February 08, 2023

Marketing and Customer Experience: No room for error in healthcare marketing (podcast episode #47)


Get ideas for biotech marketing, mobile apps, and building a brand by listening to episode #47 of the How I Made It In Marketing podcast. I had an innovative conversation with Laura Ayala, Vice President of Marketing and Customer Experience, Karius.

Listen now to hear Ayala discuss persistence, grit, and sticking to your convictions.

by Daniel Burstein, Senior Director, Content & Marketing, MarketingSherpa and MECLABS Institute

Marketing and Customer Experience: No room for error in healthcare marketing (podcast episode #47)

This article was published in the MarketingSherpa email newsletter.

“Refine your value prop until it becomes a reason…the summation of a rational/emotional argument,” Flint McGlaughlin teaches in Value Proposition Power: 3 ways to intensify the force of your value proposition (McGlaughlin is CEO of MarketingSherpa and MECLABS Institute).

I thought of this lesson while reading through the podcast guest application for the latest guest on the How I Made It In Marketing podcast. She markets to physicians, a perfect example of an ideal customer that needs to hear a rational (there is scientific evidence that this works) and emotional (the human beings in your care will be helped by this) argument.

You can hear how she responded to that question, along with lesson-filled stories from her career, in this episode with Laura Ayala, Vice President of Marketing and Customer Experience, Karius.

Karius has most recently raised $165 million from a Series B funding round led by Softbank’s Vision Fund 2 and $255 million funding in total. Its liquid biopsy for infections diseases got the company named to the Forbes AI 50, a list of the most promising artificial intelligence companies. Ayala manages a team of 12 marketing and customer success professionals, along with five agencies.

Listen to our conversation using this embedded player or click through to your preferred audio streaming service using the links below it.

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Stories (with lessons) about what she made in marketing

Some lessons from Ayala that emerged in our discussion:

No room for error in healthcare marketing.

Marketing in healthcare differs from marketing in tech, food and other industries. When a new product is launched in healthcare, there’s no room for the errors or bugs that come with launching a new iPhone.

This is mostly because a new iPhone doesn’t necessarily become a life-changing product the same way a new drug or new test does. In medical marketing, there needs to be an emphasis on clear, evidence-based reasoning as to how and why a product affects the patient – it’s Ayala’s job to ensure that happens. Along with legal, regulatory and medical affairs teams, we marketers must also scrutinize a product thoroughly to ensure it is good to go and won’t be misused. Early in her career, she didn’t understand that exciting terms like “new product” and “novel” actually scare doctors.

Instead, they prefer evidence such as medical journal papers, which carry much more heft than marketingspeak. So that’s her role now, to ensure they are stewarding the product carefully in the market with proper positioning and clear communications.

Strike a balance between thoroughness and effectiveness.

One example that shaped the way Ayala markets for Karius is what happened with Theranos. The company, once valued at $10 billion, had flashy, effective marketing that overshadowed actual science, and while it helped the company gain financial success in the short term, eventually, the gap between its marketing and science did the company in. Witnessing that debacle has been a lesson that informs many in biotech marketing.

They are very particularly focused on scientific facts, and simply do not make any claims that are not strongly backed by evidence. Nuances do matter. Accuracy in communication and making claims matters. Liquid biopsy, which is what Karius has developed, is a shiny new product – and even more reason why Ayala needs to be very careful in the way she markets.

There is value in persistence, grit, and sticking to your convictions.

The term “liquid biopsy” used to not hold the same weight in healthcare marketing as it does today. Specifically for Karius, it’s at the heart of the marketing approach. But when Ayala first proposed using the term, many people didn’t agree, so it took time, persistent education and knowing that she was right about this – and the team has been proved 100% correct since liquid biopsy is now a well-known term in the industry.

You have to have quite a bit of conviction for what you’re doing, someone has to believe and stand by the idea, Ayala says. She said this is a universal marketing lesson, not just for healthcare, and pointed to the Nike campaign with Colin Kaepernick as an example of marketers sticking with their convictions outside of healthcare.

Stories (with lessons) about the people she made it with

Ayala also shared lessons she learned from the people she collaborated with:

The power of the story and the importance of repetition.

via Alec Ford, CEO, Karius

Working with Ford, has taught Ayala two very important things – the power of the story and the importance of repetition until people absorb information. Ford often tells the team how they need to ensure the message gets across and is remembered by target audiences – so repetition is key.

Karius’s story is that the prevalence of infectious diseases is spiking sharply and presents high risk for those who are immunocompromised like cancer patients, hence why the Karius Test is hyper focused on early detection and saving patients' lives. This idea of repetition made her think: Have the biggest companies in the world, the Coca Colas and Amazons stopped advertising? Of course not. There is always room for resharing the story in building a brand.

Grit and resilience.

via Pamela Federman, guardian

Ayala came to the United States at age 16 from El Salvador with her mom (a chemist) and younger sister. Soon after immigrating to the US, her mother got cancer and passed away within two years, leaving her sister and her without a parent or guardian. They had to decide whether to stay in America or return home to El Salvador. Luckily they found a guardian – Pamela Federman. Ayala’s mother was Federman’s son’s nanny, and she took them in with open arms.

