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Hi, I'm Sarah Richardson, former CIO and President of the 229 Executive Development Community. Welcome to Flourish, where we delve into captivating career origin stories and spark conversations that inspire, inform, and foster community.

Join us as we explore the journeys that have shaped successful professionals and uncover the insights that can help you thrive on your career path. Thanks for joining us.

On today's episode, we're joined by Andrew Kerr, founder and CEO of 40AU, 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 and leadership and how it drives sustainable success. With nearly 20 years of experience in healthcare and technology industries, 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.

  📍 Andrew, welcome to the show.

Hey, glad to be here, Sarah.

Always good to be with you. Yeah.

Always fun to catch up. You and I have probably had these types of conversations for the better part of 20 years, which makes a conversation like this all the more relevant because when you add those historical perspectives and all the things that we've done in our careers, it's really fun to share that, especially with Flourish really being about those career journeys.

So I have to jump in and ask you that first one of what inspired you to transition from a career at HCA, which we both know is. safe and lucrative and has a lot of great aspects to it, to becoming the CEO of FortyAU. And how has that journey evolved with your recent Ash Investment Partners involvement?

Very good. Yeah. No, thank you. Great question. I think to start out on and you have to unpack a little history, some of this, which you know, right? I love HCA, right? What I feel like when you work with a big company or a big brand like that, I love the opportunity to operate at scale, right?

So if you make neat program or if you make a neat innovation to see it scale out across and really be impactful to people, I thought that was always really fun. At some point in my career, I got this itch. My dad was an entrepreneur and ran medium sized small businesses. And I had this opportunity to go work with an HCA joint venture, which was a much smaller services slash consulting company.

And that's where, like a lot of people's story, I had a really good mentor there. This mentor who was my boss down there was a serial entrepreneur. He also started at HCA, but was a technical person and quickly decided that corporate stuff wasn't for him. And so when I went and interviewed with him, he said, Andrew, you're a nice guy.

I'm sure you're pretty smart, but you're a dime a dozen. And he said, you're a corporate manager. You don't know anything about business, finance, strategy, and all these kinds of things. And It was a weird way to interview me. I was used to people praising me and saying, Oh, you have these good qualities.

And I had been reasonably successful at that point, but I also really liked when somebody challenges me. And so when he challenged me in those ways to dig in and develop a whole new skill set, mid career, I got really excited by that. It was very intimidating, very daunting to some degree, but he really stayed on me and I got to participate in that joint venture.

And what I saw pretty quickly was. The speed at which you could do things right. I was able to go more broadly than better than being maybe deep, un narrow on one initiative. I had five that I was working on, right? So I really enjoyed that variety. I liked the speed of being able to help more people at scale.

And so this this ability to get in and jump in and solve problems quickly. What I consider the essence of consulting is really where I found a lot of passion. And so he kept poking me in the ribs, even through various machinations of hey. HTA wants you to come back here and do this, but you need to go do your own thing, right?

And at some point, I think we all have that desire maybe to sail away from the shore a little bit. To maybe stick our neck out there and take a little risk. And I think in my situation, jump into FortyAU that had 10 or 12 people at the time from a company that had 200, 000 people.

Definitely qualified in that zone. And I actually give a lot of credit, a lot of people who are in a, my spouse was getting ready to go back into the workforce. And so I felt she's going back to work for the first time in 10 years. Maybe this is a time when I can take a little bit of risk, put my neck out there a little bit.

And maybe try and build something that I thought had a lot of potential.

I love that you shared that he said, Hey, you're not good at these things. And you're like, wait a minute. It's not because I can't be good at them. It's maybe I just don't know how to be good at them yet. And when we have mentors that push us in those dynamics, and we realize we're really good at what we need to be good at in our current roles, taking that opportunity.

To look beyond what we know and put ourselves at risk.

Were there any moments, and this is reflecting on your leadership at FortyAU, the pivotal decisions or moments that have been most instrumental in shaping the company's growth and trajectory, especially when it may not have been your superpower?

when you started or it was a hidden superpower that developed in your journey as the leader?

when I think about those critical moments at FortyAU they almost all are what I call cultural moments. So in like one of them that I'll tell you about was initially we were, we had gotten some, this is probably two years into 4DAU, and we're doing some good things.

