A hot topic in the design world recently has been the importance of building empathy between businesses and their customers, a concept well documented in the book Wired to Care, by Dev Patnaik and Peter Mortensen. The basic case for empathy is actually pretty intuitive-by spending time with customers a business can better understand their needs and therefore deliver better products and services that more effectively meet the needs of customers. Formal efforts to build empathy with customers have been underway for quite some time with consumer electronics products (a classic example might be Jan Chipchase's globetrotting research conducted for Nokia), but one area where there remain structural challenges to building and capitalizing on empathy is between medical device manufacturers and the patients who use their products.
A fundamental dynamic of the medical device industry is the disjointed relationship between the patient, doctor, healthcare administrator, and the medical device manufacturer. This relationship is especially complex in the case of sophisticated devices that are not sold directly to patients and which are instead sold first to doctors or hospital administrators and then resold (via a prescription) to patients. The following diagrams illustrate (in a simplified manner) how the sales channels are structured for a typical sophisticated medical device versus a typical consumer electronic product.
While there are some similarities between the two models (for example both have "middlemen," the Doctor and the Retailer), there are two important differences between the two models: (1) the medical device model contains an "Administrator" component, and (2) the sales flow to the patient in the medical device model is a PUSH flow, whereas in the consumer electronics model it is a PULL flow. While the presence of the Administrator component is indeed an important part of the medical device sales model, this analysis is concerned with the effect that PUSH vs. PULL relationships have on how much weight is given to empathy for the end user at the manufacturer during product development.
In the above models, a PUSH flow represents a decision made by the giver/seller, whereas a PULL flow represents a decision made by the receiver/buyer. For consumer electronics, the sales flow model is straightforward. Consumers own the purchasing decision, and—simplifying greatly—if they value a product, they buy it. if they don't value a product, they don't buy it. Whether from a Retailer or directly from the Manufacturer, the flow is always PULL in nature. As such, the Manufacturer has a natural incentive to build empathy with Consumers. After all, by better understanding their Consumers, Manufacturers can better meet their needs and ultimately sell more products.
For sophisticated medical devices, however, there is a structural challenge that puts Patients one step removed from Manufacturers. For medical devices, the flow starts with Doctors and/or Administrators choosing (via a PULL flow) which devices to stock, a decision which Patients-who can only get a device through a Doctor's prescription-are essentially stuck with regardless of their individual preferences. In other words, Doctors/Administrators (I'll refer to them simply as "Doctors" for the remainder of this post) PULL devices from the Manufacturer and then PUSH those devices onto patients.
As a result, for medical devices Doctors emerge as the primary customers and Patients become secondary customers. As decision holders, Doctors hold a tremendous amount of very concentrated power. Naturally, this results in Doctors having a rather strong voice with the Manufacturer, who from a first-order economic incentive standpoint has every reason to bend over backwards to please the Doctors. So employees at the Manufacturer spend time with Doctors at conferences, training sessions, or advisory boards collecting quantitative and qualitative information and all-the-while forming empathic bonds with Doctors. Patients, however, end up getting short shrift, something that's easy to justify when Patients account for approximately zero direct revenues. As marketing personnel tally their annual market research budgets, it's easy to conclude that the benefits associated with building empathy with Patients do not outweigh the costs, which makes the decision easy. After all, why spend time learning about and building empathy with Patients when they never buy anything?
So does this mean that Patients are forever destined to miss out on the benefits that arise from building empathy? In my next post, I will discuss some possible solutions for helping empathy become a vital part of the medical device development process.
Image from here.
Disclaimer: I work for a large medical device manufacturer (not the one that made the device pictured above.)
