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Today on Town Hall

what I always saw was that a lot of leaders built up all those great skills and then had some sort of self inflicted wound, they made it to the top, but then they couldn't stay there, right?

And a lot of times it came down to ego and arrogance good does it do us to build up all those great skills and to finally get to that spot where you could have maximum impact and then have it be so short lived, right?

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. .

Alright, let's jump right into today's episode.

 Thank you for joining us for an episode of Town Hall with Andrew Carr. He is the founder and CEO of 40AU, which is a Nashville based software data and AI consulting firm dedicated to developing cutting edge technology solutions with a strong emphasis on values partnership. and humility.

Andrew's also the author of The Humility Imperative, a book that explores the role of humility in leadership and how it drives sustainable success. Andrew's got over 20 years of experience in health care and technology Andrew's career has been Defined by his focus on building meaningful relationships and sourcing top tier talent to solve complex challenges.

Having worked together at HCA, we share a long history of collaboration built on mutual respect and shared values, making this conversation especially exciting. So Andrew, welcome to the show. Thank you so much, Sarah. It's great. Great to be back with you and always fun to share ideas and appreciate the forum here that you've provided.

Yeah. Of course. And we've been a little bit of everywhere together. And the worst part is It's over 20 years now. Yeah, that's true. Gosh, has it been that long? Yeah, it's been that long. It has. And we'll cover, some of that in our discussion, but those friendships and those business partnerships you can take with you for 20 years to multiple companies, that says a lot about you and also what you've continued to create and build at FortyAU.

Thank you. I always say, it's Making solutions like this in the complicated world of healthcare isn't easy, right? And so you have to have a partner that you're going to stick in there with, somebody that's going to do the right things, and that's going to help you make good decisions, hopefully.

And we try and do that for people, and I think that's why a lot of our business over the years is just repeat and referral business, and we love that so much, and always appreciate people that will put in a kind word for us, like yourself. So thank you, thanks so much for your support over the years, and it's just good to be working together again.

Of course, with 48U joining the This Week Health universe as a partner, the reason that I'd reached out to you when I came here, because I'm not building custom software anymore, I'm not solutioning for big team environments and big complex corporate challenges, but all of our CIOs, CMIOs, CISOs, etc. are.

And so when they have a trusted resource to go and say who would you hire for that? Or who would you do business with? I'm like, if I'm going to build anything, if I'm going to build any kind of custom widget, I'm going to call you or I'm going to refer to you because of the success we've had in multiple organizations.

And let's be honest, when you're starting out new in an organization and you have to deliver some big wins quickly, you're going to call the people who have done that with you before. we have these really powerful tools now, and again, what you can do to transform a business with these digital solutions is very real.

The downside of it is if you take a haphazard approach, or if you go into it without a measured, thoughtful approach, you can waste a lot of money on it too, right? And so we often are picking up projects that went bad at some stage, right? Trying to regain the trust of the business, trying to put back into place some of the basics that will make that company ultimately successful.

But yeah, you have some powerful tools that can work in either direction if you don't know how to wield them, nothing like a good turnaround plan. Someone shows up at a hospital and they're like, wow, this is a dumpster fire. I'm just going to call you. And then you try to work through all the details and some of that onus that goes back to the partnership where you're like, how often do you actually say no to something?

I mean, Have you ever come across a project that was just, You knew you're like, this is not going to be a good fit. Like, how do you know when to walk away? Yeah. So it's a hard one because I am naturally a helper and naturally a consultant. And I think on the good side, we think confidently that we can almost fix anything.

So other than projects, we will run a. Across 'cause we work across multiple industries with healthcare being about 70% of our business. But we do like the potpourri and like to see some of the other tech and some other approaches that are in other industries and bring that back.

So we occasionally will run across morally objectionable projects. Those are pretty easy. We'll put those aside pretty quick. I won't go into those. But then other ones that are I think it's more about maybe misguided expectations. How quickly can I have something? How easy is this gonna be to do?

And we'd really try and negotiate back. Those expectations around not quick or easy, but if we do it right again, I do think, and if I can't see, occasionally it's hard to see an ROI, it's hard to see a good, meaningful use case. And we may push back and say, maybe you're not ready, or maybe we need to think through this a little bit more.