She encouraged them to focus on school and helped them make major decisions about college and what to study when they decided to focus on healthcare, inspired by their mother’s battle with cancer. She guided Ayala through college and career decisions, which helped her get a partial scholarship at Wesleyan and a full scholarship to Berkeley. From Federman, as well as the experience of immigrating to the US and losing her mother at such a young age, she learned grit and resilience.

Understand your customer and how to deliver your message effectively.

via Sivan Bercovici, CTO, Karius

Bercovici has taught Ayala the importance of figuring out where and how you reach your audience. For instance, the diagnostics industry doesn't often deliver test results through mobile apps, but Bercovici thought this would be the best way to reach really busy infectious diseases physicians who are always on the go. He taught the Karius team how to put themselves in physicians’ shoes and think: ‘How and where is the best way to access the patient’s test results?’

The simple answer: On the phone. The idea was a huge hit, and the app has been successful in helping Karius convey test results to the doctors who ordered them. The lesson she learned from Bercovici was about understanding your customer and how to deliver your message effectively.

Ayala ended this episode by discussing the key qualities of an effective marketer. One of the elements she discussed was differentiation, and that she is a big fan of Seth Godin’s purple cow concept.

Related content mentioned in this episode

E-commerce: Testing value proposition leads to 220% increase in total conversions

How I Made It In Marketing podcast

Healthcare Marketing Leadership: Build communities…not a customer list, walk your own path, take care of yourself (podcast episode #30)

5 mini case studies about understanding and serving the customer

About this podcast

This podcast is not about marketing – it is about the marketer. It draws its inspiration from the Flint McGlaughlin quote, “The key to transformative marketing is a transformed marketer” from the Become a Marketer-Philosopher: Create and optimize high-converting webpages free digital marketing course.

Podcast guest application

If you would like to apply to be a guest on How I Made It In Marketing, here is the podcast guest application.


Not ready for a listen yet? Interested in searching the conversation? No problem. Below is a tough transcript of our discussion.

Daniel Burstein: I am a creative by nature. I'm sure many of you listening are as well. Marketing attracts creatives. Being a creative is necessary to craft breakthrough marketing. However, come on, let's admit it, there are weaknesses as well. One of them is we get bored easily. I was reminded of this when reading the following lesson in a podcast guest application.

The power of the story and the importance of repetition. What a perfect combination. Showing the dichotomy of being a creative marketer. We need that creativity to craft a powerful story, and yet we need to remember that the customer will never see the message as often as we do. They are not nearly as focused on our brand. So we as marketers can't get bored so easily. Repetition is crucial. Here to share the story behind that lesson, along with many more lesson filled stories. As Laura Ayala, Vice President of Marketing and Customer Experience at Karius. Thanks for joining us, Laura.

Laura Ayala: Hi, Daniel. Thank you very much for having me on the show. I'm a big fan. Thank you for making all that material for us marketers and yeah really excited to be here.

Daniel Burstein: Well, thanks so much, Laura. You made my day. Let's take a look at your background. Just cherry picking here. Undergraduate degree was in Neuroscience and you started your career as a Project Manager at Becton Dickinson. You went to get your MBA from Berkeley and moved into Biotech Marketing. And now are the Vice President of Marketing and Customer Experience at Karius.

Karius has most recently raised $165 million from a Series B funding round led by SoftBank's Vision Fund Two, and $255 million funding in total. Is one of Forbes top 50 most promising A.I. firms. And again, it's a healthcare A.I., really has nothing to do with marketing. But you have a marketing role and a marketing and customer experience role where you manage a team of 12 in marketing and customer success, as well as five agencies. So tell us, Laura, what is your day like as Vice President of Marketing and Customer Experience at Karius? Working with that team of 12, working with those agencies?

Laura Ayala: Well, Daniel, the first thing I'm going to say is that it's a lot of fun. It's very engaging, especially in a startup environment and marketing. It's very diverse, right? So, day to day, I'm dealing between, you know, is this content in this piece of collateral really accurate and relevant to the customer? To we're having a big show to, you know, are the ads running the way they need to be running in digital? And then on the customer success angle, we in healthcare deal with very pressing problems, right? We need to make sure that we're there for our clinicians, that we're there for our patients delivering on time. So there's no minute here where I'm bored or anything. If anything, I'm engaged all the time working with a great team. These startups are absolutely, I think, the best place to be. If you really want every minute of your life to be busy.

Daniel Burstein: I love that the first thing you said is fun. Because I interviewed the CMO of On the Border Mexican Cantina, and she had just a career of working at fun type of brands like that, like a mexican cantina, you know. And so to hear you talk about that in healthcare marketing, which healthcare is just so crucial, I love that you're having fun there as well. That's awesome.

Laura Ayala: Oh, yes. I think marketing, no matter which industry meet, like you said at the beginning, needs to be very creative. So, you need to be creative. And that doesn't mean just colors, right? Just  means how are you effectively going to communicate something very important to people? And that's why I believe in that power of the story that you need to constantly be iterating, thinking, creating, and the newer the product is, in our case, then newer the category then. Yeah, that's what I think. It's fun, But you're right. Maybe not everybody thinks it's fun.

