I was visiting clients last week. Tuesday ended in London with an investor friend of mine in a rather nice bar over a rather nice gin. Days that end over gin are never entirely a write-off.
As one does, we talked at first about family and the state of the world. On the second round of G&T, we moved on to business. Now, you need to know at this point that my friend has been something of a mentor to me over the last few years. His advice has helped form the strategy that you are beginning to see bits and pieces of on here and in some of my snarky LinkedIn comments. Naturally, once I have worked out what this strategy is in anything approaching detail my loyal audience on here will be the first to know – Q2 2019 is the scheduled launch if anyone’s interested.
The bar was quiet and we had our backs to the pouring November rain outside. The building had been a garage in a previous life and through the huge windows, we could see people squelching towards an Underground station.
“How many meetings with companies have you had since you started off on your own – best guess?” he asked.
“Well,” I said, “quite a few I suppose. One a week on average since 2001 – say 40 weeks in a year to allow for holidays and flu, that would be getting on for 700 face to face conversations – although there’s obviously going to be a few duplicates in there.”
“Almost entirely, although there’s maybe 30 – 40 VC, Family Office, Private Equity meets in there – mostly over the last couple of years.”
“How many in Diagnostics?”
“Dunno exactly, maybe 80% of them, 550 or thereabouts.”
“So, how many other people have done this…not as a corporate total but individually?”
“In Europe? Not even a handful. Also, I’m pretty sure that nobody else has combined it with all those VC meets even if they have seen the inside of a lot of CEO’s offices.”
The third gin arrived. My companion had an approving sniff of the pinkish contents of his glass.
He said, “Given all the used shoe leather you must have some insights – you can’t just have wandered aimlessly. What’s the most important advice based on all this work that you’d give anyone who’d listen and that nobody else seems to know?”
I replied, “I go on and on regularly about companies obsessing about capital and IP and forgetting people but that’s not exactly news, quite a few people have worked that one out for themselves.”
“So what don’t people understand and not realise that they don’t understand?”
My brow furrowed as a thought formed between my ears and I remembered the conversation I’ve had regularly this year from Barcelona to Berlin.
“Er,” I said.
“Well…it could be advice in the right hands I suppose,” I said.
My companion raised an eyebrow and his glass in that order.
“I’ve spent a lot of time lately talking about how much medtech success generally and diagnostics success, in particular, is more to do with anthropology than anything else.”
“Go on,” he said.
“Okay, when I go and visit companies now, I’ve worked out how to fairly quickly get to the bottom of whatever it is that they expect their people to deliver. I’ve been to so many sites that there’s a whole group of tests, platform technologies, cassette designs whatever, that I’ve looked at so often I know exactly the issues the client is going to be facing. Immunoassay? What are your issues around interference or non-specific binding? Platforms? Okay, what’s your strategy on embedded software? What’s the microfluidic performance of your cassette like on sera, whole blood, saliva, urine? Now I’m talking about it, not only do I have a decent grasp of what any diagnostic company at pretty much any stage is going to be facing I can give then an informed opinion on the solutions and the costs of those solutions because I’ve worked on this so often before. But then you’d expect me to be able to do that – I can’t go to all these places and speak to all these people and not pick up something.”
I was warming to my topic.
“Okay, hold on!” said my friend. “You mentioned anthropology, why did you say that?”
“Because like I’ve said before in all the stuff about investing, building teams, exit strategies and so on, people forget that ultimately people use their products. Doctors, nurses, lab techs and so actually have to use these things.”
“And the problem is nobody analyses that professional interface anything like closely enough. I’ve seen companies fail because they didn’t really understand how a doctor’s office works. I mean its great if you have a rapid test for something like, I dunno, prostate cancer and all, but if a doctor only has a seven-minute appointment allowance per patient the last thing they want to be doing is keeping all their middle-aged male patients in the building for 30 minutes whilst they work out if they might possibly have cancer. The doctor actually WANTS to draw blood and send a sample to a central lab in a brown paper envelope so that he can deal with you later in a more time efficient way. It’s not about the rapidity of the test, it’s about how that doctor’s office set up and infrastructure works. And I just picked on prostate cancer, there’s a bunch of other things that this would apply to. Okay, there are exceptions – I’d like to know if someone has Ebola right now for instance.”
“Also, you have to consider making things tamper proof – especially you have to make sure that disposable stuff is actually disposed of. What if the device gets dropped on a dirty floor, will it still work?”
“So this is all about how people work in the real world. When I first started out I couldn’t understand how companies could be so cack-handed in their approach to hiring people, they just wouldn’t engage and some of them really suffered because of that. Now, these days I don’t see them being quite so dismissive of putting together their own teams but I think their people blindness now goes beyond their payroll. They just assume that because something works and they can get an article in Wired then people will use it, but that just isn’t necessarily so.”
My friend drained his gin. “Maybe you should write that down,” he said.
“Perhaps I will,” I replied.