Do you have an export strategy or just international intent? By the end of this episode, you'll know how to build a revenue driven export plan, not just a strategic narrative. Export rarely fails because markets are too hard. It fails because there's no clear structured commercial plan behind it. Welcome to Clinician to CEO, the podcast helping clinicians simplify your go-to-market strategy so that you can stop guessing and turn your working prototypes into international MedTech businesses. I'm your host, Hakeem Aade. Let's get started. So in this episode, I'm gonna walk you through the five steps that will help you build a commercial plan that makes export actually work. So step one. Vision, but built properly. Now, here's what most founders say when I ask them about their export vision. We want to become the global standard. Think that we want every clinician to use this, or we want to scale internationally, and then we want to exit Now. That's ambition. And it's not small ambition either, but the thing is, ambition isn't vision. Vision isn't about how big you want to be. It's about the role you're building the company to play. Now, are you building a premium specialist brand or a volume driven category player, or a fast growth acquisition target, or a dominant niche leader? Those are different, types of visions that you're trying to. Build there because ambition without structure will start to create drift in the business. IE your pricing can shift and drift. Your markets can shift. Your distributor profile starts to shift so you're not clear on exactly what sort of distributor you're looking for, 'cause you're not clear on your vision. And then even your narrative around your products or service starts to shift because vision. Isn't about how big you want to be. It's about whether your direction is clear, whether your decisions align with that vision and whether it keeps you moving forward when progress slows and whether it attracts the right partners and employees and people to work with you. Now, this is where my vision framework damp comes into play, that D-A-M-P-I-E, direction, alignment, motivation, and people, because if your vision doesn't guide decisions, it won't guide expansion. And if it doesn't guide expansion, export becomes reactive. And without that clarity, you end up just adjusting your story. Depending on who you are speaking to. So in Dubai, you sound premium. In Eastern Europe you sound cost driven. In the US you sound like a tech platform. You start saying yes to the loudest markets, the most enthusiastic distributor, the investor who asked the nicest questions. That's not a strategy. That's movement without direction. Or let's call it drift. 'cause I like to talk about drift and drift burns runway, and it burns money. So step one isn't, let's go. International, global. Step one is defining a vision that gives you direction aligns decisions. Sustained motivation, and filters the right people. And if you want a full breakdown of how to build your own vision using the DAMP framework, then go back to episode 1 6 4, as that episode is entirely about building the right commercial vision for your business, which is critical. So. For now, just understand this. If you don't define where you are going and what role you want to own or your business to own, export becomes the reactive and reactive businesses burn cash. So step one, define your vision. Moving on to step two, that's about market prioritization. And can I be blunt here Now, to be fair, I always am. So I don't really know any of the way. So the simple truth is that most. SMEs don't choose markets. They actually tend to follow attention. Someone shows interest at Arab Health. So suddenly the Middle East is now described as strategic a US investor asset question. So now America's a priority. Now that's not a plan. And we need a plan. You need to be able to segment your market based on probability and potential. So let's break that down. So potential is really describing that if you are successful in that specific market, how big is the pie going to be? So potential is gonna be things like market size or addressable market, those sort of things. And you have to look at specifically for your markets, what would those things be? And then probability is then looking at, okay, how quickly can we access that specific market? So it's going to be, things and parameters such as regulatory, friction, competitive saturation. How many. Competitive are there in the market, and how successful are they doing? What's the speed to revenue, what's the clinical demand, et cetera. So that's what you've then got. You've then got two parameters that you can then start focusing on and taking those two parameters into account when you're choosing your markets. Because if you ignore potential and you start getting traction, then you're not gonna make that much cash because the market size isn't right. And if you ignore probability, then you may target the largest account, but you're gonna spend a lot of time getting into those. When there's markets you could get in there quicker and deliver good quality revenue. To grow your business. So you need both of those parameters when you're looking at markets, and you should be comparing those markets to one another to actually get a short list of markets that you want to focus on. So if you use this methodology, then it forces you to choose the right markets because they're based on potential and probability. And sometimes you're gonna be surprised what it spits out. But because it's based on data and information and not gut feel or glamor, then you get the right markets that you should be targeting. Simply put, you need to go where you can make money quickly and there's good potential because your first international revenue changes your confidence and your negotiating position, and the wrong first market will drain both. Because your first international revenue changes