DR. HANA SOLOMON PAGE 33
INNOVATIVE HEALTH PRACTICES PAGE 48
TRA IN E D P R OFESSIO N ALS PAGE 40
KIM BECKING AND AMANDA BARNES
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hen you think of measuring health, what comes to mind? Blood pressure? Weight? BMI? Maybe the time it takes
to run a mile? We’ve all known someone who was the perfect picture of wellness before falling tragically sick, even though they were doing all the right things. When that happens, it’s enough to make some say: “Forget it; I could get hit by a bus tomorrow. Let’s just live it up.” TRAIN ED But there’s another lesson to learn when we see PR OFESSIONA LS this happen. Usually, when someone’s going through a health crisis, they circle back to what matters in the core of their life — their closest relationships and “bucket ON THE COVER list” of activities. They start to live more intentionally. Anthony Jinson’s use of lighting at How we view ourselves physically and mentally Columbia’s Activity and Recreation plays an integral part in our longevity, and the relaCenter (ARC) beautifully provided the backdrop for Kim Becking and Amanda tionships surrounding us serve a critical role in mainBarnes on their own turf. Showing the taining our resilience. trainer/trainee duo was truly the picture Of course physical exercise is a great way to reof “health” for this month’s theme. duce tension and anxiety, and those benefits should not be overlooked. But it’s also worthwhile to focus on minimizing the stress that makes us want to bike to Rocheport for a glass of wine in the first place. If you’re looking for less stress, maybe you don’t need to sit on the board of a dozen organizations, or obligate yourself to something every night of the week. Maybe you don’t need to keep the job that’s cracking your soul or work every darned weekend to impress the boss. My point is the “extra” stuff we do is great — as long as it serves our needs. I’ve served on boards that seemed to be more like a second job, and that can suck the life out of a person. I’ve also had jobs that were so stressful it seemed like there was nothing left of me to give by the end of the day. This is worthy discussion for our Health Issue. So many of us in the business world pay attention to our physical health while ignoring our mental tension and anxiety to the point where one can become unhinged. It’s a thing. Burnout is alive and well in American society. I won’t pretend to be some expert as to why. Some say it’s long working hours; some attribute added stresses to social media; others say it’s just plain disappointment in some aspect of our lives. It’s good to remember that physical soundness is important, but we also have to nurture our minds and view wellness holistically. Efficiency, time management, and production measurements are often a part of our work day, and all of that is adding pressure to get things done. So let’s be sure we’re treating our free time as even more coveted and precious, so we can meet each sunset feeling fulfilled. Even if it doesn’t add years to our lives, it will certainly add more to our days. DR. HANA
SOLOMON PAGE 33
EDITOR'S PICKS Sometimes we need a break from business reading, but I still like to learn something when I pick up a book. Here are three selections for my fellow history buffs. I guarantee they will not disappoint.
INNOVATIVE HEALTH
PRACTICES PAGE 48
PAGE 40
KIM BECKING AND AMANDA BARNES
Be blessed,
Breck Dumas, Editor Breck@businesstimescompany.com
/Co l u m b i a B u s i n e ss Ti m e s
@ Co l u m b i a B i z
Co l u m b i a B u s i n e ss Ti m e s .co m
“EMPIRES OF THE SEA” by Roger Crowley I believe this is the best book I’ve ever read. I’ve bought it for or recommended it to dozens of people, and now I’m sharing it with you, dear reader. It’s nonfiction, but written like a novel you won’t want to put down. Seriously, don’t put it down . . . at least not for long, or you’ll forget who everyone is. It details the battles of the Mediterranean between Christians and Muslims starting in 1453 (complete with medieval torture methods, even naming the executioners.) Did you know Don Juan was a real guy?
“SALT: A WORLD HISTORY” by Mark Kurlansky The title’s a little bland, I’ll admit. But anyone with an interest in how empires and economies can be built with a commodity will find it fascinating. This is another nonfiction piece that paints an engaging story of how societies came to great wealth thanks to this precious resource, saving countless lives through its uses.
“FAMINE” by Liam O’Flaherty This book isn’t in print anymore, but you can still get a used edition through Amazon, of course. (Also, I just got my copy back, if you’re interested in borrowing it.) It was recommended to me by long-time local media guy Dan Claxton. “Famine” is historical fiction; it carefully describes the devastation of the Irish potato famine. What I found particularly fascinating was how the politics of the time were woven into the story.
Ed i to r @ B u s i n e ss Ti m e s Co m p a ny.co m COLUMBIABUSINESSTIMES.COM 13
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EDITORIAL Breck Dumas, Editor Breck@BusinessTimesCompany.com Matthew Patston, Managing Editor Matt@BusinessTimesCompany.com Madison Love, Department Editor Madison@BusinessTimesCompany.com DESIGN/CREATIVE SERVICES Jordan Watts, Senior Designer Jordan@BusinessTimesCompany.com Kate Morrow, Graphic Designer Kate@BusinessTimesCompany.com Cassidy Shearrer, Graphic Designer Cassidy@BusinessTimesCompany.com Sadie Thibodeaux, Graphic Designer Sadie@BusinessTimesCompany.com MARKETING REPRESENTATIVES Deb Valvo, Marketing Consultant Deb@BusinessTimesCompany.com Bonnie Hudson, Marketing Consultant Bonnie@BusinessTimesCompany.com MANAGEMENT Erica Pefferman, President Erica@BusinessTimesCompany.com Renea Sapp, Vice President ReneaS@BusinessTimesCompany.com Amy Ferrari, Operations Manager Amy@BusinessTimesCompany.com Beth Bramstedt, Director of Content Beth@BusinessTimesCompany.com CONTRIBUTING PHOTOGRAPHERS Keith Borgmeyer, Anthony Jinson, Amber Deery CONTRIBUTING WRITERS Jerry Dowell, Al Germond, Mike Grellner, Jodie Jackson Jr., Eli Marchbanks, Brenna McDermott, Kermit Miller, David Morrison, Jamie Patterson, Tony Richards, Anne Williams INTERNS Elizabeth Quinn SUBSCRIPTIONS Subscription rate is $19.95 for 12 issues for 1 year or $34.95 for 24 issues for 2 years. Subscribe at columbiabusinesstimes.com or by phone. The Columbia Business Times is published every month by The Business Times Co., Copyright The Business Times Co., 2008. All rights reserved. Reproduction or use of any editorial or graphic content without the express written permission of the publisher is prohibited. OUR MISSION STATEMENT The Columbia Business Times and columbiabusinesstimes.com strive to be Columbia’s leading source for timely and comprehensive news coverage of the local business community. This publication is dedicated to being the most relevant and useful vehicle for the exchange of information and ideas among Columbia’s business professionals. CONTACT The Business Times Co., 2001 Corporate Place, Suite 100 Columbia, MO, 65202 (573-499-1830) • columbiabusinesstimes.com
Inside the Issue Twitter Chatter Aaron Fox @AaronFoxInc Local media’s losses were our gains....I firmly believe @ColumbiaBiz now has the finest writing staff in Mid-Missouri SgtHestirColumbiaPD @CPDMikeCoMO Community Outreach Officer @CPDScottCoMo busts out some Taylor Swift while being honored with nomination to @ColumbiaBiz 20Under40 @CoMoGov Kolu @KoluApp Thank you to @ColumbiaBiz for this recent feature in the ‘Closer Look’ section... @FuzzysCoMo (one of our team’s fav) is great company to be in. Kaufman Organization @KaufmanLeasing What’s going on in the world of office design? @ColumbiaBiz weighs in.
DeskMakers @DeskMakers Learn how innovators have changed the look, feel, and nature of commercial real estate via @ColumbiaBiz.
Around the Office
INTRODUCING OUR 2018 ADVISORY BOARD MEMBERS: • Denise Nelson, Accounting Plus
• Dean Ajay Vinze, MU Trulaske School of Business
• Jessica Macy, New Chapter Coaching
• Anna Munson, Columbia Public Schools • Bill Costello, Central Bank of Boone County • Cale Kliethermes, Kliethermes Homes
• Nikki McGruder, Diversity Awareness Partnership • Susan Hart, Columbia Chamber of Commerce (Chair)
• Kellie Ann Coats, Missouri Women’s Council • Mike Grellner, Plaza Commercial Realty
• Teresa Snow, MU Health Care • Todd Hoien, Hawthorn Bank
Contributors
Kermit Miller, KRCG 13
David Morrison @DavidCMorrison
Brenna McDermott
Jodie Jackson Jr. @JJacksonJr
Write to CBT editor Breck Dumas at Editor@BusinessTimesCompany.com Breck@BusinessTimesCompany.com COLUMBIABUSINESSTIMES.COM 15
16 FEBRUARY 2018
FEBR UARY 2018 VOL . 24 / ISSUE 8
TA B LE OF CON T EN TS
The Health Issue 13 FROM THE EDITOR 15 INSIDE THE ISSUE 19 CLOSER LOOK 20 BRIEFLY IN THE NEWS 23 BUSINESS UPDATE
33
Elite Athletic Performance
26 NONPROFIT SPOTLIGHT Phoenix Health Programs
28 CELEBRATIONS
Achieve Balance Chiropractic
31 MOVERS & SHAKERS 33 P.Y.S.K. Dr. Hana R. Solomon
35 8 QUESTIONS
Angie Bass, Missouri Health Connection
35 A CAPITOL CONVERSATION Face to Face with Greitens
39 OPINION 75 ORGANIZATIONAL HEALTH Five Keys to High Performance
77 MARKETING
Building Trust in 2018
79 POLICY
Local Agenda: The City Budget
81 REAL ESTATE
Taking Stock of Medical Office Space
83 ASK ANNE
Stopping Sexual Harassment
85 NEW BUSINESS LICENSES 86 DEEDS OF TRUST 87 ECONOMIC INDEX 89 BY THE NUMBERS 90 THIS OR THAT
PYSK Dr. Hana Solomon, inventor of the Nasopure nasal cleansing system, is out to make Columbia healthier — one nose at a time.
Dr. Colin Malaker, Sterling Dental Care
40
48
56
62
66
71
Trained Professionals
Outside the System
Bridging the Gap
Doing Well
Treat Yo’ Self
Profiles of three high performing professionals and the personal trainers who build their work ethic.
Local primary care providers are looking for new practice innovations to circumvent the complex health care system.
CenterPointe Behavioral System builds a new inpatient facility to meet MidMissouri’s mental health care needs.
What’s the real value of employee wellness programs? It depends on which companies are practicing them.
Sometimes an employee’s gotta relax. We’ve got nine expert tips to help you restore your energy, focus, and drive.
In Focus: High Pressure Some people are abusing stimulants to get ahead in the workplace. How pervasive is the problem?
18 FEBRUARY 2018
BUSINE SS • P EOP L E • IM P R OV EM EN T • F YI
C LOSER LOOK
Closer Look
Columbia’s Epoch Escapes
Smallcakes
Line-X of Mid Missouri
Puzzles take a realistic form at Columbia’s Epoch Escapes. After a visit to an escape room in Branson, Dustin Copple decided to open the first liveaction puzzle escape room in Columbia. (Epoch Escapes opened in 2016.) Copple left his previous career as a manager at a frozen custard franchise to create an exciting, interactive puzzle in Columbia. Epoch Escapes features three distinct, challenging escape rooms. Players have 60 minutes to unravel the room’s mysteries and complete the tasks at hand to escape the room. When inside, players are provided with thought-provoking logic puzzles and a well-rounded assortment of age-appropriate tasks. The current rooms are named “Crime Scene Investigation,” “Pirate Adventure,” and “Outbreak.” Copple is particularly proud of Epoch Escapes’ Team Building Package for larger groups. Included in the package is a consultation with a leadership and performance coach both before and after the game, allowing escapees to gain insight on team-building techniques to take with them.
Very few people are lucky enough to find an opportunity to live out their childhood dreams. Adele McAlister, however, proves it’s possible. Owning a bakery has always been a dream for Adele, who last year purchased Smallcakes, a gourmet cupcake shop, with her husband, Matt, when she was working there as manager. Smallcakes cupcakes are baked fresh daily, and the store’s treat offerings don’t stop there — they also have fresh baked cookies and cookie sandwiches. Jeff Martin, founder of Smallcakes, which is now a fast-growing nationwide franchise, believes in using creative flavors, quality ingredients, and friendly service that provides a memorable cupcake experience. Smallcakes bakes 18 signature flavors each morning. Offerings include red velvet, chocolate crème, pink vanilla, lemon drop, and birthday cake. (Other specialty flavors on a recent day included cream soda, piña colada, and margarita.) Smallcakes also offers catering for your big days — weddings, birthdays, Christmas parties, etc. Or, you know, it can just be a sweet treat on your small days.
Benjamin Darbyshire, new owner of Line-X of Mid Missouri, always wanted to own his own business in Columbia. He just didn’t know it would be with Line-X. Darbyshire’s first interaction with Line-X, a car accessory dealer mostly known for their protective truck bed coatings, was when worked for a General Motors dealership after college; the dealership used Line-X as a vendor. Benjamin saw the value in the products and felt he could use his dealership background and connections to grow this company in Mid-Missouri, so he franchised a Line-X store. Line-X protective spray-on coatings can be found on more than just cars. They’re on everything from farm equipment to military gear. Darbyshire offers a lifetime warranty on his products, which guarantees they won’t crack, bubble, or flake. He says that Line-X is also the only spray-in bed liner company in Mid-Missouri that can custom match any color with their UV stable top coat, making the new coating look as integrated as possible. Darbyshire says, “As long as you own your truck, we have you covered.”
Address: 2529 Bernadette Dr. Website: columbiaepochescapes.com Contact: 573-239-9066
Address: 2609 E. Broadway #218 Website: smallcakescupcakery.com Contact: 573-607-2739
Address: 1510 B I-70 Complex Ct. Website: linexofcolumbia.com Contact: 573-777-9989
Are you an entrepreneur? Are you sprouting a new business? Tell us about it at Editor@BusinessTimesCompany.com COLUMBIABUSINESSTIMES.COM 19
BUSINE SS • P EOP L E • IM P R OV EM EN T • F YI
Briefly in the News FEBRUARY 2018
BUSINESS
NEW HAROLD’S LOCATION Harold’s Doughnuts opened their second location at the beginning of January. The new space, at 204 E. Nifong Blvd., will offer easier access and a bigger space to customers in south Columbia. The doughnut shop’s original downtown location opened in 2014. BUS INES S
KOPN LOANS PROFITS Community radio station KOPN announced the station will use profits from its online store to make loans to entrepreneurs in the developing world. The station will utilize a technology platform from online lender Kiva.org, a nonprofit founded in 2005 and based out of San Francisco. Items in the online store include mugs, sweatshirts, hats, and tote bags.
“Using our store in this way allows us to work with our members and others to make a difference for people who really need it while supporting KOPN at the same time.” — Sean Spence, General Manager, KOPN
20 FEBRUARY 2018
BR I EFLY I N T H E N EWS
INF R AS T RUC T UR E
NIFONG IMPROVEMENTS Columbia City Council approved $12.3 million in improvement projects for Nifong Road in south Columbia. Roadwork will include additional driving lanes, bike lanes, and new sidewalks. Construction is set to begin in spring 2020. The initiatives were listed as part of a capital improvement sales tax that voters approved in 2015.
R EAL ES TAT E
CIG SELLS LAND The City of Columbia purchased a 2.24-acre parcel of land from
G OV E R N M E N T
Columbia Insurance Group last
CANDIDATES FILE
month for $250,000. The plot is
Filing for local political races ended in January, setting a final field of candidates for November’s election. The candidates for Boone County Clerk are Brianna Lennon and Taylor Burks; Burks is the incumbent. Candidates Christine King, Ben Tilley, Tyler Lero, Susan Blackburn, and Teresa Maledy will run for two open seats on the Columbia Board of Education, with King as the only incumbent candidate. Greg Steinhoff and Mark Dempsey will campaign for one open seat on the Boone Hospital Board of Trustees.
on Whitegate Drive. The city
located next to CIG’s main office plans to develop it into a public park by 2021; Columbia’s parks and recreation department has identified the area as a priority for new park development.
BUSINESS
RED LOBSTER GOES UP Red Lobster, the national seafood chain, debuted their latest restaurant prototype with a new Columbia location. The design features a more sleek, contemporary look than previous Red Lobster locations. The new building is nearby Red Lobster’s former spot on I-70 Drive SW.
“As a community-minded organization, we feel it’s our responsibility to contribute to enhancing the lives of those around us. We’re glad this land will be used for the benefit of our neighbors.” — Gary Thompson, CEO, Columbia Insurance Group
COLUMBIABUSINESSTIMES.COM 21
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BUSINE SS • P EO P L E • IM P R OV EM EN T • F YI
B U SI N ESS U PDAT E
Making Gains Elite Athletic Performance provides workouts for kids with autism.
BY ELIZA BETH QU IN N | P HOTOG R A P HY BY K E I TH B O R G ME Y E R
Craig Hindelang and Jason Morris COLUMBIABUSINESSTIMES.COM 23
BUSINE SS • P EO P L E • IM P R OV EM EN T • F YI
“THERE ISN’T ANY PLACE IN TOWN that works with kids with autism,” says Jason Morris, co-owner of Elite Athletic Performance. So, to solve that problem, EAP and the MU Thompson Center for Autism and Neurodevelopmental Disorders have joined forces to give kids with autism an opportunity to work out. Owners Craig Hindelang and Jason Morris started EAP on May 2, 2015. Morris had been a trainer since 2011, and for a while, he and his wife had been chatting with Hindelang about the prospect of teaming up to start their own gym. After Morris left his freelance training job, he began discussing specifics with Hindelang about what they wanted to create. Soon after, EAP was born. EAP is a youth sports performance gym for ages 6 to 18. (They also train some college students.) Hindelang and Morris offer both personal and group training. The gym is already used to train Columbia’s rugby teams — the Outlaws and the Black Sheep — as well as professional jiu-jitsu students. Last year, EAP began offering workouts to kids with autism. “Our goal is to try to help as many different people as we can,” Hindelang says.