But normally it's not a no, it's a, Hey, how can we help you get there? And it might just be doing some more strategy work and working on the designs and things like that, but not, we're not saying no too much. I like to think that we're pretty solution oriented. And normally we're going to get to the other side of it, it just may take a little longer than you thought.

Yes, with some caveats and requirements. Requirements are a big thing that are required to have a great relationship with a partner and sometimes the hardest thing to get to. 70 percent of your business is in healthcare and you work with everything from early stage startups to some of the largest companies in the industry.

What trends are you seeing now that companies need to be prepared for? Yeah it's so you know, this year has been a lot of fun in a lot of ways because we consider ourselves a consulting company first and foremost, so we look at it and say, hey, we're technology agnostic. Let's not jump right into the tech.

Let's look at what are you trying to do? How's it going to move the business forward? And what are those key indicators that we're going to know that we're getting there, right? Then we'll talk specifics about tech and those kind of things, right? A lot of people have come to us this year asking about AI solutions, right?

How do I integrate into AI into what I'm doing? If they're a startup, and we do work with about 20 percent startups, they may come to us and say, hey, I need to have an AI enabled product to go raise money. That may be true, and I get where their thinking is from a business perspective, but that doesn't mean anything within a pragmatic sense of building a solution, right?

So when you talk about middle market or larger enterprise companies, which is about 60 percent of our clients, they're usually not ready for AI for a number of reasons, right? So a lot of times it's walking them backwards and saying, okay, I understand why an AI solution may be good for you eventually, but what about your current data posture?

What about, do you have a data warehouse? Do you have a real time streaming data pipeline? If you don't have some of the building blocks in place, it's going to make AI kind of one of those expensive forays Into wasting money and sort of disappointing business and stakeholders versus, Hey, let's do some fundamentals here that would actually get you further down the line.

So I think it's really just, yes, people do need to be thinking ahead as leaders and looking at the future and saying, how can I apply these powerful new LLMs and other solutions? But you also have to one of our favorite clients says you also have to eat your data spinach, right? You got to get your data into a spot where I can actually do interesting things for you.

before you jump into and again, I understand why people are enamored with AI, but let's walk it back and make sure we do it right, rather than cause disappointment within the business and maybe lose credibility for those stakeholders. Yeah. And that data governance, the lineage, the quality, the warehousing, the reporting, those pieces are not a one time endeavor.

It takes a long time to get it in place, get all the stakeholders, business owners aligned appropriately, and then realizing everything you're feeding into that data. Warehouse has to be that clean copy that you want, the shadow IT that pops up and starts to extract things and run their own models, you're like, it still has to go back to that single source of truth.

So when you think about the right time for an organization to consider partnering with a consulting firm like 40AU for custom software data solutions leading to the more advanced technologies, When should they reach out to you? Yeah. And again, the answer when you're a consultant is always, it depends, right?

But I'll give you a couple of scenarios that I think work well for us. One is when you're trying to innovate, right? And you're trying to move the organization forward in some significant way where there's a change component and you need to build something different, better, fill in your appropriate adjective there.

We've really, when we work in with big companies, we know that they already have. Typically a lot of legacy investments in place, right? But when you're trying to make a big change, let's say you're shifting your cloud providers, for instance, and your people don't have experience on the new platform.

We're really good at playing that Sherpa role of saying, hey, we're going to get in beside your team, we're going to co engineer this with you, and we're going to take you across the chasm there to where your people feel really comfortable, and then we will eventually disappear and go on to the next thing.

Hopefully, new or better different, right? But when you're building new things, when you have an innovation agenda to you, I think we really plug in well with enterprises there. The other more mundane use case might be where you have a good strategy in place and you know that you need to accelerate that, right?

You need some quality engineering talent, you need some good data engineers to help build out these pipelines. Maybe you just need a mobile developer or two to build out that new app for you. So where can we come in and really accelerate that? Accelerate something that you know is strategically correct, but you just don't have the talent in place to do it.

So both of those scenarios are really good for us and why a lot of people reach out to us. And one of the lasting impressions that any organization I've worked in has had where you have been there with me is the fact that you don't nickel and dime the organization. You're not trying to embed 10 people for the rest of their lives or do contract to hire.