We're getting some bigger projects, and we're doing some more impactful things, so we're enjoying that growth curve but we had this kind of pivotal project where we had a tough client. They're really driving our devs. We don't want them to work weekends. They want them to do extra hours, and they're really putting a lot of burden on these folks.

And on the one hand, when you have that big client and you're trying to please them, and again, being in a services business, a lot of it is customer service. How do I show up well? Hopefully they become a referral and a repeat customer, that sort of thing. But what we realized when we had one of our developers, good young developer, smart guy, he just got burned out and quit, right?

And I felt like it was one of those where you have to make this fundamental decision as a services company. Are you for your people first or are you for the clients first, right? And some people think, again, we're here to serve customers. And I would say that's absolutely true, right? But it's a little bit of, Stephen Covey's like P and PC principle, right?

So you have the golden egg is the output. And then you have the golden goose. And do too much to screw up the goose, you're not going to get any more eggs, right? And so it's really making that fundamental decision that, hey, our people are going to come first. If our client, who we love, not doing right by our people, we have to take a stand and say, either we're not going to work with you, or we got to redefine the terms and to create some boundaries, right?

So those kind of things nobody really teaches you that in business school. Those aren't the things that essentially and when it's in your lap to make that call between a client and a person, but it's one of those real, and I was glad that I have good business partners who, that kind of culturally and values wise, we said, absolutely, it's got to be the people, right?

And so then we can follow through and it makes a lot of decisions from a strategic perspective much easier once you create those cultural. Touchstones, or so there's non negotiables in some way, right?

I love that you say that because I just covered a story in our news show where if you operate at game time all the time, and you don't give space for your team to have the practice opportunity, you're going to burn them out, and you'll burn out your star players faster because They have the most options and they're going to seek the culture that they want to be a part of.

How do you and your team navigate the balance between being nimble and adaptable and then still maintaining those consistent high quality services you provide at scale with so many high stakes on the table?

becomes a very mundane discussion at some level between sort of what I think of as billable hours, think about as billable client work, versus, okay, what am I doing with that extra capacity, or what if somebody's not billable what would we do with them then, right?

And so number one, I think for us, growth is like the cultural imperative, right? And a lot of people say that, say, I want to grow a company, I want a growth oriented company, but I try and tell our developers it is an absolute necessity in our industry, right? Because it's not a nice to have that, oh, maybe you polish your development skills, maybe you learn a new framework, that sort of thing.

It literally is job security, and it is the way that you stay relevant in this current field, right? So when we're doing custom software development nowadays, a lot of data engineering and AI They have to stay engaged in the discipline, right? And so we'll purposely tell people when we're interviewing, Hey, we don't want to hire somebody.

With 10, 15 years of NET or Java experience, because that's too narrow and too siloed for us. We want somebody that has that adaptability, has that versatility to move around between frameworks and languages. But more than that, they have to really like that part, right? And so I get a lot of this, and people have cracked the interview code with me, right?

They know that they're supposed to say, I really love learning. And I say what do you like about learning? Because I find it really uncomfortable, right? Think about when you're learning something for the first time. I've used the analogy of snow skiing, but like when you get to the top of that hill and you don't know what you're doing, it's pretty darn scary.

And yet you got to get down that mountain. And so you're going to fall down. You're going to get banged up a little bit. It's not going to be super comfortable now. Maybe eventually once you push through that barrier, it is fun at the end of it. But the actual learning process is quite uncomfortable.

So I try and push people and say, look, we are a place where learning is required. It's a necessary imperative for you and your career but don't expect it to always be comfortable either.

You've done a really good job. And this is from first person perspective of the callings that you place into environments.

There's a couple of things that are mostly true. They are not for hire. They work for you. They are contractors dedicated to the project because you like to put that self sustainability back onto your clients. Hey, we're going to come in and refactor all your applications and all these new codes.