FILLING IN THE GAPS The idea came when Hindelang’s nephew and a young man with autism arrived at EAP one day to inquire about the prospect of starting a specialized workout regimen; the owners involved the Thompson Center to make it happen. While the official program partnering with the Thompson Center has not launched yet, EAP continues to provide workouts to kids with autism in the meantime. “We like what the Thompson Center offers because they care about everybody,” Hindelang says. “There is an underserviced spectrum that’s out there for all kids or 24 FEBRUARY 2018
adults with autism, and we would like to see that gap fill in a little bit.” Kids with autism are especially vulnerable to health issues like obesity and diabetes. By creating a program that can work with kids on all parts of the autism spectrum, EAP can help combat that problem. Some occupational therapists refer patients to EAP depending on their needs, says Nathan Hurst, strategic communications consultant for the Thompson Center. “Our therapists recognize a need for a physical fitness program for some of our patients, as well as other children and adults with autism,” Hurst says. “We’re very excited to see how this program develops and look forward to working closely with EAP in the future.” Technique is the main focus to work on, Morris says. This “technique-based program” can help kids who lack developed motor skills and coordination, which are also affected by autism. They start with the basics: sit-ups, squats, and push-ups. “When they excel in an area, we include stability using some weight for resistance,” Morris says. “One of the best tools to use is TRX [a suspension-weight training system] because it uses body weight.” A lot of kids and athletes don’t know what they are able to do until they reach their goal, Hindelang says; EAP’s approach is to make their clients’ objectives attainable. Mindset is one of the biggest challenges for many athletes. Clients may not trust themselves to go after a certain mark, but after overcoming the “mental games,” as Morris calls them, they are able to succeed. “All types of kids and every kid at every ability can do it,” Hindelang says. “There’s no ‘can’t.’”
SEEING THE PAYOFF One of the most gratifying things that Hindelang and Morris have noticed through the program is
B U SI N ESS U PDAT E
that the confidence level of the kids with autism increases after working out. One of the first clients they worked with, Jacob, had confidence issues, Hindelang says. “Once he started doing workouts, he tried to get his mom, brother, everyone involved because he was learning things he hadn’t learned before.” “The biggest thing is not only physical changes, but self-confidence,” Morris reiterates. “Their confidence level goes from being really shy to showing a random person something they can do.” Hindelang and Morris also recognized that every child and adult is on a different place on the spectrum — and might have a different mood each day, Hindelang says. They learned how to design a workout that benefits each client depending on how the individual is feeling. For one workout, there can be 10 different ways to do it, depending on the person, Hindelang says. “Remaining active is important for all children, but children with autism often have difficultly taking part in fitness activities with typically developing children,” Hurst says. “So, it’s important to develop programs that fit those children’s needs as well.” Hindelang and Morris enjoy training because they’re able to see how much people grow. Whether it’s an adult or a child, watching a trainee meet the goal they never thought they would be capable of is gratifying. “I love seeing our clients overcome adversity and reach a new goal,” Morris says.
NEW OPPORTUNITIES “Family atmosphere.” That is how Hindelang and Morris see EAP. They incorporate a wide range of athletes into their “family” — everyone from hardcore meatheads to very quiet youth athletes. “The main goal is to get to know them as a person more than anything,” Hindelang says, “because they’ll have a secure mind working with someone they care about.” Last summer, EAP raised around $3,500 for the Thompson Center through their “Power-up to Awareness to Beat Autism” fundraiser. This annual power-lifting competition encourages all athletes to participate. There was little time to advertise for the first competition, so this year, Hindelang and Morris expect the April 2018 event to make an even bigger splash. In the future, Hindelang and Morris hope to work with the Thompson Center to conduct research studies for certain age groups about different learning types. “We believe every kid should have the opportunity to work out and help better themselves,” Hindelang says, “from the athlete who is going to the top to the kid that just wants to gain confidence.” CBT
Elite Athletic Performance 2207 Nelwood Dr. 314-630-8833 facebook.com/eliteathleticperformancecolumbia COLUMBIABUSINESSTIMES.COM 25
BUSINE SS • P EOP L E • IM P R OV EM EN T • F YI
New Age of Recovery Phoenix Health Programs fights addiction and misconceptions.
BY ELI MARCHBA N KS
HERE ARE THINGS YOU DON’T HEAR people say about sick people: I can’t believe that Mike can’t manage his cancer; he should have better self-control than that . . . Sharon was so reckless to get Alzheimer’s . . . John should be ashamed of himself for having that stroke . . . It seems strange just to read those, doesn’t it? Yet it’s pretty common for people to hear or say things like: I can’t believe Mike can’t manage his drinking; he should have better self-control than that . . . Sharon was so reckless to get high . . . John should be ashamed of himself for doing drugs . . . 26 FEBRUARY 2018
When it comes to understanding addiction and those who struggle with it, “we’re still in the dark ages,” says Heather Harlan, prevention specialist and adolescent counselor at Phoenix Health Programs in Columbia. Harlan says the public often misunderstands addiction by associating it with a lack of self-control or poor discipline. Part of Phoenix’s mission, in addition to treating addiction patients, is to create “a new perspective on recovery.” Phoenix has been in Columbia since 1974 and provides a variety of outpatient services as well as residential services in their facility on Leslie Lane in the north part of town.
Those who have had friends or loved ones struggle with addiction have often asked themselves what happened to make that person so vulnerable. Often, it’s not anything the individual can control. “Adverse childhood experiences are very accurate predictors of who is more prone to addictive behavior,” Harlan says. There are ten adverse childhood experiences, or ACEs, that clinicians refer to; according to Harlan, and the more ACEs a person experiences, the more likely they are to develop substance abuse issues. “Not only that, but exposure to these experiences results in higher incidences of cancer, diabetes, and a shorter life expectancy,” Harlan says.
N ON PR OFI T
Phoenix Health Programs MISSION To improve the health and quality of life of those impacted by drugs and alcohol
FOUNDED IN 1974
treatment center’s campus for “Combine that with that fact three weeks. Phoenix Health that 95 percent of addictions does offer residence for those begin in adolescence, and who need it, but just like every we begin to understand that other form of treatment, the addiction really isn’t a choice period of time a person stays in the way most people think there is customized to each it is.” Heather Harlan individual. People don’t choose to have endured a traumatic Harlan explains that a childhood experience lot of the people who come that actually changes the in looking for help are chemistry of their brains in surprised when the staff a way that leads to addictive works so collaboratively behavior. Once those with them to customize neuropathways are there, their treatment plan. A lot they’re set, and the way to of people who have tried Laura Cameron help someone deal with those and failed in battling their behaviors is “by addition and addictions are used to not subtraction,” Harlan says. professionals simply telling “We can’t take out the neuropathways that are them exactly what to do and that those already there, so we have to add new ones that orders need to be followed precisely. are healthier.”
A DIFFERENT PATH BOARD OF DIRECTORS • Greg Deline, President • Pat Concannon, Vice President • Larry Colgin, Treasurer • Randy Minchew, Past President • Craig Chval • Dan Hanneken • Kay Evans • Carrie Brown • James Howard • Steve Santoyo • Christopher Wolfe
BEDS AVAILABLE 30 to 35
STAFF 45 full-time; 10 part-time
When it comes to adding new, healthier behaviors in regard to substance abuse, most of us would say that total abstinence is the way to go. It’s the time-honored practice of 12-step programs such as Alcoholics Anonymous. But a different way of thinking is gaining traction within the field of addiction treatment. “It’s called ‘harm reduction,’” says Laura Cameron, a treatment counselor at Phoenix. Instead of taking an “all or nothing” approach where the only option is total abstinence, it’s about finding stability — “a life that works for you,” Harlan says. At Phoenix, counselors like Cameron and Harlan tailor their approach to each person who comes to them for help. Those approaches can include traditional options like 12-step programs, but they might include other approaches so that, even if total abstinence isn’t achieved, the person can still be helped as much as possible. When asked if harm reduction is the future of addiction treatment, Cameron replies, “I think we need to move toward harm reduction.” Harlan and Cameron not only talk about a different philosophy of treating addiction, but also a different framework to implement that philosophy. Most addiction treatment centers offer what’s called a 21-day program, where a person packs his or her bags and stays at the
NEW IDEAS
Harlan is also keen on changing attitudes toward addiction in the workplace. She would like to see employers take more of an active role in helping employees with addiction, rather than simply letting them go. “We’ve had employers bring employees in here with substance abuse problems to get them help and told us that their jobs will be waiting on them once they get better,” Harlan says. “Knowing that a job is waiting can really give people a lot of motivation to get better.” An employer can simply encourage an employee to pick up the phone and call Phoenix Health to set up a screening so that the employee finds out exactly what their struggles may be. And since the individual getting the screening doesn’t necessarily have to go into residential treatment, the experience might not be as jarring to their life as it would be if they had to uproot and stay at a facility for a set term. Phoenix has evolved quite a bit since it first opened more than 40 years ago — at that time, it provided only 12-step programs and offered them only to men. As the city has changed, Phoenix has changed with it, always seeking the best way to help those afflicted with a misunderstood condition. CBT
Pheonix Health Programs 90 E. Leslie Ln. 573-875-8880 www.phoenixhealthprograms.com COLUMBIABUSINESSTIMES.COM 27
Chris Scrivner, Arminta Phelps, and their dog Olaf
2004
2008
2013
Three months after completing her undergrad, Arminta Phelps begins studying at Palmer College of Chiropractic.
Phelps returns to Columbia and opens Achieve Balance Chiropractic on South Providence four months after finishing chiropractic school.
Achieve Balance moves to its current location at the Woodrail Center on West Nifong. Phelps begins dating Chris Scrivner.
28 FEBRUARY 2018
BUSINE SS • P EO P L E • IM P R OV EM EN T • F YI
C ELEBRAT I ON S
Setting Things Straight Achieve Balance Chiropractic builds on 10 years of success.
BY JENNIFER TR UESDA L E | P HOTOG R A P HY BY K E I TH B O R G M E Y E R
WITH FEWER THAN SIX MONTHS TO GO until its 10th anniversary this July, Achieve Balance Chiropractic has grown into a bustling practice. It’s hard to find anyone as passionate and enthusiastic about their work as Dr. Arminta Phelps, who runs a team of six at Achieve Balance with the help of her mother, Gwendolyn Carl, her husband, Chris Scrivner, and their 3-year-old Maltipoo, Olaf, who regularly delights patients at the clinic. Phelps says her practice sets itself apart by focusing on education about holistic health: talking to clients about nutrition, mindfulness, and avoiding unnecessary procedures and prescription drugs. “I look at what you’re doing in your life that creates stress — whether it be physical, chemical or emotional — that’s causing you to be ill,” Phelps says. “So we teach people how to have balanced nutrition, movement, and mindset to help them have tools outside of our office to take better care of themselves.”
A POP OF INSPIRATION While finishing her last semester at MU in 2004, Phelps, a native of Rosebud, Missouri, sought treatment from a chiropractor for a neck injury. The experience opened her eyes to the wholebody approach of chiropractic treatment. She was hooked. Three months after graduation, she began studying at the Palmer College of Chiropractic in Davenport, Iowa. Three months later, Phelps learned that her mother, then 52 years old, had been diagnosed with multiple sclerosis. Carl didn’t want to take the conventional medical route with prescription drugs. Phelps suggested a chiropractic approach. “She was my litmus test — if I’m going to do something for the rest of my life, it has to help my mom,” Phelps says. “She started getting adjusted
and she stopped falling. She started eating better and getting more energy. The woman is at the gym doing HIIT [high-intensity interval training] and lifting workouts four times a week at 65 years old with no symptoms, and it’s because of chiropractic. She’s never done anything for her MS other than specific chiropractic care.” After completing her chiropractic education in 2008, Phelps returned to Columbia. Four months later, as a single mom with a newborn, Jackson, she opened Achieve Balance. Carl, now in good health, became office manager at the original South Providence Road location.
THEY’VE GOT YOUR BACK In 2013, Achieve Balance relocated to its current location in the Woodrail Center on West Nifong Boulevard. After work one night, Phelps and Carl decided to go to dinner at Babbo’s Spaghetteria, not too far from the new office, where Phelps caught the eye of Chris Scrivner, a St. Louis native who had moved to Columbia three months before to become general manager of the restaurant. “Arminta and her mom came into the restaurant, I checked on their table, and the rest was history,” Scrivner says. He joined the practice full time in December of 2015, taking over as office manager. He and Phelps married the following April. Scrivner now handles the day-to-day operations of the practice while Phelps manages patients with Dr. Alex Gohring, who joined the practice in 2016. Acheive Balance offers a wide array of services, with Phelps focusing on science, technology, and nutrition, in line with their “whole patient” approach. The practice features a new tool now, in addition to traditional chiropractic equipment — three vibrating platforms. “The vibration helps provide a nice reset button to the nervous system,
getting the brain to remember where the body needs to be,” Scrivner explains. The practice was also the first in town to implement X-ray motion studies. Using digital imagery, Phelps can take highly detailed pictures of a patient in motion, allowing her to pinpoint problems within the skeletal system. They also offer monthly health classes that are open to the public. In January, Phelps became just the second chiropractor in Missouri to become a Certified Chiropractic Wellness Practitioner, completing 96 hours of study over three years to receive the certification from the International Chiropractic Association. The training focused on proper nutrition, mindfulness, and movement. “You cannot medicate your way out of a disease that you behaved your way into,” she says. “You have to behave your way out of it.”
ALIGNING A MISSION Phelps and Scrivner are beginning to consider what the future might hold for their growing practice after 10 years. In the meantime, Achieve Balance will continue to help patients do, well, exactly what their name suggests. “My mission is to change the statistical health of Mid-Missouri,” Phelps says. “I want it to be like, ‘What’s going on in this town that’s different from the surrounding areas that they have so much less illness?’ And I don’t know if I’m going to be able to accomplish that in my lifetime, but I’m going to die trying. I want to leave the world a better place than it was when we entered it. And this is my way of doing that.” CBT
Achieve Balance Chiropractic 1000 W. Nifong Blvd, Bldg. 8, Ste. #100 achievebalancechiropractic.com
2015
2016
2018
Scrivner joins the practice full time, taking over as operations manager.
Scrivner and Phelps marry; Dr. Alex Gohring joins the team to accommodate the growing patient load.
Phelps becomes the second Certified Chiropractic Wellness Practitioner in Missouri. COLUMBIABUSINESSTIMES.COM 29
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30 FEBRUARY 2018
Heather Hargrove General Manager
B U SINESS • PEOP LE • IM P R OV EM EN T • F YI
M OVER S & SH AKER S
Movers & Shakers FEBRUARY 2018
Boone County History & Culture Center
Mike Mouser
Sheila Grant
Mouser has been named the new
Grant, a professor of bioengi-
The membership of the non-
district director of Northwest-
neering in the MU College of
profit Boone County Histor-
ern Mutual’s Columbia office.
Engineering and the College of
ical Society elected four new
He will be in charge of the over-
Agriculture, was named a fel-
directors to its board at its
all development of the office
low of the National Academy of
annual meeting in December.
while also running the com-
Inventors for her work on opti-
They are: Loreli Wilson, man-
pany’s college program, which
cal biosensors and biomaterials
ager of diversity and inclusion
typically takes 20 to 30 college
used in health care diagnostics
programs at Veterans United
interns at a time. In addition, he
and treatment. Grant’s work
Home Loans; Amy Henderson,
will continue to serve about 450
involves integrating soft tissues
vice president and relation-
households and families across
into biocomposites that help
ship manager at Central Trust
the country, around 300 of those
them grow and regenerate.
Company; Bill Thompson, a
being in Columbia.
WILKSHIRE
Jackie Marcink
recently retired specialist with
Marcink is the newest addition
ation Department and the win-
Visionworks Marketing Group
ner of the 2017 Columbia Val-
Visionworks added three new
She will work with their busi-
ues Diversity award; and Nancy
members to their team: Alexan-
ness clients across the state to
Schultz, retired senior director
dra WILKSHIRE, a recent busi-
provide high-speed internet,
of development for MU.
ness graduate from MU; Kath-
local telephone, and other tele-
Columbia’s Parks and Recre-
GRAY
to Socket’s business sales team.
rine SITTON, a current senior
communications services. In
Kate Gray
at the Missouri School of Jour-
addition to Marcink’s work with
Gray, an associate professor of
nalism; and Eric HULTING, also
Socket, she also consults with
graphic design at Stephens Col-
a senior at the Missouri School
small businesses and nonprofits
lege, has accepted a part-time
of Journalism.
on their web presence.
