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We’ve been meaning to write this one for a while. A long while. Sixteen years, give or take a few fire drills.
Every single healthcare marketer or CMO we have ever worked with, without exception, without hesitation, without needing to think about it for even a moment, recognizes this story the second they hear it. They laugh that particular laugh. The one that’s only slightly amused.
You can only watch something repeat itself over and over so many times before you become the one that has to name it. That day is today and we are the ones. So, let’s get to it.
A healthcare company comes to us wanting strategy. They say the word strategy a lot, actually. They want a brand architecture. A market positioning. A go-to-market plan that will finally get them organized before the next product launch, the next conference, the next board meeting.
We nod. We agree. This is exactly the right instinct.
And then, approximately eight to twelve business days later (sometimes fewer), the email arrives. It has an exclamation point in the subject line, or no subject line at all, which is somehow worse. The message is some variation of: "We need something for [major event] in three weeks. Can we pause the strategy work and just get this done first?"
Reader, that strategy work doesn't resume.
The fire drill becomes the job. The job becomes a series of fire drills. The fire drills accumulate into what the organization eventually, proudly, calls its "marketing program." And the cycle, which is expensive, exhausting, and largely ineffective, begins again.
This is not a character flaw. It's a structural one. And it's so common in healthcare that most organizations have simply accepted it as the natural state of things.
It's not.
In most healthcare companies, and especially in medtech, diagnostics, biopharma, and specialty health, marketing is structurally downstream of almost everything else. It sits beneath commercial leadership that reports to operations or finance. It has a seat at the table for execution, but rarely for planning.
The result: marketing learns about the launch, the conference, the investor deck, the new indication the same week (or, memorably, the same day) that everyone else does. Strategy requires lead time. Fire drills do not. So fire drills win.
Healthcare budgets are typically set once a year, by people who are optimistic about timelines and conservative about marketing.
This creates a specific kind of dysfunction: money that should fund ongoing strategic commercial activity is instead held back because it was either not planned for, or because it was planned for something that changed, and then released in a rush when a deadline appears.
Rushed money produces rushed work. Rushed work is rarely good. Rarely good work doesn't move the pipeline. And so, next budget cycle, the question becomes: what did marketing actually produce? The answer, unsatisfyingly, is a lot of activity that’s difficult to connect to outcomes. Which tightens the budget. Which increases the pressure. Which accelerates the fire drills.
It's a very tidy little doom loop.
This is the one that people least want to hear, because it's the most fixable and the most consistently unfixed.
Most healthcare companies, especially those between Series B and commercial maturity, do not have commercialization infrastructure. They have some people, some tools, and a lot of goodwill.
What they do not have is a documented system for how a product goes from clinical or regulatory milestone to market presence: who owns what, when things happen, what "ready" looks like, and what connects the science –> to the story –> to the sale.
Without that infrastructure, every launch is a custom project. Every custom project is stressful. Every stressful custom project becomes a fire drill. And the institutional knowledge from that fire drill lives in someone's inbox until they leave the company.
The three structural causes:
Let us talk about money, because that is usually where the conversation either starts or should have started.
The visible cost of fire drill marketing is easy to see: the rush fees, the agency heroics, the nights and weekends, the “version-14-final-FINAL-use-this-one.pdf.”
Those are real. They add up. They are also the least of your problems.
The invisible costs are larger.
Wasted effort: Fire drill work is, by definition, reactive. It's built for the moment, not for the motion. A sell sheet made in ten days because someone needed it for a conference is unlikely to be the sell sheet that actually moves a prospect down the funnel. Why? Because it wasn’t built with that funnel in mind. It was built to exist. An enormous amount of healthcare marketing exists without functioning, and the effort that produced it's simply gone.
Missed pipeline: The scarier number. When marketing is in permanent reactive mode, it cannot do the things that build a durable pipeline: content that educates early-stage buyers, programs that nurture consideration over months, campaigns that create category awareness before the competition does.
These are how healthcare buyers (who are equal parts skeptical, slow-moving, and extremely well-informed) actually get from awareness to conversation. Fire drill marketing skips this entirely and wonders why the sales cycle is so long.
Team attrition: We’ll say this quietly but clearly: good marketers don’t stay in fire drill cultures. They leave. They leave and take with them the institutional knowledge, the relationships and, ultimately, the judgment about what the brand is supposed to be. Then the next person onboards into a fire drill situation.
And the cycle compounds.
Here’s the part where we tell you the answer is simple, you just have to commit. We won’t do that, because it's not entirely true. But it's also not as complicated as the problem makes it feel.
The alternative to fire drill marketing is commercialization infrastructure. It's not glamorous. It's not a rebrand. It's not a new campaign or a better agency or a bigger budget, though any of those things might result from implementing that infrastructure.
It's a documented, repeatable system for how your organization brings things to market. Specifically:
"The alternative is not a better agency or a bigger budget. It's a system — documented, repeatable, and actually used."
None of this is revolutionary. Most of it, if you say it out loud, sounds obvious. The reason it doesn’t happen isn’t ignorance, it’s urgency. There’s always a fire drill more pressing than building the infrastructure that would prevent fire drills. This is the trap, and naming it's the first step out of it.
The organizations that break the cycle are the ones that create a moment to step back, build the foundation, and then protect it.
Not perfectly. Not forever. But enough.
We’ve been watching this pattern for sixteen years. We’ve watched it in companies with two-person marketing teams and companies with twenty. In Series A startups and in publicly traded medtech. In organizations that were crushing their numbers and organizations that were in genuine trouble.
Knowing that it doesn’t have to be that way, and you can break that cycle, is exactly why we wrote it down.
If any of this sounds familiar, if you laughed that particular laugh, then this one’s for you. We would be glad to talk about what the infrastructure actually looks like for your organization. That conversation, unlike most of our client engagements, doesn't have to start with a fire drill.
Not quite. An agency executes. Infrastructure decides what to execute, when, and why, before the deadline appears. A great agency inside a fire drill culture will still produce fire drill work. The infrastructure is what tells the agency what to build and gives them enough runway to build it well.
Actually, the opposite tends to be true. Smaller teams benefit more from infrastructure, not less, because they have no margin for wasted effort. A two-person marketing team with a clear launch playbook and a working brand foundation will consistently outperform a five-person team operating reactively. The playbook doesn't need to be elaborate. It needs to exist.
Less time than the next fire drill will cost you. A functional brand foundation and a basic launch playbook can be built in six to eight weeks if the organization is ready to prioritize it. The harder variable is not the work, it's creating the internal space to do it without getting pulled back into execution before it's finished.
This is the right question, and the honest answer is: you probably need outside help to make it. Not because the argument is complicated, but because urgency has a way of defeating logic when it comes from inside the building. An external perspective, whether an agency, a consultant, or a fractional CMO, creates the pause that internal teams cannot manufacture for themselves.
Get marketing into the room earlier. Before the launch date is set. Before the conference is booked. Before the budget is locked. Everything else, the playbook, the brand foundation, and the pipeline strategy, works better when marketing has lead time. And almost nothing works well without it.
A useful test: look at the last three things your marketing team produced. Were they planned more than four weeks in advance? Were they built around a specific buyer journey or pipeline stage? Do they connect to each other as part of a program, or do they exist independently? If the honest answer to most of those is no, it's not a busy quarter. It's a pattern.