Daniel Burstein: Well, me and you do. So that's okay. I'm sure our audience of marketers does as well. And let's take a look at some of the things you've learned in your career. What we can learn from it as well, and the stories behind it. First, you say there is no room for error in healthcare marketing. So how did you learn that?

Laura Ayala: Definitely. Look, I put myself in the shoes of these doctors, these patients. I've been a patient myself. You know, you probably can relate. I think everybody, right. At least a family member unfortunately have been hospitalized. And what really matters when you're there and in our current product, our customer is this patient who's in the hospital suffering from infectious disease, then you know that it's very important that the patient gets the best care possible. And it's people like me, you know, my entire teams who want to make sure that these doctors have the right information to make the best decision possible.

Of course, you know, this is not a perfect world, but that's what I mean. With no room for error, let's just ensure that the most accurate information is being delivered so that this doctor has everything on their hand to really do the best for this patient. And then when you're a patient yourself, you also feel better, right, that this is the best care you're receiving. And I think everybody in the industry tries to do that. And that's what I mean for no room for error. These decisions are life, right, or death at somebody's hand. So we feel very responsible to ensure that it's as accurate as possible.

Daniel Burstein: Well, something interesting, really interesting that you said that you can actually scare doctors, but talking about new products, novel and things like this. And that is so kind of counterintuitive to most of us marketers, right? New and improved powerful words. So I kind of wonder, like, how do you learn that or how you get that messaging right? You know, experimentation is so baked into healthcare itself, right?

Do you conduct any experimentation with your marketing, with your messaging to figure that out? So, for example, I once interviewed a healthcare marketer from the stage at one of our events, and they were conducting experimentation on their pages. They found out, you know, you always hear short copy works better. They found out they needed a really long page that worked better. And then when they took that at 140 local clinics, they took that from that one site, rolled it out to those 140 local clinics. They were able to get 220% more conversions, which is more people, you know, signing up for their clinics. I wonder when you're talking about that, I mean, I love that lesson, new and novel that's not necessarily great in healthcare, you don’t want to scare the doctors like. But how do you find out you know that nuance again that right messaging A, B, testing, experimentation, like are you experimenting like these healthcare practitioners are?

Laura Ayala: Oh, yes. We also need to experiment. Absolutely. But let me take it a step back to provide a little more context of why this novel message is a little bit more challenging in healthcare, right? Because it's very different from marketing, for example, an iPhone and get very excited right about something that's super new. I talk about that with my friends often in tech.

So, to take a step back and especially in these new category of product, because what we have here, I mean my current job at Karius is a, a groundbreaking in medicine, what we called a liquid biopsy for infectious disease. So what that means is that with a sample of blood, we're able to detect over a thousand of these pathogens that might be making somebody sick. We will return the one or two, right. That we think is the culprit. It is groundbreaking because that technology in DNA took a while to get here. You see this technology, though, in cancer, right? Screening the blood versus, say, for example, a biopsy. So the liquid element is that this is in the blood as a liquid versus going invasively to take a sample of the tumor or to take a sample of that infected tissue.

So, conveying newness in healthcare is a double edged sword. First, because everybody gets super excited about technology, even in healthcare. And having worked with these world class scientists and having done these Kariuss and my prior companies. Everybody here is a little bit in a way like, you know, geeky. I work in Silicon Valley. I myself, like you said, I have a background in neuroscience. Science was my very early love, you know, in school. And so everybody gets super excited like, yeah, we're doing this and that in the DNA. However, right at the end of the day, what does this mean for the patient and what is important for marketing and healthcare is not so much to present the excitement about the technology. Does that matter? Absolutely. But that's sort of the back story and what makes us in tech and science super excited. But at the doctor site, at the patient site, what really matters is what does this is a mean for improving the care. And so when we go out with something very new, the first question is, has this been really well vetted?

We're very familiar with software releases, right? Oh, it was buggy away that didn't work. But we've accepted that, right. It's okay. You know, actually there's a special website to submit the bugs and help us improve it. So everybody understands that with new that there are some gaps. And that wasn't obvious to me actually early in my career in healthcare. At first I went out with a bang, like, Oh, this is new, this is exciting, everybody join us. But everybody else knew that new meant it was not perfect yet. Is version one, right? Is version zero it’s MVP. So what then I've learned is to communicate trust. Healthcare. It is great that it's new, but let's apply the data that accompanies that.  Actually now, I think most of the public sees that more clearly via COVID, right? The vaccines rolling out everyone wanted to see that these vaccines have been tested in the thousands of patient, right. And so that's what I think the challenge is. But even in marketing, in healthcare, you're able to provide both. This is exciting, but this is how much this was vetted and this is really ready for you. I think that makes it more effective.

Daniel Burstein: Yeah. When you said MVP, if people aren't familiar, that's a minimum viable product. That makes a lot of sense. Like you said, for software where it doesn't work. We see the downtime indicators, whatever. But boy, we don't want that on our grandma or on ourselves, right.