Central Bank of Boone County
Scott McGinty
exhibits, building relationships
Jessica ELLISON is now a loan
last year announced plans
with prominent area artists,
officer at Central Bank of Boone
to establish a dairy process-
creating educational program-
County’s Boonville branch. She
ing facility in Columbia, has
ming for the gallery, collaborat-
will work with both current and
a new CEO. Scott McGinty
ing with local partners via inno-
potential lending customers.
will take over the executive
vative and interdisciplinary
The bank’s Customer Service
position from the company’s
approaches, and elevating the
Center also promoted Stepha-
founder, Marc Peperzak, who
presence of Columbia’s largest
nie Corrigan to customer service
has assumed a new role as exec-
civic art gallery.
representative II.
utive chairman. CBT
SITTON
position as a consultant at the Montminy Art Gallery. Gray will be directing and curating future
Aurora Organic Dairy, which
HULTING
ELLISON
Are you or your employees making waves in the Columbia business community? Send us your news at Editor@BusinessTimesCompany.com COLUMBIABUSINESSTIMES.COM 31
32 FEBRUARY 2018
B U SINESS • PEOP LE • IM P R OV EM EN T • F YI
P E R S ON YO U SH OU LD KN OW
DR. HANA R. SOLOMON C E O | B E W E L L H E A LT H L L C | AG E : 6 6 Job description: My passion: spread the word, share the news, and teach anyone with a nose about natural approaches to nasal, sinus, ear, and respiratory health. We particularly love talking about avoiding unnecessary medications and surgeries while preventing symptoms related to nasal toxic overload. Years lived in Columbia/MidMissouri: 45 years. Original hometown: My family is of Polish decent; they’re survivors of the Holocaust. After the Holocaust, they landed in Munich for a short time. After I was born, my family immigrated to the ghetto in Brooklyn, New York. Education: Bachelor of Science at Stephens College in 1982; medical degree at MU Medical School in 1986; MU pediatric residency in 1989; passed the sexual assault forensic examination in 1989. Favorite volunteer/community activity: I was a volunteer physician for Camp Sabra, at the Lake of the Ozarks, for seven summers; last year, I was a volunteer health care provider for Missouri Burn Camp. I also love being on the board of Rainbow House and Congregation Beth Shalom. There are also many activities related to my children’s schools, sports, and religious events. Professional background: I’m the inventor of Nasopure Delivery System as well as a speaker and author on nasal health and allergies (my book, “Clearing the Air One Nose at a Time” is in its second printing). I owned Solomon Family Medical Clinic for almost 20 years until I retired. I spent time as a consultant for Charter Behavioral Health and worked for the State of Missouri as an independent medical examiner.
Photography by Anthony Jinson
COLUMBIABUSINESSTIMES.COM 33
B U SINESS • PEOP LE • IM P R OV EM EN T • F YI
P E R S ON YO U SH OU LD KN OW
A favorite recent project: Painting a 40-inch by 60-inch mural for my eighth grandbaby. A Columbia businessperson I admire and why: Gene Gerke, a successful businessman who I view as an excellent example of someone who practices ‘doing the right thing.’ I define success as reaching your goals while doing the right thing, and Gene exemplifies this quality. Why I’m passionate about my job: My reason for going to medical school: follow a dream and contribute good to the world. My reason for developing a nose wash: I witnessed nasal woes addressed simply and safely with an effective cleansing. I sought to avoid the routine antibiotics doctors seem to give out like candy. I’m well aware of all the ill effects of overuse and abuse of modern medications. There’s substantial evidence that proper nasal washing will keep people off antibiotics, reduce needless surgery, and help people breathe happily! Why I’m passionate about my company: I am passionate about my company because we do good for the world. We’re keeping the world clean, one itchy, drippy, snotty, crusty, congested nose at a time. We’re focused on educating people and sharing the tools of knowledge for folks to make informed and safe decisions regarding their medical options. I’m also passionate because we’ve survived this decade while manufacturing the bottle in Missouri and not abroad, employing adults with disabilities to assemble the product, and facing competition with deep pockets and tactics that infringe on intellectual property issues (which is really the highest of compliments), all while trying to do the right thing at each step. If I weren’t doing this for a living, I would: I would pursue my love for working with children. I adore the hope, fullness of life, and spirit that children share with those who are open to their sweetness. I’d love to counsel parents on child behavior issues. Prevention through love and support for each child is priceless. Art and kid therapy is another potential route! 34 FEBRUARY 2018
My next professional goal: Nasopure has reached more than 1 million noses to date. I’d love to see 2 million noses helped. Biggest lesson learned in business: Trust my instincts — trust but verify. Truth and honesty should not be assumed. How I would like to impact the Columbia community: First, by helping make healthier people. Second, by putting fewer overall antibiotics, which lead to antibiotic resistance, in the community. Third, by decreasing the need for allergy medications. To help these goals, we’ve donated thousands of Nasopures to schools, firefighters, and other community groups. Greatest strength: I am always open, honest, and straightforward. Greatest weakness: I have a hard time saying no to requests, and therefore, I find myself running faster than I have the energy and time for.
What I do for fun: Create art. Family: My husband, Dr. George Solomon, a family physician, and four children. My older son is the No. 1 car salesman at BMW of Columbia; my older daughter is an impact-making math teacher at Rock Bridge High School; my younger daughter is a doctoral nurse practitioner in St. Louis; and my youngest son is making an impact on thousands of noses as the president of Nasopure. Favorite place(s) in Columbia: Main Squeeze, Café Poland, and Blue Stem. Accomplishment I’m most proud of: I’m still standing. Most people don’t know that I: Most people don’t know that I hitchhiked across America and, for five years, was part of The Farm, a spiritual commune in Tennessee where home birth and tofu was ‘born.’ CBT
Mercedes-Benz of Columbia
1710 I-70 Drive SW • Columbia, MO 65203 • (573) 886-7040 Columbiamercedesbenz.com
COLUMBIABUSINESSTIMES.COM 35
B U SINESS • PEOP LE • IM P R OV EM EN T • F YI
physician or care team to put a treatment plan in place that reflects the patient’s needs and medical requirements. Real-time access to information also helps clinicians find efficiencies that reduce costs and overhead, allowing them to focus on care and treatment rather than tracking down information — simply, they focus on the things they should be focused on.
Q&A ANGIE BASS President and CEO, Missouri Health Connection
3. How was the MHC formed? The MHC was started as an executive order by former Governor Nixon in relation to the HITECH Act of 2009. Through HITECH, $13.9 million in federal funding was awarded to Missouri to build the complex technology for a resource that would improve the lives of Missourians. Beginning in 2010, six working groups were formed, which were led by two co-chairs — one appointed by the state and one selected from the private sector — to organize this undertaking. They convened and conducted a year-long process of transparent meetings, all open to the public, to create MHC as an independent, private nonprofit organization. In 2013, MHC deployed its HIE network and went live. Since then, the MHC has grown into one of the best HIEs in the nation.
1. What does the Missouri Health Connection do? Missouri Health Connection is a health information exchange, or HIE, which provides technology that allows health care providers to interoperate with one another, even if they use different electronic health record systems. MHC acts as the technology bridge that electronically connects health care providers, allowing access to a comprehensive health record for any one patient. A member connected to MHC is able to access their patient health information from other members of MHC and view a comprehensive and consolidated health record using MHC’s platform.
4. How does MHC work to secure patient health information? MHC’s infrastructure is protected by a top tier operating system. We undergo routine audits and testing to ensure the network has the most sophisticated technology to protect from cyber threats. We take this responsibility very seriously — we have encrypted messages, secure inboxes, multiple layers of cyber defense, expert technical staff, and a policy allowing only authorized medical professionals with the proper credentials to access the system. To date, there has never been a breach at any HIE in the country.
2. How can this interconnectivity between health care providers solve problems? A clinician can conduct more effective and informed decisionmaking for patient care when he or she has all of the information at the point of care. Having a patient’s full medical record available during an examination allows a
5. Do patients have control over whether their information is shared through MHC? Absolutely. MHC’s operational policies require every patient to provide written consent in order for their health information to be shared across the MHC network. A patient can opt to share or not and change their mind at any time.
8 QU EST I ON S
6. Does the sharing of patient records have any economic impact? There’s no question there are savings for patients, providers, and insurance companies. An HIE reduces the costs associated with duplicate testing, saving patients and doctors money and time. The demand from patients to have their health information made available to their health care providers — no matter who those providers may be — is driving health information technology companies to perform and provide more advanced services for health care providers, insurers, and patients. 7. What are some challenges Missouri health care providers face in 2018? The biggest challenge for health care providers is the threat of losing critical federal and state funding for health care services. Every day that Congress fails to reauthorize critical funding for the Children’s Health Insurance Program, or CHIP, or the Disproportionate Share Hospital Program, or DSH, is another day that patients will have less access to care they require. A strong health care system needs to have access, resources, technology, and funding to support a healthy community. Health care providers are now being asked to do more with less. The longer they experience funding threats, the greater the risk of a community losing health care access, which drives up health-related costs. 8. How engaged is the Columbia medical community in the MHC? As one of the largest HIEs in the country, MHC succeeds because of the commitment of its participating members. The Mid-Missouri health care community is engaged with MHC through several local hospitals and clinics that are participating, and we’re actively working to include all of the health care providers in Mid-Missouri, as well as the rest of the state. As a member of the business community, encouraging your health care providers to join the MHC network (if they’re not members already) is a great way to make sure that your health records can be available if and when you need them. You can find a list of participating health care providers througout the state on our website. CBT
Check out more questions and answers with Angie Bass online at ColumbiaBusinessTimes.com. 36 FEBRUARY 2018
B U SINESS • PEOP LE • IM P R OV EM EN T • F YI
A CAPITOL CONVERSATION
Face to Face with Governor Greitens
KRCG 13’ S K ERMIT M IL L ER
WHEN I SAT DOWN with Governor Eric Greitens shortly before Christmas for a conversation about his first year in office, I expected that we’d air it in a half-hour special report in January, just before he delivered his second state-of-the-state address to Missouri lawmakers. I did not know then that KMOV-TV, in St. Louis, was preparing its bombshell expose on Greitens’ extramarital affair and the allegation that he had blackmailed the woman involved, which ended up airing the same night, right after his speech. Other news agencies in St. Louis have reported that the story, which is based on secret recordings made by the ex-husband of the woman in the affair, was shopped to them last year as well, but they held off when the woman at the center of the scandal refused to be interviewed. KRCG-TV was not on that shopping list, so my December interview with Greitens focused on his policy agenda and the political controversies that dogged his first year in office. In our interview, Greitens hung his hat on a jobs agenda, and he reflected on his choice to put lawmakers on overtime to get the results he was after. He credited legislation from the first special session — which allowed regulated utilities to nego-
tiate special rates with commercial customers — for a commitment, made in November, to bring a steel mill to Sedalia, and for opening the door to bringing an aluminum smelter back to the Missouri Bootheel. The jobs agenda also made Greitens the first Missouri governor to sign right-to-work legislation (or, as he prefers it, “freedom” to work), but that bill still must win a ballot fight before it can become law. In December, the governor expressed confidence in winning that battle in 2018. Greitens last year also allowed legislation blocking localized increases in the minimum wage to become law without his signature, while he did sign a bill making it harder for workers to sue over alleged discrimination in the workplace. Both of those bills ranked high on the GOP priority list. All of that accomplishment was overshadowed by Greitens’ strategy for gaining control of issues and agencies run by appointed boards and commissions. He put the Missouri Clean Water Commission and the Missouri Veterans Commission in his crosshairs in an effort to change standards for farming and for veterans homes. And, at the end of the year, he lit a fuse in the state senate with
A CA P I TO L CON VER SAT I ON
his inter-session appointments to the Missouri Board of Education. Those appointees succeeded in getting rid of the sitting commissioner of education, but they now have almost no chance at senate confirmation this year, and therefore no control over the naming of a new commissioner. Some lawmakers have vowed to reign in the governor’s appointment powers. The issue which most dogged the governor into his second year in office is transparency. Greitens ran on a promise to be the most transparent governor in state history. But before the echoes of his inauguration had faded, reporters were asking about the high-dollar contributors who paid for that party, and about the dark-money fundraising operation set up by his campaign people. That group, A New Missouri, has targeted issues that Greitens considers important, but it has also targeted people he considers a problem. And any claim of transparency seemed completely undermined by revelations that the governor and his staff used a smartphone app that deletes text messages and prevents screen grabs, which has prompted an investigation by the state’s Republican attorney general. And his preference for Facebook Live videos over face-to-face news conference encounters minimizes his exposure to the damage that transparency could otherwise bring. Our meeting in December was my third sitdown interview with the governor since he took office. I’ve observed that he comes prepared with his talking points and he does not stray. As the head of a national charity for veterans, Greitens was in front of a camera many times, including on national broadcasts, before running for governor; he does not come across as a deer in the headlights. During our interview, the governor promised to pick up where U.S. Congress left off in 2017 — with a major new tax reform plan, this time for the Show-Me State. As I’m writing this, his rollout of that plan has been delayed by his need to control the damage from his extramarital affair scandal. More than a few lawmakers have expressed doubt that the governor can advance anything that significant in the current political climate. Some don’t think he can stay in office at all. If he’s no longer governor when you read this, you’ll know they were right. CBT Kermit Miller anchors the 6 and 10 p.m. news for KRCG 13. Kermit is an award-winning 45-year veteran journalist and one of the longest serving members of the Missouri Statehouse press corps. You can reach Kermit at kmiller@krcg.com. COLUMBIABUSINESSTIMES.COM 37
38 FEBRUARY 2018
B U SINESS • PEOP LE • IM P R OV EM EN T • F YI
Hope and Despair BY A L GERMON D
COLUMBIA RECORDED ITS FIRST HOMICIDE while the New Year was still very young. Not something to boast about. It’s a problem about drugs, as individuals — rivals and their gangs — spar with each other over the sale and distribution of a cornucopia of various controlled substances in the local marketplace. And so it goes – meanwhile, entering 2018, there’s much to exalt about. Confidence and a renewed sense of excitement about the University of Missouri continues to build with the new leadership team in place bolstered by a group of new deans. UM System President Dr. Mun Choi and Columbia campus chancellor Dr. Alexander Cartright have been imparting optimism about MU’s future that’s contagious. Then there’s Dr. Marshall Stewart, who’s reinvigorated the university’s extension program. There are other appointments to celebrate, and relations with the folks in Jefferson City have turned around. Let the bad times of the past shock the university into the better days that lie before us. It’s likely the future of Boone Hospital Center will be decided this year with arguments pro and con about inclusion into the universi-
ty’s hospital complex. BJC, the St. Louis group that presently leases the hospital, wants out, leaving the county, which owns the building, with a restricted number of options for the future. Some of us chafe at the loss of competition between the two area providers of medical care if consolidation is allowed to occur, but it seems to be inevitable. There’s renewed confidence about local economic conditions. The metropolitan area’s unemployment rate of 1.5 percent is one of the lowest in the nation. Housing starts continue apace, especially outside the city, while two major business projects — Aurora Organic Dairy and American Outdoor Brands — are under construction, assuring employment for hundreds of new workers. Other employers we’d run out of space listing here continue to grow, adding employment opportunities while occupying a growing crop of new buildings. Finally, there are two projects about to be undertaken by the city itself where 2018 may go down as Columbia’s Year of Broken Promises. This comes just when the city has regained some citizen credibility as a great place to do business after the city council on
OPI N I ON
December 4 approved tax-increment financing to expand The Broadway hotel. More than two years ago, voters extended the city’s parks and recreation sales tax to include construction of a new athletic complex at Discovery Ridge in southeast Columbia. It seems like a perfect match — a four-court indoor basketball arena next to a new hotel — another tourism destination that would reinforce the city’s role in the Show-Me State Games. Now there’s a competing proposal to develop a similar facility with a greater number of courts and other amenities designed to resuscitate the county’s dormant fairgrounds property at the city’s northeast edge. It’s being privately financed for now, but will county voters be asked to hike the sales tax one more time to assure completion and future operation? A total cost of $35 million dribbled out of one press account. Then there’s this bomb. Last August, Columbia voters assented to hiking the lodging tax to finance construction of what we and its supporters were led to believe at the time was a new north passenger terminal near the intersection of the two runways at the re-awakened Columbia Regional Airport. It makes sense for reasons of security and expansion: separate the airport’s passenger service function from general aviation — the fixed base operator — which would occupy the existing terminal building. There would be plenty of room on the north side for a multilevel parking structure and a hotel, and the terminal’s neighborliness to the new Cartright Business Park, Route H, and Highway 63 would be an advantage. All of this is apparently not to be, marking what voters approved as another broken promise and a violation of our trust that the city is a progressive, forward-thinking municipality when it pertains to aviation. From the day the city, teamed with the chamber of commerce, leased the Allton Brothers Airport on Highway 40 for $1,000 a year — January 2, 1932 — Columbia has followed an uncertain, rocky road when it comes to operating its airports. Here’s another municipal horror. Beware of politicians who bear gifts of dubious value. Haste makes waste. CBT Al Germond is the host of the Columbia Business Times Sunday Morning Roundtable at 8:15 a.m. Sundays on KFRU. COLUMBIABUSINESSTIMES.COM 39
TRAINED PROFESSIONALS Building discipline through relationships. BY HA RT L EY W RI G H T | P H OTO G R A P H Y BY A N TH O N Y J I N S O N
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hat kind of relationship can we expect from someone we’re paying to tell us what to do? We’re likely to choose a stranger, so we can cut ties if things don’t go well. Our tendency is to put careful boundaries in place to preserve the professional relationship. But sometimes a friendship develops — and that can be a good thing. Here are three Columbia professionals who took a chance on trusting their health to physical trainers who have helped them develop a work ethic in every part of their lives, especially in business.