You're pretty specific about what you just said. We're going to walk in. We're going to help you. We're going to teach you and show you. We're here for longer term support. You need to check in once in a while, but at the end of the day, you're like, Hey, we came in to do what we needed to do and get my favorite part.

And we left you with the documentation, because nobody really wants to do documentation, and yet for as fast as things are moving, some of these new code bases require documentation to go with it, there's tools to do that, which is why I love being able to ask you about, as healthcare companies explore how to use AI solutions, they want to innovate within their organization, how do you help them adopt AI solutions by balancing risk and opportunity, and really understanding which Portion of AI plugs into a part of the organization that, again, can be low risk, can be something that is more of an automation of administrative tasks versus going just straight for the clinical solution, as an example.

Yeah, no, it's so we're actually going through this right now with a potential prospect, right? And so, large value based provider uh, ACO, if you will that has 18 counties. And so they've come to us with seven different workflows that they all want to get done in 90 days, right? And what we're having to do is go wait a minute, take a time out here, right?

Let's walk through and let's pick out three, right? That are going to be the most impactful for the business. And as we discuss all seven, we'll be able to tell pretty well, which of those three will move the needle. And then what we're typically trying to do is yes, we can make an impact pretty quickly.

So let's go in and do a POC end to end, technically improve that this will work, right? Maybe just on a small scale, let's show them what will work. let's talk to and put it in front of a few nurses and a few practitioners that will be using it. Get a little feedback, and then we might come back and say, okay, now that we've got this mapped out, we know there's value here.

Now we'll build sort of the enterprise scalable version. So those AI, what I call AI POCs to really go in and take a 60, 90 day, look at something, workflow, map it, let's say how we can improve the business and then let some people touch and feel it. When it comes to the practitioner, there's still a lot of trepidation around AI, so you show them what it is and what it isn't.

You let them put their hands on it a little bit, it eases that change curve, which you and I have talked about in the past. Technology is great, but if the people who are supposed to use it can't adopt it that's a big reason why a lot of software projects implementation wise fall down, right?

So we're always thinking about that component, the phrase that you used earlier, is we like to go A lot of times on the sales side, you're thinking about how do I get into a company, but you also have to think about how do I exit, what does a good exit look like, and how do I leave that organization better than I found it, thing, right?

So that's kind of always part of our thought process. Your company's always been focused on values. And so when you think about 40 AU having the values that you do, how do you ensure that company culture and values remain as you scale for your clients? Really tough question and good one. But, so we're going through and we've been in a very, we know we're growing 30 percent year over year and based on those good client referrals and things like that.

But one of the things that's core central to us has always been passion for growth, right? And so that passion for growth has to be, yes, we want to go find new customers. And yes, we want to do more with our existing customers, but it's also internal, right? as a tech team and as a developer, am I growing my skill sets internally?

Do I still have that passion to learn new tech stacks, to get in and explore those frontiers? So you try and make it to me, those values really have to permeate the organization in a meaningful way. And so we talk about it in performance reviews, right? We talk about it and go, Hey, One of our goals is to be a confident advisor.

So you don't seem particularly confident in this phase. How do I get you there? What does that look like to invest in you a little bit, to make sure you can be confident the next time we put you in front of a client or whatever it might be. So the values and the interesting way we did it, Sarah, was we didn't actually, when we thought about our core values, we hadn't been, we had been in business three years, right?

And so we didn't say well, it's time to put some values on the wall. What we said was, let's look at the people in our organization that really, that we just love, that are modeling the way we want to have, we want more of those people. And we actually pulled the values from them and the way they were already acting and the way they were treating clients and one another.

And then we said, okay, that's the team that we want going forward. And now we're going to start talking about it in an intentional way and saying, Hey, let's build around that and let's coach people to it. So it was a little bit of a reverse values creation process. And I think it's worked really well for us because they're genuine and they're embedded in the organization in that way.

And you've done a phenomenal job of your team. Always being on the cutting edge of what is out there in the industry. Because when you are running your own shop, like a healthcare delivery system, it can be harder to get your team to stay current on newer technologies because they may not be utilizing them and they've gotta still focus on day-to-day and running the operations.

How do you keep your team hungry? How do you keep them working on these projects for your clients meaningfully? And then next step is, hey, by the way, you have to always be current on every technology that's coming down the pipeline because. We may be asked to support it, define it, teach it, et cetera.

