Is your B2B SaaS product preventive medicine or a morphine drip? (Part I)

My favourite aunt is 75 years old and has Type 2 (adult onset) diabetes.

Three times per week, she drags herself out of bed and down to the hospital for kidney dialysis treatments.

There she sits, for 4 hours from 6am to 10am, connected to a machine that filters the toxins from her blood… because her kidneys can no longer do the job on their own.

She’s had diabetes for 15 years.

When she was first diagnosed, all she needed to do was modify her diet — like eat more whole foods and consume fewer sugary and starchy processed foods.

She tried to make some lifestyle changes, such as buying green, leafy vegetables and cutting back on making Potato Varenyky​​​​​​​ (pierogies, a popular Ukrainian dish). But after decades of eating the same carb-rich diet, nobody in her family was willing to get onboard with those changes… which ultimately made her attempts futile.

Her diabetes wasn’t yet “visible”, outside of her blood test results. She understood the doctor’s admonishment that over time she would begin to notice the disease’s impact. But beyond his warnings, there was no immediate consequence for maintaining the status quo. So maintain she did.

What happens when you ignore your physician’s recommendations?

What happens when years pass in which you ignore their recommendations?

The disease progresses.

My aunt began to experience hunger even after finishing a meal. She’d often feel fatigued. And sometimes she’d notice a slow-healing cut or sore.

Diabetes began to show itself.

At first, the seemingly quick progression of the disease shocked her. This in spite of the fact that she knew that the doctor’s predictions may become reality at some point. All at once, diabetes became real for her. Because she could see it. Because she could feel its effects.

Miracle pills can’t work if you don’t swallow them

In an attempt to slow the progression of the disease, my aunt’s doctor’s revised course of action was to prescribe medication on top of the still necessary dietary changes.

Interestingly, by introducing medication into the mix, I think my aunt felt even less pressure to modify her eating habits. In her mind — and I suspect in the minds of many other diabetes patients — a pill was the next best thing to a cure: a low effort, high impact solution.

One day during a family get-together at her home, I asked about her medication.

This time it was my turn to get a shock.

She told me she hadn’t been taking her medication as often as her doctor had told her to. “Sometimes I forget,” she admitted.

Quoi?! The medication had been having a positive effect. My aunt had been feeling good thanks to it. And even though she was still eating what she wanted (instead of the prescribed diet), her symptoms had largely disappeared — all thanks to the medication.

A pill was such a seemingly simple solution to what could be a painful future for her.

Yet instead of switching to a life with a slightly new habit — that is, taking a pill a few times a day — she started to regress toward her own status quo… back to her comfort zone… and ultimately down a path that might one day lead to dialysis, blindness or limb amputation.

Pain is the best motivator for change

My favourite aunt is now in end-stage kidney failure.

Here’s the process she went through at the outset of her dialysis regimen, as described by the National Kidney Foundation:

In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.

Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.

However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft.

The average life expectancy for someone on dialysis is 5–10 years. The thrice-weekly procedure my aunt now takes is very expensive. Luckily for her and the family, the Canadian government covers almost all costs. (Don’t imagine, Canadian readers, how much money we’d be able to put toward better education, infrastructure, etc if everyone just took their damn pills to regulate their diseases.)

If my aunt travels anywhere outside of her town with her husband, the trip necessarily revolves around her treatments. So she tends not to go far from home.

Had she maintained a proper diet, it’s possible that she wouldn’t need medication at this point. (Disclaimer: I’m not a physician, nor do I play one on the interwebs.)

When the solution to our pain is presented to us, why don’t we take it?

I suspect my aunt’s reluctance to switch to a life of daily pills was all about the level of pain she didn’t experience.

Early on, eating well did nothing to reduce her pain because she had no pain at that time. Eating well is almost always a preventative measure, no matter your affliction.

