Building away from the capital hubs isn’t a handicap. Handled right, the constraints become the discipline.
I built my company in Tennessee, not in one of the coastal hubs where the capital and the noise concentrate. For a long time I thought of that as something to overcome. I’ve come to see it as an advantage I didn’t fully appreciate at the time.
When money is abundant and close, it’s easy to solve problems by spending. When it isn’t, you’re forced to solve them by being right — about your customer, your product, your unit economics. Constraint is an uncomfortable teacher, but it teaches the things that actually keep a company alive. Some of the most disciplined operators I know came up exactly this way, and it shows in how they run.
There’s also something about building among people who aren’t all building the same thing. In a monoculture, everyone chases the same trend and validates the same assumptions. Away from it, your customers are your reality check, not the founder two tables over at the same coffee shop. That distance from the echo keeps you honest.
I don’t want to romanticize it — there are real disadvantages to being outside the hubs, and pretending otherwise would be dishonest. Access to certain networks and certain kinds of capital is genuinely harder. In my own case, I bootstrapped for the first seven years before Salesforce Ventures led our first outside funding in 2018 — proof, to me, that you can build something fundable far from the usual venture path. But the answer isn’t to move; it’s to be deliberate about building the networks you need while keeping the discipline the location gave you.
The best thing I can say about building where I did is that it made me a better operator than easy money would have. And when the market got hard — as it always eventually does — that discipline was the difference.
Tammy Hawes is a healthcare technology executive, founder, and operator based in Brentwood, Tennessee. She founded Virsys12 in 2011 and led its 2025 acquisition by HealthStream, where she now serves as VP, Payer Solutions. She writes on AI in healthcare, leadership, and the founder’s path. More about Tammy →
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