Great is the Enemy of Good – Be Smart With Your Startup!

Things are looking good! You’ve raised some money for your new medical device startup and are ready to take your idea to the next level – from a back-of-the-envelope notion into real product development. You know the process. You have a Quality System that will guide you in the Design Control portions, but you’re not there yet. Your idea needs to be codified, worked out, refined into a real product definition, followed by requirement documents and specifications.

So, you start with your users. Very appropriate. Learn their needs, their procedures, their constraints, and limitations. You then work with marketing experts, perhaps members of your board of directors or advisors from your investors. Where are the market inflection points relative to product features and pricing?

OK, let’s get the best and brightest minds to do focused ideation, i.e., brainstorming. That gives us a variety of expanded and different concepts to augment or maybe even replace our napkin idea. At this point it seems like the options and issues are expanding to a confusing level. And then there’s the hazard analysis and risk assessment. Preventing the “what could go wrong” issue will create its own set of requirements.

Naturally, we all want the best. The Board wants the greatest return as quickly as possible. Marketing wants the most desirable product that will demand the highest margin, and they’re ready to launch today. That product has all the bells and whistles, of course. What’s taking you so long?

You’re at a very critical juncture. Decisions you make regarding the product you develop can and will make or break your company.

A well-known best-selling business book is “From Good to Great” by Jim Collins. In this examination of what sets apart great companies from good companies he postulates that “Good is the enemy of great.” His hypothesis comes from a detailed study of over 20 companies, looking at ones who made decisions that led to significant increases in stock value compared to those whose stock either stayed about the same or rose only modestly. He concluded that when new ideas, products and services are considered and developed, those companies that “settled” for a good outcome were outstripped by those who persevered in pursuit of a great outcome, a stellar, outstanding, market-changing product or service. 

Sounds good at first, but what kind of companies were the subject of Mr. Collins’ study?

The list of the 28 companies studied included Abbott, Upjohn, Circuit City, Silo, Fannie Mae, Great Western, Gillette, Warner-Lambert, Kimberly-Clark, Scott Paper, Kroger, A&P, Nucor, Bethlehem Steel, Philip Morris, R.J. Reynolds, Pitney Bowes, Addressograph, Walgreens, Eckerd, Wells Fargo, and Bank of America. What do these companies have in common? They’re all established, profitable publicly traded companies. Most are household names. At the time, they were all on the Fortune 500 list.

Given that information, what kind of resources do you think those companies could put into a project striving for “great?” Vastly more that your startup has available, I’m sure. And what if, in pursuing their great new product they should fail? Most likely they could write the expenditures off the books and the company would continue to move on and prosper. If your project fails, however, you’re out of business. Kaput!

In the context of a startup medical device company, Great is the enemy of good! 

So, as you’re sorting through all the user options, extra features, marketing requests and similar considerations, think about this goal: Define and focus on the MVP. Period.

What’s the MVP? The Minimally Viable Product. The product that will take your idea to the marketplace focused on the minimal subset of features that will be accepted by the market as a first product. The minimal number of features to be designed, developed, tested, qualified, and manufactured. The minimal number of features to install, service and provide training for. The minimal approach for regulatory clearance.

Here are a couple examples.

A simple device was designed to sample saliva and fluids from the esophagus and place them in a stabilizing solution for shipment to a laboratory for analysis. This was a small, delicate device and sterilizing the device without damaging it was difficult. Much time and considerable money was spent trying to qualify and validate a sterilization cycle that was reliable without damage to the product. When asked the question “Why does it have to be sterile?” the answer was that the predicate device was sterile. Digging deeper, the probe continued. Why was that? The mouth is not sterile. In researching the history it was discovered that one of the uses for the predicate device was to detect the bacteria h. pylori, a causative factor in stomach ulcers. That was not a use for this device so after considerable time and expenditures the decision was made to require the product to by hygienically clean. It did not need to be sterile after all. This is an example of not understanding the parameters of the MVP and thus including an unneeded requirement.

Based on breakthrough research to improve the survival rate associated with CPR (Cardio-Pulmonary Resuscitation), a patient positioning device was envisioned which would raise the patient’s head during the procedure. This patient positioning device was one more piece of equipment for the first responder to carry, along with all the other equipment that was already over-burdensome. So the idea morphed into a multi-function product – one device that would include the patient positioner and incorporate other features to reduce the load. Such features might include a built-in AED (Automatic Electronic Defibrillator), a mechanical chest compression mechanism or other devices. Designing and qualifying the product to include such additional features would have taken significant additional time and money, so the MVP was determined to be the positioner itself in a custom carrying case with both handles and straps so it could be carried in most any manner the first responder chose. The benefits of the product were extremely compelling, so even though it was “one more thing to carry,” it was added to the first responder’s equipment ensemble. Other features will be added to future models.

While you need to focus on a “good” rather than “great” product definition, getting the MVP to market as quickly and efficiently as possible, you want to make the design of the product excellent. Don’t skimp there. Implement that MVP with care and attention to detail. Make sure it does what you claim it will do, every time, flawlessly, reliably. Enthusiastic acceptance of your MVP in the marketplace is your ticket to success. It establishes your new company’s reputation – a reputation that will spread quickly among users. A good reputation will yield increasing sales. A poor reputation from a shoddy design will create hurdles that small companies may not be able to overcome. Make your MVP great, while staying minimal.

During the process, many temptations will emerge to alter your MVP trajectory. At market meetings, design reviews, focus groups and Board meetings you’ll be asked about “just” adding this feature or that capability. You would be unwise to ignore such requests, they might be the one addition that will truly make your product sell and should be considered as part of the MVP. So, acknowledge such requests and consider them carefully. Use your wisdom, judgement, and wise counsel from your advisors to make your decisions, but also consult your bank balance and Gantt chart. Those two items will speak loudly as well. MVP! MVP! MVP!

In the end, focusing on a well-crafted, highly sought-after Minimally Viable Product will be the most achievable goal and the shortest path to revenues. Those revenues will allow you to attract more investments, develop follow-on, more feature-rich products, and eventually lead to positive cash flow and a self-sustaining company. And perhaps sometime in the future, you can say that “Good is the enemy of great” from your position on the Fortune 500! You have my best wishes! For now, please remember to focus on a high-quality MVP because “Great” truly is the enemy of good for your startup company!

Larry Blankenship, Director, Boulder iQ