#397: Winning Over Skeptics: the Key to Product Adoption in Healthcare

Etienne Nichols: Welcome to the Global Medical Device Podcast, where today's brightest minds in the medical device industry go to get their most useful and actionable insider knowledge direct from some of the world's leading medical device experts and companies.

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Hey, everyone. Welcome back to the Global Medical Device Podcast. I want to talk about winning over skeptics and some of the keys to product adoption in healthcare when it comes to selling those products directly to the healthcare professionals.

And with me today to talk about that is Tiffany Ryder. How are you doing today, Tiffany?

Tiffany Ryder: Hi. Good to be here.

Etienne Nichols: Great to have you. Tiffany Ryder is a healthcare advocate and physician assistant with a passion for expanding access to medical care. After transitioning from her role as an NFL cheerleader, she gained extensive experience in rural emergency medicine and now as founder of Red Flag, Hiroshi champions helping patients become better consumers of healthcare, which I have become pretty passionate about myself.

So I know you're passionate about equipping professionals with, interacting with healthcare, interacting with medtech, and so on. I was looking through your background. You have done so many different things.

I didn't know if there's anything you wanted to highlight or call out real quick.

Tiffany Ryder: I don't know. You know, it's funny, like, I used to look at my background and. And I was a little embarrassed at how nonlinear it was. And then now I look at it and I'm like, this is so cool.

I've, like, had the opportunity to fail in so many different ways and learn in so many different ways. You know, I think an essential part of my background that, that doesn't always show, certainly not on my resume, but I almost wish it did, is that I grew up in a rural area of the country in Louisiana, and, And didn't have health insurance or access to healthcare.

We were really poor. We lived in.

That was very poor. And I think that that's shaped a lot of my. My perspective and the way that I look at things in a good way. In a good way, like knowing what those conversations behind closed doors look like when, you know, perhaps the doctor says you need a medication and there's just, you know, it's more than your rent.

Like, how do you, how do you have those conversations? And you know, and then moving, I moved to the D.C. area and enrolled in college and, you know, tried out for the NFL, actually tried out for the NFL the first time.

25, 30 pounds overweight. You know, I didn't know what I didn't know showed up, did my best, was in a place where I had prediabetes diagnosis, pcos, you know, was being told by the medical community, you know, it's okay.

Like, this is, this is, you know, these are conditions that happen to people. And you know, we give you Metformin and you know, you, you do the best you can and, you know, if you develop type 2 diabetes, which you certainly have a higher likelihood of doing so, like, here's how we manage that.

And, you know, and I believed that, I believed that. And if it hadn't been for my, my desire to, I don't know, do something big and go into the NFL and I hadn't, you know, found myself in a position where I ended up losing those 25, 30 pounds and, and made the team and lost those diagnoses.

Wow. Yeah, I would have never known that, that I shouldn't have believed that. And so, you know, all of these experiences, I think, certainly play into my interest in expanding conversations, expanding the knowledge that patients have about perhaps what their clinicians do or don't know.

And I think, you know, that that's all part of the story of how I ended up where I am now.

Etienne Nichols: When I think about a company coming to a healthcare professional trying to sell their product, I mean, the, the level of skepticism, or we could look at just your medical device or your medical background, your healthcare background, but that doesn't really include your personal experience with HealthC.

A person may not understand that either, but all of those things are going to impact that product adoption. And what would you say is important for medical device professionals to turn those doubters?

Like, if I'm trying to sell you a medical device and convince you my product really is better, what is it going to take for me to turn a doubter into a believer, do you think?

Tiffany Ryder: I love this.

Such a great question.

So, I mean, so let's start by saying I think you have to have a good product, right? Like you have to have something, you have to have a belief that what you are offering is actually good for the world, for the other human that you're communicating with who actually wants good things for the world to care.

There are Forces at work, whatever they are, whether it is, you know, subconscious, like, nonverbal communication, or it is, you know, energy in the universe. Like, I don't know. But I believe that, you know, authenticity comes through.