Like where does that exist for that learning come from on your team? The hard thing is that the reality is for large organizations, it benefits them if people go narrow and deep, right? So they pick a technology and they go narrow and deep, right? And that does benefit in a lot of ways, the company strategy, the problem, and the way I see it, and the thing we advocate for.

Is more technical range, right? Being able to be wider, right? One of the works, you may have heard of the book called Range, and it talks about why generalists will thrive in a specialized world. That is the mentality of our company, right? And it makes us a little bit different, and it makes us a little, I think, stand out in a number of ways, because we're looking for holistic engineers, that are constantly, one of our other values is fearless curiosity.

And we're saying, okay, are you really being fearless? Because if you're just staying on that same project year after year, going narrow and deep, then you're going to eventually run into a spot where, hey, the technology shifted on you. Hey, that paradigm isn't as in favor as it was in the market as it was five years ago.

And now all of a sudden, your skills aren't as cutting edge as they were strategically, it's a different choice that we made to have technical range rather than to be narrow and deep. And I think it's made us a really versatile partner for a lot of companies. You think about the way private equity is sweeping a lot of different markets, right?

Private equity is buying up companies. When they're buying up companies, they're buying up multiple different tech stacks, right? And so how do you rationalize and put all those pieces together? You'd have to hire five different partners and know five different tech stacks in the old way. Or you can hire us and we can help you rationalize those pieces, look at them all with a professional lens, and then be able to bring that better, together in a holistic picture.

So those are the kind of things that I think about that make us a little bit different. Even beyond the PE space, you've got all the mergers and acquisitions occurring with all these different platforms, and these healthcare arenas and divestitures are still a thing. Who's ever merging and acquiring, somebody else is divesting that and that whole strategy of connecting these platforms and making sure that those API connections are sound and you know how to turn them on and off and avoid that third party risk, to your point, is something that, heck, we brought you in, Activity, to do a lot of that work with us and to rewrite and go cloud native on so many different applications.

And guess what? It worked. That's one of those things where you're like, you have the vision, you know it's possible, who are the right partners? to get you there. So when you joined 40AU as a CEO, I think almost 10 years ago now, what prompted you to make that leap? And what's the story behind the name? Okay well, well, so, I'd had a great experience working at HCA where we met.

And for many years, I was there almost 10 years as well. And I just, I'd gotten into consulting the last two or three years there. I got to consult pretty widely across the company and working in some of the Parallon business units. And I just like the pace and the speed of consulting, right? I like being able to go wider, to solve different types of problems, to get more exposure, and so I got, I got bit by that bug when I was working in one of their joint ventures.

And I just was trying to figure out for about two years, how do I circle back and maybe make a more full time commitment to consulting? And and I'd met my partners in that joint venture. I saw that they were doing pretty well. I had actually made them Logan and Dwayne were my software go to guys.

And so I was getting to know them pretty well, coaching them up. Their business was quite small, but growing. And I thought that looks pretty interesting. And these are pretty talented guys. And I, my wife at the time was going back into the workforce and I said if there's a time where I can take some household risk, if you will, I'm going to go ahead and put my neck out there a little bit and see if we can go make a go of it with these guys.

And so that was the Genesis. Getting to the name, what we were kind of uniting around was we all like to consult and we like that problem solving aspect. But we figured, that we didn't want to be a management consulting firm that sort of advised and didn't execute. So what we think about when we think about 40AU, so 40AU stands for 40 Astronomical Units, right?

So that is the distance that the 40 astronomical units is the distance that the Voyager 1 spacecraft took a famous photo of Earth that Carl Sagan used as his inspiration for a great essay called The Pale Blue Dot. And it shows Earth as a just a tiny pinprick off in the distance. And really what he talks about a lot is humility, perspective, being able, and we thought about that as a consultant, that it really resonated that you're coming in from the outside, you're You do need to zoom in sometimes and look at a problem, but you also need to be able to zoom out and take in the broader context and understand that you're coming into something that is, every organization is delicate in its own way.

So how do you go in and be a true partner to folks and really when we think about 40AU, it's about perspective and about humility and going about the way you do your business versus being the know it all, right? We're coming in from the outside. We know everything. We're going to know. It's about partnering well.