everything. It changes your confidence, it changes your negotiated position, it changes, your exit plans, if that's where you're trying to take your business to. And the wrong first market. Conversely drains everything. So that is step two, choosing the right markets in the right way, a market prioritization. Moving on to step three, commercial readiness, and here's the reality. Most export failures are actually internal, not external. So if I was to ask you, why does a hospital buy your product or service? Now have a quick think about it and if your answer. It's basically features of the product and not benefits of the product, then you're not commercially ready. Now, a little trick that I always, work with people on is to get to the real benefit of your product. Take whatever you think couldn't leave your benefit and then say to yourself. What does that mean? So you say whatever your benefit is, and then say, which means that now when you can go no further, then you have a real benefit to that customer. So that's just a little exercise for you to do to get to that benefit. Now, if I were then to ask you, why do the distributor push your product and you say something like, because it's really innovative, then you're not ready either because that's too generic and it's very bland, if I'm honest. And that's not gonna get that distributor through or motivated or working hard when the going invariably gets tough when you're trying to get your adoption going in the first instance, because your business plan must really define at least five things when you're talking about this commercial readiness. A, you need to know who your ideal customer is. B, you need to understand, what's the decision making unit is for your product, and for the different decisions that need to be made. In getting your products adopted. C, you need to have an economic narrative. In this day and age, just having a clinical narrative is great, but it's not gonna get your products adopted. You need to have an economic narrative because every facility is going to look at what does this mean to them financially? And then D, you need to really understand the margin structure and the margin play that you are. Instigating with your distributor partners and E, you need to understand the adoption triggers. Because otherwise you're exporting a product are not proposition and products get compared and it's much more challenging. Propositions tend to get adopted. So let me give you a worked example to illustrate what I'm talking about. 'cause you might be thinking, oh, what does he mean by ideal customer decision making unit, et cetera. So let me just take you through that. Let's imagine. An imaginary company called Ortho Flow. I'm hoping there isn't any company called Ortho Flow 'cause I've just made it up. Now they've developed a disposable surgical fluid management system that reduces contamination risk and shortens theater turnaround times in orthopedic procedures. They're c marked. They've completed two UK pilot evaluations. And they now want to export. So here's what their business plan should actually define a, an ideal customer. Be specific, not broad. When I ask people about an ideal customer, they'll say something like orthopedic hospitals in Europe. Unfortunately that's weak and it's not gonna get you where you need to go. So a stronger version would be something like high volume orthopedic centers performing more than a thousand joint replacement procedures annually. We've documented theater turnaround pressure, and existing single use device procurement pathways. Now, why this matters and why I would consider this a strong version compared to a weaker version, is because this version so this second version means that smaller centers fall out immediately, so you're putting them to one side. ambulatory centers may not qualify Digitally immature systems drop off Distributor selection then must include ortho specialist reps. So this ideal customer profile now drive targeting instead of just some generic. Hope of, getting into orthopedic hospitals in Europe. You're now very specific and therefore you can start really honing in on exactly what your narrative needs to be, what your distributors need to look like, and what your value proposition needs to be to map the real power. So instead of what a hear all the time surgeons are our target. That's what I'm focusing on surgeons. What you really need is your plan needs to define. Who is the clinical champion? Is that the lead orthopedic surgeon? Okay. Let's say it's who is the operational gatekeeper? Let's say that's the theater manager who is the economic buyer. Procurement committee or CFO, but you've defined it. Who are the secondary influences or, or the users that are gonna have an influence on the decision? Is that an infection prevention lead, for example? Now, once you've got start defining all those and you've got all that information, now all flow. Understands that a distributor with only surgeon relationships won't get them listed. They actually need access to theater, operations and procurement. That changes who qualified as a viable partner. So hopefully as I'm going through it, you can see that the more specific you get in your business plan, and remember, we're still in the commercial redness stage here, but the more specific you're getting in everything that you do, it affects everything in terms of distributor selection, in terms of value proposition, et cetera. So we're now moving on to. C economic narrative because you, what you want to do is match the system incentive so. Saying that the economic narrative is, oh, it improves workflow and safety is not really the sort of economic narrative that is gonna get you used. What you need is something which is a bit more, specific. So you'd say it reduces three to turnaround time by seven to 10 minutes per case, potentially increasing daily procedure. Capacity. It lowers cross contamination risk. It therefore reduces re sterilization events and associated costs. And the best thing in all of these is try to find those costs, from that specific facility so you can put some numbers on it. Because in publicly funded systems, capacity and efficiency story leads and in private systems revenue per theater, our and in private system revenue per theater hour. Story may well be the leader. It's the same products, but you have a different economic trigger. So if your export business plan doesn't adapt the narrative per system, then your adoption is going to stall. So then we move on to D, which is about engineering distributor behavior. 