Your team has to want to do it. We'll help you get there. Our job is to teach you how to fish and not have you dependent upon us, except for new projects and new work. Once we deliver what's there, like You don't just hire a bunch of people and park them at these organizations, which is such a win in helping an organization that wants to be more strategic, wants more forward thinking, really getting there because they're not just having to get there by themselves.

They're able to watch others who are doing it successfully. What's super interesting, though, about the clients you serve and in the space that you are is that

AI continues to dominate all of the discussions we're having in healthcare technology. What are some of the untapped opportunities that you're seeing, and how is 4DAU addressing them?

And I'll just add one piece onto that, Andrew. Very specifically, how you may even see a commercial during a football game that basically shows, Co pilot, coding for you, and we know it's much more than that.

Yeah. Yes the football game commercials, I think this is the height of the IT hype industry, right?

And some of the things you're seeing, I was reading a health IT newsletter the other day that Somebody was at a convention and they said there's thousands of AI powered clinical solutions and they're all putting the stamp on it that says approved by the FDA. And they're like, it's literally impossible because the FDA has only approved a couple hundred.

And here you have thousands of vendors saying we've got these FDA approved solutions. Number one, when we think about AI the way I try and break it down and just simplify it for people is it is what we've always been doing and to some degree as consultants which is to come in and go, where is the problem in your organization?

Where is the friction point? Where is the pain point? Where is the drudgery, right? So where's the drudgery? Where is that work that you know that you could be doing more efficiently, right? And so we've always tried to look for, we used to call it automation, then we called it robotic process automation.

The way I think about it is, yeah, those same problems still exist in many organizations as they're on that path towards being digitized and being fully digital. Now we have, instead of what I would call sort of 1. 0 tools, now we have power tools, right? So I think about, you take a sander, I can still accomplish the same job by hand sanding down the table, right?

But if I get a power sander out, This could be breakthrough in efficiency for me. The other thing to think about though, is that if you put the power sander in the wrong situation, you can also really damage and do some bad things, and so I think of AI as our new automation power tools.

And so there's so many opportunities, whether you talk about rev cycle, you talk about clinician documentation, all the things that I think we're getting to the better use cases now, I still think we're in a heavy, experimentation mode with this stuff. And so you need a partner that's going to.

Number one, look at accurately. And then let's do the crawl, walk, run thing, right? Because hear too many boards and too many executives that say I got to do something with AI because my board said so. That's really the wrong approach. And that's what I'm going to try and talk them out of every time.

When you go to. Either talk somebody out of something or influence them from an awareness perspective. How do you position yourself as a thought leader and partner for organizations aiming to tackle these complexities? I'm going through interoperability, data integration, And really getting a clean slate upon which to build in healthcare because it usually starts with the data.

Before that, it's going to have to start with the desire of the organization to want to have some of these single sources of truth. What are some of the nuances you're seeing in conversations with CIOs and beyond today?

I think number one, as a guy who wrote a book on humility, I wouldn't call myself a thought leader, right?

But in this space and very specifically, if I can get to know your business and where you're trying to go, I think I can be a really good thought partner, right? And I think that starts with, taking the perspective of, I'm going to tell you the truth, would rather tell you the truth than sell you something,

so if you start with that basis of where there's really trust and collaboration, then I think you've got a good basis to start from. Now. Sometimes that people would tell me that, that makes you a bad consultant. You're supposed to go play up how bad their problem is. Tell them they have more problems than they thought, and thereby you can get more work.

We've never really approached it that way, right? Because I think people have a fundamental BS detector, and the good thing is they have a detector for actually figuring out who provides value, right? So value is that kind of tricky piece that we're always trying to define, right?

But an AI showpiece, or a show pony tool. That maybe looks good at a board meeting, but doesn't really provide value down the road. People pick up on that pretty quick. And you get either reputation as somebody who provides value or somebody who maybe over hypes things or plays up drama solutions and things like that.

I'd much rather be the one that comes in incrementally and says, Hey, I'm not trying to make a big splash. I'm trying to help you where it really can be impactful. Even if costs me larger contract kind of thing, if that makes sense, just from a more of the sort of mentality on how we approach

but in doing business, especially for as long as we have been doing this in our industry.

