In search of the tipping point

pharmafile | February 10, 2014 | Feature | Manufacturing and Production, Medical Communications, Research and Development, Sales and Marketing |  abbey, goldman, marketing, tipping point 

The germ of an idea, a very good idea. What if the idea could, like a germ, be a contagious idea infection, so infectious that it became an epidemic? It may not be visible at an early-stage, but as long as someone recognises the value and finds a way of spreading it, success might just come. Is there anything that can be done to help it on its way?

A little change here and there could be the stuff that tips the balance between mundane failure and roaring success. That is the stuff that blockbusters are made of. But for most of us, that does not happen every day. If it was that easy, the world would be full of Goliaths and no Davids. What we need is a way to tip the scales, or to know how to get others to do it for us. 

In bringing a new product to market and nurturing it, there are established practices to maximise the outcomes and minimise the risks. What I want to tell you about is an alternate way to look at how the processes and outcomes evolve, and some of the types of individuals who may be the sling-shot loaders in the battle for success. I have been evaluating a book called The Tipping Point by an ‘ologist’ called Malcolm Gladwell. 

Gladwell is primarily a journalist and author, but brings social science (his ‘ologies’ are psychology and sociology) to bear on his theories. In this book, he looks with an epidemiological viewpoint at what makes things change. He sees similarities in the spreading of ideas and the spreading of an infectious disease.

The mathematics are similar and, just as the spread of disease could be halted, unless there is the opportunity to spread, an idea, product or message may die away also. So we need to look at the best way to spread a message.

When an idea takes off, it can become like an epidemic. The ideas of The Tipping Point probably were not Gladwell’s own, and the bibliography in the endnotes confirm that some of the concepts were alive even in the 1970s. In the context of the pharma industry, I can see that his theories can be applicable.

Everyone wants a blockbuster, and even though we undertake due diligence and conduct market research, maybe there are things that we can do to make a good thing better in the eyes of prescribers and patients.

If we have a good message about a good project or product, are there additional ways to not only to communicate the best message but also to find a way for the recipients of the message to grasp that message and run with it?

Conversely, if we can identify the made-for-failure flaws in a project, is it possible to correct them? If we can swallow the concept that there might be better ways to do this, can these methods be incorporated into working life? 

It must be possible because we can all think about projects and products that have taken on a life of their own – and their owners, who have bathed in the glory of success (even if they may not have actually had very much to do with it).

Although not the subject of this discussion, Gladwell has published another book called ‘Blink’ which is based on the premise that the very first evaluative thought from a true expert is likely to be the best, but that kind of skill is possessed only by the gifted few.

Gladwell’s books are somewhat anecdote-based, but supported by sound academic support – it seems that having created his hypotheses, he has gone out and looked for the data that will support, and also provided support for the support. 

However, what seems to be missing are the data that do not support his model, and the conclusions are not to be taken as a critical overview but more a ‘suck-it-and-see’ for the reader. Once that is accepted, it seems his ways of thinking are infectious in their own right and it is worth considering how they can be applied. 

Imagine you have a new product for a disease area, and during development, its advantages and disadvantages have been identified, target patients and prescribers have been documented, and the financials have been worked out so that the project should make a profit. This sounds familiar, and if all other things are equal, the company should have a success on its hands.

However, we all know that sometimes, despite very best efforts, a product does not take off – or, despite what the company is doing, the product surprisingly does take off, but not for the reasons intended. 

This looks like a loss of control in both cases, and whilst the second situation is tolerable, the first usually results in blame and dissociation. Gladwell’s concept is to treat ideas (they could be products or modes of behaviour) like epidemics. The aim is to make them spread. And just as the epidemiologists know that there are factors that will enhance or limit an epidemic, this principle can be applied to ideas.

This is not quite the same as classic marketing and sales of products, where features and benefits are outlined – and unmet needs are identified – but as you will see, there are many overlaps and the missing parts may already exist within your organisation to create an epidemic growth for a product.

The first revolutionary idea is that it may be little things that make a big difference, and that consequent change may happen rapidly. The second big idea is that there are three agents of change that will influence an epidemic and create the ‘tipping point’ – that point in an epidemic where things take off.

The first agent is ‘the law of the few’ which suggests that there are a few individuals with rare social gifts who can spread a message, and it will be received by the many.

The second agent is what Gladwell calls ‘the stickiness factor’ which simply means how well a message is remembered (I think this is probably well known already, but I can think of many messages created by the industry that were completely forgettable and may have been incomprehensible or irrelevant from their birth). 

The third rule is ‘the power of context’, which means changes are sensitive to the conditions and circumstances of the times and places in which they occur. That might sound obvious, but subtle changes of the context for a product which can be difficult to define may influence the outcome. This may be something as simple as changing the layout of desks in an office to create a chain of communication that ultimately has an impact on sales.

I want to focus on the law of the few – the identification of the special individuals who can start and maintain an epidemic (of commercial success). Gladwell identifies three separate types of special people (interestingly enough, it is not clear if these individuals can fall into more than one group and still be effective, but I think they probably could). 

The first group is ‘connectors’. In a nutshell, these are people with contacts – but they are much more than that. They are rare individuals who have lots of connections and are credible. If they say something or write something, not only will it be read, but it will be believed.

In our industry, we call them key opinion leaders (KOLs). They are the sort of person whose name always comes up when a particular area of interest is mentioned. In addition to having credible opinions, they also know who to influence and who the next person in a chain of information should be.