JERRELL JACKSON TRACY TAYLOR “It sounds crazy,” Tracy Taylor admits, “but I think my trainer has made me a better Mom. And, in my job, a better worker.” Her declaration is a testament to Jerrell Jackson. In the year they’ve been working together, Taylor has become accustomed to Jackson’s physical training sessions doubling as life development. “It’s definitely more with him than just physical training,” she says. “He gets into your head and makes you want to change everything, to do better at everything.” “It’s my job to pull out the motivation she already has,” Jackson says, “which is why I focus on taking out the distractions. We zone in on one thing and concentrate on that.” One of Jackson’s guiding principles as a personal trainer is to build a friendship with his clients early in the process to establish trust, develop a rapport, and strengthen their bond. Were it not for this principle, Taylor would have quit meeting with Jackson when she fractured her foot shortly into their journey. For a month and a half, they could only exercise her upper body. “With any other trainer, I would have quit and not come back,” she says. “Jerrell made the difference. I knew he would have been very disappointed that I would let something like that stop me. And I don’t ever want to disappoint him, because we’re friends. I knew he wasn’t going to let me go away because I hurt my foot.” Jackson played wide receiver at MU from 2008 to 2011 before embarking on a professional career in the NFL and, briefly, the Canadian Football League. His experience lends him considerable credibility; he knows first-hand the hard work it takes to reach goals, so he’s passionate about his clients reaching theirs, whatever they may be. “It may not be the same feeling scoring a touchdown against the San Francisco 49ers, but I know the excitement Tracy feels when she steps on that scale and she puts on that dress, feeling amazing,” Jackson says. “Physically, I have to carry a lot of equipment,” Taylor says. “It’s easier to do now because I’m stronger and I’m in better shape. It used COLUMBIABUSINESSTIMES.COM 41
to be a struggle. I was heavier and I felt weak when carrying stuff.” The success they’ve achieved together has generated a mutual love, respect, and trust for one another. Last year, Jackson’s mother and father each lost their homes in the wake of Hurricane Harvey. When he traveled to his hometown of Houston to lend them a hand, Taylor loaned him her car so he could haul donations from clients and friends. “When she trusted me with her car, it let me know how I impact her life,” Jackson says. His impact on Taylor has transformed more than her physical health. “He’s real about everything,” she says. “He’s become my part-time therapist as well, because I can talk to him and trust him on a different level than just as a trainer.” Jackson reciprocates the appreciation. “I think Tracy has a genuine relationship with me that if I need anything, she’s there for me,” he says. “This is someone in my corner, and if I need her, she won’t disappear from me.” Jackson tries to instill an element of mental conditioning in his workouts, believing it builds a strong work ethic in the client’s everyday life. Taylor has developed that mindset, which she carries in raising her kids, operating her own court reporting business, and, as she says, “in every aspect of life.” “Whenever I’m training, I’m training your mind more than anything,” Jackson says. “If your mind is strong, your body will follow. If your mind is weak, your body will quit every single time. If you want to get that promotion, if you want
“When she trusted me with her car, it let me know how I impact her life.” - JERRELL JACKSON 42 FEBRUARY 2018
to get that raise, if you want to better that relationship with people in your life, if you want to get stronger, faster, lose weight — it all takes you pushing yourself further.”
AMANDA BARNES KIM BECKING On any given workout with Kim Becking, trainer Amanda Barnes knows “the two of us are going to discuss something that’s close to both of us, vent if we need to, come up with ideas about this and that, and it’s going to help me with the rest of my day.” “I had a male trainer while living in Kansas City, and we did not have this type of relationship,” Becking says. She felt her old trainer was good at focusing on strength training, but didn’t tailor his training in Barnes’s style, which is more holistic, focusing on being emotionally and physically healthy in equal parts. “It’s the physical, it’s the emotional, it’s the nutritional aspects, all of it, because I’m a whole person with different things going on in my life,” Becking says. “But it’s all connected,” Barnes interjects. “I think everything is connected, whether it’s our muscles connecting throughout our body or what we’re doing in our lives connected to what our lives are becoming. . . . We are women in our 40s, and we need to not worry so much about the number on the waistband or the number on the dress.” After battling breast cancer, Becking began exercising because “it took me a while to rebuild and get back to a point where I felt strong again. Now that I’m 46, I want to be healthy and I want to be strong.” Her success is evident. “Kim has gotten stronger,” Amanda testifies, “and she is setting such a good example COLUMBIABUSINESSTIMES.COM 43
for her kids, too. They’re seeing transformation, learning they also can put their health first and be strong. They see their mom being a healthy role model.” In the process of working out with Barnes for four years, she’s learned that her best success comes when keeping her life balanced — and when she doesn’t, she gets called out. “I can tell when she hasn’t exercised,” Barnes says. “She does need to have a balance in her life — if she’s all work, it’s not good for her emotional well-being.” It’s also not good for her business. “I do motivational speaking and I talk about this, but I have to live it myself,” Becking says. “I walk the walk. Making that commitment has been absolutely life changing not only in my physical well-being, but in my mental health as well. It has allowed me to be more productive, have more clarity, and have more focus.” Barnes affirms the connection. “As you get stronger physically, you’re also getting stronger emotionally and mentally, and sometimes I think it parlays professionally,” she says. Becking and Barnes succeed because of mutual respect, admiration, and love. “We’ve had sessions where we have spent the entire time having therapy and walking and not even touching a weight,” Barnes says. “Sometimes we need that, and it’s just as important as doing 50 squats.” Becking knows full well how lifegiving those sessions have been, and she’s come to trust Barnes as a friend and confidant, a result of her trainer proving to be more than simply a professional who is paid to focus on physical health. The trust flows both ways. “We keep each other in check when it comes to our life goals beyond the physical stuff,” Barnes says. “She knows what my goals are for myself and just as I’m asking her questions, she’ll ask me if I’ve followed through on important things. You can’t spend time with someone on this type of journey without having that relationship and that connection. It has to be there. Otherwise, I don’t know if everyone can achieve what they need to.” 44 FEBRUARY 2018
NICHOLAS GOLDA LINDSEY STINSON Dr. Nicholas Golda made the decision to prioritize his own health early in his career — very early, in fact. “After my residency training, I became heavier than I needed to be,” he says. “I saw my primary care doctor and it was the first time in my life someone looked at me and said, ‘You need to lose weight.’” Golda didn’t rush to find a personal trainer. He’s a dermatology surgeon specializing in facial reconstruction related to skin cancer, and he always felt too busy to seek out the right person to help him. Fortunately, he came across Lindsey Stinson. “She trained my wife for a long time before training me,” Golda says. “I would lift weights at home and my wife would train with Lindsey.” Seeing the health results Stinson produced in his wife, Stephanie, led Golda to join their workouts and put his confidence in Stinson. “I was positive about the process in advance because of my wife’s positive experiences,” he says. “I knew Lindsey wasn’t going to sell me a bill of goods. The motivation was strictly health.” “It was an easy transition when Nick started working out with his wife,” Stinson recalls, “because he was wanting change. He was willing, and he was ready.” When Stephanie took on a new job that conflicted with their workout day, Nick didn’t drop out. “My wife impressed upon me the importance of taking it seriously, both diet and exercise, and Lindsey does a good job of emphasizing how those two come together,” he says. “For me, it’s been quite a bit more about managing my diet and working out in a manner that’s smart.” When they started working out together, Golda wasn’t eating enough. “He was not giving himself enough fuel to burn fat,” Stinson says. “He would not eat anything all day and just go crazy at night.” (Nick interjects a quiet confession: “I would eat my kid’s food too.”)
Golda isn’t on a diet plan now; he’s simply more mindful of when he eats, how much he eats, and no longer indulges in his children’s macaroni and cheese. Stinson and Golda have devised workout plans to help him counter the physical demands of his job, where he has to stand and perform surgeries and make rounds to care for eight to 10 people. He’s had lower back issues and muscle strain, which he and Lindsey addressed by working together to strengthen his core. Golda has extra motivation to work hard as well: there’s a history of heart disease in his family. He wants to see his two little girls grow up and have children of their own. “I want to be able to have useful life where I’m living full and active, doing things and engaging with my family and my friends for as long as possible,” he says. Considering Golda lives in Pierpont and Stinson’s gym is in Hallsville (about a 30-minute drive), his commitment to keep working with Stinson speaks volumes about their shared dedication to his goals. “I give Nick the opportunity to Skype if he wants because of his busy schedule,” she says, “but he knows he works so much harder here and he makes it a point to come . . . the one thing I love about our relationship is I know he’s committed. He makes that effort and he realizes getting here is going to make him better in the long run.”
“This journey, for me, has been one where I focus on myself.” - NICHOLAS GOLDA To Golda, it’s an ongoing investment of invaluable time. “I’ve seen the results,” he says. “There is no room to dispute this is time well spent. I’m accomplishing something with Lindsey I wouldn’t be able to provide for myself. This journey for me has been one where I focus on myself and I’ve got accountability and I see results. You can’t beat that.” CBT COLUMBIABUSINESSTIMES.COM 45
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SMALL STEPS.
BIG IMPACT. With busy schedules, it can be difficult to find time for yourself. Our heart experts encourage you to incorporate small steps into your daily routine to stay heart healthy.
Learn more at muhealth.org/heart-month
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O UTS IDE TH E
New medical practices hope to fill gaps in patient care. BY JO DIE JAC KSON J R. | PHOTOG RAPHY BY AM B ER D EERY 48 FEBRUARY 2018
THE LONG-AGO MEDICAL TELEVISION DRAMA “Marcus Welby, M.D.” undoubtedly prompted countless baby boomers to pursue medical careers. But nearly 20 years after Robert Young’s titular character, a kindly old doctor who still made house calls, had finished a successful run, another prime time doctor — from a much more distant time — was inspiring more aspiring physicians. Bridget Gruender vividly remembers watching “Dr. Quinn, Medicine Woman,” about a physician in the Old West, in the early 1990s. The show was the spark that ignited Gruender’s passion to become a doctor — but not just any doctor. “I watched Dr. Quinn,” Gruender says. “That’s who I wanted to be when I grew up.” She smiles. “And that’s the kind of practice I have now.” In July 2016, Gruender opened Liberty Family Medicine, a direct primary care practice absent of insurance companies, price-hiking pharmacies, and other players that continue to stack the cost of health care against consumers. It’s a direct approach Gruender borrowed from her favorite TV doctor, who would traverse the West and use her relationship building skills to do her job outside of a traditional health care system. “I have no horse and buggy,” Gruender says. “But I’m pretty much Dr. Quinn.” Direct primary care practices charge patients a monthly, quarterly, or annual fee — consider it a retainer, of sorts — that covers all or most primary care services, or at least provides a significant discount on those services, which can include lab work, consulting, and care coordination. Another direct primary care clinic, Big Tree Medical Home, opened September 1 of last year. Adam and Jen Wheeler, with the help of Blake Barnes, opened Big Tree at 200 Southampton in a suite shared with Tiger Pediatrics, where both Adam and Barnes also practice, though the two groups aren’t financially affiliated. (Big Tree is also unaffiliated with Jen Wheeler’s other enterprise, the nonprofit City of Refuge.) The concept of a medical home takes the care coordination a step further by acting as the base for all of a patient’s health care needs, helping them navigate the full health care system when specialty or emergency care is necessary.
The significant similarity between Liberty Family Medicine and Big Tree Medical Home is marked by the absence of a common health care player: insurance companies. Neither practice accepts insurance, but both advise patients to have some form of high-deductible, catastrophic insurance and a health savings account, or HSA, a type of banking product for health care costs, that are compatible with direct primary care in order to meet medical costs not related to membership fees. “We don’t care that insurance companies can’t figure out what code to use for a text message-based visit,” Adam Wheeler says. “We don’t play with insurance companies anyway.” In an industry rife with high costs and complex processes, Columbia is producing health care companies founded to provide simpler solutions for patients — but simplicity can be a complicated goal to achieve.
FORGING NEW PATHS Big Tree Medical Home offers three membership options. The “unlimited plan” monthly charge is $59 and covers all services, including access to medications at wholesale costs. The HSA-compatible plan is $25 per month. Acute care and smartphone-based visits are an additional cost, and access to medications at wholesale is an additional $10 per month. The “pay-as-you-go” plan requires fees for each service as well as $10 per month for access to the wholesale medications. Big Tree, which took its name from the centuries-old bur oak outside of McBaine, is also offering its $59-per-employee plan to employers that are unable to afford commercial health insurance. Adam Wheeler says employers can think of the benefit as a purchase of health care, not health insurance. Big Tree is also fashioning an employee wellness plan as part of its services for small businesses. Liberty Family Medicine charges monthly fees of $25, $50, $75, or $100, depending on age. There’s also a referral bonus for patients that refer others to the practice, and patients who pay for 12 months at a time can receive one month at no charge. Like Big Tree, Liberty Family Medicine offers access to wholesale prescription drugs and overthe-counter drug prices and dispenses medications in the office. Big Tree, which promotes itself as “Simply affordable primary care,” embraces modern communication technology to create “highly
relational health care” independent of insurers. Technology in traditional physician offices is often a necessary burden — doctors use electronic filing and databases to prove to commercial insurance companies and the Centers for Medicare and Medicaid Services that the care they’re providing is producing good patient outcomes at lower costs. The alternative to these direct primary care plans is traditional health insurance, which routinely costs hundreds of dollars a month in premiums before any additional costs for medication or other services. Gruender said one Liberty patient was paying $150 a month for a medication that costs just $5 per month from Liberty. “If patients can afford a medication, they are more likely to take it,” she says. Health care has long been, along with education and insurance, one of the main pillars of Columbia’s economy, which has made it an ideal place for alternative care providers to experiment with new models. Another new player in Columbia is Epoch Men’s Health, which bills itself as “the next evolution in comprehensive health care designed for men,” matching symptoms to appropriate medical treatments, regular screenings, and lifestyle modifications “that return you to a healthier, happier way of life.” Epoch focuses on “patient care pathways” that include diabetes, wellness (fitness, nutrition, and vitamin deficiencies, for example), prostate health, sexual health, testosterone and hormones, mental health, heart health, sleep disorders, and more. Adam Cole, Epoch’s national medical director over the for-profit company’s six locations (one in Anchorage, Alaska; one in Columbia; and four in Arkansas) shrugs at Columbia’s apparently high physician-to-patient ratio. “We identify [men’s health patients] as an underserved population,” Cole said, “especially when it comes to preventative health care and cancer prevention.” Unlike Liberty or Big Tree, Epoch does accept insurance, but they’re battling some of the major carriers that haven’t yet or won’t credential Epoch’s physicians. That’s a headscratcher for Cole, who says Epoch’s focus on preventive care should be a plus for insurers. “It takes very little to prevent disease,” he says. “The money we’re talking about is a drop in the bucket” compared to treating and managing chronic illnesses in a wide COLUMBIABUSINESSTIMES.COM 49
“This is what patients want. They want a doctor that takes the time and gets to know what’s going on.” — BRIDGET GRUENDER
range of patients. Cole shakes his head. He says health care in general is built to be “more reactionary, treating something that’s already developed.” He says the much-maligned Affordable Care Act has a plethora of references to preventive medicine, “but there’s not really been any kind of blueprint to achieve that.” And health care ultimately costs more when preventative care isn’t provided. Epoch specializes in diagnosing and trying to prevent metabolic problems, such as diabetes and high cholesterol, as well as hormonal deficiencies or imbalances. They also hope their narrow focus can help overcome societal stigmas that deter men from seeking care. “From a social standpoint, on men, we’re programmed that you’re just supposed to feel like crap as you’re getting older,” Cole says. “It’s setting you up for failure for your quality of life.” 50 FEBRUARY 2018
Bridget Gruender in the office of Liberty Family Medicine.
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He says women typically have more tailored health care options, from family medicine to obstetrics/gynecology. “Women are so much better at this,” he says, noting that women are statistically more likely to get annual physicals and tend to their health needs. Hormone replacement therapy is standard treatment for many women, yet there’s reluctance among men to seek a boost in testosterone or estrogen, or to figure out why their bodies aren’t making enough testosterone. “For guys, maybe they got a sports physical in high school, then they don’t see a doctor again until they’re in their mid-40s or if something’s wrong,” Cole says. “It’s okay to reach out and ask for help. It’s been a huge social obstacle.”