'cause I'm assuming that you'll be growing your export business with distributors. So what I'm talking about here is making sure that you know what makes the distributors tick, really, and then how do you manage and monitor them to make sure that you drive them to deliver, a successful launch within that market. So. The first thing that you want to look at is what's the distributor margin? What's gonna make that person motivated? So rather than just saying, oh, well actually I wanna pick an arbitrary figure and say, well, I wanna give a distributor 25%, because I think that's re reasonable. What you want to put in your plan is, what that market should be aligned with other products, in that marketplace that the distributors may be selling. So you look. And you'd speak to people in the market for example, understand that the gross margin that, people generally work towards or distributors generally work towards, with single use surgical consumers that so then what you try to do is benchmark that product and the margin. So let's say for example, you found out that the, benchmark for single use surgical consumables in that target market was 30 to 35%. That's what you'd offer. You may offer slightly less 'cause you're gonna negotiate upwards or you might offer slightly more. To make them more motivated, but you need to have an understanding of what it's like in that market so that you can give them a decent margin, that they're gonna be motivated by. Then you then wanna understand, okay, so how am I gonna make sure that we're measuring and monitoring that individual distributor, so you'd put in quarterly performance milestones, which are then tied to the exclusivity in that marketplace. And then you'd have, a initial. Three month stock holding requirement to make sure they didn't run out stock. So these are the things that you'd put in that are part of the plan to make sure that when you're launching into a market, then it's working effectively. Then you've gotta start looking at some targeted accounts, and you'd be happy, you'd suggest that you're happy to co-fund launch activity for maybe those first five targeted accounts. 'cause then it's showing that you're committed as much as they're committed. And then the incentives. To that distributor a clear, and there's a lot more we could go into here, but. What you're really trying to do is match what you are trying to achieve in the market with what they're trying to achieve in the market, and then document it in a distribution agreement to make sure that all of the things are clear. The distributor knows what their responsibilities are, you know what your responsibilities are. And I'm gonna do a completely separate episode on the best way to construct a distributor agreement. so watch out for that one. Then we move on to e adoption trigger. What does adoption trigger mean? I hear you cry. This is about how do you get movement, how do you get adoption, what are the triggers, to get adoption of your products in those hospitals and those groups. So this is a big area where most export plans don't have an answer, and there's nothing in there about it because generally you'll describe the product, you'll describe the benefits, you'll describe potentially the margin that you want to make But you never define what makes the hospital act. Hospitals don't adopt because something is interesting. They adopt because something is pressing there if a compelling reason for them to use. So what also flow needs to define is. It's primary trigger, IE it may be theater capacity bottleneck during peak demand that makes the hospital acts. The secondary trigger may be there's an infection control audit finding. And then the acceleration trigger. The thing that's really gonna start the adoption is there's an adoption by flagship Orthopedic Center in the same network all of a sudden. You've got people who are interested because there's a bottleneck, during peak demand, which people are aware of. There's an infection control audit finding, which suggests that you need to do something, different. And then you see there's adoption by a flagship orthopedic center in the same network. And referrals and third party references still are effective today as they have been for the past 20 or 30 years. So when you have that primary trigger, that secondary trigger and that acceleration trigger. The distributor conversations change. So instead of, oh, let's arrange some meetings, you're asking more specific questions. IE which hospitals are under capacity pressure, which networks are currently reviewing infection performance and who's just had an audit issue? Now you're targeting pain. You're finding what the pain point is, you're not targeting interest, and that's the difference between exporting a product and exporting a proposition. Products get compared. Propositions, solve something urgent. So what you need to do, and you don't write it down now because you're out running or whatever you're doing, then start thinking about what's your primary trigger for your product? What's the secondary trigger and what's the acceleration trigger? And write them down because you need to know what they are for your product or your service so that when you're speaking to distributors. You can be explaining that so they're then targeting