Laura Ayala: Exactly.

Daniel Burstein: New can be scary.

Laura Ayala: Yes, yes, yes. So then experimentation, right. Going to your specific question on that, we are going to experiment, but not at the product level, right. That has been very well vetted. We will experiment at the messaging level. And this brings me to another challenging aspect, but I also welcome it in healthcare, which is that balance between being very thorough versus being very effective in communication.

An example about that that I also talk to my other colleagues about in healthcare about maybe consumer products is the following. So take a brand like Sprite and their tagline Quench your thirst in healthcare. We debate this shorthand way of communicating quite a bit with the teams internally with medical, with legal, regulatory. Quench your thirst for us would mean something like this, If you're thirsty, being defined as your throat is a little bit scratchy, your mouth is dry.Then if you take three gulps of this drink, we think that you might perhaps relieve your thirst. But also you need to check afterwards. And if you're still thirsty, drink water. And so that would be the most thorough way to communicate about something. But is anybody going to read it? Is anybody right, going to spend time? Well, at the end of the day, even in healthcare, clinicians, patients are humans.

There's a lot of information out there. There's a lot of noise. Everybody needs that succinct, effective message. And so this balance between providing the sufficient information to be accurate but succinct and lay language enough to be effective in communication is what we need to address. And that's what we experiment with. So what was the most concise way to communicate something that was effective? So we yeah, we talk with that quite a bit.

Daniel Burstein: Well, and that brings up I want to ask you specifically about Theranos or Theranos,  I don't even you know, because when I saw your lessons strike a balance between thoroughness and effectiveness, I thought of that example. And so people I mean, I think everyone listening to this podcast will probably be familiar, but if you're not, Theranos was a healthcare startup that could supposedly test your blood with just a few drops of blood. It was led by Elizabeth Holmes, who I believe now has been convicted of fraud and all those things. And but specifically, here's one thing I remember from that story.

So I saw Netflix or Hulu or someone madea story about it. I don't remember who. And in one part, I think she's on a yacht with Larry Ellison and Larry Ellison is kind of telling her to be more daring or whatever. And when we were talking in the pre-call  you mentioned your headquarters. You're located in Redwood City. You can see Oracle's, you know, headquarters. You can see the yachts and stuff. And as you mentioned, Silicon Valley has that kind of startup mentality that move fast and break things, right. So how did you bring into healthcare? How did you overcome that Theranos story? Because when I heard about Karius to,  that's the first thing I thought I am liquid biopsy in drops of blood. How did you overcome that with your marketing message and say, okay, like no, no, here's the thoroughness and you know, effectiveness part like this is legitimate. Just because we're in Silicon Valley doesn't mean we're a move fast and break things type of place.

Laura Ayala: Oh, that is so interesting, Daniel. And I'll never going to forget. You're right that lesson about that is about Theranos and doing the right thing and not the wrong thing. Instead of thinking that it's about Oracle. So I do pass that all my commute to the office, like you said. Yes, so, the Theranos comparison is the first place that everybody goes. And why? There's so many parallels between, you know, what we did and what we do here at Karius  specifically and Theranos.

So our founders also from Stanford University, that technology, you know, being linked to that, a Silicon Valley company, a young company in the blood sample space, in the diagnostic space. So I'll tell you, though, before I knew that things were wrong, I was another one like everybody else. We didn't realize that Theranos was not ethically doing the right things or communicating effectively. I was super jealous. Like how what this was. Yes, this was a great PR machine. This founder was everywhere. The valuation was crazy, right? Billion dollars. She was in the cover of magazines. If anything, what I was thinking is I need to supply my application to this company. There's a lot to learn. And when it came crashing right then I realized, Oh my gosh, this was too good to be true.

There's been no other healthcare company that I can think of that had that ability to propel to the top in the news cycle with the founder and cover of magazines, Right. If we think here about together what other healthcare company can you mention with that coverage? And it was very sad, actually. It was very disappointing that it was all fake news.

And then he brought all of us in healthcare marketing back to sort of, okay, you know, we're not the most exciting thing to be talked about on the front cover of magazines, but we're doing the right thing. And what is the right thing? The right thing was being very transparent about everything that we worked on. And Karius because of Theranos, then and also my job has been with the teams here, with my teams to ensure that transparency. So we have, you know, over 100 of these publications where we make sure they're on the website, right? We enlist our customers to tell us what is working about our product, what is not working. We message on this in our industry, it's called diagnostic stewardship. And I thought here with another colleague of mine, Sivan Bercovici, who is our Chief Technology Officer. What we think we're doing here, and Alec Ford, our CEO, is marketing stewardship, the responsibility to ensure that our product is adopted responsibly. That our doctors have the right information to get to the right patient at the right time with our test. Our test is not for everybody it’s not to save the world like these other companies were promoting. It is to be decided by that clinician. And that's what we're really trying to do. But boy, that was yeah, that did a number for all of us. I have more work now after Theranos.

