Most of us grew up with the idea of America as the land of opportunity — a place where hard work could build a better future. I have arrived in Anaheim in something of that spirit. Next to Disney’s wonderland, I am more interested in the other one down the road.
ADLM is a conference and a trade show, and there is a third part, less seen, that I will come to. Thousands of clinical laboratory professionals attend, mostly from the United States but with serious international weight among them. The concentration of laboratory leaders, users and buyers is substantial.
The conference is large and layered — sessions for every level, from introductory to deeply specialised, and a good number that are frankly commercial. But most business people either work the exhibition or live in it, and the exhibition is where I want to start.
What the floor actually is
The ecosystem is easy to describe. The clinical laboratory sits at the centre, and the IVD industry shows up around it in full force. Reviewing the exhibitor list in mid-July, I counted 691 companies and sorted each by its main role: 330 IVD manufacturers, 237 suppliers to the IVD industry, 71 life-science companies and 53 general suppliers to laboratories. The boundaries are not always clean, but the shape is clear enough.
Those 330 manufacturers are the ones I find most telling. The companies on this floor account for around 78% of world IVD sales — yet they are barely a tenth of the world’s diagnostics companies. Most of the industry, by headcount, is not in the room. And the part that is in the room is astonishingly top-heavy: the five largest manufacturers average over six billion dollars in IVD revenue, while the companies below the top thirty average around thirteen million. Six billion against thirteen million, in the same business.
So with all of that under one roof, what does a business leader actually come here to catch?
Customers — but not at the booth
The booth is necessary, and not sufficient. It does its slow, expensive work of visibility and brand reinforcement whether you crowd it or not. I would not let it absorb the whole commercial organisation. The account development happens elsewhere — in scheduled meetings, small groups, the parallel and post-show programme — and that is where I would put my best people. The honest question to put to your own team is a simple one: are we running social events, or business meetings?
Reading the market — the croissant question
The reports will come. What they cannot give me is my own feel for the event, which is worth more, so I will spend real time on it. The richer read is on how clinical laboratories are actually thinking, and that comes from choosing a few sessions carefully and talking to a few people at length. Productivity has been the industry’s bread and butter for years. Is that still the whole proposition — or is there room for something more differentiated, built around a defined clinical problem rather than another claim of efficiency? Can we eat a croissant instead? Positioning is what sustains a business, and it is decided in questions like that one.
Margin — where it is leaking, and who could restore it
Margin matters more than it has in years, and every material supply agreement deserves a periodic look. The suppliers are all here, which makes this the place to start those conversations rather than finish them. Changing a running product is unpopular and rarely justified on its own — but resilience and margin together change the calculation. So the question is worth asking on the floor: who else could supply the critical component that is quietly eroding my margin? You will not answer it at ADLM. You can start it here.
Downstream partners — cheap to get, expensive to leave
I would use ADLM to widen the network of potential route-to-market and go-to-market partners — and commit to none of them here. A downstream partner deserves a business case and real diligence, because taking one on is cheap and getting out of one is not. The floor is for finding candidates and reading them. The decision happens later, somewhere quieter.
Investment — weigh the risk by watching the actors
A consultant will hand you a risk profile, and it will be confidently assumed. What it cannot give you is the judgement that comes from watching the actors in a market behave — how a company answers a hard question at its own stand, which claims it leans on, who it is nervous about. ADLM is a compact and inexpensive way to acquire exactly that: not the valuation, which the floor is poor at, but the feel for where a risk is real and where it is priced-in fear. It is also the place to spot who might buy an asset later — the strategics reveal what they believe in by what they crowd around. Read the room yourself. The risks that matter are the ones no report has named yet.
The partnering that gets no spotlight
The downstream partners above are the commercial kind — routes to a customer. The partnering I want to end on is different, and it is the part of ADLM the spotlights never reach. Not the multi-year supply and distribution contracts that run on both sides of the business, but strategic agreements around capabilities and adjacent opportunities that matter to a company yet never win enough capital or management attention inside it.
Diagnostics carries so many constraints that partnering ought to be a deliberate strategy for the mid-sized and smaller companies. Curiously, it is the large companies I see doing it most — which suggests partnering is not a substitute for scale, but one of the ways scale is now exercised. Few durable positions in diagnostics are built by organic development alone, or by acquisition alone. The models other industries take for granted — partner-led revenue, co-design, co-sell, co-service, multi-layer distribution — remain materially underused here. Each case needs its own answer, and the hard part is never the introduction. It is finding the right partner, not the one you were introduced to yesterday.
Why I am here
This is my industry, and the one I care about. I want to see it flourish, because when it does, more people get better healthcare at a cost the system can carry. Its next phase will be built on strategy, partnerships and commercial execution — the work I have spent a career on and expect to keep doing.
If you are building, financing or commercialising a diagnostic company, and weighing which capabilities to own and which to reach through partners, I would enjoy the conversation. I am at the Anaheim Convention Center Monday to Wednesday.