Growth strategy discussions often move too quickly toward the size of the opportunity.
In healthcare, that can be particularly misleading.
A category may be large and growing while still being difficult for a particular company to win. Clinical adoption, referral patterns, procurement structures, reimbursement, channel economics, installed-base dynamics and service requirements can all create a substantial gap between market growth and capturable growth.
That is why I prefer to frame the commercial question before building the market model.
Before asking how large is the opportunity?, I find five questions more useful.
1. What customer problem are we uniquely equipped to solve?
“Healthcare” is rarely a useful unit of analysis.
Even within a narrow product or service category, the underlying customer problem can vary materially by segment, geography and care setting.
The starting point should therefore be:
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What problem are we solving?
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For whom?
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Why does that problem matter enough to change behaviour or spending?
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Why does this organisation have a credible right to win?
That last question is often underdeveloped.
A market can be highly attractive without being equally attractive for every participant. Existing technology, clinical credibility, customer relationships, distribution reach, service capability, cost position or ecosystem access may determine whether an opportunity is genuinely strategic for a particular company.
Growth strategy should begin with fit between opportunity and advantage, not with market size alone.
2. Where does the buying decision actually sit?
Healthcare buying decisions are rarely simple.
The user, influencer, economic buyer, payer, procurer and beneficiary may all be different people or institutions.
A clinician may influence product choice while procurement controls the tender. A patient may be the end user while an insurer or employer bears the cost. A hospital may purchase the equipment while the physician determines utilisation.
This means that addressability cannot be understood without understanding the decision pathway.
The relevant questions include:
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Who initiates the need?
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Who specifies the solution?
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Who controls the budget?
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Who approves the purchase?
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Who bears the economic consequence?
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Who can block adoption?
A strategy that ignores this structure can substantially overstate the realistic opportunity.
3. What must be true operationally for growth to happen?
This is where many growth strategies become too abstract.
The market may exist, but capturing it may require capabilities that the organisation does not yet possess.
Growth could depend on:
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a new distribution channel;
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stronger clinical education;
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government or institutional access;
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service infrastructure;
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local manufacturing;
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financing;
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partnerships;
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regulatory capability;
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key-account management;
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or a different commercial operating model.
These are not merely implementation questions.
They determine whether the strategy is commercially viable in the first place.
If a growth thesis requires capabilities that cannot be built economically or quickly enough, then the theoretical market opportunity may have little strategic relevance.
The execution model should therefore be developed alongside the market model, not after it.
4. Which part of the market is realistically capturable?
I find it useful to separate three ideas:
Total market → reachable market → winnable market
The total market tells us how much demand exists.
The reachable market adjusts for factors such as geography, channel access, regulatory constraints, customer eligibility and product fit.
The winnable market goes one step further. It asks how much of the reachable opportunity the organisation can realistically capture given competitive intensity, customer relationships, differentiation, commercial capability and economics.
The gap between these three numbers often contains the most important strategic insight.
A €1 billion market can be less attractive than a €200 million opportunity if the second offers a much more credible path to share, margin and defensibility.
The objective is therefore not to maximise exposure to market growth.
It is to identify where the organisation has the strongest combination of market attractiveness, right to win and economic potential.
5. What will we deliberately not pursue?
A good strategy creates concentration.
If every geography, segment, customer type and adjacency remains a priority, the exercise has produced a market map rather than a strategy.
The difficult part of strategy is not identifying attractive opportunities.
It is deciding where not to allocate management attention, capital and commercial capacity.
Explicitly defining the non-priorities forces sharper choices around:
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customer segments;
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product categories;
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geographies;
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channels;
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partnerships;
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and investment requirements.
The result should be a smaller number of opportunities where resources can be concentrated sufficiently to create an advantage.
The practical implication
The market model is still essential.
But its purpose should be to quantify commercially framed choices, not substitute for them.
In healthcare, the strongest growth strategies connect five things from the beginning:
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Customer problem
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Decision pathway
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Right to win
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Execution requirements
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Realistically capturable opportunity
That shifts the discussion from:
“How large is the market?”
to:
“Where can this organisation create disproportionate value, and what has to be true for it to win?”
That is usually a much more useful starting point for growth strategy.