Daniel Burstein: Well, I don't see you wearing a black turtleneck, or like your hair pulled back, right. Glad you didn’t like mimic the Elizabeth Holmes look and everything. Well, so transparency. It's really interesting. So you mentioned artificial intelligence. A.I. is a key part of your  tool. So to me and this is my you know, I'm a neophyte when it comes to A.I., it seems like A.I. is the opposite of transparency, right? It seems to be. It's all these secret algorithms or neural networks and machine learning that, you know, when you try to, like, dig under with a company, they're like, Oh, don't worry, input A.I. output it all works. And you don't, you know, don't understand. So how do you bring transparency into that element? The artificial intelligence element of your technology?

Because the one thing that Theranos, which I think would be similar to yours, is that was a blood test. So people would go to see and make sure they were healthy and get those results. And they really relied on those results. And yours with the liquid biopsy, again, I would assume, too, it's they're really relying on whatever that A.I. s saying if they have cancer or not or whatever is coming from the biopsy. So how do you meld transparency and marketing the artificial intelligence element of your technology?

Laura Ayala: Yes, I realize that a A.I. is a little bit of a black box to everybody, right? A lot of stuff happening in the background. Who knows what this is? However, though, what really matters is for us is a step beyond that, right? Not so much what's happening in the lab, I mean, you know, in these computational algorithms, but the data about when a patient was diagnosed with our product, what happened, what didn't happen, what did we catch, what did we miss? So it's more about transparency on how the product performed versus how the product was put together. And in medicine, that's what people look for, right?

So for example, we can go on and on about how the MRNA named vaccines work for COVID and trying to understand that. But you know what really people care about is how they, you know, worked in patients. For A.I., equally fascinated. But look, we're an open door. I'm not the expert here to go into the nitty gritty, but our team here, our A.I. team, very happy to talk about all that technology behind it so that it's not this mysterious thing. That's not what we want. What A.I. does for us is put together. It's really amazing, actually, all these data points. There are millions of them in a way that this DNA, right, producing all this data can be stitched together and then revealed to that patient. It is this DNA of this pathogen, though, that might be making you sick. So hopefully that, you know, offers an insight into this. Shouldn't be that mysterious, but you will need really advanced degrees to really get to the nitty gritty.

Daniel Burstein: Yeah. Yeah. Well, I think, you know, I've worked in technology earlier in my career with software companies, like we were talking about at the beginning the call. And one of those biggest challenges is taking that complex, like when I would get on a call with some of the technology folks and product development folks, the engineers taking that complex of what the thing does, but then communicating it to the point in a business term where it makes sense into it gets to an actual solution.

And this kind of gets into our next lesson here. You said there is value in persistence, grit and sticking to your convictions. And you’re talking about you, I guess working when you were with the team came up with a word to describe it or a group of words, right? Crafting those words and those words are not going to happen instantly. You really got to stick with them to get through to the market, to get through to people, to have them understand this. So, first of all, tell us what those words are. But then how did you do that and how did you come up with those words?

Laura Ayala: Yes. So, I mean, marketers, we're going to relate or are mostly working on marketing new products, new things, right? Then the next level to that is the new category of products, which is what I've been working on for the last decade or so. What you call something is up to you and it's a big deal, right? The category, not just the product itself. So I know a lot of thought is put behind that by us marketers, right? We talk to customers. We're hearing the team brainstorming sessions, and I've done this a few times, you know. Before Karius I worked in a another diagnostic company in cardiovascular disease in the rejection of transmitted organs for example, for heart. And in that test, the novelty was that we were reading the expression of the genesin patients of this DNA, not so much the DNA itself.

And so the category there was that the products were genomic tests and not genetic tests. Genetics, I think most people are able to relate to, right, it’s DNA. But now what happens when those genes are at work in the body and that becomes now a genomic. And everybody was very confused, like, why are we calling this something different? Let’s just call it, you know, blood test, you know. And so you had to stick with No let’s own it, genomic, and now it's more standard.

Most recently here the other challenge we had was what I mentioned earlier. Our product is a liquid biopsy for infectious disease. Now liquid biopsy, it's a new category, very new. And at the beginning I was in a room with at least 30 of my colleagues presenting, this is what we're going to call ourselves. Well, the room, you know, a lot of hesitation. No, nobody gets it. Please, we need to use something simpler. Why are we doing something that nobody understands? And so I've come to understand then and now, and I see other examples that are beyond healthcare, like, for example, the Nike campaign on the athlete, right? Kaepernick, very controversial. That you have to have quite a bit of conviction if what you're doing, somebody has to believe, somebody has to stand by the idea, right?

And I think this is very relatable to all of us marketers. You have to stand by, I think this is going to work. Hey, it might know work all the time., I think we're wrong. But you have to have belief in what you're doing. And that's what I mean by conviction and grit, that everybody's going to take you down if you don't believe in what you're doing.

Daniel Burstein: Yeah. So Colin Kaepernick, I think, was the Nike campaign, right? That's the point that's really, really sticking their neck out there. But you bring up that good point, too, when you're selling a very new product, alot of times first, before you even get to selling the product, you have to sell the category. And if it's new enough you have to define the category and your point. I love what they were saying in the meeting. No one knows what this is. Of course, they don't know what it is. It hasn't come out yet. We have to, that's the point of marketing, right? We need to be on the leading edge and I know a lot of times marketing gets a bad rap for maybe forcing people and tricking them into buying things.