And so that's our cultural touchstone when we think about 4DAU and what does it mean to us. And I, full transparency, after you went to 4DAU and I'm like, what does that mean? And you told me, I have used the pale blue dot in every single executive leadership development class that I have taught ever since you shared that with me.

And for anybody listening, got to YouTube, you pull up pale blue dot Carl Sagan. There's about a three minute and 30 second excerpt of him reading a portion of his essay with that. And I. Believe maybe once a week, I still listen to that because of the perspective and realizing that what, everything that happens in our world happens in the fraction of a sum beam, those different perspectives.

And so for anybody looking for a touch of humanity, go and research that and learn it. And what a perfect, yeah, I get chills thinking about it. Yeah, I do too. I literally, you're talking to me. I'm like, again FHIR, I call it for my FHIRs raising up because it's so powerful and it's always powerful.

But speaking of humility, you wrote the humility imperative. How did humility become such a central philosophy for you? And why do you believe it's essential for leadership? And the way I'll think about it, here is, we do a lot of work and you and I did some of this together.

You have to build up your skills to be a leader. There's all kinds of leadership tasks and skills and things we try and build up. When I got fascinated with humility, I was on a journey learning a lot of those skills, right? And I loved reading leadership biographies, but what I always saw was that a lot of leaders built up all those great skills and then had some sort of self inflicted wound, where they made it to the top, but then they couldn't stay there, right?

And a lot of times it came down to ego and arrogance and a little bit of hubris. And so I was like what good does it do us to build up all those great skills and to finally get to that spot where you could have maximum impact and then have it be so short lived, right? And so humility fascinated me in that way.

If you go back to, Good to Great, he talks about level five leaders. That was one of the original ideas of, it's not that level five leaders. And I think this is the misnomer about humility. It's not about being meek, right? It's not about being a doormat. It's about having perspective and lowering the ego quotient in what you're doing so that the mission of the organization or the mission of your team can really take center stage, right?

So he says in Good to Great that it's not that level five leaders are not ambitious. They're incredibly ambitious, but they're ambitious for their cause, for their organization. They're, I started using the word zealous. You and I have talked about this. They're zealous for something that isn't necessarily themselves and their own ego.

And I think that solves a lot of problems in teams and organizations when people really get a genuine sense that you're out for their good and you're out for the organizational good, rather than it's about me and me as the leader, maybe shining. You mentioned like the tech industry, it's big time, innovation, competition, it will drive ego, because of that pressure to always deliver.

So as you think about, as a leader, mentoring and guiding the next generation of tech professionals so that they can be humble, have the zeal to go after the things that they want. What is your approach in teaching them and guiding them in these spaces? Yeah, I mean, you know, here at 48U, we talk about being willing to raise your hand, right?

And then again, typically in two contexts. One is just saying, hey, I don't know, right? Or I'm confused or whatever it is, because you know how it is. You can get in some of these large Zoom meetings where you got all the people you're supposed to impress on there. And everybody's nodding their heads and going along with the program.

And yet there's this elephant in the room that nobody's going to talk about. And we want our people to raise their hand. And we want them to be afraid not. On the one hand, you got to be courageous and say, hey, I have a better idea, or maybe I have an objection. On the other, it's, you got to say, have the courage to say, hey, maybe everybody else got that, but I didn't.

Can you repeat it for me? Can we go back over that? Do you mind if I ask a follow up question? And so that, that really, to me, is being able to both be confident in what you're doing and your skill set. One of the things that I think a lot of the younger generation battles with is imposter syndrome, right?

And so this imposter syndrome is I'm not good enough, right? And so you have to find that fine line between you are good enough, you wouldn't be there if you weren't, right? So I want to inspire you with that confidence, but you got to ride that thin line between being overconfident and overconfident. And humility is really the thing that I think can help balance that out for a lot of people.

So the humility to say, hey, I messed up, right? Hey, I didn't deliver that project on time, or I spent too long on that feature. Whatever it might be, we try and cultivate that. Because I think it both lessens the fear of failure, and it makes you more approachable within a team context, right? This ability to step in and step back and to be able to lean in confidently, but also step back and say, Hey, I don't know.