And I. So I think that's first. So I think you have to actually not be selling snake oil. That's like the perfect first step. But I do believe that there are these.

These pieces that you will just never, never know about the clinician or whoever it is that you're in a conversation with. Again, I identify as a poor person, and I.

It doesn't matter if I, you know, move past Elon Musk as the richest human on this earth. Like, I am always going to be, you know, affected by that sense.

And, you know, people who, you know, perhaps have grown up under other circumstances are also going to have those biases. And so I think it's a matter of communicating with the information that you have on your end and saying, I have this, you know, this product, this device, this pharma product, whatever it is.

I have this thing that I really think is good for the world.

And you have people that. In your orbit that I believe I could help.

And how do I get that message across? And I think if that's the, you know, the. The place that you're coming from of, like, do I want to, you know, sell a million of whatever this is?

Absolutely, I do, because I think that is what would be good for the world. And why. Why wouldn't we all want that if we all believed that, you know, this is.

This is true.

And so, you know, I'm not a salesperson. Clinicians, like, we. I like to joke about, like, we don't do anything. Customer acquisition is not an issue. Right? Like, you can see more patients than, you know, as many patients as you have time for.

But, you know, I do. I do believe that clinicians, you know, physicians, nps, pas, everyone comes into the medical industry. Most of us come into the medical industry because we're not just looking for an easy job.

We're not just looking for status to be able to say that we have a respectable place in this world.

Yes, we need to pay our rent, and yes, we would like to do work that we find interesting. But I think that underlying all of that, there are easier ways to make money than practicing medicine.

There are certainly ways that require less emotional investment and time investment and delayed gratification for training and all of this.

And so you have to assume that the person sitting across from you is someone who really cares about people or at least once did very deeply and.

Etienne Nichols: I think or the system broke them.

Tiffany Ryder: Right? Like, like I think that that, that is the base assumption.

And, and so speaking to the concerns that some, someone, you know, who sacrifice years of their life to be able to do this job would have is, is a great starting point.

Etienne Nichols: You know what's interesting to me about that is I think a lot of founders, when I talk to company and founders who are starting medical device companies, a lot of times they are starting it because a family member experienced something or someone they close to them experienced something.

For example, one man I know started a company called Alert G. He wanted a non invasive continuous glucose monitor because he just didn't know there was an option out there and his wife had a diabetic issue and so he started this non invasive continuous glucose monitor.

But I think that gets lost somewhere along the way when the company grows and other people are transition or other people are positioning the product to a healthcare provider or whoever may be the purchaser of that product.

And they may forget the initial stories that this, this saves someone's life or he dedicated his life to save his wife or whatever the case may be. And so when you are interacting because you interact probably with hundreds of medical devices on a daily basis, some of those just because you've always used those, maybe others that have entered your workflow as a newer, newer product.

I'm curious, are there any you just love because these are just great products or are most of them in your world because they've always been in your world?

Tiffany Ryder: That's a really, that's an interesting question and something I'm not sure that I've thought about previously.

And I think, you know, my off the cuff answer would be most products you use because they are what is in the environment and they are what you know. I can absolutely say that on a regular basis.

I encounter random things that seem really cool, but I'm not going to use them because they're not part of my workflow. I definitely think that the conditions in which most of us are practicing is really important for any salesperson to consider.

The idea that you show up to work and you are expected to be prepared to deal with whatever happens when you walk into the room. And not just in the emergency department.

Right. People show up to primary care or to surgeries not having read all of the medical textbooks. Patients show up as they are and you're expected to be able to pivot and improvise and make smart choices on the fly.

And I think that with that comes a Certain degree of time pressure of, you know, wanting to spend every moment that you have in the clinic or in the hospital doing your highest impact work, which is generally not learning a whole new system or a whole new device or a way to do things.

So, you know, if I am going to spend my precious time, either the time that I really should be spending at home with my family or, you know, sleeping, for example, right.