FINDING ALTERNATIVES On the surface, the proliferation of new models for primary and niche health care in Columbia doesn’t seem to fit with the statistics that show an abundance of physicians in the city. The annual County Health Rankings that the Robert Wood Johnson Foundation produces each spring routinely shows Boone County and Columbia at or near the top of Missouri counties for the number of physicians per resident. Boone County was No. 1 in the 2014 report, which showed that there was roughly one physician for every 900 or so residents in the county. But those numbers don’t tell a full story; for instance, they don’t reflect access to care or affordability of care. In fact, the same County Health Rankings also show wide disparities along socioeconomic, ethnic and racial, and gender lines. There’s also another important disclaimer for Columbia, Adam Wheeler says. “Though there is an abundance of physicians, there’s a shortage of primary care physicians,” he says. All but three of Missouri’s 114 counties — Cole, Jackson and Platte counties — are labeled as primary care shortage areas. “The primary care doctors that exist are, therefore, free to be quite selective,” Adam says. “None of us went into primary care to be wealthy; that’s part of why there’s a primary care shortage.” Both Wheeler and Gruender want to be crystal clear about their approach to medicine as a relationship, not a transaction. “All sorts of perverse incentives pop up if I have to or get to charge you for every little thing,” Wheeler says. “With our model that pays for an ongoing relationship, rather than a visit, it allows us to have a longer conversation with each patient. If I can figure out your sinus infection over email, and you want to just stop by the office and get your antibiotics — sold at cost — then everyone is better off. It’s quicker for me and you, and you miss fewer days of work, so your boss is happy.” “I got into medicine to take care of people, not paperwork,” Gruender says. “Doctors go into medicine to help people. But the system doesn’t allow you to do that.” 52 FEBRUARY 2018
Alphabet SOUP
Ready for your head to spin? Here’s a quick glossary and brief explanation of the changing landscape of Medicare payment regulations that are flooding physicians and hospitals with indigestion-inducing alphabet soup. When Medicare came into existence in 1967, the sustainable growth rate (SGR) formula was put in place to determine physician and hospital reimbursement for the government health insurance program. The SGR was replaced with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which is the king of alphabet soup, because it’s an acronym within an acronym — CHIP is Children’s Health Insurance Program. More quick background: MACRA was the overhaul put in place to move our health system from fee-for-service (FFS) to value-based care (VBC), which was a move to provide financial incentives — and penalties — aimed at achieving the Triple Aim: better care, better outcomes, lower cost. Now, take a deep breath. MACRA birthed the Quality Payment Program (QPP), which uses the Merit-based Incentive Payment System (MIPS), Alternative Payment Models (APMS), and Advanced APMS (AAPMS) to determine the quality of patient care and, subsequently, the up or down adjustment in physician payment. MIPS has four “legs,” which are Improvement Activities (IA), Advancing Care Information (ACI), Quality, and Cost. (No abbreviations for the latter two). Each leg of MIPS receives a score, which are then added together to come up with a total MIPS score, which helps determine payment. So, if you’re keeping score — your own score, not the MIPS score — the dot-to-dot connection looks like this: SGR changed to MACRA, which brought about QPP, and the PQRS shifted to MIPS, which includes ACI (which replaced meaningful use, or MU) and IA. PQRS also presented APM and AAPM as options to take us to VBC. Oh, and don’t forget, some Accountable Care Organizations (ACOs) are also Medicare Shared Savings Programs (MSSP), all of which must now use Certified Electronic Health Record Technology (CEHRT), either the 2014 or 2015 edition. Now, where were we?
Dr. Thomas Nittler of Epoch Men’s Health
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Middle: Big Tree Medical Home’s Jen Wheeler, Adam Wheeler, and Marisa Salanski. Bottom: Adam Wheeler
A typical primary care practice will have a physician load of 2,500 to 3,500 patients. Direct primary care limits that patient load to somewhere between 600 and 800. Gruender will spend an hour with patients on their first visit. That’s harder to do if a doctor is required to see 30 to 40 patients a day, Gruender says. “I’m doing what every doctor wants to be doing,” she says. “I am living the dream, as far as a family medicine doctor is concerned.” A new flood of regulations has in recent years inundated physicians and hospitals that accept Medicare patients. New Medicare payment regulations contained in the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, created the Quality Payment Program, or QPP, which uses Advanced Payment Models, or APMs, and the Merit-based Incentive Payment System, or MIPS, to determine the quality of patient care and an increase or decrease in payment to doctors. The impetus for the new rules is Medicare’s seismic shift from a fee-for-service system to a pay-for-performance system, also known as value-based care. Gruender shakes her head at the new rules. “MIPS and MACRA. Don’t know. Don’t care,” she says. “It means nothing to me. It means nothing to my patients. It’s more boxes to click.” Gruender is ready to expand from a onewoman clinic to a larger practice, starting by hiring a nurse. And she’s already receiving resumes from other physicians who want to join her. Adam Wheeler also has some strong feelings about the government’s new rules that define quality health care and, subsequently, physician reimbursement for Medicare services. After all, he still works within that system in his role with Tiger Pediatrics, which attained the highest level of certification as a National Committee for Quality Assurance-certified Patient-Centered Medical Home. “I can tell you that, in the year of changes that we made to work on [getting the certification], very few benefited patients,” he says. “Many were merely to help the insurer know that I was already doing something that they wanted me to do.” The experience reinforced the conclusion he’d already made. “Quality metrics won’t save medicine,” he says. “Relationships will save medicine.” Gruender concurs. She says the direct primary care approach is new for medicine, but it’s not something that patients needed time to adjust to. “This is what patients want,” she says. “They want a doctor that takes the time and gets to know what’s going on. That’s what I do.” CBT
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BRIDGING
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THE GAP CenterPointe Behavioral Health System expands to meet needs in Columbia. BY DAVID MORRISON
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A FEW YEARS AGO, the leadership at CenterPointe Behavioral Health System noticed a trend taking place within its two inpatient mental health facilities in Missouri. CenterPointe Hospital, a 150-bed facility in Weldon Spring, was receiving a sizable number of patients from Mid-Missouri, who were driving two to three hours for services that weren’t available in their communities. The same went for CenterPointe’s Signature Psychiatric Hospital, a 36-bed facility on the other side of the state, on the North Kansas City Hospital campus. Doctors and administrators knew that access to mental health treatment in rural areas is scarce, but even patients from Jefferson City and Columbia just weren’t able to find the help they needed close to home. “A lot of times, we turn away patients from the Columbia area because we don’t have a bed available,” says Sheila Hunt, regional director of business development for the St. Louis-based CBHS. “The number of patients we admit from across the state of Missouri is just growing and growing. In a lot of the rural areas in Missouri, people are traveling three and four hours just to get psychiatric or addiction treatment services. There are just not enough services.” CenterPointe saw an opportunity to close the gap in the middle of the state and began planning a new inpatient facility in Columbia. The Missouri Health Facilities Review Committee, which reviews and approves all health care facility plans, accepted CenterPointe’s proposal for a new facility in July 2016; the City of Columbia’s Planning and Zoning Commission signed off on construction in January 2017, and CenterPointe broke ground a month later. Construction began in earnest last fall, and CenterPointe is anticipating a Fall 2018 opening date for the 72-bed, $22 million CenterPointe Hospital of Columbia. The new hospital will be located where International Drive and Rangeline Street meet, about five miles north of downtown. Buddy Turner, CBHS executive chairman and chief executive officer, envisions a place that can accommodate overnight stays for severe mental health patients while also allowing CenterPointe to greatly expand the outpatient psychiatric and substance-abuse treatment capabilities already established in its office on W. Nifong Boulevard, which opened in 2014. “We try to find different types of services — gaps of services in a community — and, when you look at Columbia, we started with general outpatient services, then added group services, then some more intensive outpatient programs,” Turner says. “That led us to pursue a certificate of need to add inpatient beds. It’s all just a natural outgrowth of that outpatient facility.” In Turner’s 25 years in health care, he has witnessed a change in how people think about mental illness. It is no longer as stigmatized as it once was. People are less ashamed to seek out help. He wants CenterPointe to be the place Mid-Missourians go for that help. 58 FEBRUARY 2018
A CONTINUUM OF CARE CenterPointe Behavioral Health Systems is hoping that, with its new CenterPointe Hospital of Columbia set to open in fall 2018 and its outpatient facility already operating on Nifong Boulevard, it can be the provider for Mid-Missouri residents at any level of psychiatric care. Here, according to regional director of business development Sheila Hunt, are the categories of services that CenterPointe will be able to provide upon the hospital’s completion: INPATIENT HOSPITAL SERVICES What Hunt refers to as “acute crisis stabilization.” This runs the gamut from psychiatric to addiction situations, with detoxification and substance-abuse responsibilities thrown in. Includes stays of up to a week in the new 72-bed facility. PARTIAL HOSPITALIZATION PROGRAM (PHP) The highest level of outpatient care, PHP involves five or six hours of treatment a day for patients in a clinical setting. This is for patients who need intensive therapy but are not, in Hunt’s words, “in a crisis and not a danger to themselves.” Similar to hospitalization, but the patients go home at night. INTENSIVE OUTPATIENT PROGRAM (IOP) This involves three half-days of treatment per week. For adult patients who work during the day, they can still come to group therapy in the evening. Same with adolescent patients who have school during the day. INDIVIDUAL DOCTOR APPOINTMENTS This is for patients scheduled to see a therapist once a week, with more time between visits if the treatments start to work. Hunt says that while most of the nuts and bolts of CenterPointe’s Columbia operation are still to be determined, the hospital facility could take on the PHP and IOP patients, while the outpatient facility on Nifong houses the individual therapist appointments and other kinds of specialized outpatient therapy.
“The University system offers some services, and there are other medical centers that offer some services, but we’ll be the only freestanding, pure psychiatric hospital in the region, and we think there’s a pretty significant need,” Turner says. “Our hospital will look and feel just like any other hospital. It’ll be a really nice haven for people who need care.”
ADDRESSING A NEED CenterPointe first filed its letter of intent with the state’s Health Facilities Review Committee in March 2016. There was just one problem: Oceans Healthcare, a company based in Texas, already had a proposal before the committee for a 60-bed, $12.7 million psychiatric facility for elderly patients in Columbia. “It was quite the interesting process,” Turner says. The committee rejected Oceans’ proposal on March 7 after a public hearing in which health care professionals from Columbia, Jefferson City, and surrounding communities stated that Mid-Missouri already had the capability to house mental health patients in the over-55 community. CenterPointe’s proposal, on the other hand, hinged on meeting the psychiatric needs of adolescents and younger adults. It passed unanimously. “Our proposal resonated with more people because we were looking at, big-picture, what was best for the community,” Turner says. “Not trying to replicate services, but really trying to fill in those gaps. We think this hospital does it.” It helped that CenterPointe already had a presence in Columbia. Its outpatient office on Nifong employs two full-time physicians, two full-time nurse practitioners, and some contracted therapists. They currently see patients in all age ranges with all types of mental health disorders. It was a good start, but not really enough to service the community. “We’re barely covering the need. We’re still seeing a number of people having to leave the community to seek out care,” Turner says. “The push, and the real driver behind us looking for an inpatient hospital, was not just the inpatient business, but also to do an expansion of our outpatient system, too. We need to be able to provide all those different services to the community.” Turner and Hunt say CenterPointe will be able to pair its outpatient facility with the new
hospital to provide patients a “continuum of services” — basically, meeting the patients where they are and assessing what next steps are necessary, keeping it all within the CenterPointe system. “Someone can enter at any level of service,” Hunt says. “If they don’t need to be in the hospital, we don’t want them to be in the hospital, but the more serious the condition, the higher the level of care. There is a lot of fluidity between inpatient, outpatient, and the different levels of outpatient. It’s very much based on the individual patient’s needs. No one is alike.” Turner also sees the potential for exponential expansion in CenterPointe’s capabilities for treating addiction and substance abuse. Non-heroin opioid deaths in Missouri have risen from just over 90 in the first quarter of 2013 to 160 in the first quarter of 2017, according to the Missouri Department of Health and Senior Services. The department recorded more than 900 deaths due to heroin and opioid use in Missouri in 2016. Boone County and the seven counties that border it — Randolph, Howard, Cooper, Moniteau, Cole, Callaway and Audrain — experienced more than 120 deaths due to heroin and opioid overdoses from 2012 to 2016. Combating opioid addiction has been a point of emphasis for Governor Eric Greitens, who signed an executive order in July directing the departments to launch a program monitoring the flow of prescription drugs in the state. Turner says the new hospital will have detoxification services as well as the ability to treat underlying mental health issues that may lead patients to addiction. CenterPointe also has a residential treatment facility in St. Louis for longer-term rehab stays. “The idea is to try to get people back into their natural home environment,” Hunt says. “Or they may be in a nursing home, group home, or some type of supportive environment in the community, and then they’ll attend outpatient services.”
COURTING THE COMMUNITY Turner says he has already hired a CEO for the new hospital. He hopes for that person to be on-site by the spring to start developing relationships with people in the community. CenterPointe Hospital of Columbia will employ around 175 to 200 people. By the time construction is about halfway through — a target date of early spring 2018 — Turner hopes
to have the facility’s management team hired and on location so it can start preparing for the grand opening. Turner and Hunt are tentatively hoping for an October unveiling. If the weather is especially bad this winter, it could push back into November, but a mild winter could push the opening up into September. “We’ll do an open house (prior to opening),” Turner said. “It’s always a good opportunity for people in the community, especially those that have some stigmas associated with psychiatric hospitals. I think they’ll be surprised.” On the ground, Hunt says, Mid-Missourians are eager for the facility to be completed. CBHS leadership has made multiple trips to Columbia and every time, Hunt says, the same question pops up: How quick can you get here? “People tell us how excited they are that we’re coming and that we just can’t get there quick enough for them,” Hunt says. “We’re feeling a lot of anticipation from the community, and that excites us, that the community is welcoming us and feels the need for behavioral health and addiction treatment. We anticipate continuing our growth after the hospital is built based on the community needs.” CBHS has been laying the groundwork for this expansion since 2014, starting with the opening of the outpatient facility, through consultations with local providers to see where gaps in services existed, to the certificate of need process with the state review board, and on into the start of construction on CenterPointe Hospital of Columbia. The goal is a one-stop shop for mental health care. “We’ll have 72 in-patient beds, outpatient services, some physician offices,” Turner said. “That allows us to assist patients who need step-down services or after-care appointments. On that same outpatient wing, it’ll also provide some additional group services to adults. You can see patients on an outpatient basis and, many times, prevent an unnecessary hospitalization using that service.” They’ve already seen an overflow of Mid-Missouri residents who need help driving to hospitals halfway across the state. Once the hospital is built, help will be closer to home. “What we didn’t want to do is come in and provide redundant services,” Turner says. “We wanted to start meeting some of those unmet needs.” CBT COLUMBIABUSINESSTIMES.COM 59
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62 FEBRUARY 2018
Doing Well What’s the real value in employee wellness programs? BY M ATT PATSTO N
T
he first scholarly interrogation of the relationship between health and the workplace was published by Bernardino Ramazzini, an Italian physician and professor born in 1633. In 1700, Ramazzini published “De Morbis Artificum Diatriba,” or “Diseases of Workers,” the book that would earn him the title of “the father of occupational medicine.” In the book, Ramazzini recorded and proposed treatments for common ailments associated with workers in 52 different occupations. He observed, for example, the high rates of mercury poisoning that affected Venice’s mirror makers — at the time, most mirrors were manufactured by dipping sheets of tin foil into vats of mercury and then pressing the sheets underneath glass. (This type of mirrormaking practice didn’t cease until the late 19th century, nearly 200 years after Ramazzini, thanks to workplace reforms brought on by the Industrial Revolution. All the mirrors now in your home are probably safe.) Now, imagine you’re a mirror manufacturer in early 1700s Italy. You run a good business, so you have several employees. But there’s a workplace inefficiency that’s vexing you, as it would any business owner — high turnover. You see, all of your employees are gradually losing their peripheral vision, then their coordination, then their ability to speak, and then they’re dying. You
call up Ramazzini. (Well, not “call,” but talk to.) “Ram,” you say, because you’re on a nickname basis with him in this fantasy, “what’s my problem? Why do I have all this turnover?” “Well that’s obviously mercury poisoning,” Ramazzini says. “Probably from all those vats of mercury you have lying around.” What’s a business owner to do? You’re tired of having to train a new employee every time a mercury-addled one can no longer work. Hopefully, you’d have more sense than mirror manufacturers did between 1700 and 1890 — you’d realize that it’s probably worth investing in a different manufacturing process, or at least getting your employees some protective breathing masks. Ramazzini’s motivation for studying workplace health was medical, of course: knowing a patient’s risk factors makes him or her easier to diagnose. But business owners have come to see the bottom-line value in investing in their employees’ health. For much of the 20th century, that meant employersponsored health care — taking on a business expense to recruit good employees and make sure they stay healthy enough to work. But investing in wellness programs — paying for disease management, gym memberships, yoga classes, health coaching, smoking cessation classes, etc. — can have an even bigger long-term payoff for businesses, if they do it right.
COLUMBIABUSINESSTIMES.COM 63
Looking at the Payoff Wellness programs as they’re currently used came about after the 1996 Health Insurance Portability and Accountability Act, which allowed employers to offer financial incentives to employees who participate in a wellness program. The first limit, set in 2006, capped incentives at 20 percent of the overall cost of a group health insurance plan; the second limit, passed as part of the Affordable Care Act, capped incentives at 30 percent, with the possibility of being raised to 50 percent at the discretion of the Department of Health and Human Services. But wellness programs are far from standardized. Companies can work in whatever wellness initiatives they think fit. A smaller company may not offer any incentive for participating, but they may allow employees to leave work early for a group fitness activity, for example — that’s a wellness initiative. In a 2015 Deloitte survey, employees of companies with wellness programs reported that 46 percent offered a financial reward for participating, while another 26 percent offered subsidies, such as a discounted gym membership, for healthy lifestyles. 26 percent also offered non-monetary rewards, like points or recognition.
