The Fishbone
I’ve used the fishbone (Ishikawa) model since 2011 to help biotechs transition from drug development into commercial mode. It’s a fan favorite.
The first version was for designing a Medical Affairs function. It proved useful in helping stakeholders see the current and future business capabilities that need to come together when building a new function or, in this image, preparing for commercialization.
Unlike a timeline or project plan, this is a conceptual model. And that matters for a few reasons:
Models are not playbooks. They are inputs into timelines, plans, and playbooks - and must be adapted to each company, therapy, and market situation.
Most useful early. It helps stakeholders imagine the future, see interdependencies, and start real conversations about what’s required (and what’s not).
Not all capabilities are equal. Some are table stakes with ready-made solutions. Others demand real focus because they create differentiation and value.
Launch readiness isn’t just “commercial.” It’s an organizational transformation. Every function is affected by new processes, systems, and people.
Two common reactions. Either the “oh $#!” look, realizing how much is involved, or thoughtful analysis, using the model as a checklist of where things stand today. The latter often leads into a structured organizational diagnostic, where we uncover assumptions, plans, and gaps across teams. The real power of the model isn’t the diagram itself, but in the conversations it sparks. It gets people from different backgrounds to see the bigger picture and think together about what it takes to serve patients and create value. Want help, Let’s Chat.
Late-stage capabilities for cross-functional discussion about preparing for a potential launch.