If I'm going to finish a 12 hour shift and I'm going to say, oh, you know what's important, it's learning how to use this new gadget that we have. Like, I need a really compelling reason to be willing to do that.

And, and I think that is the space where, you know, a medical device can make a difference. If you can explain to me how this is going to either change my life as a clinician, like while I'm on shift, and allow me to, you know, either save time, right.

Or produce more effective outcomes for my patients or, you know, whatever, be more comfortable, like go home without, you know, my back aching or, you know, whatever the question is, right, what you're doing that benefits my life and makes my life better, allows me to function more effectively and serve the people that I really care about, which are the patients sitting in front of me, or if you can deliver a better outcome for those humans that I care deeply about.

Now I'm listening. Now I'm at least open. I'm not saying yes, but I'm at least open to the conversation. And believe it or not, the people whose job is to convince me to care about their device, they don't always approach it that way.

Right. And so I think like, starting at that point, like, why should I care? Is. Is definitely essential.

Etienne Nichols: You told me a few stories, and so I don't know if you have one that you'd care to share, but you told me a few stories when we were kind of preparing for this, about people who have pitched things to you, whether it's new processes or new products.

Anything come to mind that you. Because I love hearing the actual. This is how it happened. This is what I was wearing. All of those details.

Tiffany Ryder: Yeah, I mean, I could tell a couple of stories. Certainly one that comes to mind is, well, this is not so much a story other than, you know, just an example of really cool things that are in the hospital that we paid tens of thousands of dollars for that aren't used.

Like things like we have this fancy medical device that is essentially a vein finder. Right. So it's a, it's A light.

It. I have no idea how it works. Don't pay a lot of attention to it. Right. Because it sits in the closet. But, you know, we have patients on a regular basis who, for whatever reason are difficult to get vascular access for or to.

And, you know, we do a lot of things. There's ultrasound guided access, there's all sorts of ways to approach this particular problem. But one of the solutions that someone pitched at some point was this, this finder, this device, and it shines the light and it's really cool.

You shine it on the area where you're looking for this vascular access and you can see the vascular vasculature. Like it's, it's almost like a, like a little roadmap. And it allows you to see through the skin.

Like, how cool. Do you want a device where you can see through the skin? Like, yes, I do.

And that device sits in the closet 98% of the time. I don't. I personally have never pulled it out of the closet to use it because I haven't been convinced why this is worth my time.

Pulling it out of the closet and learning how to use it and then, you know, doing the things.

And on that note, we had, we had some sales representatives who had come in and, you know, apparently as part of the contract, the hospital was going to be using, you know, different IV equipment, like different needles, different access equipment, for lack of a better word, they were going to be sourcing it differently.

And, you know, these, these pieces required a different approach when you were trying to, you know, establish an IV in a patient.

And most of the time the nurses establish the IV access. And, you know, we show up and we say, oh, this is great.

That IV access I ordered is here. And really, you know, the only time that I am involved in getting access is when it's really difficult. And then they say, hey, we weren't able to do this.

The team isn't available to come down and help us. Like, can you maybe come do this, you know, ultrasound guided IV placement or something? And anyway, so I come to work, you know, I walk through the waiting room.

As I'm walking to my, to my station, I sit down at my computer and these two there, there are these two very nicely dressed young people. And I say they want something from me.

Like, this is my, my first impression is like, oh, God, like, what do these people want? I've got 20 patients that I need to see. I'm in my scrubs. My whole team is in scrubs.

Because that's the appropriate Gear. These people are wearing business casual. And I'm like, they have an agenda. What could it be? Anyway, so they're right in front of my desk, so I can't ignore them.

So I go in and I say, hello, I'm Tiffany, I'm the PA who's coming on what's going on?

And they're like, oh, we have a treat for you.

We're here to help you learn how to use our fancy schmancy like IV placement equipment. And, and I think to myself, okay, now I have a whole nother task, right?

