Med Devices, Butterflies, and Increasing Sales: The Little Things

I was leading a workshop recently for a client bringing a new critical care device to market. As one step in the process, we were doing wide-open brainstorming to generate a large quantity of ideas on what the value proposition might be that we would later synthesize and vet with customers. We were specifically looking for meaningful differentiation.butterflies

One savvy marketing person bravely expressed that as a former clinician, she knew that little things, as silly as it might sound, can make the difference between winning the hearts of critical care nurses and getting the sale – or not. The example she gave was butterflies. As in enabling butterflies to appear on the monitor display (out of the way of patient data of course). Then she suggested other simple ways of allowing personalization.

These “humanizing” gestures cost almost nothing to med device  manufacturers, and can mean a great deal to the customer.  They convey that you understand the realities of the emotional toll it takes to provide critical care day after day. And they make you in a simple and profound way a valued partner – not just a vendor of commodities – which is where you want to be.

Obviously, butterflies and other personalization aesthetics are not going to be the core value proposition for any med device. But these kinds of things can enrich your value proposition, differentiate on an emotional level, and enable a deeper more meaningful connection with your customers.

So… what’s your butterfly?

Why Selling New Technology into Hospitals is Hard: Overcoming the Status Quo Bias

You’re pitching your company’s new device or software solution to a hospital. You believe your product is clearly superior to the outdated technology the hospital is currently using. You know they have the money to switch. Standard economic theory would predict that the hospital decision-makers would rationally choose your product since it would provide them with greater utility. But the hospital decides to stick with what they have. What’s up??

There are a lot of barriers companies face selling into hospitals. One of the most pervasive and misunderstood, is the tendency for customers to make non-rational decisions to stay with the products they have. By non-rational, I mean the decision is based on an emotional preference, not an objective judgement that the current technology is as good as or better then the new one. Psychologists call this emotional preference the status quo bias. It’s a big deal.

Research in behavioral economics shows the status quo bias significantly affects important life decisions like health care plan choices, selection of retirement programs, stock market investments, recommended medical treatments, and all kinds of purchase decisions. It’s one of several biases scientists have identified to explain what appears to be irrational decision-making.

Think about it in your own life. The food you eat, the places you go, the clothes you wear, the things you buy… how often have you stayed with the familiar rather than trying an alternative?

While there are many explanations for the status quo bias, here are three of the big ones:

  1. Uncertainty: Good or bad, clinicians or IT directors know what to expect from the technology they use now. Switching to your product means taking a risk; they don’t know if it will perform as promised. As the old saying goes, “better the devil you know than the devil you don’t.” Scientists call this loss aversion.
  2.  Transition costs: It’s not just a matter of buying your product, it’s also all the  costs – time and money – involved in switching from what they’re using now. Training staff, updating clinical protocols, adapting workflows- all these things go away when a hospital maintains the status quo.
  3. Minimizing regret: People feel worse about problems that come from changing to a new product (action) than problems that come from sticking with what they have (inaction). To avoid regret,  hospital decision-makers choose inaction and keep the technology they have.

How can you overcome status quo bias so that customers buy your superior technology?

  1. Connect emotionally: Acknowledge and empathize with the tendency people have to stay with what they know. Give relevant examples of when that has worked for hospitals and when it has backfired and led to significant negative outcomes.
  2. Recalibrate their status quo: Change the reference point from the status quo being doing nothing to the status quo being doing something. Make the case that most hospitals are switching to new technologies- that’s the norm. The question is which to choose, and when.
  3. Reduce their risk. Demonstrate that staying with what they have is the risker option because it guarantees negative outcomes (be specific, e.g. more IT downtime, unnecessarily complicated workflows, less time with patients, incompatibility with EMRs or other devices, etc.).
  4. Reframe transition costs: Recognize objections related to transition costs. Acknowledge those that are true, then dismiss the remainder with evidence of savings that will result from switching.

Try it and let me know what happens. When you can overcome the status quo bias in these ways – and you can! – customer trust and sales can increase dramatically.


The classic from the founders of Behavioral Decision Theory: Kahneman, D., & Tversky, A. (1982). The psychology of preference. Scientific American, 246, 160-173.




Why Health Tech Companies Should NOT Emulate Apple

“We want to be like Apple!” I can’t tell you how many times I’ve heard this from teams innovating new products. What they mean is they want their new products to be sleek, attractive, and easy to use – something that does not come easy to most med device manufacturers.

The aspiration is good and noble. If fulfilled, the company is providing customers with things they want and love, improving healthcare, and making money.