the right people at the right time. Just a quick check in here to make sure that you're all still with me, because I know there's a lot of information that we're going through here. So the first three key elements of a commercial structured export plan that we've just gone through are, number one, vision. Know where you're going and why you're doing it. Number two, it's about market selection. Going to the right market from the beginning, and then three commercial redness. Make sure that you understand. What and how you are offering your proposition to the market. And then that brings those two step four partner strategy. This is where emotion often kills the logic. Because founders often meet enthusiastic distributors, and then the founder feels very validated. The contract gets signed, the exclusivity is granted, but there's no performance milestones. And then 12 months later, the blame game starts. And that's why you need step three, because once you've defined all those things in step three, then it enables you. To have a business plan that can then define what type of distributor fits your stage, what are the KPIs that matter, what stock holding is required? What happens if they don't perform? And this has to all be tied into a clear distribution agreement. Absolutely no handshakes. I mean, you can't have a handshake, but what I mean is you don't handshake and then hopefully everything's gonna be all right. You need it clearly written down now, and I can't. Actually believe that I'm saying this, unfortunately, and whilst you may well be thinking that actually no one's ever gonna just have a handshake and then, put their business in the hand of someone else in a different market. Sadly, I've seen it many, many times, but it, as you probably can understand, it never really ends well. So that's step four, having a clear partner strategy. And then step five is the 180 day reality check. This is the part that, again, people don't tend to write down what's gonna happen in the first six months in that export market? Who is the first reference site that you're trying to achieve? Who is the ca opinion leader that your charter influence? What evidence are you collecting? When do you review performance? What metric proves traction? Regulatory approval is the starting point. If your business plan ends at approval, you've planned compliance, you actually haven't planned growth. So we've now been through the five steps. Remember, step one is division. Step two is market prioritization. Step three is commercial redness. Step four is partner strategy, and step five is the 180 day reality check. And I'm gonna do each one of those a separate episodes, just as I did with the vision, to make sure that we can go through it and workshop it and then actually go through your plan into the market prioritization, et cetera, commercial redness. if I was to ask you today. Show me your export business plan. Would you show them a slide deck that you prepared or would you show them a structured commercial system like I've just been through? Because if it's not the latter IEA structured commercial system, then you're not really setting yourself up for export success. Because export isn't about building slide decks or building what looks good on paper that you're never gonna use. It's about building a clear structure that you can execute. And the companies that treat export as a system are the ones that scale, the ones that treat it as an opportunity, to hopefully get into other markets. They're not the ones that are gonna deliver, they're gonna store. But before I close this episode, let me give you this week's decision point scenario because frameworks are very easy to not belong to, but they're a lot harder to apply. So I want you to use the framework that we've just been through. And here's the scenario. Imagine this, you're a MedTech founder, which you are. Uh, you've got, uh, a c Mark products. You've got small but solid UK pilot. You've got limited cash runway international sales team. So you've just built your business plan on those five key principles and those five key stages that I've just presented in this podcast episode. And you're now looking at your market prioritization and your scoring within that prioritization have given you three possible priority one markets market a. It's large high revenue, ceiling complex reimbursement, long regulatory timeline. Two, strong established competitors. Market B is mid-sized, moderate regulatory complexity. Clear clinical need and one motivated distributor with the right align portfolio. And then market C is a smaller market, fast regulatory pathway, weak reimbursement structure. Does distributor interest, but they want exclusivity immediately. Now you have capacity to properly execute one market in the next 12 months, only one. So here's the question, which market do you choose first? And more importantly, why? Because this is where most business plans fall apart. They say that they're strategic, but when faced with trade-offs, they revert to emotion. So which would you choose? And in the next episode, I'm gonna talk you through exactly how to evaluate this using this business plan structure that I've just talked about. And then I'll tell you which one I'll choose. And if your export plan only works in PowerPoint but falls apart on the commercial pressure, you don't have a strategy. At the very best, you have a narrative. So understanding where your export structure is strong and where you are commercially exposed is the key to bringing your MedTech device to the market on a global scale. So to find out. What is holding you back? Book a free healthcare export accelerator discovery. Call with me now via the link in the show notes and on this call, I will personally audit your systems and tell you the exact next steps you need to take to help you accelerate your international growth. Thank for listening. Keep listening and keep growing.