They are the people you go to when you also want to find someone. The trick is not identifying these individuals – any fool with Google will almost certainly be able to find an often-quoted expert – but knowing when they are consistently going to be on side. 

I remember going to the product launch of a new variation of treatment for a common condition. The KOL was produced and she was the woman with her name on all the important papers in the disease area – it sounded like an easy goal. 

But within 30 seconds, it had all gone pear-shaped, because the expert did something unexpected, and suddenly said that the main features and benefits of the new product were not such a big deal. You could visibly see the blood drain out of the brand manager’s face, even with the lights out – it was amazing.

The product died at the launch because the connector disconnected from the brand, and all the sales people realised that this viewpoint was going to cascade out. So the message is clear: choose your KOLs with care, take regular checks on their viewpoint and prepare to shoot the messenger – or, even better, make sure your message has a bullet-proof vest before it is taken out in public.

Gladwell’s second group is called ‘mavens’. Maven is a Yiddish word meaning ‘one who accumulates knowledge’. I think it can probably go further than that: it also means those with substantial relevant experience. Usually, knowledge is power, but these individuals are driven by their knowledge and may not visibly seek power. 

Mavens are information specialists – they know everything worth knowing in a particular field. You probably have this sort of person in your organisation, or know somebody externally. However, mavens are more than just that. They not only have the right information, they are also pleased to pass it on, and they succeed in advisor roles, as trainers and in creating information resources.

They are not opinion leaders, because they may not have or even want the ear of their peers. And they may not have the connections either, but they know as much as an opinion leader. They get to know things before anyone else, and when something has changed, they may be the first to realise it.

This is not the sort of expert that can be imported or contracted for an organisation: it’s the sort of person that sits on the sideline with lots of books references and more desktop icons than seem sensible.

This kind of expertise does not come instantly and may have to be grown over many years. (Consider ‘the 10,000-hour rule’, and now think about what it might be like if someone had spent 50,000 hours learning their area: this is one reality). 

Now that the laws on statutory retirement age have changed, it may be the new role for the organisational veterans. Bring these people together with a connector, and it is a very potent force for your message because the mavens have the information, and the connectors know how to pass it on.

The final group is very familiar to us: ‘the salesmen’. That makes sense because that is the old-fashioned title for those within the organisation who take the message and alongside the connectors ‘infect’ those that matter with the message.

These are the infectious people trying to spread an idea; they are the persuaders who then convince the people with the money to go out and buy, and believe they have made the
right decision.

There may be a bit of a connector in these people but true connectors depend on their ability to communicate with the contacts, rather than infect them with a message. The few can deliver the message, but some other crucial element needs adjusting – this is the stickiness factor. It is how well the idea or message sticks. 

This is fairly basic marketing, but what is different is that one message does not fit all and the difference may not be easily tangible. Sometimes it is easy when a good slogan or headline is caught by (i.e., infects) the customer. Whilst branding is considered dirty work for prescribers, it is what gets a medicine remembered.

In the good old days, it might have been an attractive, branded mug which kept the name in the eye of the drinker. In some ways it is a pity that the PMCPA has intercepted some of the stickiness of promoting medicines (did a mug ever change a doctor’s prescribing habits?) and it is now a bit more challenging to find that credible truth that will hook the customer.

A real game-changing product is its own stickiness factor but, other than that, it is a matter of identifying the adhesive that will make the idea stick. One of the good sides of social media marketing is that messages and information can be tweaked slightly and regularly so that adhesiveness can be maximised. 

However, the bottom line is: you must find the idea or message that sticks and ditch the ones that don’t. So we have the rule of the few in disseminating the message and the message stickiness that makes the customer remember. 

The final piece of Gladwell’s puzzle is the power of context. The physical and social environment in which a message is delivered can influence the outcome and whether the message sticks, and whether it is passed on. 

A simple example of this is being at the presentation that is heard immediately after lunch: post-prandial torpor may limit how much is heard, let alone remembered and understood.

Knowing this, the talking head who makes the audience wake up and forget they just had lunch is more likely to win, just as the first talk of the day is typically the one remembered most.

But there is some tinkering that can be done with the context. Is the room well lit? Are the lights up or down? Is it just that bit too cool? Does the AV presentation grab them by the throat? Is there some interaction going on? 

And, most importantly, has the audience been told that what is about to happen? If the small things can be identified in the context, and adjusted, the message is more likely to get through. As a seeming aside, Gladwell observes thatw within organisations, no one can effectively manage or communicate directly with more than 150 people. 

It may be a useful rule of thumb when organising an idea-spreading meeting to limit audience size, and you are more likely to get high class information and communication going with this sort of number.

Having known a number of individuals that would aspire to the ‘rule the world’ school of management, it is comforting to know that there is now a clear definition of ‘too much of a good thing’. 

So in summary, there are a number of things we can do to tip the scales so that ideas become epidemics. We can involve the few who are the connectors with the right contacts, the mavens with their experience and knowledge and the salespeople who persuade and convince.

Then there is finding the way to make your message sticky and not forgotten. And finally there is identifying the right environment in which to deliver a message, or tinkering with some small detail so that the message is best received.

I have one final thought. In these cost-conscious days, companies do not necessarily want to house all these skills under their own roof and may want to contract out. This raises the question of whether contractors, who will be moving on to their next job as soon as yours is done, can acquire the skill sets and passion that seem to be essential for this model to work every time.

Maybe that will be the next trend in contract services – contracted tipping point construction. It might just make sense.

Brad Abbey is the pseudonym of an experienced pharma industry executive