But there's a big education component too. And I think what you're talking about there is that education component. And that gets into kind of our next lesson here. In the first half of the podcast, we talk about some lessons from the things you made, the second half of the podcast. We talk about lessons from the people you made them with. And this comes from Alec Ford, the CEO of Karius. You said you learned the power of the story and the importance of repetition. So when you're talking about something like that, like I said, that educational component of a new category and then your new product within that category, how does that importance of getting that story right, and as you said, repeating it. Because one thing I've learned is when you work for a brand, I mean, you live it, you know, all day long, all week long, the weekends that you're thinking about it constantly, you scrutinizing every message it has. And so, you know, by the time that maybe customer sees it for the first time, you've seen it 72 times and you like, I'm sick of this already, right? So how do you balance that, the power of the story and the importance of repetition?

Laura Ayala: You know, those two things make me realize that this is why I have a job. And my marketing team, we're like everybody, this is why we have a job. It used to be and I've heard this, you know, you've probably heard it and you know more about this. It used to be that it would take seven instances, right, to really learn something or for something to stick with you. And then I heard later in other articles that it's now 77, based on the information that we're receiving. So I actually put that message out. And a lot of my decks when I'm presenting here internally, it has that quote. It's now everybody probably time stamps 77 on repetition.

I was very fortunate when our CEO, Alec Ford, joined our company. I was here before him and he asked me, Laura, do people know what is the story? What are we doing? Do they understand the problem? And he's an amazing storyteller and I learned a lot from him. He's like, look, these stories, they all begin with the bad guy or like, what is the problem? Do you think our customers know what the problem is? You know, have you shared that with them? And then I started pulling the data, right, asking customers, you know, is there a problem here? Let's start there. And you know what Daniel, I learned that most people didn't think there was a problem. And there was a huge problem in our space, specifically, for example, in cancer patients. Most people don't know that in certain cancers half of the patients succumb to an infection versus the cancer itself. That's how big the problem is. Roughly 800 patients every day are dying because of an infection and not to cancer.

So it was then my job to actually start from there, that beginning. Let's ensure our clinicians, patients, the company, us, my teams understood that the problem here is bigger than everybody thought and that is very real and it's happening all the time and every day. So that's where we started. So marketing then my campaigns were not just about our great solutions. I think we talked about the excitement of the technology and A.I.. But it was about that, it was, you know, a year almost in messaging about the problem. And every time we went on air, every time we had the opportunity to write, you know, even a brochure, we started with the problem. And it was really nice to see when that data came back that we, you know, maybe not just us, right? But the industry had made a little bit of a dent in yes, the current standard of care, taking care of the patients. There's opportunity for improvement. We can help. There's room for, you know, products from carriers, products from other companies. And so then the power of the storytelling and the repetition, right. This wasn't going to be happening after one email or one ad then is what I saw and what I learned that made a difference. And the importance of telling the story.

Daniel Burstein: Yeah, something that you said that really resonated with me there. You know, I think a lot of companies, they make the mistake and they jump into messaging and value proposition to sell their company or their product. And we actually even created a whole like we call the Value Proposition Decider Infographic to understand what value proposition you need to communicate at this point in the customer journey. And to your point, one of the as we talked about earlier, is of the category. Another one is just of the problem, right? And I really like what you said I think everyone can learn from that is, hey, if we communicate about this problem and we really get it out there, other companies will benefit too. And that's okay, right? I love that. That's okay. Karius is going to benefit. Other companies are going to benefit too.

So you got to think about that. You know, when you're out there wrestling again, especially we're talking about being pretty on the cutting edge here. It's not just I will use another Larry Ellison quote just because you’re there by Oracle like, you know, not only must we succeed, but all others must be defeated or whatever, whatever he said, quoting Genghis Khan, right. If we're being new, hey, let's teach about the category. Let's teach about the problem. We're going to get good business out of that. And our competitors will as well. And hopefully our customers will be helped by that. Which brings up actually, this is a really good lesson for that. You said grit and resilience. So now I can see how that grit and resilience a term I love, I try to teach my kids tenacity. I could see that has really paid off in your career. But I think you originally learned it, you mentioned one of the people you learned from was Pamela Federman, who's your guardian, and this really gets into your personal life. So thank you for kind of opening the book and sharing about that. But you want to give us a bit about your background there and how you learned grit and resilience from Pamela.

Laura Ayala: Sure. And I have an 11 year old, but I agree with you. I'm trying to teach grit. But it's harder here, I think, than in other places, or at least the place I grew up in. So I grew up in El Salvador, Central America, third World country. And even though you know, I was lucky to be middle class, you still didn't know if you were going to have running water and electricity every day. It was my upbringing during the Civil War. So it was scary, right? There were bombs. There were kidnappings happening. People who you knew, right, who could be impacted. And so I think having that upbringing really gave me that grit you talked about, right? You had to problem solve almost every day. And I don't know how I can translate that into my current 11 year old. I mean, the phone gives her all the answers, I should say siri, right. What's the weather for today?