93% of employers with wellness programs believe they’re important to recruit and retain top talent. Source: Deloitte Surveys of Employers and Health Care Consumers
64 FEBRUARY 2018
These variables make the exact benefits of wellness programs difficult to quantify. Cost savings for some components of a wellness program, like chronic disease management, come in the short-term and are pronounced — companies that help employees manage heart disease have fewer heart attacks. But other benefits, like gym memberships, are harder to see in a balance sheet. You don’t know which otherwise healthy employees would go on to develop health problems without the benefits, and it’s hard to find truly representative control groups to measure against. And again, the modern corporate wellness program is only a couple decades old, so the data showing truly long-term benefits is still relatively scant. A study published in Harvard Business Review in 2010 showed that Johnson & Johnson saved $2.71 for every dollar spent on their employee wellness program from 2002 to 2008. Another study, published by the Rand Corporation, showed a return of only $1.50 for every dollar spent. The vast majority of that was in disease management rather than lifestyle management, which would include something like a free gym membership. The report did note that longterm benefits are more difficult to calculate. Also, obviously, $1.50 is still more than $1.00. As to be expected, business owners are wont to avoid spending money without having a concrete idea of a return. Tom LaFantaine is the manager of Optimus, a wellness-minded fitness center that shares many of the same preventative goals as employee wellness programs. In fact, Optimus is owned by TIG Advisors, formerly The Insurance Group, and TIG employees all have access to the gym. In 2007, TIG and Optimus tried to engage businesses in a wellness program supported by INTERxVENT, a company based in Georgia. They felt comfortable with the proof of results in the program, but LaFantaine says local businesses weren’t biting. “Most CFOs wanted to know how much we could save them in three months — they always seemed to be focused on quarterly profits,” he says. “It simply doesn’t work that way.” Business owners looking for evidence might turn to the Truman Memorial Veterans’ Hospital, which was one of seven veterans’ hospitals selected to pilot test the “Whole Health” program, a patient-centered care approach that shares a preventative philosophy with many of the most robust employee wellness programs. Whole Health pairs VA patients with health coaches, who
help veterans reorient their health around life goals — so rather than asking “What can I do to quit smoking?” patients ask “What can I do to continue working productively into my 60s?” and create a health plan from there. The hospital supports them with classes, checkups, and coaching as needed. “At any other health center,” says April Leverett, manager of the Whole Health program, “it’s basically a disease-driven model — you may come in twice a year for a physical, but predominantly visits occur because somebody has a chronic disease, and it’s either out of control or they’re trying to get on top of it, so the discussions are more around managing their disease. We want discussions about improving their life.” The fact the VA is investing in an approach that shares many components of employee health plans — fitness classes, health coaches, etc. — should encourage businesses to take a closer look. After all, as the insurer of all its patients, the VA has the same financial interest in lowering health care costs that business owners have. “Just like the employer ones, where you’re not going to see the cost benefits that year maybe, or maybe even in five years, down the road, you will,” says Heather Brown, strategic partnership officer at the hospital. “I think that’s good of the VA to look very far ahead and say we’re going to start here, building this model of health, and we know we’re going to see cost benefits down the way, we just don’t have the exact numbers. Just like how most companies won’t.”
Fully Invested In the 2010 Harvard Business Review paper, researchers found that a wellness program’s success was largely dependent on how much it was embedded in company culture. As part of its wellness efforts, one of the companies they researched, Healthwise, instituted an every-other-week tradition of sharing healthy snacks with other employees. “One executive calls it ‘adult recess,’” the authors wrote, “an investment that ‘pays back in spades’ by creating opportunities for crossteam connections.” “What makes an effective wellness program?” LaFantaine says. “A comprehensive wellness program has to be integrated into the company culture and supported by the executive staff.”
Columbia College, while eschewing direct financial incentives, has created a number of wellness initiatives to create a culture of wellness among employees. Faculty and staff have 24/7 access to the campus recreation center, even when students aren’t on campus, and many walk or run on the track at the school’s soccer field. “That’s available even when teams are practicing,” says Sam Fleury, the school’s public relations director, “although you do have to be a little more careful then.” If they want in on the competition, faculty and staff can compete on intramural sports teams alongside students. Early in his tenure, President Scott Dalrymple started a successful intramural volleyball team. The school also hosts an annual health fair in which the HR staff brings around 40 local vendors to campus to connect with staff, faculty, and students. The school also hosts the “Walk Our Way to Wellness” contest across its nationwide campuses every year, where teams log all the steps they take in one day and compete to earn prizes. All these little things have built wellness and health into the workplace culture — Fleury says he’ll even take “walking meetings” when the weather is warm, doing business by walking around the track with a colleague. “I think, when you exercise and you take some time to do something for yourself, you come back to your desk more energized,” Fleury says. “When I go on a walk for 20 minutes, I think more clearly than if I sit in front of a computer for three hours.” Even with small, low-risk wellness initiatives, the college has contributed to a culture of wellness that, at the very least, helps employee morale. “I think it’s just another way to bring people around campus together with something that makes them feel better and feel like a part of something,” Fleury says. Scholarly research on wellness programs has tended to focus on big companies with institutionalized processes, but for small to medium-sized businesses, an effective wellness program can mean something different to different companies. Ultimately, it’s about creating something that both management and employees can be enthusiastic about. “The value is obvious,” LaFantaine says, “Improved employee health, reduced expenditures, and, perhaps, enhanced profits by creating a more productive workforce.” CBT
PILLARS OF AN EFFECTIVE WELLNESS PROGRAM In a 2010 Harvard Business Review article, researchers studying 10 large companies identified six factors that lead to a successful wellness program:
Multilevel Leadership: Companies must designate wellness advocates in each level of leadership, including the C-suite, middle management, and lower-level employees.
Alignment: A company should build a wellness program that fits in with its overall identity and aspirations.
Scope, Relevance, and Quality: Wellness programs should be comprehensive and offer a clear benefit to employees, or else they won’t participate.
Accessibility: Focus on offering no-cost benefits and on-site integration. Make the program as convenient as possible.
Partnerships: Find community partners, including vendors, who can provide some components of your wellness program or enhance what you already offer.
Communication: Make sure you have different ways of getting the word out to employees — simply sending emails won’t do.
Bonus Tip: Focus on offering benefits, not threatening consequences. You can land in ethical and legal trouble if you penalize employees for not participating in your wellness program. COLUMBIABUSINESSTIMES.COM 65
Nine self-care tips to empower your workplace one employee at a time. BY BRENNA McDERMOTT 66 FEBRUARY 2018
READ ALMOST ANY ARTICLE on workplace perks — the internet is awash in them — and you’d think that every business has an on-site gym, massage therapist, and juice bar. Some companies are fortunate enough to provide gym memberships for employees, or leadership coaching. But the reality is most employees don’t get the flashy perks. Many employees work in environments where work–life balance is not fostered. Some can’t even get a quiet 30 minutes to eat lunch. In a fast-paced world with endless meetings, appointments, and distractions, stress can get out of control in the workplace. And there are no guarantees that employers will take the time to care for the emotional needs of employees. Sometimes, it falls to the employees themselves. But there are free and simple (but not necessarily easy) fundamental practices you can use in the workplace to practice self-care, manage stress, and sustain high performance at work.
WHAT IS SELF-CARE? It sounds new-agey, right? Maybe it makes you think of standing on a mountain or acupuncture or kale. It’s really much simpler than that. “Self-care is being aware of your fundamental needs to be healthy and high performing — and then fulfilling those needs,” says Carolyn Paris, a leadership consultant and coach. There’s nothing new about self-care, says Paris, but there is an increasing need for self-care as we increase our number of appointments, meetings, and to-dos. “We’re just adding more and more to our lives, and as a result, we have less and less [energy] available to us,” Paris says. Think about it in these terms: for employers, encouraging self-care sustains your high performers. For employees, the concept is about making a great life, physically, mentally, and emotionally — and part of that is reflected in your work. Self-care is not something you do when you have time: it’s a state of mind, a way to make your life what you want it to be. “It really is what life is about,” Paris says. “Selfcare determines the quality of your life.”
Dr. Anand Chockalingam is an MU Health cardiologist who specializes in wellness and stress reduction. When he sees patients, he’s not just looking at cardiac symptoms. He takes a more holistic viewpoint. Stress, he says, is the elephant in the room. “If we can understand stress, I honestly believe work output would be better, family life would be better, individual health would improve so much,” Chockalingam says. “We can prevent, you’d be surprised, nine out of 10 heart attacks if we recognize and address stress.” Stress leads to bad habits: overeating, smoking, and sleep disorders, to name a few, which lead to hypertension, diabetes, and more physical symptoms. Our increasingly fast-paced way of living contributes as well. “I look at this as one of the most important things to address in order to get so many health benefits downstream over the years,” Chockalingam says. Again, kale smoothies not necessary — in my own experience, sometimes a really, really delicious donut can do just as much to boost your energy. Self-care is about something more basic than your diet. “The way to have sustainable high performance is to plug into the fundamentals,” Paris says. “And the fundamentals are not sexy, they’re not easy, but they’re simple,” Paris says. How to build those fundamental skills, though? Paris suggests setting the intent to make good choices every day, even when faced with the temptation of extra responsibilities that are thrown our way. “It’s so easy to overdo, because then we get that addiction to that adrenaline high, that fast heartbeat,” Paris says. “It’s a hard road [to overwork]. You can do it for a lifetime, but it’s a really hard road and it separates you from having a high-performing, high-quality life.” Chockalingam’s goal is to teach patients to take more responsibility for their own health. He’s so passionate about the topic that he teaches classes on how to smile 20 times a day, how to savor food, how to enjoy life. “I teach people about how to take more responsibility for our own health,” he says. So here we go: some tips and tricks for focusing on self-care that don’t require deep pockets or an advanced psychology degree. COLUMBIABUSINESSTIMES.COM 67
01.
03.
05.
QUANTIFY STRESS
SIT QUIETLY
PAY ATTENTION
Learning to objectively measure the stress we experience can help us manage the feelings we have about it, says Chockalingam. There’s a difference between the stress of being in a car accident and the dayto-day stress we experience; that day to day stress is what he calls perceived stress. “This perceived stress ends up being the biggest bulk of the stress that we undergo in our lives,” Chockalingam says. “So first thing is to understand what it is and to quantify the role of the stress in our individual lives. The next step is
When’s the last time you sat comfortably for five minutes with no technology, no to-dos, and no purpose but relaxation? This can be a simple and fast gateway into mindfulness techniques. When Chockalingam sees a patient for the first time, he might tell that person to sit quietly for five minutes each day and to think about something pleasant. He says the next time he sees the patient, he always hears that they’ve really enjoyed that five minutes. “This is the first step to rest — relaxation,” he says. “The next step is mindfulness, then formal meditation techniques. All this we can gradually incorporate depending on a patient’s level of comfort.”
understanding that this is contributing to my way of living. Then we can address it specifically.” If you can stop and quantify stress, smaller challenges related to that stress will seem more manageable.
02.
GET GROUNDED In high-stress situations, Paris says, we can feel ourselves go out of our bodies and experience extreme anger or nervousness. Grounding is becoming aware of your body, and it can provide relief to strong emotions. Paris suggests literally putting your feet down on the floor and feeling the ground beneath your feet. 68 FEBRUARY 2018
04.
REST Gone are the days of bragging about getting two hours of sleep. It’s now out of fashion to be the overworker on the team. Rest doesn’t just mean getting enough sleep though. It’s also about stepping away from work and taking breaks, whether it’s a walk around the building a few times a day or not checking email on the weekend. Paris relates it to the sharpened saw analogy, originally used by Steve Covey, the author and business speaker. “The blade gets dull and you have to push a little bit harder and it takes a little bit longer,” Paris says. “But if you stop and sharpen the saw, when you start back in, your blade is sharp and you can just go right back to work.”
Mindfulness might seem like a challenging concept, and meditation even more so. It’s simply a way of introspection, Chockalingam says. It’s being more aware; it’s thinking about what we’re thinking. As life gets more stressful, he says, “The best way to cope with that is becoming more present in the moment.” This means savoring the food you eat, noticing the taste of coffee, feeling yourself sitting in your chair. Play some calming music and hear the individual notes playing. When Paris starts out coaching a new client, often her first assignment is to practice self-awareness. Awareness will be the key to the next steps. “Until they have awareness,” she says, “there’s nothing to do.” As you go through your week, ask yourself to notice the situations that cause you stress. When does your chest tighten? Is it often in a particular situation? Maybe jot it down in a notebook. “Once we’re able to notice it, then we can be in choice, and until we notice it, we have no choice,” Paris says.
06.
GET VULNERABLE This tends to be a tough to-do item in the workplace — it’s not typically the setting where most of us want to let our guard down. “Most leaders think that they have to be invincible and cannot
show any vulnerability for fear of looking wrong,” Paris says. “That trickles down to everyone else on your team.” But being vulnerable about your stress level or personal challenges you’re overcoming can allow others to support you through your challenges. And leaders, if you’re concerned about a high performer, you can’t expect them to be vulnerable with you if you’re not willing to do the same with them. “Share about yourself and be open and vulnerable to them,” Paris says. “Say ‘I don’t know what it’s like for you, but here’s what it’s like for me. I want to have a conversation to be able to support you through this.’” And then, once you’ve been vulnerable with the people around you, consider also putting in place boundaries to protect yourself. Set self-imposed prohibitions on answering work questions after 5 p.m. Insist on taking breaks throughout the day — it helps you do your job better. Refuse to pretend that working 60 hours a week is giving you the fun, satisfying, powerful life you want.
07.
GIVE YOURSELF THE PRESENT Ever been in a conversation where you’re certain the other person isn’t listening, or isn’t really “there”? Paris says listening is key to being present with others. “Being present raises a level of trust, and being present allows for creativity and authenticity,” she says. Check in with yourself privately before a meeting. Close the door of your office or step outside for a
moment. Who are you being right now? Are you forgiving? Are you resentful? Are you feeling generous or stingy? “We have no control over our environment, really,” Paris says. “There’ll always be challenges and circumstances . . . but how we show up is what we do have charge over.” Being aware of our own behaviors and tendencies enables us to “walk the walk,” Paris says. Be present in your nervousness leading up to a hard conversation. Be present to irritation when coaching an employee. Be honest with yourself about your feelings. It might lead to some discomfort initially, but dealing with feelings and emotions is essential. “Most of us try and numb out, inhale our feelings, drink our emotions,” Paris says, “and so when we show up, we have less resiliency, because we’re not in our top sustainable high performance.”
08.
BREATHE DEEP If you snicker at the idea of meditation, consider that terrible feeling you get when you’re nervous or scared and your chest tightens. Your body is not getting air, your brain is not getting oxygen. Practicing deep, cleansing breaths can be a lifelong stress reliever — and once you’ve done that, you’re basically already meditating. It’s simple to start: pause, close your eyes, and breathe as deeply as you can. “That gives you access to a whole new level of performance,” Paris says. “When we’re preoccupied, we tend to breathe more shallow,” Chockalingam says. “If you take a
deep breath, you may find that the coffee in front of you right now tastes a little bit better. Our mind becomes more perceptive once we take a deep breath. We’re able to become more alive directly with a deep breath.” Yoga is a good way to practice breathing, but you can also just sit and take 10 deep breaths. “If we fix the breathing, we can even fix the perspective of what we’re [experiencing],” Chockalingam says.
09.
CAST VISION How do you create your ideal working situation? Your ideal life? You envision it. Paris suggests creating a full, descriptive picture of what a fun, satisfying, powerful life looks like for you. Maybe it’s achieving an advanced degree, or getting home at 5:30 each night instead of 7:00. Whatever’s missing in your life, create action items that will help you head in that direction. And don’t keep that information to yourself. Paris suggests sharing your goals with a trusted friend, mentor, or coach. They’ll help hold you accountable, and they may even share the same goal. “So many times, people try and do it alone. You have your goal setting and it never works out,” Paris says. “Cynicism and resignation about people leads to laziness in our leadership.”
