While competitors scaled back after COVID, First Citizens saw a gap and built a long-term play around it.
First Citizens Bank has launched a healthcare equipment finance vertical with strategic intent, relationship-first thinking, and a sharp eye for underserved provider segments. In a recent Monitor Podcast, Joe Turner, SVP of Strategic Markets, and Todd Beaver, leader of sales and business development, broke down what sets their approach apart—and why this move matters now.
Q: Why did First Citizens Bank decide to enter healthcare equipment finance now?
Joe Turner: We saw a gap. Healthcare has always been part of the bank’s DNA—serving physicians, hospitals, professionals—but we didn’t yet have a bridge between that and our equipment finance business. Coming out of COVID, others were pulling back due to portfolio pressure. We saw opportunity. Good opportunities weren’t being met. We had the stability, long-term thinking, and relationships to move in thoughtfully and make a difference.
Q: How does your program differ from legacy bank approaches?
Joe Turner: It’s all about relationships. Our bank thinks long-term—we’re not chasing quick wins. We brought in people like Todd who think strategically and understand market gaps. We structured a program to act like a local bank, but with national vendor capabilities. Our goal was to bring a local bank’s understanding and flexibility into the vendor finance world.
Q: How do you approach complex ownership models, like those in ambulatory surgery centers?
Joe Turner: Many banks treat these as startups—which becomes a no. We don’t. We see them as de novo enterprises, backed by real clinical practices, hospital equity, and seasoned operators. That mindset shift alone unlocks a lot of deals. We also minimize unnecessary friction—like chasing 15 personal guarantees—by designing structures that fit the real risk.
Q: Todd, how does your experience with OEMs influence your approach?
Todd Beaver: I’ve worked on both sides—OEMs and banks. It’s often a language barrier. Everyone’s regulated: banks, med device companies, hospitals. But no one stops to ask what the other side needs to make a deal work. I try to translate those needs and build agreements that meet the clinical, regulatory, and financial goals of all parties.
Q: How do you structure deals that reflect where the market is going?
Todd Beaver: One example: moving procedures to ambulatory surgery centers. Everyone wants that—patients, doctors, systems. So we look at how we can provide complete capital solutions tied to where procedures are actually being done—not just where they used to be done. It’s about supporting care migration with flexible, future-facing financing.
Q: Tell us about the Dexter deal with Distal Motion. What made it a fit?
Todd Beaver: Dexter is smart tech with a purpose. They’re targeting less complex procedures with a smaller footprint robot. It complements—not competes with—the big robotic players. They were pre-commercial, so the opportunity was to accelerate their U.S. entry with financing. It was the perfect example of a manufacturer we could help grow and serve providers better.
Q: What metrics will tell you this vertical is succeeding?
Joe Turner: Scale. We didn’t get in to do $50 million in deals—we’re thinking hundreds of millions. But we also track partner engagement and traction—how many OEMs, providers, and vendors are coming to us. That tells us our message is resonating, and that our model is working.
Q: Final thoughts?
Todd Beaver: We’re not here to sell one deal. We’re here to raise the standard of healthcare by helping providers get the tools they need. That’s what drives our decisions.