What you said is so powerful. I'm going to tell you the truth versus just trying to sell you a solution because someone may come out of that board meeting, Andrew, and they may say, gosh, I need to do something in this AI space, or I need to bring an innovative idea forward because my board's asking me to.

And these may be CIOs who have tons of great innovation ideas, or it may be somebody who has a lot of responsibility for just keeping the lights on because of legacy environments, funding, etc. They're dipping their toe into those next waters. When you think about your leadership style, how do you approach fostering creativity and innovation in both your company, but also ones that are industries that are diverse?

You do work in finance as well, but things are constantly changing. And they're probably faster now than they ever have. So you being on top of the things that someone may hear about today, which is maybe even change six weeks from now. What is some of that magic that you bring from a humble perspective in keeping your team and your clients aligned?

so number one, and again, speak negatively about the hype cycle. And, you've already heard some of that, but The reality is we do want to be an innovation partner, right? And I think you have to look at the different organizations that you're serving, right? And we have this profile where we serve certainly large enterprises in the healthcare and fintech space, like you said.

We've got growth stage middle market customers that are doing cool things in the market and trying to scale. And then we even work with a small percentage of startups, right? And so the reason we do that is because there's different risk postures in all those organizations, right? A startup being the most risky is a place where you can go in there and you can co create and say, Hey, you have a really good idea, but you don't have the engineering horsepower or know how to make it happen.

So we're going to jump right in there with you. We're going to jump into that deep end of the risk pool, and we're going to try and create something really cool, right? If I go up and I'm talking to a big, established healthcare provider in IDN, their risk posture is a little bit different not that they don't have, as much risk, they, in some ways have a lot more when they have lives to take care of, right?

But their dollars are going to be more constrained. In a lot of ways, they're going to sit there and go, Hey, I can't take on as much risk. My internal employees won't do that. We have a different profile of who wants to come work here. So what we want to try and do with them is to be that Sherpa, to be that innovation partner.

And as long as we define it well, going back to AI, we've done a lot of great work doing AI POCs over the last 18 months for different companies that are trying to explore in a responsible way, what could I do with this thing so I don't get left behind? But at the same time, I'm also not putting patient lives at risk, those kind of things, right?

So helping them find and carve out those good use cases. That's where I feel like we can really be a good partner. And then the other quality that you mentioned before is let's say we build out a POC and something that does look like it could be impactful for your upper level, leadership or your board.

Now, what I want to do is figure out how do we help your organization get up to speed and feel comfortable so that, internally, it's not just a product we created and dropped in your lap, but your internal teams are scaling up and getting the skills they need and get more comfortable because it's like anything we build in technology.

If the folks who are going to live with it. Don't understand it and can't support it. What they're really going to do is just tell you that it's bad, right? And that's usually not the case. It's just that change curve that we, you and I have talked about a lot. You got to get people comfortable with it and guide them down that path to where they don't see it as an enemy, and that's a lot of the battle I think that AI is facing.

I would put AI in a bucket of, you go to the doctor, they tell you need to do something different, and you know that you need to, but the psychological and physiological drivers to make that change are still rooted in human behavior, and it's something else usurping it, and that you're not quote unquote in control of it.

To your point, the understanding and the elements of whether it's AI or any other new technology, put your arms around it enough to educate yourself so it's not scary, You may be more likely to go down some of those paths.

I would be remiss if we didn't touch on the humility imperative and how impactful it's been as a blueprint, a guidebook, so many ways that leaders can look at things a little bit differently.

Tell me a little bit about the genesis of even writing that first book. And it's been. A few years, and you've talked about the next version of a story to be told. your inspiration for that one? And what is driving you towards thinking about that ultimate storytelling in the next book that

the inspiration really was and again, in some ways a negative one that I really watched a lot of leaders that I looked up to, and I was in that middle stage of my career and aspiring to get to those higher level leadership positions. But people that would get there and then not be there very long.

And what I saw in example after example was these leaders who once they'd reached the pinnacle or whatever they thought of was, the high position they got arrogant. Maybe they even got a little bit of lazy. Maybe they felt entitled to certain things.