Like, there is this whole nother thing that I have just added to my plate that isn't doing the thing that caused me to sacrifice years of my life to learn this skill so that I can help people.

It is something that my hospital administration has now plunked on my plate in addition to all of the epic charting and all of these other things that I have to do.

And I think that overcoming that sort of hurdle is sort of a big ask. So, so I'm, I'm aware that like that, that the hill is, the hill that has to be climbed is very high, but that's the reality of it, right?

And, and you know, and immediately my thoughts are, okay, now I have to take time away from patient care to do this thing that I don't want to do.

I have these people who look well fed and like they've had time to go to the restroom and they are showered, who I now have to like appease in some way when, you know, I know that I'm entering a 12 hour shift where I am not going to have time to do any of those things.

But then in addition, like, you know, you can't help but have that skepticism of, well, did the hospital purchase this because it's actually better for my patients. Is this, is this actually going to make my life better or is it going to, you know, create more successful outcomes for people that I care about?

Or is this some sort of like, arrangement that was better for someone's stock portfolio or what have you? And I'm not like, you know, this is not knowledge. Like, I have no idea, but I have a healthy skepticism of conflicts.

And these are my thoughts. And so I think it's a, it's a rough job for, for people out there trying to, to make this happen.

Etienne Nichols: Yeah. Is it just cheaper? Are you just trying to save some money? I could totally see where you're coming from with this.

Tiffany Ryder: Totally.

Etienne Nichols: That being said, there have got to be some companies out there who do it slightly differently. And let me. I'll try to give you an example outside the medical device world.

So when I'm, you know, doing my video recording or whatever else, I saw someone using a gimbal and I thought, wow, that thing looks so cool. I want to use that.

And because the videos were a lot better, a lot of different things were a lot better. I'm curious if there's anything that translates to where you maybe you see something like, you know, I wish the hospital would buy this product because I saw it somehow.

I don't know if you've ever experienced that or gone through that where something. You just wish you had this tool that you know would.

And. And I don't. You probably see where I'm coming from. What was the upstream effect that got you to think that. And maybe, you know, maybe I'm barking up the wrong tree here, but I don't know.

Tiffany Ryder: So it's an interesting question. And it's an interesting question because working in the emergency room.

No, I mean, no one that I know. I'm not like the emergency room guru expert who knows everything about everyone, but no one that I know who goes to work in the emergency room does so without, like, a backpack or a locker or a whatever.

We are notorious for being like, we don't actually care what the hospital provides. This is the thing that I need to do my job effectively.

And, you know, for me, one of the things that I have to have is a headlamp. I have like a re. Like a rechargeable LED, like, you know, $150 headlamp for hunters.

I'm pretty sure the. The. The camouflage band, like, has had to be replaced, like, at least twice.

Because this is what I need to do my job because I really need to see. Well, when I'm suturing the hospital, you know, lights, sometime, sometimes they don't. Sometimes, whatever.

And so the answer is like, yes, there are absolutely things I know, like, you know, just some docs that I work with, like, have, you know, a whole variety of things stashed for, you know, everything from incising a.

An abscess to, you know, establishing lines to, you know, we. We hoard things when we do get the equipment that we like.

So, yes, that happens. That is something I'm familiar with. I think it's really important, and in my experience, at least, it's always been like a grassroots movement. It's always, you know, oh, I did this procedure with another doc and, you know, like, you know, or a specialist who came down to like, do this thing.

And I'm like, hey, man, what's that? Does that work?

Etienne Nichols: Yeah.

Tiffany Ryder: Can I buy it on ebay? Like, you know, not really, but, like, how do I. How do I get one of those?

Etienne Nichols: I get my hands on that.

Tiffany Ryder: Yeah. About it or, you know, I think that medicine is relatively territorial and, you know, we all have, like, podcasts that we. That we know, like, and trust or, you know, people that we follow and.