When her first symptoms appeared, she experienced some degree of pain (perhaps not physical pain, but blurry vision and tingling limbs tend to cause emotional pain) — and that’s when she took her medication as prescribed, until the pain was reduced. At that moment, in her mind, her diabetes medication became usefully preventive, just like changing her diet.

Now here’s a question for you: Can you guess how many dialysis treatments she’s missed in the past 2 years? After missing countless prescription doses over the years, how many dialysis treatments has she missed?

That’s right: zero.

Acute care — such as dialysis — is about giving immediate relief.

When an overweight man suffers a heart attack, he’ll likely (and quickly) agree to bypass surgery, despite the risks involved with major surgery and the associated pain of recovery.

But once the blocked arteries have been addressed, what are the chances he’ll make these long term changes?

• Stop eating bacon
• Take cholesterol medication 2x a day
• Quit smoking
• Say no to Friday-night pizza and weekend burgers on the grill
• Take low-intensity walks each night
• Stop drinking soda

It’s more likely that he’ll end up getting a 2nd or 3rd bypass surgery. The only hope for change? Possibly if his doctor, friends or family can make him feel some degree of pain or angst for not making lifestyle changes.

How much pain does your target audience feel?

In the world of software, many of our decisions to use a product or service are based on an immediate need or acute pain.

Can’t stand one more day dealing with traffic problems on your commute? Add Waze to your iPhone.

Having no luck hooking up in bars? Download Tinder.

Tired of moving your files around on thumb drives? Dropbox to the rescue.

Immediate pain. Immediate pain relief.

And if a user deletes Waze or Tinder or Dropbox, the problem resurfaces immediately.

Being able to relieve acute pain immediately is a great position for any startup to be in. But for SaaS, such visceral pain and such pill-perfect solutions are rarely the case.

SaaS products require onboarding and learning, and their benefits aren’t immediately apparent. There’s often an investment of time required, beyond initial onboarding. And unlike the consumer products I mentioned, SaaS products typically carry a monthly fee.

So what if the pain isn’t acute?

What if your prospects — like my aunt — are barely aware of their symptoms because the disease (within their organization) hasn’t progressed sufficiently?

Chances are good that your prospects don’t feel acute pain.

From the perspective of new users, adopting a new software tool is like trying to adopt a new diet — but within an entire family of people (i.e., their team), who also need to adopt the new diet.

Most people are content to muddle their way through their existing, suboptimal workflows — their status quo — as seemingly painful as that may appear to someone on the outside. They’re numb to the pain and largely oblivious to the symptoms.

Even if you can get them to recognize a few symptoms, they’ll likely decide that the perceived effort of changing their less-than-ideal workflow is greater than the perceived benefit of using your new SaaS tool.

No acute pain. Medicine that takes time to work (and costs money). A group of people that have to agree on the proper course of treatment. …Recipe for zero change.

Like so many other B2B startups, Airstory is in this category.

We’ve learned through direct user feedback that we’re building a product for people who don’t yet feel their own pain, or more accurately, who’ve become accustomed to it.

Our target market is largely comprised of people who unknowingly experience “inertia of the status quo” on a daily basis.

We hear about the same messy processes over and over. It goes like this:

Evernote to manage clippings and research. Trello or Asana to manage tasks and workflow. Google Docs or Word for writing and collaborating. Slack or email for getting approvals. WordPress, Drupal or Medium for publishing.

It’s messy, they admit, but not so painful as to require that they change.

Huh? Five tools, none of which speak to each other, to get a single document created? In business? — where money doesn’t flow into your account until you’ve put words on the page? Sounds painful to us.

We suspect that our early users’ need to meet internal or client-driven deadlines has numbed the pain of stringing together and managing all sorts of tools: they’ve had the same doc-related problems for a long time, and they’ve become accustomed to their shitty hacked-together solution. The only real pain they seem to anticipate is that of moving away from their existing process.

But the pain is there, masked only by the status quo.

And in part 2 of this post, I’ll share some examples and suggestions for how to uncover the pain that your software solution relieves…