How do we run April Dunford's first positioning step ourselves?

Of 302 healthtech homepages we scored, 278 never name what a buyer would do instead. That's the whole gap. Competitive alternatives are the full set of things your buyer could do rather than buy from you, and the list includes doing nothing at all. You can build it yourself in about a week, with your own deal data, without hiring a positioning consultant to hand it back to you.

Here's the short version of how. Pull your last twenty lost and no-decision deals, write down what the buyer chose instead in the buyer's own words, group those choices into three or four buckets, then find the bucket that wins often and appears nowhere on your website. That bucket is your positioning work for the quarter. The rest of this is the detail that keeps the exercise honest.

What are competitive alternatives, and how are they different from competitors?

April Dunford put this step first in Obviously Awesome, and the credit is hers. Her argument is that positioning is relative. Every claim you make only means something measured against the thing your buyer would otherwise pick, so you can't write the claim until you know the thing.

A competitor list names companies. An alternatives list names whatever the buyer would actually do next Monday if you disappeared, which is often not a company at all. Four buckets cover almost every B2B case:

• Do nothing. Keep the current process, absorb the cost, revisit it next year. This is the most common choice in almost every category, and it is the one your CRM records as 'no decision' and then forgets.
• A homegrown fix. A spreadsheet, a script somebody wrote in 2023, an analyst, a contractor, an intern with a template.
• An adjacent tool bent to the job. Something they already pay for that covers 60 percent of it. Nobody has to get budget approved to keep using it.
• A direct vendor. The one your sales team names in every pipeline review.

Most teams write down the fourth bucket and call it competitive analysis. The first three are where the deals go.

How do we build the list without hiring anyone?

Budget one week and one owner. Here are the five steps, in order.

1. 1Pull the last twenty closed-lost and no-decision deals. Not the wins. Wins tell you your own story again. Losses and stalls are the only place the alternative shows up, because in those deals the buyer picked it.
2. 2Write down what the buyer chose instead, in the buyer's words. Read the CRM note and the last real email in the thread. If the note says 'went another direction,' that deal is unusable until a rep tells you what the direction was. Expect to get honest answers on maybe twelve of the twenty. Twelve is enough.
3. 3Add the deals that never opened. Ask two reps which sentence ends a call before the demo. 'We already handle this in-house' is an alternative. 'We're not looking at this until next year' is an alternative. Both belong on the list.
4. 4Group them into three or four buckets, named the way a buyer would say it. Not 'legacy vendors.' Write 'the report our analyst rebuilds every Monday.' The buyer's phrasing is the part you'll reuse later in the copy.
5. 5Score each bucket twice: how often it beats you, and how many words your homepage spends on it. The bucket that wins often and gets zero words is the answer you ran this exercise to find.

That's four hours of pulling records, two conversations with reps, and an hour with your CEO to argue about the buckets. The argument with your CEO is the valuable part.

Where does this go wrong?

• You list the vendors you want to beat. Aspiration creeps in fast. If you're a $12M company writing down a $400M incumbent because you meet them in three deals a year, you've just built your competitive set out of the deals you lose least often.
• You throw out 'nothing' because it isn't a company. Doing nothing has no salesperson, no website, and no G2 page, so it never makes the slide. It also has a champion inside the account, which is whoever built the current process.
• You run it once. Alternatives move. A new AI feature inside a tool your buyer already owns can rewrite your whole comparison set in a quarter, and you'll feel it as unexplained pipeline slowdown. Re-run this every two quarters.

There's a fourth failure that's harder to see. If your buyers are comparing you to the wrong group entirely, a clean alternatives list will hand you the right answer to the wrong question. We wrote about that separately in why buyers keep comparing you to the wrong competitors.

How rare is skipping this step, really?

On September 1 we scored 302 healthtech companies' homepages against a published 19-criterion rubric. One criterion asks whether the page acknowledges what else a buyer could do, including doing nothing. It finished last of all nineteen. 278 of 302 scored a flat zero.

The other half of the same question scored nearly as badly. A separate criterion asks whether the page names the cost of not acting. 172 companies scored zero on both at once, which is 57 percent of the set. Exactly one company out of 302 earned full marks on both.

Now the part that's worth your week. Six companies earned full marks on alternatives. All six sit in the top 29 of 302 overall: WELL Health at rank 2, SmarterDx at 5, Capital Rx at 7, Heard at 16, Condor Software at 19, Certify at 29. Below rank 29, nobody does it.

Read that carefully, because it's a correlation from one vertical and not a proof. The same rubric scores eighteen other things, and strong companies tend to score well across the board. What makes it interesting is the counter-example inside the same data.

Fifteen of the top 25 companies by total score, averaging 29 out of 38 points, still score zero on alternatives. These are well-written pages with clear products and real proof. Good writing earns you the other eighteen criteria. Only asking your buyers earns you this one.

You can read the rubric and every score on the 2026 Healthtech Messaging Index, and run the same nineteen criteria against your own homepage with the free Brand Signal Score. Criterion 12 is the one this article is about.

When should we hire from Dunford's school instead?

Building the list is genuinely do-it-yourself work. Deciding what to do with it is where outside help earns its fee, and there are honest reasons to get some.

Dunford's method is the sharpest tool in the field for one specific symptom: buyers keep filing you into the wrong category, so you inherit that category's price expectations and feature checklists. If that's your symptom, read Obviously Awesome and consider her school. We put that decision side by side with the alternative in Dunford's school or Andy Raskin's, and laid out seven positioning frameworks and the input each one needs so you can pick on fit rather than on reputation.

There's also a version of this problem that isn't a framework problem at all. If your alternatives list comes back clean and your messaging still doesn't move buyers, the issue usually sits one layer up, in what your company actually stands for and who it's willing to say no to. That's the narrative identity work, and it's what the 90-Day Magnetic Messaging Sprint exists to do. Before that, the cheapest next step is running a competitive positioning analysis on the buckets you just built.

One more reason to do this yourself first: a consultant's first week is largely this exercise. Walking in with twelve real buyer sentences already written down buys you a much better engagement, whoever you hire.

What this means for you

Open your CRM this afternoon. Filter to closed-lost and no-decision, last twenty, and read the notes. You'll know inside forty minutes whether your team has ever recorded what the buyer chose instead.

If the answer is no, you don't have a messaging problem yet. You have a listening problem, and it's the cheapest one on this list to fix.

Most of the companies beating you aren't better. They're clearer about what they're an alternative to. We wrote about that pattern in why competitors with weaker products win more deals.

Start with twenty deals. The list is already in your data. Nobody has read it out loud yet.