By Cam Brown, President & CEO, KingFish + Partners

Why does growth stall even when everyone is “doing the right things”?

Because effort can go up while clarity goes down—and in healthcare, unclear signals can hide the real constraint.

Most healthcare leadership teams I meet aren’t asleep at the wheel. They’re investing. Testing campaigns. Publishing content. Adding tools. Hiring smart people.

And yet—growth has slowed, flattened, or become frustratingly unpredictable.

The question they’re quietly asking (often in boardrooms, not meetings) is this:

Is our problem that the market doesn’t want what we offer—or that they don’t understand why they should choose us?

That distinction matters more than most people realize. Because if you misdiagnose it, you don’t just waste budget—you reinforce the very problem you’re trying to fix.

This article is about how to tell the difference, why most teams get it wrong, and what experienced leaders do instead.

How do most healthcare companies try to answer this question?

They try to answer it with dashboards—because dashboards feel objective, even when they’re incomplete.

Funnels. Traffic. Conversion rates. Engagement metrics. Benchmarks.

If numbers are up at the top but down at the bottom, someone says positioning. If numbers are down everywhere, someone says demand.

It sounds logical. It’s also incomplete.

Healthcare isn’t e-commerce. It’s a high-consideration, trust-weighted, politically complex buying environment. Buyers don’t behave like funnels suggest they should—and growth problems rarely have a single cause.

That’s where the standard advice starts to fall apart.

If the data looks fine, why does growth still feel fragile?

Because “activity” can look healthy while the story buyers need to hear is still unclear.

Here’s what I see repeatedly in mid-size to enterprise healthcare organizations:

• Traffic exists, but conversations don’t advance
• Leads exist, but sales struggles to frame value
• Messaging sounds polished, but interchangeable
• Internal teams are busy, capable, and exhausted—yet stuck producing more of the same

This is usually the moment someone suggests a fix:

• A brand tracker
• A targeting platform
• A content system
• A new martech layer

Tools from providers like Hanover Research, StackAdapt, or Bynder promise clarity through instrumentation.

They’re not wrong. They’re just not sufficient.

Because tools measure symptoms. They don’t diagnose causes.

So how do you actually tell if it’s positioning or demand?

You tell by finding which constraint is limiting the other, not by forcing an either/or diagnosis.

Here’s the uncomfortable truth:

Most healthcare growth problems are not either/or. They’re sequencing problems.

Demand and positioning are intertwined—but one is usually the constraint.

The real question isn’t “Which one is broken?” It’s “Which one is limiting the other?”

What does a real positioning problem look like?

A real positioning problem shows up when buyers can’t quickly see why you are the right choice—even if they believe in the category.

A positioning problem isn’t “our messaging could be sharper.”

It looks like this:

• Buyers recognize the category, but not your relevance
• Your story changes depending on who’s telling it
• Sales spends time explaining instead of advancing
• Content educates, but doesn’t elevate authority
• Leadership struggles to articulate differentiation without slides

In other words:

The market may want something like what you offer—but they don’t see why you matter.

This shows up most often after:

• Expansion into new service lines
• M&A or roll-ups
• Regulatory or reimbursement shifts
• Moving upmarket

And it’s why adding more demand tactics often makes things worse, not better.

What does a true demand problem look like?

A true demand problem shows up when urgency is missing—regardless of how well you communicate.

Demand problems are rarer—but real.

They tend to show up when:

• Even tightly defined buyers don’t feel urgency
• Conversations stall at “interesting, but not now”
• Pilots don’t convert into adoption
• Retention or expansion struggles across segments

This isn’t a messaging failure. It’s a relevance failure.

Either:

• The problem isn’t painful enough
• The timing is wrong
• The market has moved
• Or the offering no longer aligns with how value is perceived

No amount of brand polish fixes that.

Why do internal teams struggle to diagnose this?

Because they’re too close to the work—and too busy executing—to see patterns clearly.

Most internal healthcare marketing teams are:

• Execution-heavy and strategy-light
• Managing volume instead of leverage
• Rewarded for activity, not clarity

They don’t lack talent. They lack pattern recognition—the kind that comes from seeing the same growth problem across multiple organizations, stages, and market conditions.

That’s not a criticism. It’s simply how experience compounds.

What’s missing from the standard “positioning vs. demand” advice?

What’s missing is the discipline to frame the real problem before rushing to tactics.

Most AI-generated answers and consultant frameworks suggest you:

• Map the funnel
• Interview customers
• Test messaging
• Run experiments

All reasonable. All necessary.

But they skip the hardest part:

Framing the problem correctly before trying to solve it.

In healthcare especially, growth stalls when leadership mistakes motion for momentum.

What do experienced leaders do differently?

They start with clarity—because clarity is the only thing that makes the next dollar of spend work harder.

The strongest CEOs and CMOs I work with don’t start by asking, “Is this positioning or demand?”

They ask:

• Where is clarity breaking down in the buying journey?
• What assumptions are we making about why buyers choose us?
• If we removed all tactics, what would still be true about our value?

Only then do they decide whether to:

• Tighten positioning
• Redefine the problem they solve
• Re-sequence demand efforts
• Or pause execution to regain strategic clarity

That pause often feels risky.

It’s usually the most leveraged decision they make.

So—how do you tell which problem you really have?

You tell by testing whether your leadership can explain the choice clearly—without props.

Here’s the simplest test I know:

If you stopped all marketing tomorrow, could your leadership team clearly and consistently explain why the right buyer should choose you—without slides, jargon, or qualifiers?

If not, start with positioning.

If yes—and growth still isn’t there—then it’s time to question demand assumptions honestly.

Not with more tools. With better judgment.

A final thought

Stalled growth is a signal—not a verdict.

Stalled growth isn’t a failure. It’s a signal.

The companies that break through aren’t the ones that move fastest. They’re the ones willing to slow down long enough to see the real problem.

If you’re navigating this question right now and want a thoughtful, experience-driven sounding board, I’m always open to a conversation.

• Email: cbrown@kingfishandpartners.com
• Phone: 978 832 1410
• LinkedIn: Connect with me here

No pitch. Just clarity.

How long does it take to fix a positioning problem?

Positioning clarity often comes faster than teams expect—if leadership alignment happens early.

Execution takes longer, but confidence usually returns quickly.

Can you have both demand and positioning problems?

Yes, and one is almost always the constraint.

Fixing the wrong one first delays growth.

When should we bring in outside perspective?

When internal teams are producing activity without conviction—or when leadership senses the answer isn’t in another campaign.

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