#175 | The 4 Ps Clinicians Must Fix Before Your Medical Device Will Scale

0:00In this episode, you're going to learn the four P's that determine whether your mid-tech actually gets adopted and not just been mined. If you've got a regulatory approval but no traction, this will show you exactly where you'll launch you breaking down. Welcome to Commission to CEO. The podcast helping clinicians simplify your go-to-market strategy so that you can stop guessing and turn your working prototypes into international mid-tech businesses. I'm your host, Haki, at Debbie. Let's get started. Now, the reason for this episode is simple. I keep seeing technically strong mid-tech products stall after launch. Not because the device is poor, but because something critical in the launch was weak. And when that happens, going deeper into tactics doesn't fix it. You need to step back and ask what's actually structurally wrong here. So today isn't a deep dive into case study or war stories is to call structure. The four P's that tell you very quickly where you'll launch it exposed. And we'll go deeper into each one

1:04in later episodes. But first, you need to know where the crack actually are. And the four P's are the mid-tech product launch and not expert marketing jargons. This is the real world version born out of experience. So what are the four P's? Number one product. Number two proof. Number three pathway. Number four people. Miss one and you stall. So let's get into it and break it down. So number one product is it actually commercially relevant. Now, most founders obsess over the product. And rightly so, they look at a CE mark. They look at FDA clearance. They look endineering perfection. But here's the uncomfortable truth. Regulatory approval and endineering perfection does not equal commercial readiness or commercial success. So I want you to ask yourself if the product even to explain in 30 seconds. Does it fit into existing workflows? Does it require behavior change or not? And it's pricing aligned with the perceived value of the customers.

2:08Not what you think it's worth, but what the customers think it's worth. Now, if the answer to those questions means that friction gets introduced into the system, then that's the problem. It's not the product. For example, if a nurse has to change your team, you have friction. If you're selling the product for £50 and every customer is feeding back the value of the product is £15 based on workflow improvements versus what they currently use, then you have friction. And if the people don't understand the benefit to them in under 30 seconds, you have friction. And friction kills adoption. So if the product doesn't tick those boxes, don't launch until it does. And then when it does move on to the second piece. Proof. Where is the commercial evidence? Now, you telling everyone that the product is great and eating commissions, saying that you love it and telling you that they would love to use it, that's not proof. Nor even is two pilots with good feedback. What proof means in this context is measurable outcome improvements,

3:10cross-saving or efficiency gains, risk reduction, published or defensible data. This is what proof means in this context. Because if you can't quantify impact, procurement won't care. In the UK, bodies like NHS England are nicer expecting economic justification, not just clinical enthusiasm. In the US, you need to understand who gets paid and how. If your product needs new reimbursement and CMS coding isn't clear, you're climbing uphill. But if you can prove margin protection or cost reduction inside existing payment models, reimbursement is in the barrier economics is proof turns curiosity into people actually making budget available for your product. Without proof, you may be interesting, but you're not going to get adopted. So let's say that you've now got the right product and you've got proof that the product is going to improve something significantly in that facility. So let's say that your product is now commercially ready and you've got the right proof to present to the facility, you now need to move onto the third P

4:13and that pathway. How does the hospital or customer actually buy this? So this is where lots of companies with technically strong products die. Because they think if the condition wants it, then it's going to happen. No. I'm afraid to tell you no. Hospitals buy through processes that don't buy through passion and enthusiasm. You need to understand simple things like who is the economic buyer? If this attended category, does it go through a value analysis committee? When it goes through a value analysis committee, what's the structure? Is it a capital or consumable budget? Does it require coding changes? Because if you don't understand the root, you're going to waste months pushing in the wrong direction. And here's the thing actually, even if you understand the process, processes are not the things that make decisions. People do and that takes us onto a fourth P, which is people who is actually pushing this forward. And this is where decision-making unit mapping comes into play. And I actually could happily do a whole episode on this on its own

5:19and I will do actually, now I'm thinking about it. So let's start externally first, I, the hospital or the facility that you're trying to get into. So what we need to know is what is the decision-making unit in that facility? Do you know who is involved in making decisions and what basis they make those decisions on? Are they a user and they're making through the lens of actually usability of that product on an expert? In our case, generally clinical, are they making through clinical grounds in terms of their decision-making or are they an economic decision-maker? So they're just thinking purely about the cost, maybe the cost of the actual unit and also the cost in the long term. And then what's the influence within that decision-making unit? Who influences who? Because you might not always be able to get to the person who's going to make decision, but you might be able to get to the person who's going to influence that person. Then you want to know, do you have a champion inside the decision-making unit or on the converse, do you have a detractor

