on Thursday, March 7, 2013
Last week I flagged the shocking and even depressing statistics that most entrepreneurs - holding constant for socioeconomic factors - make less money, work more hours and suffer more work-related stress - than their employed counterparts.
And when we combine these statistics with those that show a very incredibly low percentage of startups and small businesses ever attaining meaningful profitability, it is remarkable that people ever dream to be entrepreneurs and start businesses at all.
But start them they do!
Quite possibly the most amazing and inspiring number in all of American business is 550,000.
That is the approximate number of new businesses that are started in American each and every month, or more than 6 million per year, or close to 3% of the U.S. adult population.
Now these opposing statistics beg the question, “Why?”
Why would 550,000 people - who statistically are far better educated and wealthier than the population as a whole - engage in behavior that on the surface clearly seems contrary to their self-interest, irrational, and dare I say, delusional?
Well, on the cynical side, many of these brave folks probably think the odds of economic success are greater than they really are. And even if they know the odds, they think that they don’t apply to them.
On the slightly less cynical but still not totally inspiring side, one could argue that businesses are started out of boredom – out of the need for that “action rush” that in the realm of business only an entrepreneurial endeavor can truly provide.
Inspirationally, many believe like I do that entrepreneurship is the greatest force for positive change in the world today, and they start and grow businesses to be positive change agents, on levels big and small.
They start restaurants to create and share beautiful food, service, and atmosphere.
They open day care facilities to provide quality, spirited child care for working families.
They start creative agencies – graphic design, public relation, web development firms, and the like to leverage their business and creative talent to its most effective end.
And they start drug development and medical device companies to help people live longer, healthier lives.
And thousands of types and forms and sizes of business in between, led by entrepreneurs with aspirations big and small, driven by motivations both pedestrian and soaring.
But at the heart of all of their reasons for starting businesses, at least of the ones that survive, is that often begrudged but really most inspiring motivation of them all.
They start businesses to make a lot of money.
Now the key word in that sentence is make – as in bringing into existence through creativity, effort, and as often as not more than a little serendipity and luck, something that did not exist beforehand.
Making money is the difference between Mo Ibrahim becoming a billionaire through bringing inexpensive mobile telecommunications to millions in Africa and Mo Gaddafi stealing billions of his people’s money at the point of a gun.
It is the difference between Steve Jobs and Apple creating $325 billion in market capitalization (and untold additional hundreds of billions in economic and multiplier effect), and governmental “who you know” redistribution and inefficient waste of this created wealth.
Now often, for the entrepreneur and those that back them, the touching of this money often takes many years, even decades, of under-paid, hard, and often thankless work, before a cash windfall in the form of a business sale or a public offering.
But that is a story for another day.
For now, find those that can truly make money, encourage and back them, and you and the world will get to a better place.
Written by Jay Turo on Monday, March 4, 2013
This past weekend, I had the privilege of moderating a planning session for the leaders of some of the world's best known and most successful collections agencies, collectively responsible for billions of dollars of receivable's debt.
They traveled from around the world to progress toward a common end - making doing business globally as credit safe as doing so close to home.
This is of course extremely challenging, and in a world of exploding international trade, also an enormous opportunity.
So for 40 hours over three days together we grappled long and hard with the various aspects of the business problem - from the right SaaS technology to use to fee-sharing to compliance to channel and end-user marketing.
It was hard. It was draining. It was often contentious.
It was time away from the pressing and equally vexing concerns of everyday work.
AND it was glorious.
Now, if you thought that in a hard bitten business like collections - and at a meeting attended by 25 year+ industry veterans - that there wouldn’t be many moments of idealism, well you would be mistaken.
No, there were a LOT of those “aha” moments - always the best and most inspirational evidence that whole new worlds of strategic and tactical possibility had been discovered.
For sure, post-meeting the participants have now traveled back to their home markets and are faced with the hard challenges of tactical implementation and the inexorable pull of business as usual.
And while meeting for 40+ hours, and traveling to them from around the world IS hard and painful…
…and while we all love our e-mail, our text messaging, our web conferencing, our video hangouts…
…There is just no substitute for personal contact.
And there is NO faster, better, and yes cheaper way to arrive at great and actionable business ideas.
So for a moment, let’s all put down the phone, turn off the e-mail, stop the texting.
And fly, drive, run, walk, crawl to that conference, that party, that face-to-face get together.
When done right, it is always time well spent, and in its aggregate creates both businesses well run and lives well lived.
Written by Jay Turo on Monday, February 25, 2013
So much of the challenge that both entrepreneurs and investors face in earning return on time and capital is driven by the low growth rate of the economy as a whole.
U.S. GNP growth, after averaging 3.6% annually for the period 1982-1999, has since 2000 slowed to a mere 1.8%.