I'm going to raise my hand on this one. That's where we try and find that balance. And that's what I spend a lot of time, coaching people on is trying to find that right balance of when to step in versus when to step back. And the highest performance can come from the moments of you're in the trough one moment, maybe at the top of the mountain the next time, but that in between to your point, and really appreciating what it looks like and knowing when you're there so that those pieces of wisdom can be shared thoughtfully with the team.

But you mentioned being zealous and having zeal, and that's your second book that you're working on all of your spare time. So when you think about the zeal factor now coming in as the, as a follower to humility, how does that play into the equation? It started for me, you know, with thinking about what is that other side of the equation, like I said, and balancing it.

And I tell people, I've said leaders, forever, it's not enough to just be humble, right? That can't be the only quality you bring to the table, right? And so what is it then that equation that we need to balance out? And what I think people get confused on is like passion versus zeal. You'll hear a lot about passion.

I call passion sort of the punchline that everybody talks about. And I think it's, I think it's misguided to some degree because passion is a lot of times internally driven and it's about you really, right? We respond to things passionately. I think of it as the spark, right? What gets your attention? What do you respond to innately?

Where is maybe your talent aligning? But passion is also can be very short lived. It can be something that misguides you. It can be something that overwhelms you. And so to take that spark of passion and to turn it into something that is not about yourself and is externally focused on the greater good is really what I think zeal is.

So if passion is the spark that lights it, zeal is going to be that, that burning ember. And it reminds me, I ask people the question a lot of times, what are you willing to fight for, right? Considering all the options out there, if you're a passionate person, what can you stick in the fight with for two, five, ten years and really make a difference?

Because passion is, is a love affair. A good marriage is zealous, right? You got to be zealous for the other person and for their good, right? And so those are the kind of things that I've tried to draw people and say, hey, it does matter, words do matter, and how we parse that. And I ask people, passionate about, zealous for.

What are you zealous for? Passionate about might be a way of indicating what you might be zealous for, but this is the much more important part of the equation. And what a powerful conversation to have with someone in software development, as an example, where it's so easy just to move to the solutioning of the products for your clients and appreciating that with the teams and how they're also going to interact and work with others.

Cause healthcare doesn't move as fast as some other industries. I appreciate that you've got the biggest part of your book is with healthcare, but you also. Do you serve other industries? And it does inform the things that you can work on and ways you can bring new ideas forward. So when you think about custom software development in industries like healthcare, what challenges do you face delivering those tailored solutions?

And what can other industries do to help inform healthcare in terms of speed to market? Yeah, and I think one of the big values that we do bring to Teams, mentioned that innovation piece before, but it is just some outside perspective of seeing how things are done in other spaces. A lot of times we'll get to cut our teeth on some new technology, something like Elixir comes to mind, right?

There wasn't a lot of Elixir in Nashville, certainly in healthcare when we started using it 10 years ago on a sports analytics app that we were doing computer vision and we were doing real time shot tracking. And so we cut our teeth in Elixir and using some real time APIs and being able to display things in a way that we thought was pretty cutting edge.

In a much less high consequence industry. So you get familiar with the tech, the use cases are a little bit easier to put into place, less risk. And then you say, hey, this is a great tool that now we have in our tool belt. Now let's bring it back to healthcare, right? So things like computer vision and things like that.

We were able to, once we understood the discipline, understood the tech, to kind of bring some of those and go, hey, let's do a POC in the healthcare realm. And now there's quite a few healthcare companies that are using tools like Elixir. And some of these other more exotic functional programming languages.

But that's a kind of a, probably one good example just right off the top of my head of how you can cross pollinate and bring a little bit of know how, not IP, but know how from a, maybe something completely different in terms of context. And how has that, the ability to bring some of these new technologies forward and cross inform industry, how has that changed over the years or evolved over the years between you and your clients?

What have you found to be some of the key elements to success as you bring these philosophies forward? Yeah, I think number one, people will say that our team really blends in well, they're collaborative, and that sort of transcends industry, right? And so I think that approach, and how we operate, and how we conduct ourselves is really a lot of the 40AU experience, if you will.

Now when you think how has it changed I think, I don't know, Sarah, in some ways the tech always changes, right? So again, that passion for growth and that ability to keep yourself out of the comfort zone comfortably is, is I think the part that really keeps us on edge. But I think in a lot of ways, it's still people, right?

