January 21, 2022

Success story from reader John Holcroft

Fellow list member John Holcroft replied to my recent message with a success story that illustrates the advantages of identifying an “expensive problem“ (shared with permission):

Hi Jonathan,

If you are interested I have a specific example of me switching from a big problem to an expensive problem in my business. I’m happy for you share this with your readers if you think they’ll be interested.

The Big Problem

I’d been looking for problems to solve in the health care space, particularly health education. I teamed up with a doctor and together we went through a start-up accelerator with an idea for an otoscope simulator. An otoscope being the thing doctors use to look in your ears. This simulator would train doctors on how to diagnose ear conditions. It worked great, my ten year old son learnt to diagnose common ear conditions in minutes.

We thought family doctors would be the main audience, as they need to do this every day but aren’t well trained in it. We spoke to lots of doctors who all confirmed how much of a struggle it was to diagnose ear conditions and how they had to do it all the time. But when we asked them what they were doing to fix this problem they all looked a bit sheepish and admitted they weren’t doing anything. They weren’t learning from a book, or on the internet, or going on a course. Though it was a big problem to them, it wasn’t an important or costly problem. They just passed on most patients to a specialist.

It isn’t impossible that a success could have been made out of the otoscope simulator but I couldn’t see a path. We’d worked very hard on it for a while but hadn’t found a strong signal for who cared. I decided to cut my losses and try another idea.

The Expensive Problem

The problem that took off was clinical guidelines. This is providing short guides for juniors doctors on how to investigate and manage common conditions in their hospital, on their phones. The hospitals already had clinical guidelines on their intranets but they weren’t used, the junior doctors googled for information on their phones in preference. There are multiple reasons for this, but basically they needed simple concise information on their phones, when they were in front of a patient. What the hospital gave them were small text books on a condition, which they probably didn’t know exist, and were only available on a busy shared computer, and then were 18 easy clicks away.

This is an expensive problem in multiple ways. Without good clinical guidelines doctors make mistakes or provide sub-optimum care. Clinical errors are really expensive. If it goes to litigation there can be massive payouts, and it damages the reputation of the hospital. Even if the care is only sub-optimal then the patients are staying in hospital longer costing the hospital more. (I’m talking about UK hospitals here) Plus not have good guidelines slows doctors down, meaning they see fewer patients.

When doing a discovery call with one hospital I asked the ’Why now?’ question. They told me multiple reasons why it needed to happen now. One was that there had been a ‘never’ event in the hospital, a clinical error that should never happen, and a lack of good clinical guidance for the doctors was seen as a factor. There was pressure from the senior management in the hospital to fix this. This was a problem they were prepared to pay to fix.

By the way I’m in the middle of your 10 days system challenge and getting a lot out of it, thanks for putting it on.

Also, that expensive problem story is also a success story for your proposal template and value pricing. On the discovery call they told me everything about why this mattered to them. I followed your proposal format, largely just a situation appraisal where I wrote down what they had told me, then provided three options (small, medium and large) for ways that I could help. I hadn’t designed it at this point, the options said what features I’d add and what problems they’d solve and benefits they’d provide for the hospital. The immediate response from my contact was ‘Excellent comprehensive summary’, even though I’d only really written down what they’d told me. I won the business and they paid me up front, before I’d built it.

Thanks for everything you do for the community.

Cheers, John

Thanks to JH for sharing!