Clinical Product Is Blocking by Default - And That's the Point

One of the most uncomfortable truths about Clinical Product is that the role is blocking by default.

As much as we talk about how the role shouldn't be approached only for sign-off, or as a tick-box exercise, at its absolute core - it can block.

Why blocking matters

In a previous article, What clinical accountability actually means, I talked about how the role is responsible for clinical accuracy, safety and appropriateness.

If Clinical Product cannot block a release, the role becomes advisory. The result is that your suggestions get weighed against speed, and speed usually wins.

Blocking is the enforcement mechanism. It's what transforms "please listen to the clinical person" into "the clinical person has the authority to ensure patient safety.”

The discomfort of being the blocker

Nobody wants to be the person who stops things, especially in fast-moving product teams where momentum matters and delays are visible.

As a Clinical Product Manager, you're embedded in the team and understand the pressure everyone is under to ship. Because of this, you’ll also be feeling pressure to let things through when you know it’s not quite right.

This is the central tension of Clinical Product roles: you're embedded in the team, but you're also the one who might stop the team from shipping. Navigating that tension can be tough.

What blocking actually looks like

Blocking doesn't mean saying no to everything, and it definitely doesn't mean threatening teams on a daily basis that you might block the feature. It does, however, remind teams of your role and the responsibility you hold.

Work that doesn't quite meet the bar can be handled much better than a flat 'no', for example:

• "We can ship this, but not with that edge case unresolved."
• "This is fine for a limited rollout. It's not fine for general use."
• "I need more information before I can sign off."
• "This doesn't meet the clinical threshold. Here's what would."

Good blocking is specific. It gives teams something to work with by outlining the problem, and, where possible, points towards a solution.

The cost of not blocking

When Clinical Product doesn't block - or can't - the consequences tend to be invisible, until they're not.

That edge case you let through, knowing it wasn't quite right, hoping it wouldn't surface? It reveals itself as an incident. Either as a single event, or through the accumulation of regulatory risk that the company is eventually pulled up for.

A delayed release is far better than a release that harms someone. Incidents are costly - not only for patients who are harmed, but also for the business. Time is spent fixing the issue, responding to the patient, to the media and to the regulator.

Building the credibility to block

Blocking only works if people trust your judgement. If they don't, they'll go round you, or above you, to confirm your call.

Trust is earned, and it takes time. It comes from:

• Being right more often than you're wrong, and being honest when you're uncertain.
• Understanding the product, not just the clinical domain.
• Picking your battles - blocking when it matters, not blocking reflexively.
• Explaining your reasoning, not just asserting authority.

If you block too often, you lose credibility, but if you never block, even when you should, you lose the point of the role.

Knowing when to step back

Not every decision needs clinical product to make the final call.

You're part of the product conversation - shaping direction, contributing to trade-offs, understanding what's being built. But some decisions - like choosing between two equally safe design patterns, or prioritising one low-risk feature over another - can be left as a team decision. There may be commercial factors, or patient experience considerations, that pull one option over the other.

The question to ask yourself is: does this decision require me to exercise clinical authority, or can I contribute as part of the team without needing to be the deciding voice? If it's the latter, step back and allow the team to own it.

This is harder than it sounds. When you're accountable for clinical outcomes, it's tempting to assert your position on everything, but knowing when not to block is just as important as knowing when to block.

A note for organisations

If you're hiring for Clinical Product, ask yourself: does this role have the authority to block a release? If the answer is no, you're not hiring for Clinical Product - you're hiring a clinical advisor.

If you’re looking for a role in Clinical Product, check with the hiring manager: does this role have the authority to block a release?

Remember: clinical accountability requires the power to stop. Without it, you're responsible for outcomes you can't control, and when something goes wrong, you carry the blame without ever having had the influence to prevent it.

This post is part of a series on what Clinical Product actually is. Subscribe to be notified of new posts.