Guide · Step 1 of 8 · Positioning
Which of the four failure modes are you in?
Sales. Positioning. Feasibility. Enablement. Most healthcare commercial leaders are running a campaign against the wrong diagnosis. The four failure modes look identical on a green dashboard. They need different fixes. Until you know which one you are in, every other lever amplifies the wrong signal.
The 4 failure modes
Sales
“The reps need to try harder.”
Pipeline exists, reps aren’t closing. The rarest real diagnosis - and the most-commonly assumed.
Positioning
Most likely“The message isn’t earning the right to be heard.”
Pipeline isn’t forming. Activity is high. The clinical audience self-selects out before they engage.
Feasibility
“The product as positioned doesn’t fit the market as scoped.”
Regulatory, reimbursement, ICP, or product itself is misaligned. Marketing can’t close this gap.
Enablement
“The team can’t execute the strategy consistently.”
Strategy lives on a slide. Onboarding takes nine months. The dashboard doesn’t exist.
Not sure which one you’re in?
Take the 7-question diagnosticThe wrong path
Treating a positioning problem as a sales problem.
The pattern is consistent enough to be predictable. Pipeline slows. The dashboard turns amber. Leadership concludes the sales team needs to try harder. Targets get raised. New reps get hired. The pitch deck gets refreshed. Twelve months later the same conversation runs again, with bigger numbers and fewer people in the room.
What looked like a sales execution problem was almost always a positioning problem in disguise. The message wasn’t earning the right to be heard. The clinical audience was self-selecting out long before a rep got involved. No amount of rep training fixes that. No amount of paid amplification fixes that. Until the message lands, every other lever amplifies the wrong signal.
The Equipped Test from Chapter 4 is the cheapest way to find out. Can your message survive a sceptical clinician asking the three questions a sceptical clinician always asks? If not, you haven’t earned the right to spend on amplification yet.
The right path
Five moves before you spend another marketing pound.
Healthcare positioning is harder than it looks because it has to survive three readers - the clinical buyer, the financial buyer, and the regulator. These five moves get you to a message that passes all three filters before you commit budget to amplifying it.
01
Run the diagnostic before you run the campaign
Pin down which of the four failure modes you are actually in. The 7-question diagnostic is the fastest read; a triage call is the deepest. Do not skip this step - it is the load-bearing one.
02
Build the messaging house from clinical evidence outward
Start with what you can defend in front of a regulator and a procurement panel. Then layer the human story over it. Most healthcare positioning fails because it inverts this - story first, evidence retrofitted.
03
Tighten the ICP until you can name the next ten conversations
If you cannot list ten clinicians or buyers by name, role, and the specific phrase that gets their attention, the audience is too broad. Broad audiences make weak messages.
04
Pressure-test against the Equipped Test
Three questions a sceptical buyer always asks. If your team cannot answer them in plain English in under two minutes each, you have not yet earned the right to amplify. Fix this first.
05
Earn the right to amplify - then amplify hard
Once the message survives the Equipped Test, the order of operations flips. Now the campaigns, the events, the paid, the outreach all start to compound rather than dissipate.
The decision
How positioning sits inside the four failure modes.
The temptation when revenue stalls is to fix all four at once. Don’t. Each mode wants a different first move, and several of them actively undermine the others when sequenced wrong.
| Failure mode | Symptom on the dashboard | First move |
|---|---|---|
| Sales | Activity is high, conversion is low, win-rate has slipped. | Last-20-deals post-mortem before any new hires. |
| Positioning | Activity is high, pipeline isn’t forming, “good conversations” don’t convert. | Rebuild the messaging house against the Equipped Test. |
| Feasibility | Multi-year stall. Regulatory, reimbursement, or formulary keeps blocking. | Re-scope the product, the audience, or the pathway. |
| Enablement | Heroic individuals carry the number. Onboarding never finishes. | Build the single source of truth - playbook, dashboard, claims matrix. |
From the manuscript
The medical device company that thought it had a sales problem.
The dashboard was green. Activity was up year-on-year. Reps were hitting their call targets. Marketing was running events. The forecast still missed by 40%, against an industry baseline that already had 73% of healthcare launches missing forecast in the first year.
The first instinct, the one every leadership team has, was to fix the sales engine. More reps. Higher targets. Better incentives. None of it moved the number.
The actual diagnosis was positioning. The message had been built from an internal product brief, not from the language clinicians were using to describe the problem. Buyers were filtering it out before a conversation started. Once the messaging house was rebuilt and the ICP narrowed, the same sales team - same dashboards, same targets - closed the next quarter ahead of plan.
What good actually looks like
Two artefacts: the proposal we wrote, and the thinking behind it.
The proposal shows you the scope and structure of a real positioning programme delivered for a healthcare client. The decision log shows you the question we asked, the option we ruled out, the option we recommended, and why.
Want a second pair of eyes on your positioning?
A 30-minute triage call is the fastest route to an honest read. Bring the messaging you have, the dashboard you trust, and the question that has been keeping you awake. We’ll tell you which of the four modes you are in.