In the mid-1960s, a Nashville architect named Batey Gresham had the good fortune to be one of Thomas Frist Sr.'s patients. Whenever he saw his patient, Dr. Frist would ask Mr. Gresham how his architectural career was going. The young architect would tell him, doubtful that his regular updates would ever amount to anything more than just friendly conversation.

However, in early 1968, Dr. Frist called Mr. Gresham to congratulate him when his small firm, Gresham and Smith, was selected to design a high-rise residential facility in Atlanta. At that point, Dr. Frist asked him if he had any interest in designing hospitals.