However, Don Norman, my mentor, friend and former VP at Apple, makes a strong case for not emulating Apple any more, because at Apple, beauty is coming at the expense of function:

“Apple has gotten carried away by the slick, minimalist appearance of their products at the expense of ease of use, understandability, and the ability to do complex operations without ever looking at the manual. Today, the products are beautiful, but for many of us, confusing.”      -Don Norman

For the med device industry, the challenges are even greater because of the inherent complexity of most medical devices. In fact, many companies over-engineer devices with far more capabilities than customers want or need. We hear from clinicians and the C-suite time and time again that they’ll choose the workhorse machine that’s easy to use and provides the most needed functionality, over the uber-sophisticated, feature-laden device that can do more but is harder to use.

If, on top of providing too many features, designers, engineers, and product managers prioritize aesthetics and the “cool” factor over discoverability and ease of use, then clinicians and executives get even more turned off.

On the other hand, when the team puts the customer first and only provides features that solve meaningful problems customers care about, and makes them attractive and easy to use within the fast-paced clinical workflow, then they’re on the way to a winner.

So be like Apple was, when they practiced good design principles and made beautiful devices that were easy to use and love. And keep customers first!

Think or Know? Disarm Dangerous Marketing Assumptions With The “Sandwich” Approach

Which new idea should you invest in?  What’s the right value proposition for your portfolio? How should you position your game-changing product for a winning launch?

These are significant questions that if not answered correctly, can cost you a lot of time, money, and trust. Here’s the “sandwich” approach we use to help med device and other health tech clients avoid making risky moves based on unspoken assumptions.

The Bottom Slice: Identify your high-risk assumptions. Gather your team together for a hard-hitting work session, with all egos aside. Set the expectation that you’re going to identify the key assumptions that must be validated because they’re so mission critical that if you’re wrong, you’re, well, screwed. Here’s how in detail.

The Filling in the Middle: Validate your assumptions. Do the needed research with customers to determine which of your assumptions were on target, and which need correcting. To get the most from your investment, focus on your top priority, highest-risk assumptions.

The Top Slice: Refine Your thinking. Bring your team back together. Review the assumptions you had earlier identified as high-risk and in need of validation. Consider the customer research results by noting which assumptions were right on target, which would need fine-tuning, and which were way off base. No shame, no blame. Now refine your thinking based on what your learned.

This “sandwich” approach works because 1) it gives team members much needed permission to not know everything, 2) it acknowledges that customers can provide many answers, and 3) it lets your team refine their thinking together and get on the same page.

Most important, the “sandwich” approach efficiently and effectively helps you avoid assumptions and wisely answer the tough questions that can spell the difference between success and failure.

The Better MVP: Why “Minimum Viable Products” Are Dead

The basic idea of a “minimum viable product” – popularized by Eric Ries and the Lean Startup movement – is good: Create just enough to validate that what you’re making meets a customer need. And it’s led to many hugely successful companies, like Dropbox and Zappos (more here by Vladimir Blagojevic).
The problem we’ve seen is that “minimum viable product” can also lead to a product-centric mindset in which value to the customer takes a back seat to minimizing features. The dominant thinking is how little can we put in this product to be viable.

What’s the alternative? The intersection of “minimum viable product” and a different MVP we call “maximum value product” (others call it that too, like in this solid prezo by from Liquid Reality’s CEO Adam Smith).

“Maximum valuable product” is not about how many features you can pack into a new product. It is about how well can you solve whatever problem you’re addressing. That’s how you maximize value. The dominant thinking is not about how little, but how much; specifically how much of that particular problem you can solve for the customer.

The order and integration of the MVPs is critical. Here’s the 5 step sequence we recommend:

1) Maximum value: Start with the “maximum value product” perspective. Identify how much you value you can provide customers on a particular problem. Specify in details what aspects of the problem you’re solving, what benefit is created, and how important each is to customers.

2) Value validation: Validate with customers the meaningfulness of the problem you’re solving and have them rank order the importance of the benefits your product can provide.

3) Features: Make a list of what technology or features are needed for customers to experience each benefit and its value. Be sure to include low tech and high tech possibilities. Align features with the ranked benefits.

4) Minimum viability: Now bring in the Minimum Viable Product approach to decide what it will take to provide the required  features. Start with the features needed to deliver the most highly ranked benefit, then continue down the list. Think about trade-offs like this:

Option A: Do a good job at providing for the most important benefit, so that you’ll have enough resources to also provide for the second most important benefit.

Option B: Do a great job at providing for the most important benefit. Pour all your resources into that, and come back to the second most important benefit later.

5) Viability validation: Use lean and agile research techniques to get customer feedback on option A vs. Option B. Now you’re ready to take something to early adopters that has the optimal balance of providing value to customers and being viable to make.

Please share your experience with MVP vs. MVP!