And in many cases, they just stopped learning because now they feel like they're in that position of just, dispensing advice rather than gathering it. And so this was a bad pattern that I saw, and I was wondering what the anti pattern would be, right? And so I got to see humility as that antidote to a lot of those evils that come once you reach a high position in any organization, right?

You can look at, and one of my favorite tools that's come out in the AI revolution is just a simple tool that you would put on a meeting like this, and it'll actually tell you what percentage of time do you talk, and when I talk about humility, what I tell you is good leaders create space for others, right?

So if you have, we all talk about the value of diversity, for instance, in a lot of organizations. The value of diversity doesn't really mean much if you have this great diverse team. And yet you go into that staff meeting every week and you talk for 80 percent of the time. And and sometimes as leaders, we don't feel like we're even doing it.

We feel like we check for understanding and maybe people nod their heads and we take that as a signal to keep going. But you actually have to stop and say, Hey, I want to hear from you, Sarah. I want you to give me your thoughts on this and really solicit it. And I think, unfortunately, as leaders, we want to be the people with the answers.

We want to be the people that have all of them. the best part of humility being able to say that, no, we don't. We're creating, especially for an innovative industry, we're creating the future as we go. There's no golden playbook. And the best thing we can do is figure it out together.

And yet so often we'll berate people on a national interview because they get asked a question they don't know the answer

And, when you're a CIO, you get humbled pretty quickly because, there's tools today that tell you there's a problem with your interface that may self log a ticket and fix it before it creates a problem downstream from a clinical perspective. Yet, how many times in your career did someone say, Hey, you know what?

This isn't flowing. This isn't working. And someone comes up to you and says, this is broken. And your first answer, if you don't know, is we're working on it. Let me get more information from you because you assume your team's working through it and you know that they're going to react to that. Is it okay in today's environment as the CEO, as the principal leader to say, you don't know something.

Like, how do you go about. Letting people know that you may not have the answer and yet you are going to find it.

I'll draw a differentiation between, it's certainly being humble is not an excuse for being unprepared, right?

So if you're going into a situation where you very well should have the answers and you should have your eye on the ball you don't get to sit there and say, I don't know on the other hand, right? When you get up into the really innovative, complex stuff I heard an interesting podcast earlier this week where Adam Grant was interviewing Sam Altman from OpenAI, and he said, A lot of these newly evolved AI models.

The best thing about 'em is that they, they have some humility built into 'em and they're now starting to say. I don't know, or I don't have the answer to that. The other ones wouldn't do that, right? And so when you hear about hallucinations in AI, it's essentially a sense making machine. And it's going to give you an answer.

One of my favorite data scientists says it's like just when a human is BSing, right? When they're just making up an answer and we have pretty good human detectors for it, but when AI does it, we call it a hallucination and we want to throw out the model, but it's what we do all the time.

So you've got to find fine line between saying, hey, you know what this is a pretty complex problem, here's a couple thoughts on it, but, maybe I don't have the, the actual answer. And again, I think it's okay. I think it's a mark of strength actually, to go back and say, Hey, I'm going to go get some more diverse perspective from my team, hopefully you're hiring people that are smarter than you in many domains, and we're going to circle back to you and we're going to come back, right?

And I've always felt like that's the best way to do it. And again, just be honest up front, rather than trying to BS your way through some of those tougher conversations.

There was a term I picked up a few years ago called MSU ing, making stuff up. And I literally just put that in the conversation. Now, I'm like, I might have just made that up.

Let me make sure that I didn't. To add some humor and some self deprecation to it. To your point, you get to these higher levels in certain roles. It's actually the hardest time in your career. We think getting there is hard. Honestly, being there to a degree is even harder because the expectations and the stakes have changed and they've accelerated in the last few years and that need to stay up on all these technologies is a constant self journey.

It's 7 30 at night, dinner's wrapping up, all the different particulars of your household are done. What do you do? And you read an article about Was virtual telehealth actually successful five years since COVID and why certain aspects of it aren't? It's crucial for leaders to be able to say, I'm not sure.