6:22in there? And then there's a massive range of people between being a champion and being a detractor. So you need to understand all those things and then lastly, critically, who is the ultimate decision-maker? Because I know a lot of people will say, it's a committed decision, but it's the own way one person in that decision-making unit, who if they veto it, it doesn't happen, and if they sign it off, it happens. So we need to understand all these things. It's not just about finding one person who likes the problems in the facility and thinking that it's going to go through. I'm telling you, it won't. I've seen it store millions of times. So if you're talking to the wrong people about the wrong things or not enough of the right people, then your launch is definitely going to store. So that's a quick look at the external people, and I genuinely want you to ask yourself, do you know the things that I just outlined there in terms of who's involved in decisions, what are they making their decisions on, what's the influence between the individuals,

7:23where the champions, where the detractors, and do you know where the critical decision-maker is? Because if you don't, before you go any further, go and find those things, how it'll mean that your product will then be much more likely to get adopted. So now let's take a look internally. And I include the distributors in this, and they are your representative in whichever country that you're working in. So when I talk internally, then I'm talking specifically about the people that execute the launch of this product. So the question I want you to ask yourself, here, if do you have a distributor who really understands the category that they're now selling into? Is your sales messaging aligned, your sales messaging aligned with the distributor and the distributor sales messaging, then clear and concise to the end user? Are your incentive aligned, are you going to be able to motivate your distributor to do what's required because they're not

8:24going to just be selling your products? These questions are critical to the answer because the keen distributor doesn't actually mean anything. You need stock commitment, you need agreed targets, you need defined, focused accounts, and you need a rhythm for structured review, i.e. is it going to be once a month? If it's going to be once a quarter, I would say no less than once a quarter would require recommendation. And then obviously at the end of the year as well, whatever that financial year is, that needs to be clear to both yourself and the distributor. And lastly, you need to make sure that the distributor also understands clearly the four P's, so that actually you're completely aligned because sadly I've seen completely enter five markets at once and they're getting very excited but then they stall everywhere because nobody own the execution and that's because they didn't understand the four P's and the distributor has to be the one who owns that with your support and hence you both need to be aligned because people execute

9:24strategy not just plans. So that's the four P's, product, proof, pathway and people. And the brutal reality is that you can survive weakness in one of those P's. You can survive weakness in one of the P's for a while. So for example, you got strong product, proof is solid, pathways clear, but people is weak. So for example, your distributor is passive and you don't have a strong champion inside the facility. What happened in that case? You're not going to collapse, you're just going to move very slowly because deals are going to drag or you follow up with them a bit inconsistent because your distributor is not that great, you know, meant and then stalls. But if you fix the people section, growth is going to unlock quite quickly. So yes, you can't survive one week P, you just don't move fast. But you cannot survive weakness in two of the P's. So imagine this scenario, proof is weak, people is weak, procurement therefore isn't convinced economically and nobody inside the facility is championing that product.

10:29I remember liking device is not the same as championing it. Permissions can like it, that doesn't mean that they'll fight for budget for it. So you've got all that going on, but then your internal engine isn't forceful enough to compensate for those things that are going on inside of the facility. So now you're stuck because there's no economic case and there's nobody inside the organization who's actually going to drive it and you haven't got an execution engine from your own business either either distributor. So that's not just slow growth, that's complete drift and stall rarely because launch is not just the one offer then. So what I want to do now is a rapid 60 second self-order. So here's your quick check you can do now. So on a scale of 1 to 10, I want you to mark your product readiness, your strength of proof, your clarity of the buying pathway and then also your quality of people driving adoption. So if you've got a pen in the path,

11:32obviously right down. If you're out running or listening on a train or driving or whatever, just mentally think right where are you because there's only four numbers that you have to remember. Now anything under a seven means that you have vulnerability. So don't try and fix everything at once. You identify the vulnerability that you can realistically move in the next 90 days and the critical thing here is that you should work on the thing that will change commercial momentum. And to help you with that, remember this, don't fix what's easiest, fix what move contracts. So now as usual, I want to give you a decision scenario for you to go away and try and think about and then I'll answer it on the next episode. So let's say your product is an eight. Proof is a five. Pathway clarity is a six and people alignment is a four. You can only move one of those peas materially in the next 90 days. Which one do you choose? Do you A,

12:35we find the products and remove friction? Do you B double down on generating strong the proof and health economic data or C map and unblock the buying pathway properly or D strengthen the people ending driving adoption? There is a right answer, but it's not obvious and I won't give you this scenario if it's going to be obvious because there's no point. And it's not always going to be the same for every company. And in the next episode, I'll break down how to make that decision without guessing. So, in closing, if your product is approved but adoption is slow than you expected, it's almost always one of the four peas breaking down. And if you want to help pressure testing your four peas and helping you focus on what you can do in the next 90 days to gain traction before you burn any more runway, book a healthcare expert accelerator discovery call with me, be a link in the show notes and I'll personal audit where your launch is commercial exposed until you're next move. They actually move revenue. Until next time, thank for listening,

13:38keep challenging your assumptions and keep growing.