It's still people and solutions, people, process and technology. We used to talk about back in the day. It, a lot of that is just aligning those three factors, right? And how do we stay in close connection with how that business is evolving so we can recommend the right solutions and bring the right people to the table.

So, you know, What's old is new. In some ways it hasn't changed except for the tools. Like I said, we, I think, when you, especially. When you start talking about LLMs and the ability and some of the tools that you have there, you just have better tool sets to do your consulting with, I feel like.

And one of the things that I do believe has been such a success in working with your organization over so many years is the fact that Check about humility and the zeal factor, where as a leader, as an SVP, C suite, etc., you don't always have the answers. Part of your goal is knowing where to get them, obviously, in a safe environment.

And I cannot think of how many times I called you. I'm like, hey, this thing's happening here. I need help with this. And I have absolutely no idea where to start, but I know I need to do these things to get I know what it looks like, but that's about all I can tell you. And you're like, got it on it and coming through with those solutions.

Cause everybody needs a safe place to go to ask the right questions. And so I want to finish with this question for you and with our long history of working together at HCA and beyond, what do you believe has been the key to maintaining strong business relationships for nearly two decades? For you and I specifically, there's a high trust factor, and I think that goes with a lot of our clients.

And, again, when you're wading into stuff that's unknown and scary, or, you don't know where to start, you need somebody that can at least point you in the right direction, right? And so that trust factor. I think, one of the things that I pride myself in, and I think 48U does well, is just consistently show up.

Even if we're, even if we're having a great day or a bad day, we're going to consistently show up and we're going to try and give you our best, right? So consistency is something that is very undervalued in this world. The ability to keep showing up day after day, even when times are tough or when times are good, I think is one of those things that I hopefully has been a key, I think, to keeping and establishing trust.

I think, or both of those are really the big things that I think about. And I hope it's something that is reflected, obviously, that's the way I think about it. But, our teams, I think, model that in a lot of ways. And I think those values, like we talked about earlier, you have to model them if you're the leader.

And hopefully I'd do a good job of doing that. And then that trickles out to our teams. And that, again, is part of the 40AU experience, I would hope. And your third book, Consistency. I'm just making that up. Oh, it sounds like a good idea for a third book. You're like, I haven't finished writing the second one yet.

That's right. Humility, is a hard one to promote, right? Because you can't be too braggy about humility. Consistency would be another tough one to market. The unsexy qualities that lead to success, right? But I'll tell you if you are that leader and you're listening to this conversation and there's things you just are like, I don't know what to do about this or this, or you have the idea for a solution that you know is possible and you can't quite get that traction.

I would call you and be like, here are the things I need to think about. And I've been in an organization before where I said, something's fishy. And I just need you to Dig around. And you came back with, hey, these are the things we found and recommend. And it's never an accusatory perspective. And you've never presented it as a, statement of work and it's going to cost you a million dollars to go fix it.

It's more hey, here's what I found. What do you want? Where do you want to start? What do you want to help with? And so those are just always important perspectives. I'm very much looking forward to the continuation of 20 years. Having you now here at This Week Health as a partner is huge because, to your point, Why we both, I think, left HCA when we did on great terms was, I want to solve for a lot of people all the time.

And you get to be able to do that when you take a role like what we have both done, and you're seeing everything all the time, and you can direct people to solutions that you would use if you were in that seat. And that's really the defining factor for all the partnerships at This Week Health. So thank you for joining our ecosystem.

Thank you for always delivering in my previous lifetimes. And for all the clients that Depend on you for exactly the things that you talked about. Humility, zeal, consistency, values. Like you want those people with you and definitely. A moniker for everything that you have built. So thank you for joining me today.

Sarah, I'm really excited about what you guys are doing. I think this idea of bringing healthcare together through relationships is the way to solve most of our problems. And so you guys aligning great people and introducing them and connecting them, I think is a big service to the industry. It's not a technical solution, but there's a lot of tech that goes around it.

And I think you may have hacked the system. So I really appreciate what you guys are doing and thanks for including us. Likewise. Thanks for listening to Town Hall. It was a pleasure to have Andrew Carr from 40AU on with us today. That's all for now. Thanks for listening.

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