If people

are too certain, it often makes me skeptical, that they really know what they're talking about. Almost like in this day and age, if you're 100 percent certain, I almost go, no, how could you be?

And you're grateful when you get to be with clients and be with partners who allow you to have some room for, again, we went back to that practice time, where at least you're honest about what you do and don't know.

And gosh, I think the older I get, the less in some cases I do know, because I find new things out every day. And I get more excited about it now maybe than I even did as a kid because now I'm learning because I want to, not because I have to. In some aspects. One of the things I'd love to do on Flourish is celebrate diverse career paths.

What lessons from your own career would you want listeners to take away as they navigate their own journey?

It's always helpful and I think this is where we can be helpful. I think sometimes in sharing our stories, I know you didn't start out, none of us start out as a healthcare executive.

None of us start where we are today, kind of thing. But I think it's really hard for young people. I have three teenagers in my house, and I think a lot of times what they want is that path that perfect, laid out path, that certainty. And I like, so I like to tell people my first job outta college was in advertising.

I didn't enjoy it that much. Second job was I was a college football coach in the SEC, and I thought that was pretty great. I was at my alma mater at Vanderbilt. I thought that was going to be super fun. I thought I was going to be an athletics director. And then 9 11 happened and I thought, gosh, I've always wanted to go to DC and be a part of that.

So I was a presidential management fellow in Washington, DC. And in DC, ironically enough, going up there as a political science major is where I learned IT, right? I got put on an e government initiative and I was the lead trainer who got to go out and train all these government agencies on how to use a new piece of software that automated background investigations, right?

And so how does that get you to be a CEO of a software company? The answer is my path may be one of one and to some degree, but it's also very true to that you have to have some diverse experiences to figure out the things that you're good at, the things that you're not good at, the things that you really feel passionate, even zealous about, and be open to the fact that you're going to stub your toe sometimes, right?

And so I'm trying to coach my son and some of his, even his friends, that look, you don't have to have it all figured out right now. The key thing is to go into every experience with what can I learn Am I around good people? And then where does this lead from an adjacency space? And then, circling back all the way to like when and if do you take those risks that really put yourself out there?

And I to encourage young people. I wasn't brave enough to do it when I was young and to some degree but to take more risk, right? When you're young, You're starting out, you can take on more risks because gosh, if you fail you've got all kinds of time to make up for it. So trying to have that perfect path out of the gate, I think is probably the misnomer today.

And, a lot of the data will tell you that the best jobs of the future haven't, we don't even have titles for them yet. They haven't been created. So just focus on good people, good skill sets, and making sure you're giving a great effort wherever you happen to land.

I love all of that advice because as you're talking, I'm like, okay, When you're, I'm going to make up the span of 20 something, you don't have a mortgage, you probably don't have a car payment, you're not married, you don't have any kids, you probably, you may or may not have a pet you're responsible for keeping alive, and that desire to be fearless in those times when, oh, I might have to go sleep on someone's couch, or I might end up back in my parents house for a couple of years, a thing, and really knowing that you will land.

on your feet, especially when that's always the plan. I'm going to go try this. I'm still going to be okay in the end. And I might have had some really good experiences in the process. I love that you shared that. Are you still involved? Are you, do you follow Vandy football? Hardcore, and how many years have they disappointed you versus the years that you're excited?

You caught me at a good point in Vandy football that we are we are at the, at our apex of the last 20 years right now. Such a great season. Have a lot of fun. We try and take the team over there once a year for a tailgate. And we had all of our employees, that came up from our new Paraguay office around December and I got to send them to the Vandy UT game and they got to experience an American football game.

And just some of those experiences are priceless, and it's been really fun.

It was nice to ride the wave as any kind of a fan. You're like, some years are really good and some years are really bad. We have

bad decades, so that's the difference as a Vandy fan, so we're at the top right now, so I'm going to enjoy it.

Enjoy it for sure. I'm going to change the tide on you here and go to ground, which is not quite as thought provoking yet equally fun in the question and answer portion of the interview.

If you could have dinner with any tech or healthcare leader, past or

present, who would you choose? Why would you choose them?