And, you know, you see something on TikTok from, like, you know, a doc that you follow that's in your specialty or whatever, and you say, oh, cool. Like, I don't know, I'm gonna try that.

And so, like, in my, in my experience, like, it's really that, like, grassroots word of mouth from other clinicians who are in your space who speak your language. Right. Who can and aren't necessarily at the hospital selling it to you.

But if I see that, you know, that doc, talking about it on a, you know, on a podcast or on a whatever, then I'm like, oh, okay, that's interesting. I wonder if we can, you know, talk to those guys, someone get.

Get that rep and get them in here, like, so we can, like, have this conversation or if it's a lower ticket item, like, I'm just going to buy it and then try it, and then I'm going to tell every single one of my friends about it, because that's what we are.

We're a community.

Etienne Nichols: Yeah, no, that's really good. Maybe we'll have to do an episode someday on what's in your backpack when.

Tiffany Ryder: You go to the emergency butterfly ultrasound. You know, like, there's just, like. Yeah. Lots of. Lots of interesting things. You should ask any clinician that you come into contact if they, like, have stuff that they bring to work.

Etienne Nichols: Yes. Okay, I'm going to do that. I'm putting that on my list.

Tiffany Ryder: You can totally do that. I think you would get. I think you would get some interesting ideas and some interesting insight to talk about.

Etienne Nichols: Yeah.

Tiffany Ryder: If.

Etienne Nichols: I mean, if I could database that. That I could run one. Everybody carries this. Everybody has a headlamp. I saw Tiffany do it, and it's great. So, yeah, that's interesting. If we could condense this into one.

One golden rule that you think every medtech professional should have as they're thinking about developing this product and with the knowledge that someone's going to have to use this product.

If you could think of just one golden rule to give those companies and those people to help win over skeptics, what would it Be.

Tiffany Ryder: I think it's talking to the.

The. Instead of talking to the people who love your product and are inclined to want to. Want to love it, you need to find the most skeptical, the most, like, negative, derogatory person who's, like, on LinkedIn, talking trash about whatever it is that you're trying to do.

You need to talk to that person. Right? Like, I think that there's a lot of interest in, you know, sort of finding your echo chamber of people who agree with you and are, like, on your team.

And, like, those aren't really the people that you gather the most. The most information from. Like, you really need to be talking to the person who's like, you know, I'm not going to allow you to use my patients as, like, your guinea pigs.

Like, here's the evidence I would need for me to even consider having a conversation about X, Y and Z. Here's what's wrong with your product. Like, I know people who used it, and you charge X, Y, Z, and this is the outcome.

Never going to buy that. Like, having more conversations. I mean, I think from the very beginning of, you know, what's wrong is I think how you get there. And I can.

I mean, I can share, you know, one more story about a conversation that I had with someone. I met someone at a. At a conference, and we followed up and.

And this person was in the startup space. They were doing this, you know, really cool work where they were doing a test similar to some things that are out on the market.

They were doing a test to evaluate, you know, different genetic flags, for lack of a better word, of just, like, what, you know, Humira might work well for this patient, but it's probably not gonna work well for that patient.

Like, so those sorts of tests that would. That would guide treatment guidelines, would guide, like, maybe which drug you put your hand on first.

And. And so, you know, the. This. This. This young woman, you know, explains to me what they're doing. She's very excited about it. She's very passionate, very authentic. She passed that test, right?

Like, the test of, like.

Like, yeah. First test of, do I believe that you actually care about my patients? And the answer was yes. And I said, oh, wow, you know, this all sounds very exciting.

Here's what I'm thinking, though, right? Like, I'm thinking that my patients. Access to my patients is a cash cow for you. So even if. Even if her product was amazing and was going to be transformative for my patients, I'm already coming into the conversation knowing that.

That she's incentivized to believe that. And so I'm already skeptical right from that, like, just from the get go. And I said, you know, really, the hurdle that you're going to have to overcome is you're going to have to have enough data and enough evidence to prove to me that, like, that you've overcome this bias.

