This is an opinion column
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Today’s guest columnist is Dr. Del Smith.
Most entrepreneurs dream of joining the S&P 500.
Few are bold enough to announce it as their destination.
Fewer still would choose Birmingham, Alabama as their launchpad.
But that’s exactly what we’re doing at Acclinate.
When I tell potential investors, partners, or recruits that our digital health company is headquartered in Birmingham, the reaction is predictably consistent: raised eyebrows, followed by the inevitable question, “Why Birmingham?”
It’s a fair question. In the biotech world, Birmingham doesn’t register. Boston, San Francisco, and the Research Triangle dominate the conversation. These are the places where billion-dollar companies are supposedly born, where venture capital flows like water, where the “smart money” congregates.
Here’s what the smart money is missing: Birmingham represents the most compelling opportunity in American business today, a city intentionally building an innovation ecosystem from the ground up, where ambitious companies can help shape the future.
The moment everything changed
In 2020, my co-founder and I were comfortable at the HudsonAlpha Institute for Biotechnology in Huntsville. We had launched Acclinate as I finished my tenure as dean at Alabama A&M’s business school. Huntsville provided a solid foundation, but our vision demanded more. We weren’t building just another biotech startup, we were building what we believed could become a Fortune 500 company.
So I did what any rational entrepreneur would do: I explored the established hubs. San Francisco, Boston, Atlanta, all the usual suspects where “serious” companies plant their flags.
Then Victor Brown from the Birmingham Business Alliance asked me a question that reframed everything: “Do you want to be a small fish in a big pond when you move to one of those other cities?”
That question cut straight to the heart of our strategic choice. In Boston or San Francisco, we’d be one of thousands fighting for attention, capital, and talent. In Birmingham, we had the opportunity to help build something unprecedented, a biotech ecosystem with our fingerprints on it.
The decision crystallized when I realized this was my full-circle moment. Twenty-five years earlier, I had founded my first company right here in Birmingham before selling it to pursue my PhD. Birmingham wasn’t just offering us business opportunities; it was offering us the chance to come home and build something transformational.
Why Birmingham makes business sense
The data supports what my instincts told me. Birmingham delivers everything a scaling company needs, without the friction that slows growth in overcrowded markets.
Capital access
Angel and institutional investors stepped up with critical early-stage funding. The local investment community may be smaller than Silicon Valley’s, but they’re more accessible and genuinely invested in company success.
Market validation
Key anchor institutions and local companies didn’t just offer encouragement, they provided real contracts and pilot opportunities. When you’re proving product-market fit, nothing beats customers who are genuinely invested in your success.
Infrastructure advantage
Birmingham has world-class medical institutions, a growing tech talent pipeline, and Fortune 500 companies like Regions Financial and Vulcan Materials providing the business ecosystem infrastructure that matters.
Competitive positioning
In Birmingham, we stand out. Our story gets told. Partners return our calls. Media covers our milestones. Try achieving that level of visibility in oversaturated markets.
The lifestyle multiplier effect
But here’s what the business case misses: Birmingham offers something that directly impacts our bottom line, quality of life that translates into competitive advantage.
The food scene rivals any city in America. The cost of living means our employees’ salaries go further, reducing compensation pressure and increasing loyalty. I can get from my house to a flight in 25 minutes, which means more time focused on building the company and less time trapped in traffic.
Most importantly, Birmingham is where I met the love of my life.
These aren’t soft benefits, they’re strategic advantages. High quality of life drives productivity, retention, and company culture. When your team isn’t stressed about commutes, housing costs, or work-life balance, they focus on what matters: building something extraordinary.
Building the future, together
Great companies don’t just succeed in their cities, they help define them. Walmart shaped Bentonville. Lowe’s built Mooresville. Birmingham already has Fortune 500 anchors, and we’re determined to join that list as a company that helped shape the city’s next chapter.
Since relocating our headquarters here, I’ve turned down opportunities to move elsewhere, including Atlanta, where I was born and have family. But between the traffic and the costs, there’s simply no compelling reason to leave a city that offers this unique combination of opportunity and quality of life.
The next time someone asks me, “Why Birmingham?” I’ll tell them the truth: I came for the business opportunity, but I stayed because Birmingham became home. And that’s a competitive advantage you can’t manufacture in Silicon Valley
Dr. Del Smith is CEO and co-founder of Acclinate, a digital health company combining culture and technology to promote more inclusive clinical research. He’s a serial entrepreneur dedicated to using business to create positive societal impact.
David Sher is the founder and publisher of ComebackTown. He’s past Chairman of the Birmingham Regional Chamber of Commerce (BBA), Operation New Birmingham (REV Birmingham), and the City Action Partnership (CAP).
Invite David to speak for free to your group about how we can have a more prosperous metro Birmingham. dsher@comebacktown.com