Oh, good question. So tech or healthcare? I know they're intertwined, but Atul Gawande, I've read several of his books, and I like his writing style, probably more as an author, and I think having the experience he's had across the healthcare sector, I think would be high on my list.

I finished one of his not long ago, so he would be high on my list as far as the healthcare side. Tech side, I think the easy answer is Steve Jobs. I think that the real answer is, I'm not a techno nerd, I would want to talk to somebody that's built a company, somebody that has had to go through probably some personal trials in doing that, and I'd be more interested how did they build the company versus maybe the technology aspects of it.

So a little bit of a cop out there.

Not a cop out. Only because, I mean he didn't even have furniture, for a long time because he was just thinking about other perspectives, and he finally, lived in this beautiful home and had no furniture. So there's limits to each of our nuances and our personalities that you're like, the first question, why did it take you such a long time to buy furniture?

And he would tell you about lack of importance in what he was building, and yet You start to get a little thought that get in the head of the genius of it. And Atul Guwande, I'm glad you brought him up. His book, I remember Checklist Manifesto. I, to this day, recommend that book to people in terms of how to create better process in your organizations.

How do you put quality first? Think about having a checklist to do it. I have 50 checklists in my life. Thanks to that book, 20 years later, if you were not leading 40 AU, what career would you have pursued? And may I be a little clairvoyant and say, what's next for Andrew?

Yeah. Interesting. The thing that I think would be a fun career arc for me, as I mentioned earlier, that I got to work in Washington, DC.

And to be around and to serve in the government for a couple of years. I've always thought that would be a fun career arc to take all of my career experiences and maybe go back and serve in a different capacity, maybe at a different leadership level. I feel like to do that, would be a pretty interesting deal.

And again, It circles back to my idea of doing it at scale and being able to solve a really hard problem now that I've gathered all these good friends and experiences and some skills, hopefully. So something in Washington, something like that, where I could get in front of people and hopefully solve something some kind of big hairy challenge.

Especially too, this goes back to where you started, where you're fearless in the beginning, you reach certain levels of success in your career now, and you get to go back to being a little bit of fearless again because you have all this room where you can play because you spent those 30 years in the fight, making a difference.

And now you get to bring it back into some of the things for which you have passion projects. I will love to see the day that you are in D. C. and I may be following you around trying to get policy affected, equitability in healthcare, seniors, equity, reimbursement models. Those are the things that I was passionate about.

it's easy to be cynical about that world, but I think, having had a little taste of it, I saw that you could move the needle. And from inside, you can move the needle even more, and I wish more people knew that. Michael Lewis has got a great new book coming out shortly about these career civil servants that serve in these really unique roles that only the federal government actually, would that even be a job?

And it's just some fascinating stories there.

And if you have not heard of the Alliance for Health Policy, it is a self funded by a few philanthropists that teach it is, humans that are in the day to day aspects of what we're doing, they're helping to inform Washington on why certain health care policies matter.

So it's like the layman's version of health care policy, but also allows people to influence, to your point, just takes one person to say this needs to be better or true. Coffee or tea? And how do you take it as a busy CEO?

That one's easy. Neither. If I'm going to a breakfast meeting, I drink Coca Cola.

I grew up in Atlanta and I've never had a cup of coffee. So tell people jokingly, I'm saving it for my fifties, but I'm blessed with a good bit of energy. So normally I don't really need it. Yeah.

I love you have Coke in the morning. And honestly, if you did the side by side comparison based on all the things I see people put into their lattes, The coke can actually be a healthier choice first thing in the morning.

I don't know. I may have to give one a whirl. Andrew, thank you for spending time with me today. Thank you for your stories about your own personal journey, which are really important for our listeners, but also what it means to then be an expert in a niche space, but be an expert with a lens of humility that says, I may be running an organization that's doing amazing things, We're a learning organization.

Every day we make ourselves a little bit uncomfortable so we can best serve the clients that are seeking our assistance and making themselves exceptional and differentiated in the marketplace as

Thank you so much, Sarah. 📍 always glad to be with you and always enjoy the conversations and take care.

Okay.

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