So, you know, even like coming across, like having sufficient school supplies, right. So it is a challenge. But I was fortunate that as a teenager, then I moved to the country here to California. My mom was a nanny and fortunately, she succumbed to cancer after only a couple of years of being here in the country with me. And I have a younger sister.

Daniel Burstein: Sorry to hear that.

Laura Ayala: Yes. And Pamela, who you mentioned, she was the mom of a young boy and my mom was the nanny for that young boy. What happened then is that after my mom passed away due to cancer, then Pamela just jumped in and she helped me and my sister by offering to be our parent. And she was extremely valuable in terms of mentorship about this. All that you need to do, girls, is do well in school. If you do well in school, you'll be fine. And that was beautiful for America. She was absolutely right. All we did was get good grades. And then guess what happened? The scholarship started coming in. It opened the doors for, you know, attending top schools here in the United States. And that's, you know, how I'm very grateful then, right, about having had that hard upbringing, but also very fortunate to have that mentorship and opportunity, you know, by being in this country with so many resources and hard work being rewarded to make a path forward here.

Daniel Burstein: So has that experience or how has that experience helped you to mentor your team? You mentioned you have a team of 12 because, you know, one thing I notice is in marketing, it's so deadline driven, it's so results driven and it can be stressful. And especially in a startup culture and you have younger people coming in and so many things can seem like the biggest crisis in the world. But you know, when you have experience under your belt and some of that, I mean, that's an amazing story and some of the experience you went through and great resilience you had to go through, it really helps to put things in perspective. That, oh, this campaign I'm running isn't getting the results they want or, oh, I just missed a deadline or our competitor beat us on this or my stock options didn't vest the way I wanted. Nearly a million things that can go wrong.

So have you been able I mean, that's a deep well of grit, resilience. You're talking about being through more things in life than many people probably have just from your childhood in El Salvador coming to America, your mother dying, being in a new country and being able to get an education in neuroscience and being able to now be a successful marketing leader. So, you know, what can we learn from it? How can we tap into that to mentor our teams that we manage when we come across difficulties in, you know, our marketing campaigns or even in their lives?

Laura Ayala: Yeah. Two things come to mind as to how that has translated into my career, right, my upbringing and how I hope that I'm transferring this to the teams who work for me and other people who I work with. The first thing is this passion and this really genuine belief that what we're doing is making a difference. And what is that? That gets you going, right? So I believe that everybody in my company, for example, is really passionate and dedicated to making sure that these patients get the best care right. It's about trying with these clinicians to save their lives, because I've experienced that firsthand. That's what my experience with my mom gave me. I've been doing healthcare since, you know, I got out of school. So that's what I hope we hire, right? I look for that. I look for that conviction of not just is this, you know, something I do. I needed to 5:00 and I go home. So, I think that's very important. That element.

The second element here in terms of resilience is that, and I think people who I work with will tell you, I think the default is that nothing would happen. I think that there's just like a mountain of problems, even if you want to get like a brochure out or, you know, however simple this project might be, I think that it just looks almost impossible. In healthcare it’s extra difficult. Are we going to get the right wording? It's going to take us six months, right? Is the caller right?

I mean, look, we can spend all of us like an endless amount of time trying to get something. And when you work in the industry you work in, you're so focused on getting it right. And I know there's another podcast there. You have about, you know, doing the right thing versus getting it right or I mean, something like that. So it's super then important that we have the ability to problem solve every day, not just big problems, but also prioritize like, you know what, maybe that caller actually doesn't matter, right? Let's focus on what matters or let's get this out. It's good enough. And the reward is helping more patients versus getting it 100% right. So, I found that those two things right is what are very important in terms of translating this into like the workplace or the every day.

Daniel Burstein: I like that you say the default is nothing's going to happen, right? It's so true. We forget about that. It's like, I'm mean, I'm no scientist, but in physics, right? It's basically like that which is at rest tends to stay at rest. We have to put it in motion. It's not going to happen unless we, there's that great resilience and tenacity and we push it over the finish line to make it happen. So, yes I totally agree. Let's look at one more lesson here, understand your customer and how to deliver your message effectively. And you learned this from Sivan Bercovici, the CTO of Karius. So how did you learn this from Sivan?

Laura Ayala: Yeah. Another element of marketing here is, and I think we all are very familiar, is where is this message best delivered to our customer? You know, is it going to be on that commute driving, right. Like maybe for this podcast or is it going to be reading, you know, a magazine that is relevant to the topic? And so one of those things that I learned about communication, right, is not just what you say and how you say it, but where are you saying it?

And Sivan with his team. They were very instrumental in bringing in a mobile app to Karius. And at the beginning everybody was hesitant, like, why do we need a mobile app for these doctors, right? Most of the information is already being delivered, you know, via these portals at the hospitals, right. We have I think what we need. But they really push through. And now that we have this mobile app that delivers results as fast as possible to these clinicians it's like duh, why didn't we think about this before?