Self-care doesn’t have to cost a dime, and it doesn’t have to be complicated. Mostly, it’s about taking time for yourself and learning to be aware of your feelings and reactions. Simple, but not necessarily easy. CBT COLUMBIABUSINESSTIMES.COM 69
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IN FOCUS
“HIGH” PRESSURE
Performance enhancing drugs creep into the workplace. BY BRECK DUMAS COLUMBIABUSINESSTIMES.COM 71
IN FOCUS
O
ver a dinner conversation with my husband’s extended family a few months ago, his cousin mentioned that another college student at MU had recently overdosed on Adderall in the library. He said they must have taken an “insane” amount to actually OD. I had questions: what is this stuff? How did the student get it? Why would they do that? It seems this prescription, intended for treating ADHD, is popular among students to help them focus. Since it’s widely prescribed, it’s widely purchased on the street and widely used. “You think usage at college is bad?” his sister piped in. “Look into how many accountants in the big city firms are taking uppers to get ahead.” What? “Oh yeah,” said another family member who used to work in high-pressure sales, “in my last job, the drug of choice is cocaine — the work has gotten so competitive and the hours so long that people are taking anything to either keep up or get to the next level.” I needed answers. Have I been competing all these years with the Lance Armstrongs of the business world? So I asked a few friends. One told me “Breck, the last thing you want to do is write something that makes people think their car salesman is high.” Another friend, a counselor, confessed, “Sure, we know it’s out there, but the numbers are too tough to find — most of these ‘addicts’ are highly functioning, so they don’t seek treatment.” Turns out a recent survey conducted by detox.com found that 7 out of 10 employees have done drugs while at work. It sounded a little tough to believe, unless they’re including over-the-counter medications. Besides, the name of the website alone makes me wonder if users would be more likely to respond than non-users. (1,100 people were part of study.) Regardless, it’s worth noting that the majority of participants were in the retail and food service industries, with the third and fourth highest representation reportedly coming from education and health care. Even if the number of workers partaking is at a fraction of what the detox.com survey found, we’re looking at a quiet undercurrent across the workforce: the use of super-stimulants. Coffee or Red Bull don’t cut it anymore, so ADHD drugs like Ritalin and narcolepsy treatments like Modafinil are being used by workers to focus and maintain longer hours. These are the new ‘smart drugs.’ Also, just like Adderall has followed its users from high school to college to that eventual posh corner office, steroids are trekking a similar journey into the blue collar workplace. Back in 2007, Dr. David Martin and attorney Steven Gold published an article in Occupational Health and Safety magazine, warning employers of some studies showing staggering estimates that around 10 percent of high school males could be abusing steroids — and those former students have
Ironically, Livestrong. com (founded by Lance Armstrong) has compiled a list of the 10 most abused prescription drugs. They’re listed in alphabetical order, since the statistical data acquired was not consistent enough to provide usage rank:
• Adderall • Ambien • Codeine • Hydrocodone • Lunesta • Fentanyl • Morphine • Ritalin • Valium • Xanax
72 FEBRUARY 2018
P e r fo r m a n ce E n h a n c i n g D r u g s i n t h e Wo r k p l a ce now trickled into the workforce. Maintaining the physical demands of some positions has meant an uptick of usage; but a dock worker isn’t typically held to the same drug testing standards as Major League Baseball. Alcohol, of course, remains the drug of choice for most American workers — it’s linked with a loss of productivity ranging from $33 billion to $68 billion per year, according to U.S. Office of Personnel Management. Conversely, “smart” drugs are seen to enhance worker performance; that means more money for the worker, more money for the employer, and more money pumping through the economy. And the incentive for employees to push themselves past their limit is as present as ever — even though there’s been a lot of talk about work–life balance in recent years, it doesn’t come with a mandate. Encouraging employees to take a certain amount of vacation days or supporting their leaving early to coach Little League doesn’t prevent the occupant of the cubicle next to them from putting in more time, sometimes equating to higher performance numbers and, ultimately, a promotion or a raise. Getting ahead at any cost matters more to some employees than others, and that’s difficult to change through policy. But the competition isn’t just limited to the workers next to you. In 2008, a survey conducted by the academic journal Nature found that, out of 1,400 respondents from 60 countries, one in five said they had used brain-boosting pharmaceuticals for non-medical reasons — primarily for the purpose of increased concentration, memory, and focus. I got more insight from a local therapist who treats families and individuals, Stephanie Parsons, of Counseling Associates. Parsons confirmed that workers who are at the greatest risk of abusing these drugs tend to not only be high functioning, but also in professions that emphasize “being the best.” She cited physicians, attorneys, and salespeople. And having easy access doesn’t help the problem. “Doctors, nurses, pharmacists, [medical] residents are sometimes expected to work
Abusers can blend in, given that the side effects of stimulants — increased energy, alertness— are also perfectly normal traits of high performers in demanding industries.
30-hour shifts, and sleep is not always a part of those shifts,” Parsons says. “These are professions where you have to be on your game at all times, sleep or not. It’s no surprise that these drugs are overused in professions like those. They’re also readily available.” Obtaining a prescription is based on simple, self-reported symptoms to a general medical doctor. “Anyone can read up on and report symptoms to obtain these drugs,” says Parsons. We can’t dismiss the legitimate diagnosis of ADHD or any other condition for which these prescriptions are needed — “Prescription and use do not equal abuse,” Parsons says. And abusers can blend in even more easily, given that many of the side effects of these drugs include increased energy or alertness, traits that aren’t at all abnormal among high-performers in demanding
fields. Rooting out stimulant abusers is not something you could easily pursue with a witch hunt. Further, there’s little incentive for an employer to do so: this isn’t the Tour de France, and the race in the workplace is a different type of competition. There is little reason for an employer to level the playing field, or to scrutinize their top performers. Particularly when it comes to legally obtained neuroenhancers, as the stigma toward them decreases, usage is expected to rise, according to Nature. It seems this new method of gaining an edge might be here to stay for the foreseeable future. As one survey respondent put it, “It’s my duty to use my resources to the greatest benefit of humanity. If ‘enhancers’ can contribute to this humane service, it’s my duty to do so.” CBT
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OR G A N I Z AT I ON AL H EALT H
by claiming that’s “just how you are.” You do need to maintain some decorum and dignity if you want to gain respect. But always be yourself, and approach every experience with your unique perspective. If something doesn’t go right, ask yourself: what is the gift here that I can use and learn from to be a better me?
ORGA N I Z AT IONAL HE ALTH
Five Keys to Doing High Performance Work BY TONY RICHARDS | Founder of Clear Vision Development Group
AS A HUMAN BEING, you’re built to be creative. For too long, we’ve categorized creativity into something synonymous with the arts. We look at songwriters, painters, or sculptors as creative people. But you, as a human being, create things every day. Sometimes we create fantastic interactions with people; other times, we create drama. Sometimes we create documents, sometimes spreadsheets. You are creative no matter what you produce, and when you’re really good at what you do, you gain the respect of others, especially your peers. The first key to doing high performance work is to realize you are a creator that has the power to produce the life and work you want. You are not a powerless victim without any options. When you make the decision on where to focus your creativity, you must ask yourself what your creation will lead to: is it more money or less money? Is it more vacation or less vacation? Is it adding to my credibility or taking away from it?
1. Practice innovation and imagination. Innovation is nothing more than making everything you come into contact with better than it was before. It allows you to be more of an artist. Use your imagination and make things around you more brilliant. Ask yourself: what new approach can I take to my work? 2. Put some ‘wow’ in everything you do. When you go to work, operate at a level beyond what’s expected. Think of what you do in three different categories: the Expected, the Nice Surprise, and the Wow. Ask yourself: How can I can make a given scenario work better? How can I offer greater value and get to the next level of performance? 3. Be the real you. The best performers in any industry are those who are authentically themselves. This does not mean you get to excuse rudeness or impolite behavior
4. Exercise courage. Courage is what will drive you forward to try new things and increase your capabilities. No person is good at something the first few times they attempt it. We tend to look at masterful performers and just assume they’ve always been that way. Not true. It takes work to get better, and it takes courage to work. High performers know that the commitment they’ve made means they have to continually try new things in order to stay relevant. If you can’t seem to generate the courage you need to journey into those areas, ask yourself: do I have a strong enough commitment to be the best at what I do? 5. Be true to your ethics. It could take 15 years just to become an “overnight” success, but you can lose it all in 30 seconds of bad judgment. One moment of moral or ethical weakness can cost you everything you’ve worked so hard to achieve and attain. Ask yourself: If I were to read about me doing this on the front page of the newspaper tomorrow, would I still do it?
ACTION STEPS • Writing in your journal is a real conversation with yourself. In your journal, write about playing at your best level. What are the five things that need to happen for you to have a remarkable day? • Spend some time learning every day. The American Society of Training & Development says the average employee spends only 30 hours a year working on their craft. No wonder there’s so much mediocrity out there. This is where you can create a big advantage! • In the next seven days, do one thing at your work you’ve been resisting. Oftentimes, that’s the thing you need to do to get to the next level of performance. CBT COLUMBIABUSINESSTIMES.COM 75
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76 FEBRUARY 2018
B U SINESS • P EOP L E • IM PROVE M E N T • F YI
M AR KET I N G
Types of Ads that US Internet Users Trust When Making a Purchase Decision, Oct. 2016 Note: n=2,400 ages 18+ Source: MarketingSherpa, “Customer Satisfaction Study.” Dec. 12, 2016
69%
39%
37% Ads in Podcasts
25% Digital Pop Ups
39%
Mobile Phone Ads
43% Ads embedded on Social Media
43% Sponsored posts on blogs that I read
(Google, Yahoo, Bing, etc)
Video Ads that appear prior to a digital video
47%
Online Banner Ads
61%
Search engine ads
(Like billboards, transit ads, posters, etc.)
Ads in outdoor & public spaces
71%
Radio Ads
76% Ads/catalogs I receive in the mail
80%
TV Ads
Print Ads (newspaper, magazines)
82%
MA RKET I NG
Building Trust in 2018 BY JAMIE PATTERSON | Vice President of Marketing and Business Development, JCMG
Market Fragmentation: “The emergence of new segments (in a previously homogeneous market) which have their own distinct needs, requirements, and preferences. These fragments reduce the effectiveness of mass marketing techniques and erode brand loyalty.” (BusinessDictionary.com) With the internet and social media, consumers no longer have to “take our word for it.” They can research and learn with devices in the palm of their hand. And with all this information, they can more easily develop their own individual and unique product preferences. The market is becoming fragmented. As the digital age proceeds full-speed ahead, modern marketers turn to internet marketing more and more. Digital conferences, webinars, seminars, and tutorials are a dime a dozen. And rightly so — while the advent of connectivity and digital communication has created the challenge of market fragmentation, digital marketing also offers us the best and most advanced solution to this new problem. Digital advertising is the platform that most effectively enables marketers to serve hyper-customized messages to fragments (not just seg-
ments) almost immediately when the consumer has a need (or even slightly before — see my previous article on predictive advertising and the death of search). So it’s no wonder that many organizations are making massive marketing budget shifts to digital. But there’s just one problem, and in an age of eroding brand loyalty, it’s a big one: digital advertising is the least trusted form of advertising among consumers making a purchase decision, according to an extensive research study by Marketing Sherpa in late 2016. Among digital ads, website pop-ups are the least trusted, which makes sense to me — when I see those, I think it’s a virus and close the window as fast as I can. Social media ads on Facebook or Twitter are slightly more trusted, but not by much, and they tie with sponsored posts on blogs. Video ads and search engine ads fall in the middle of the pack as far as purchase-decision trust, although we know (thanks to SearchEngineWatch.com) that 90% of people do not click on paid search ads and choose organic results instead.
These findings are significant. As consumers have developed hundreds of unique needs and preferences, we’ve developed remarkable technology to serve them ads with the right message at the right time and in the right place. However, these fragmented consumers are also not brand loyal — so these well-messaged and welltimed ads are doing little to build trust or loyalty. In fact, they may be further eroding loyalty, reducing trust, and negatively impacting conversions and purchases. So what do you do? Interestingly, Marketing Sherpa found that print platforms — magazines and newspapers — are the most trusted advertising platform. 82 percent of respondents said they trust print advertisements when making a purchase decision, but only 39 percent trust a mobile or banner ad online. TV ads are almost as trusted as print ads, pulling 80 percent of respondents. Catalogs and direct mail are well-trusted also, which surprises me, since direct mail is known as a low-response and low-engagement channel. Radio makes the cut of trusted advertising platforms as well, rounding out the top four with 71 percent of respondents reporting trust in ads heard over the airways. Over the course of my career, I’ve seen considerably better results when digital is used in combination with another medium. The combination of targeted digital advertising plus print or TV advertising may balance the scales by efficiently delivering your message on one channel and building trust on the other. Recommendation for Smaller Budgets: If your budget is limited, go digital. Try out social channels, particularly Facebook News Feed or audience network, and read up on SEO. Hiring an SEO company is expensive, but SEO is not rocket science. A few hours of work a month may make a big difference in your search visibility, which is the holy grail of trusted digital marketing. Recommendation for Larger Budgets: Combine digital and print or TV! Print is not dead — building trust is critical in the modern age, and it’s very hard to do in our fickle world. A trust-building platform like print, TV, or radio may seem like an inefficient use of resources, but it may not be if consumers trust the ads they receive there. CBT COLUMBIABUSINESSTIMES.COM 77
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POLI CY
are dedicated to capital improvements, parks and recreation, transportation, hotels, gasoline, and motor vehicle taxes, to name a few, and are restricted for their purpose. The current strategic plan was drafted in October 2015 to reflect 2016 through 2019 and included five pillars. 1. Economy: Create more jobs that support families. 2. Social Equity: Improving the odds for success for every citizen.
P OL IC Y
Local Agenda: The City Budget
BY JERRY DOWELL | Director of Government Affairs, Columbia Chamber of Commerce
FOR THE SECOND YEAR, the Columbia Chamber of Commerce has produced a local agenda intended to help direct and steer the policy discussion with our local leaders and elected officials. One of the agenda items is about the City of Columbia’s operating budget. The fiscal year 2018 budget approved by the City Council in September expends an estimated $455,718,617 with an expected revenue of $432,537,592. I know that, from the outside, the numbers don’t appear to balance, but departments are allowed to save money over several years and then expend that money in later years for planned capital projects, which can cover some of the difference. The actual budget document for the city is nearly 700 pages in length — you could probably count on two hands the number of individuals that have read the entire document and can truly understand how we’re spending our money and whether that spending reflects citizen identified priorities. I’ve read all 698 pages and I have no idea where to begin to explain the complexities that exist. So where do we start? The budget covers 20 city departments, 52 separate spending plans, and hundreds of service-line items. This process of producing the next budget starts even before the current budget is adopted, and the budget is
tracked line by line throughout the year before the city manager presents it to council at their first meeting August. Then there is public comment at the next three regular council meetings, with a work session scheduled to take further testimony from the public and to debate the merits of budget amendments by staff, citizens, or council members. Final approval is required before the new fiscal year starts on October 1. Within every department, spending plan and service line items, the expenditures are accounted for in seven different types of funds: the general fund, capital projects fund, debt service funds, enterprise funds, internal service funds, special revenue funds, and trust funds. Where does the money for each of those funds come from? Exactly nine different sources: taxes, intragovernmental money, grants and capital contributions, interest, transfers, fees and service charges, other local revenue, lease and bond proceeds, and appropriated fund balance. If that’s not complicated already, each funding source is either dedicated or restricted for a particular service or use. A fee or service charge that supports a specific city activity can only be used for those services. Taxes, the second largest source of revenue for the city, includes voter-approved sales taxes that
3. Public Safety: Making citizens feel safe wherever they are. 4. Infrastructure: Connecting the community and building for the future. 5. Operational Excellence: Improving workforce performance, engagement, and satisfaction. The city manager has dedicated 10 pages inside the budget to further detail the outcome objectives, actions to be taken, and performance measures to be used to judge our progress on these pillars. So how can we as individuals be part of this process? This brings me back to the Columbia Chamber of Commerce’s local agenda and our priority to encourage the City Council to align the City Budget with citizen-identified priorities. We as the chamber and we as citizens need to be involved in every step of the process. We’ll engage businesses and citizens to voice their ideas when the next strategic plan is developed in 2019. We’ll encourage community leaders to speak up at a city council meeting when the budget is being discussed. We will be a convener of groups to tackle problems using teamwork and communication. I’m reminded of a quote by James W. Frick, a former vice president for the University of Notre Dame who raised hundreds of millions of dollars for their endowment: “Don’t tell me what your priorities are. Show me where you spend your money and I’ll tell you what they are.” As I advocate on behalf of the Columbia Chamber of Commerce’s nearly 1,000 members, I’ll try to do my best to identify opportunities to bring transparency and participation to craft a budget that reflects our priorities. CBT COLUMBIABUSINESSTIMES.COM 79
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B U SINESS • P EOP L E • IM PROVE M E N T • F YI
R EAL ESTAT E
tices that existed for many years are being displaced by large practices with multiple physicians. As a result, medical space that is geared towards smaller practices may see greatly diminished demand if it can’t adapt to facilities able to accommodate large occupants. Another factor impacting medical space and its location is the patient’s preferences as to where they obtain their services. Generally, medical space is located in two geographic distinctions: 1. ON-CAMPUS SPACE — meaning on a hospital campus, where a patient may be traveling some distance from their home or workplace but is visiting their provider on a campus with other specialties and ancillary services present, both inpatient and outpatient.
R EA L ESTAT E
Taking Stock of Medical Office Space BY MIK E GRELLNER | Vice P re side n t , P laza Co m m e rc i a l Re a l ty
MEDICAL OFFICE REAL ESTATE has emerged as a significant and robust subclass of office real estate. (The category can be very broad and include everything from a hospital facility to a chiropractic office.) There’s been exponential growth in this market segment in recent years, and current demographic trends indicate that the growth trend will continue for decades to come. An aging population, coupled with the mass retirement of the baby boomers, will presumably spur demand for medical services required by that population. Simply put: demand for those services creates demand for the real estate that houses them. Hence the rise of medical office space. This apparent demand has also made medical office space a preferred product type for investment buyers who anticipate consistent and certain income in the foreseeable future. However, within this generally positive outlook for medical office space, there are some tones of unpredictability.
Patients’ penchant for convenience may further shift the medical real estate landscape. First, there’s the ongoing possibility that the Affordable Care Act may be altered, or completely overhauled, or completely scrapped, which would cause some unpredictability in certain medical practices’ revenue model. Additionally, we have been in, and likely will continue to be in, a massive shift toward consolidation of larger medical practices and organizations, along with their corresponding facilities. The small one- and two-physician prac-
2. COMMUNITY SETTING — meaning a clinic or outpatient facility that’s located in a community-based setting, amongst rooftops, and geared to be convenient for the patient. Usually, these are a short distance from a patient’s home or workplace. The consumer trends in recent years have demanded convenience, sometimes in the form of “convenienent care” clinics located in the community retail setting. The future may require services to become even more convenient to the consumer. There’s some chatter in the industry of clinicians practicing inside of grocery stores and pharmacies such as Walgreens and CVS. Should the industry respond and accommodate that consumer preference, it could redirect demand from on-campus space and other large clinical facilities into community-based medicine that blurs the line between clinical and retail space. On a local level, the medical industry, and the corresponding real estate that serves it, has thrived. Columbia now has several hospital campuses and significant specialty facilities that have made our community a regional draw for health care services. This is among the reasons that the recession didn’t hit Columbia with the same ferocity it hit other communities, and we recognize that to the point that “medical tourism” is now being focused on as an asset that we’ll attempt to nurture in the future. If we’re successful, our community will see robust economic growth as a result. And I believe that will translate to high occupancy rates at both on-campus and community-based clinics. CBT COLUMBIABUSINESSTIMES.COM 81
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ASK AN N E
are criminal, they must be reported to the authorities. Sexual harassment can emotionally cripple people, often ruining their careers. Watch the news and you’ll see.