Not coincidentally, in that same period stock market returns have declined dramatically.
From averaging over a 17% annual return rate in the '80s and '90s, most of the major indices have painfully dwelled in negative return territory since.
And to pile on the misery, with budget deficits exploding from 58% of GNP in 2002 to over 100% today, all of the "free" money poured into the system over the past decade has not had any kind of meaningful stimulative effect.
But it is going to be okay.
Why? Well, because as business people and as investors we do not work in the "macro", but rather in the far more confined - and controllable - dimensions of our particular “micro.”
And here, we can escape from the “tyranny of the average.”
How? Well by simply exhibiting that most blessed of American freedoms – individual action.
Here are actions that smart entrepreneurs and investors can take today to “break out” and attain well above average results and returns:
Think and Act Globally. The developing world continues to maintain rates of growth and virgin and nascent market opportunities probably never again to be seen again nearer to home.
How about China, even with its recent slow-down, still averaging well over 8% growth?
Or India, at 6%?
Not your cup of tea? Well how about Mexico, Brazil and South Korea all growing faster than 4%?
And don’t tell me that you can’t compete there - via technology these markets are more accessible to small and medium-sized US businesses and investors than ever.
Think Sector. The overall economy may be flat, but there are sectors within it that are booming.
Like software, growing close to 6% annually.
Or how about the entertainment industry, growing at 5.5%?
Even seemingly mature industries, like transportation & food services, are growing at close to 5%.
Think Inefficiency. Remember that to make a small fortune - and a big difference - we do not need to solve the challenges and difficulties of the overall economy.
No, we just need to find those little market and competitive inefficiencies, those niche needs and wants, those investment strategies born and won far from Wall Street.
Now, when tens of thousands us follow our particular rainbows toward our particular pots of gold the byproduct of all of this thoughtful, opportunistic, and individual action…
…is that yes collectively we all do win.
Written by Jay Turo on Monday, February 18, 2013
The greatness of Napoleon, Caesar or Washington is only moonlight by the sun of Lincoln. His example is universal and will last thousands of years…He was bigger than his country - bigger than all the Presidents together…and as a great character he will live as long as the world lives.”
- Leo Tolstoy, The World, New York, 1909
In honor of President’s Day, I went and saw Steven Spielberg's great movie “Lincoln” this past weekend.
As it has for many, the movie exceeded my very high expectations for it.
The film's core narrative - President Lincoln's efforts to get the 13th amendment abolishing slavery through Congress before the end of the Civil war - offered a treasure trove of leadership wisdoms applicable to our modern day.
The movie paints a basic leadership dilemma in stark relief, namely what is the proper balance between morality and expediency?
Between "being right" and being effective, and to what degree do moral ends justify messy means?
Lincoln, through the leadership role into which he was uniquely thrust, probably grappled and suffered more publicly with this dilemma than any person in history.
Beset on all sides by the bitterest of adversaries - the incorrigible racists and States’ Rights advocates of the Southern and Border States on the one hand and the moral absolutists (combined with desire for revenge) of the Radical Republican North on the other - no matter what decision Lincoln made or action he took there would be a large, powerful, and vocal group vociferously opposed to it.
Adding monumentally and tragically to Lincoln's challenge was that so much of his power and decision making revolved around those most awful of choices - to send tens of thousands of young men into battle from which the almost certain outcome for very many of them would be death.
For anyone, the awesome responsibility of this kind of leadership is beyond overwhelming.
For a great soul like that of Lincoln's, it was tragic beyond our ability to possibly relate.
But it was also triumphant, and for any of us that strive to do great and moral things with our lives, there is no better role model.
First, Lincoln did not make his enemies "wrong."
Rather, he found that delicate and transcendental space whereby he was strong in decisions to prosecute that bloodiest of American wars harshly and vigorously, but while so doing found space in his heart and in his leadership directives to not deny the humanity nor the deserving of forgiveness of his enemies.
Secondly, he did not lead from "up on high," but rather with great vigor and charm appealed to the “better angels” of his adversaries to see things a bit different - more nobly and more charitably.
And finally, Lincoln recognized that even in the midst of a horrible war, that laughter is as much a part of living as are tears.
And thus, so often when a stern reprimand or harsh words would be the reaction of a lesser leader, Lincoln chose humor to make his point.
This is maybe Lincoln’s greatest lesson for modern leaders.
To stand and to work for great things, yes…
To forgive your adversaries, yes…
But, to do so not with a heaviness of heart or obligation of purpose but with a gentle and even mischievous lightness of being that makes the journey its own reward.
And when done with the dexterity and openhearted wisdom of an Abraham Lincoln, things not thought possible even to dream about come to pass.
Happy President’s Day.
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