Our doctors are at the hospital, they're running around. Guess when they want results, as quickly as possible, in their pocket, on their hand. How is my patient doing? That's where we can find them. And even though this is not a marketing per say tool, right, it is about the delivery of the message if there's anything important, because I also work on customer success, right? I'm making sure that we have this data available to them was sort of the best channel, and that's what I learned from them also.

Daniel Burstein: Well, what tactics have you used in your career to learn about what message you should deliver and where you should deliver it? You know, I've written about this before. We talk about experimentation briefly. You know, some companies AB testing, actually talking to customers, doing surveys, you know, I mean, there's so many different ways we can learn about what tactics have you used? Do you use to learn about your customer so you deliver into the way they want it and you say it in a way they understand it.

Laura Ayala: Yes. I never go out without testing, even if I don't have access immediate to an actual customer but who's the closest to that experience and customer. In my case it’s going to be we have doctors here on site who have patients still. And so I work with them. Does this make sense right. So I would think that's essential.  I also like we talked about experiment, right? And that I could do it with longer term aspirations. But sometimes you're right. Like you don't have time for that. So I search for that person who might be closer to the experience.

And also, after a while, I have learned to trust also my instincts. I might not trust them like day three on the job, but, you know, year three, after talking to hundreds of customers, you do start acquiring that language. You read enough. You've talked to a lot of people. You kind of know which words are going to land and which ones are not. So a shorthand for not being at summer for three years is that person who's doing this every day.

Daniel Burstein: And you know, from that I think we've talked around this topic a lot, but I want to kind of address it directly. Like when you do the messaging, what have you learned about balancing the rational and the emotional? So we have, for example, a free marketing class and in FastClass #19 of the free marketing course Flint McGlaughlin teaches, refine your value prop until it becomes a reason, the summation of a rational emotion argument.

And I really thought of that when I was reading through your entire podcast guest application and thinking about healthcare marketing. You know, when it comes to messaging to physicians, which is your primary market, I think, you know, how do you balance that rational, emotional? Yes, the physicians are very rational because, I mean, they're very evidence based and data and based on their training. But it also has to be emotional to be there directly with cancer patients and informing loved ones that, you know, someone has died or is sick. So how do you balance that rational, emotional? What have you learned from that, that research you've done so far?

Laura Ayala: Yeah, I think that's the secret sauce Daniel, for all of us. Well, for my experience, I think that where I'm landing is the channel and the format of communications. So in an ad, what's going to stick the most on your homepage? It's going to be visuals and it's going to be probably three words. And so the goal of communication varies depending on your channel. And at the end of the day, that being telling everybody everything, but not at once.

So what I try to do then is let's start from the highest level of the message. What is the one or two things that really matter right? Let's take my example. It's this product that avoids this invasive procedures, Okay, we’ll stick that up there first, use effective visuals, right. And then in other channels, like a white paper or, you know, a 5 page document, then be more thorough. So do a multi communication approach. Don't think one thing is going to be enough. Don't promote, you know, your five page document everywhere that's going to get you very little. So I try to then be thoughtful about that consumption of the information. And probably at the beginning, if it's very new, do a lot more on those visuals, right. And that high level message. And then later I get more in depth.

You know, I was just talking about this this week with the teams here for a new product, new category.We started with a high level awareness. Do people even know what we are, who we are? And this takes time, Daniel.  I'm just looking at the data and I'm seeing, you know what, after a year, two years now let's go deeper.

Daniel Burstein: That make sense, I mean, you need to open people up before. Then you can kind of go in there with a lot of that more.

Laura Ayala: Yes. And the brand right is also super important. What is the brand identity that I care about communicating and in my case is going to be trust. I know a lot of people here put a lot of work and due diligence in making sure this product works. And that's, you know, my job to help communicate that externally.

Daniel Burstein: Absolutely. Well, that's your job. It takes many things to do that. So let's ask now. We've talked about many different things that it means to be a marketer from the grit and resilience, you know, to the envy and many different things. So, what are the key qualities of an effective marketer if you had to break it down?

Laura Ayala: Yes. So first and I know everybody says this right is understanding your customer. But what I hope I provided here is the next level of that. Does the customer understand itself? Does the customer understand that problem also that you're addressing? So I think that's very important in a marketer.

The second thing I'm going to say is that conviction that we talked about, right, that somebody has to believe in what you're going to deliver. And then the third element is differentiation. So, Seth Godin, I, you know, read his books and I'm a big fan of the purple cow concept, right? There's a lot of cows out there. Is yours really purple? Because no matter how good your storyline is and no matter how strong your conviction, if you're not able again, like we talked about, breakthrough that like massive amount of information then nobody's going to hear and read about, you.

Daniel Burstein: Yeah, I think this Seth Godin concept if you’re driving down the countryside, you see all these cows. I don’t know if everybody knows. If you are driving down the countryside and you see all these cows and one of them was purple, well that you are going to remember, right? Well, thank you so much, Laura, for sharing everything from your life, from your early childhood, to everything you've learned in your in your biotech healthcare marketing group. Thanks for sharing it with us.

Laura Ayala: Thank Daniel. Thanks for having me.

Daniel Burstein: And thanks to everyone for listening.

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