Q A SK A N N E
Stopping Sexual Harassment
BY A N N E W ILLIAM S | P re side n t , JobF in de rs E m p l oy m e n t S e r vi ce s
Q The topic of the day is sexual harassment. Do you have any advice on how to keep it out of our workforce?
Sexual harassment is not a new problem, but it has been hidden, for the most part, for as long as I can remember. It’s been brought up on occasion, but one-on-one cases are about all I remember hearing. I surely have never turned on the daily news and been bombarded with a new “celebrity” name being accused of sexual harassment before the last few months. Sexual harassment is bad for everyone and everything to do with a company. The goal is not to have it anywhere, let alone the workplace. And I do think there are some steps a company leader must take to help prevent sexual harassment in their workplace. It starts at the top! Not with the HR folks putting out a Sexual Harassment Statement that says “it’s not tolerated.” I’m saying it starts with the CEO, president, or owner. The person in charge — the person with the power — is the right person to deliver and act out the message,
which should be “there is zero tolerance for sexual harassment.” This person should live and breathe the message. If the CEO has trouble with this, perhaps due to their own indiscretions, they need to go. Another practical idea is to build the “zero tolerance rule” into everyone’s performance evaluation. With a one-strike-and-you’re-out rule, employees will stay on their toes. They’ll be more aware of what they do and say and hear. (I know most people think I’m referring to men in this answer, but for the record, women are sexual harassers too. And women do wrongly accuse men occasionally.) The lack of a safe place to report if you’ve been sexually harassed is one reason it goes unreported. Often, women don’t feel comfortable talking to their male bosses, or vice versa. I would suggest putting some space on your website where your employees could write in to report sexual harassment, or perhaps have a designated voicemail so the offended could leave a message. It needs to make the employee feel safe. It’s the job of the CEO and the managers to promote its use. Lastly, whatever you do as a company, don’t let this matter slide. Once reported, an investigation must be done, and if the actions
I manage a company with about 35 employees. We have an onboarding process that entails a meet-and-greet, completion of new hire, and benefits paperwork, and then the hire starts learning our software or reading our website. After that, we have a learning schedule and that’s about it. We do check on them periodically, but I know there must be more we can do to make the new people successful. Can you give me some ideas?
Most managers and owners are so relieved that they’ve filled an opening that they don’t think much about onboarding, much less getting a new person integrated into the company. Larger companies generally have an established process, but smaller companies should too, even if it’s not as extensive. Some companies will have seasoned employees talk about how stressful situations are handled, what they do on birthdays, or, perhaps, what the boss is like. If your company is big enough, assigning a mentor is a great idea. Formal mentoring can be weekly for the first 60 to 90 days and then upon request. The mentor can be an invaluable source of support. Supervisor meetings on a regular basis are vital. Bosses, put them on your calendar. You’re the people that matter, and new people need to know where they stand with you. Make sure the new employee is a cultural fit by talking about the contributions team members make regarding goals, projects, outside-the-office activities, etc. It’s a time you get to know the new employee and make sure they fit into your organization. During the first 90 days, you should learn if the new hire is a fit or not. No one wants to make a bad hire, but if it happens, it’s better to say goodbye quickly. Hope it doesn’t happen to you! CBT Anne Williams is not an attorney. All content in this column is not guaranteed for accuracy and legality and is not to be construed as legal advice. COLUMBIABUSINESSTIMES.COM 83
olumbia Region al A by C irp red or we o t P
TOP
CBT’s
OF THE
TOWN 2017
TOP PLACE TO WORK – 1-25 EMPLOYEES
TOP ARCHITECT
TOP ADVERTISING AGENCY
TOP ACCOUNTING SERVICE
1st Place: Columbia Eye Consultants 2nd Place: Caledon Virtual
1st Place: Simon Oswald Architecture 2nd Place: PWArchitects
TOP PLACE TO WORK - 26-50 EMPLOYEES
TOP HR FIRM
1st Place: True Media 2nd Place: Visionworks Marketing Group
1st Place: Williams-Keepers LLC 2005 W. Broadway, Columbia 573-442-6171, williamskeepers.com
1st Place: Woodruff 2nd Place: Century 21 Advantage
1st Place: Moresource, Inc. 2nd Place: Accounting Plus 1604 Business Loop 70 W. B, Columbia 573-445-3805, accountingplusinc.com
TOP PLACE TO WORK - 51+ EMPLOYEES 1st Place: Veterans United Home Loans 2nd Place: Central Bank of Boone County
TOP EMERGING PROFESSIONAL 1st Place: Amanda Quick, The Hatchery 2nd Place: Brandon Banks, Modern Media Concepts
TOP SEASONED PRO 1st Place: Eric Morrison, Providence Bank 2nd Place: Gina Gervino, Columbia Insurance Group
TOP COMMERCIAL REALTOR 1st Place: Paul Land, Plaza Commercial Realty 2501 Bernadette Dr, Columbia 573-445-1020, paulland.com
TOP SALESPERSON 1st Place: Brooke Berkey, Central Bank of Boone County 2nd Place: Danny Gingerich, Joe Machens Toyota-Scion
TOP CHAMBER VOLUNTEER 1st Place: Tom Trabue, McClure Engineering Co. 2nd Place: Sherry Major, Columbia EDP
TOP CEO 1st Place: Steve Erdel, Central Bank of Boone County 2nd Place: Gary Thompson, Columbia Insurance Group
TOP BANK 1st Place: Central Bank of Boone County 2nd Place: Landmark Bank
2nd Place: Gina Rende, Maly Commercial Realty
TOP COMMERCIAL LENDER
1st Place: Coil Construction 2nd Place: Little Dixie Construction
1st Place: Chris Widmer, Landmark Bank 2nd Place: Chris Rosskopf, Central Bank of Boone County
TOP REAL ESTATE DEVELOPER
TOP BUSINESS INSURANCE
1st Place: Mike Tompkins, Tompkins Homes & Development 2nd Place: Jay Lindner, Forum Development Group
1st Place: Stephanie Wilmsmeyer, State Farm 2609 E. Broadway, Columbia 573-445-5774, insurecomo.com
TOP COMMERCIAL BUILDER
TOP PLACE TO CLOSE A DEAL 1st Place: 44 Stone 2nd Place: Boone-Central Title Co.
TOP STAFFING COMPANY 1st Place: JobFinders Employment Services 1729 W. Broadway #4, Columbia, 573-446-4250, jobfindersusa.com
2nd Place: Kelly Services
TOP JANITORIAL SERVICES 1st Place: Atkins, Inc. 2nd Place: Safi Sana
TOP HAPPY HOUR 1st Place: Logboat Brewing Co. 2nd Place: The Roof
TOP IT COMPANY 1st Place: Midwest Computech 311 Bernadette Dr., Ste. A, Columbia 573-499-6928, midwestcomputech.com
1st Place: Fresh Ideas Food Service Management 2nd Place: Missouri Employers Mutual
1st Place: LG Patterson 2nd Place: Casey Buckman
TOP COMMERCIAL VIDEOGRAPHER 1st Place: The Evoke Group 2nd Place: Cosmic Sauce
TOP EVENT LOCATION 1st Place: Logboat Brewing Co. 2nd Place: Stoney Creek Hotel & Conference Center
TOP PLACE FOR BUSINESS LUNCH 1st Place: Addison’s 2nd Place: D. Rowe’s
TOP COFFEE MEETING LOCATION 1st Place: Kaldi’s Coffee 2nd Place: The Grind Coffee House 2nd Place: EasyPC IT & Computer Repair
TOP NATIONAL PRESENCE 1st Place: True/False Film Fest 2nd Place: Veterans United Home Loans
TOP CATERER 1st Place: Bleu Events 2nd Place: Hoss’s Market 1010 Club Village Dr., Columbia 573-815-9711, hosssmarket.com
TOP WEB DEVELOPER 1st Place: Hoot Design Co. 2nd Place: Delta Systems
TOP B2B PRODUCT OR SERVICE
1st Place: Crockett Engineering 2nd Place: McClure Engineering Co.
1st Place: GFI Digital 2nd Place: CoMo Connection Exchange
2nd Place: Columbia Insurance Group
TOP OFFICE DIGS
TOP COMMERCIAL PHOTOGRAPHER
TOP ENGINEER 84 FEBRUARY 2018
2nd Place: Accounting Plus
TOP LOCAL TEAM-BUILDING EXPERIENCE 1st Place: Breakout CoMo 2nd Place: Escape Plan
BU SI N ESS • P EOPL E • IM P R OV EM EN T • FY I
New Business Licenses FEBRUARY 2018
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1401 Forum Blvd.
Barber shop
573-445-7772 Retail meat
KC Construction
Columbia Culinary Tours LLC
1902 Old US Hwy 40 E.
2105 Bay Brook Dr.
704-657-5097
573-268-6087
Light construction
Tourism service
Culver’s
2520 Broadway Bluffs
Superior Transitions LLC
Wills & Trusts Business Law 303 N. Stadium Blvd. Suite 200 Columbia | 573-874-1122 NathanJonesLaw.com
1511 Timber Creek Dr.
573-239-8786
573-239-2182
Fast food franchise
Staffing agency
The choice of a lawyer is an important decision and should not be based solely upon advertisements. CBT COLUMBIABUSINESSTIMES.COM 85
B U S I N E SS • P E O P L E • I MP R OV E M E N T • F Y I
DEEDS OF T R U ST
Deeds of Trust WORTH MORE THAN $810,775
$600,000,000
$2,800,000
$1,048,000
Y R C INC.
Rader Family Limited
White Oak Investment
Credit Suisse AG
Partnership THE
Properties LLC
LT 4 CONCORDE EAT
First State Community Bank
U M B Bank
PLAT 1
LT 17 ROCKBRIDGE SUB
STR 24-47-12 //W SUR BK/
BLK 9
PG: 383/120 AC 29.88 FF
$39,440,000
Ryan Boone County LLC Associated Bank STR 11-47-13 //NW SUR BL/ PG: 328/236 AC 2.29 FF TR $34,560,000
Partnership for Kelly Farms
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of Columbia LP Central Bank of Boone County LT 101 KELLY FARMS
W/EXCEPT $2,800,000
Bryant Walkway II Housing
$1,008,000
Development Group LP
A G Marketing Partners
U M B Bank Trustee
LLC
LT 1 BRYANT WALKWAY
Missouri Bank II THE
APARTMENTS II – EAST
LT 102 BG 100 LEXINGTON SQUARE
$2,600,000
CONDOS
B C Investments of Columbia LLC
$968,000
$28,652,000
Landmark Bank
Dgogharrisburgmo LLC
Dri/Ca Columbia LLC
STR 29-49-12 //NE
Bank of Missouri THE
P N C Bank LT 1 SAM SUB
STR 11-50-14 //NW SUR $1,520,000
BK/PG: 3093/92 FF
Burlington Vandiver LLC
TRACT A
$5,989,000
Callaway Bank THE
Bryant Walkway Housing
STR 30-49-12 //SW SUR BK/
Development Group LP
$875,000
PG: 414/115 FF PT LOTS 1&
Puckett, Loy C & Lynn D
Missouri Housing Development Commission LT 23 PT CROUCH ADD $3,690,000
Wilcox Properties of Columbia LLC American National Bank LT 1 CANDELELIGHT TERRACE
Wells Fargo Bank $1,290,000
LT 232 THORNBROOK
Bryant Walkway II Housing
PLAT 4
Development Group LP Housing Authority of the
$810,775
City of Columbia Missouri
Bianco, Frederick John &
THE
Sarah Jo
LT 1 BRYANT WALKWAY
Landmark Bank
APARTMENTS II -EAST
STR 8-47-11 /E/SW SUR BK/PG: 4331/31 AC 10 FF
StudioHomeInteriors.com 573-445-4122 1029 E. Walnut St. Columbia
86 FEBRUARY 2018
$3,250,000
$1,085,000
Grantwood Village LLC
Js Gerau Properties LLC
First State Community Bank
Central Bank of Boone County
532 deeds of trust
LT 12 GRANTWOOD
LT 31 EASTPORT
were issued between
VILLAGE
GARDENS PLAT 1
12/4 and 1/3 CBT
TRAC
BU SINESS • P EOP L E • IM P R OV EM EN T • FY I
Economic Index LABOR
HOUSING December 2017
UNITED STATES
Labor force: 160,466,000
Total single-family
Employment: 154,180,000
home sales: 144
Unemployment: 6,286,000
Existing single-family
Rate: 3.9 percent
home sales: 127 New construction single-family
MISSOURI
Labor force: 3,021,930 Employment: 2,925,830 Unemployment: 96,100 Rate: 3.2 percent BOONE COUNTY
Labor force: 99,244
home sales: 17 Single-family homes active listings on market: 737 Single-family homes average sold price: $216,230 Single-family homes median sold price: $190,000
Employment: 96,998
Single-family homes average
Unemployment: 2,246
days on market: 61
Rate: 2.3 percent
Single-family homes pending listings on market: 133
COLUMBIA
Labor force: 67,619 Employment: 66,061
UTILITIES
Unemployment: 1,558 Rate: 2.3 percent
Water
December 2017: 49,107 December 2016: 48,599
CONSTRUCTION
Change #: 508
December 2017
Change %: 1.045 percent
Residential building permits: 43 Value of residential building permits: $6,415,402 Commercial building permits: 12
Number of customers receiving service on January 1, 2018: 49,114 Electric
December 2017: 50,192
Value of commercial building
December 2016: 49,055
permits: $1,418,958
Change #: 1,137
Commercial additions and
Change %: 2.318 percent
alterations: 12
Number of customers receiving
Value of commercial additions:
service on January 1, 2018:
$1,418,958
50,210 COLUMBIABUSINESSTIMES.COM 87
ADVERTISER INDEX 3M................................................................................................................................ 6
LANDMARK BANK................................................................................................ 2
ACCOUNTING PLUS............................................................................................91
MEDIACOM..............................................................................................................16
ACHIEVE BALANCE...........................................................................................82
MERCEDES OF COLUMBIA..............................................................................35
ANTHONY JINSON PHOTOGRAPHY............................................................. 9
MIDMOTIX.............................................................................................................. 80
BERKSHIRE HATHAWAY HOME SERVICES.............................................. 70
MIDWEST COMPUTECH....................................................................................22
BMW OF COLUMBIA...........................................................................................14
NATHAN JONES LAW........................................................................................85
BOONE HOSPITAL..............................................................................................38
NAUGHT NAUGHT INSURANCE AGENCY................................................ 80
COLUMBIA CHAMBER OF COMMERCE......................................................18
REALTY EXECUTIVES- HEATH HIGGINS...................................................... 5
COLUMBIA EDP................................................................................................... 80
RESTORATION EYECARE................................................................................78
EAT FIT GO..............................................................................................................12
SILVERBALL............................................................................................................. 8
EDWARD JONES..................................................................................................76
SOCKET...................................................................................................................87
ESI COMMUNICATIONS.....................................................................................32
STANGE LAW FIRM.............................................................................................88
FERGUSON..............................................................................................................61
STONEY CREEK INN.......................................................................................... 30
FIRST MIDWEST BANK.....................................................................................55
STUDIO HOME..................................................................................................... 86
FIRST STATE COMMUNITY BANK.................................................................82
THE BROADWAY HOTEL..................................................................................78
GAINES CAR DETAILING................................................................................. 30
TRUE FALSE FILM FEST.....................................................................................4
GFI DIGITAL............................................................................................................. 3
UNIVERSITY CLUB..............................................................................................74
HAWTHORN BANK.............................................................................................92
UNIVERSITY OF MISSOURI HEALTH CARE................................... 46 & 47
HEART OF MISSOURI UNITED WAY.................................................... 10 & 11
VAN MATRE, HARRISON, HOLLIS, TAYLOR, AND BACON, P.C.........76
HOSS’S MARKET & ROTISSERIE....................................................................82
WILLIAMS KEEPERS...........................................................................................55
JOE MACHENS TOYOTA..................................................................................... 7
WILSON’S FITNESS........................................................................................... 60
88 FEBRUARY 2018
B U SINESS • P EOP L E • IM P R OV EM EN T • FY I
BY T H E N U M BER S
6.5%
7.8%
Columbia residents with a disability
Columbia residents without health insurance
Source: U.S. Census Bureau
Source: U.S. Census Bureau
$33.37 Average hourly wage for health care practitioners and technicians in Columbia
Source: U.S. Bureau of Labor Statistics
1:160
1:71
Mental health clinicians to patients in Columbia
Primary care clinicians to patients in Columbia
Source: Data USA
Source: Data USA
1,452
Cases of influenza reported in Boone County during the
2016-17 flu season Source: Columbia/Boone County Dept. of Health Human Services COLUMBIABUSINESSTIMES.COM 89
B U SINESS • P EOP L E • IM P R OV EM EN T • FY I
T H I S OR T H AT
DR. COLIN MALAKER Owner, Sterling Dental Care
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