Like you, I already know that you're biased to want your product to work, but like, I'm going to need it to be so overwhelmingly objective that I'm now like, okay, that might be worth it.

Right. For me to try this with a subset of my patients or what have you, you know, and I, I tried to have that conversation with her and she didn't, she didn't really understand.

You know, she was like, but this is so wonderful. And I was like, yes, I hear you. And I even believe that. That you believe that. Yeah, but I'm gonna need, you know, XYZ in form of evidence.

And so I think also, like, you know, just having your, the degree of evidence that you're going to have to present and the 10 different ways that you would present that evidence because, you know, everyone is going to need a different take on it.

I would say that in my experience, most salespeople underestimate that.

And when you're talking, at least to a clinician, you shouldn't underestimate that. Maybe if you're just talking dollars and cents and, you know, it's a different conversation, fine. But when there's a clinical voice involved, I think that the level of evidence is going to be higher than you think.

Etienne Nichols: Yeah.

The level of data needed I think is important, the types of data, because I think when medtech professionals think data, they think, okay, X number of patients experience this percentage better increase.

But we forget about the part of my workflow part. We forget about part of the ease of use part of the all of those different things that go into it.

There's a lot of different aspects that you've touched on.

Tiffany Ryder: Having a testimonial from a nurse saying, I use this. And it's made my life easier in the following ways. And because it's easier, I'm able to take care of four patients instead of three.

Etienne Nichols: Yeah. If you can get that from a nurse, that's big. Because my wife's a nurse and you talk about skeptics.

Tiffany Ryder: Yeah, exactly right. And I think that's, I mean, I think that's also another, you know, good point that I wish I saw more of. Like a physician should be leading the medical team.

Yes. They should. But also, like, I want to hear, how is your device affecting the nurses? What do they think about it? What does the NP think? What does the app think?

What does the. The phlebotomist in the office think? Like, whatever. What. Whoever is, you know, going to come in contact with that patient in regard to whatever product or solution you're, you know, advocating for.

I want to hear all of those voices because it matters.

Etienne Nichols: Yeah. Would you be open to people sending you products to use?

Tiffany Ryder: I don't know. Maybe. Depends. Right.

Etienne Nichols: Like, if it's a new headlamp, that sort of thing. Maybe. I don't know.

Tiffany Ryder: I mean. And that's how it is, right? Exactly. Like, if you're. If you're going to send me, like, something that's like a different version of something I use every day and that I think is valuable.

Like, heck, yeah, man. Like, right. Like, I'll try this thing. Is this cool? I don't know.

Etienne Nichols: But when it comes to this, could potentially hurt. Yeah.

Tiffany Ryder: What's that?

Etienne Nichols: But when it comes to this could potentially hurt a patient. Makes sense. Yeah. You wouldn't. Yeah, there's a whole lot more involved. Yep.

Tiffany Ryder: There's a whole lot more involved. And you can't assume that just because it makes sense to you that it's going to make sense to whoever it is you're sending it to.

Etienne Nichols: Yeah. This has been a great conversation. I've enjoyed it. I always enjoy your passion when you talk about your patients and your work. Any thoughts or any last piece of advice that you give the audience?

Tiffany Ryder: You know, as a. As a shameless advocate for, you know, patient information, I would say, you know, my big thing to leave would be when you have something, when you have a device, when you have an offering or a solution that the patient needs to understand how it works.

I know you and I talked about, you know, pacemakers, like, if you're inserting a device into a patient's body also, you know, don't underestimate what those patients need to know, how those patients need to interact with clinicians and the medical system to.

To be able to get the best use from whatever it is. So I think that, you know, the education component is something that absolutely cannot and should not be neglected from patients all the way through the medical team, up to the physician.

Etienne Nichols: Yeah, I think that's good. That's powerful. Thank you so much, Tiffany. I appreciate it. Those of you who are listening really appreciate you listening, and we will see you all next time.

Everybody. Take care.

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