This article originally appeared as part of The Vendor Edge series on LinkedIn. This is an expanded and updated version for kieranengels.com.
Clinical catfishing is what happens when a vendor’s proposal does not match their operational reality. The proposal promises a team, a timeline, and a methodology. Execution reveals different staff, different timelines, and different capability. This is not always malicious. It is often a systemic problem: the team that writes the proposal is not the team that executes the work. The incentive structure rewards winning bids, not honest capability assessment. A vendor can promise excellence in the proposal because the proposal team has no accountability for execution. The execution team operates under different constraints. Kieran Engels has observed this pattern across CROs, sites, and specialized vendors. A proposal names a medical director with 15 years of experience. Execution reveals that the medical director will be reviewing work but the day-to-day team is junior and less experienced. This is not deception. This is misalignment between proposal and execution incentives.
KEY TAKEAWAYS
Key Takeaways
- Clinical catfishing occurs when the proposal team and execution team have different incentives, creating gaps between promised and delivered capability.
- Proposal-execution gaps are often not malicious. They reflect the reality that the person promising execution is not the person delivering it.
- Named staffing commitments with contractual protections reduce the likelihood that execution will involve different people than what was proposed.
- Governance infrastructure with early feedback surfaces proposal-execution gaps within weeks rather than after they compound into major program delays.
- Effective vendor management requires treating proposals as aspirations requiring specificity, not commitments requiring only contract enforcement.
The Challenge
The problem with clinical vendor selection is misaligned incentives. The person writing the proposal is incentivized to win the bid. The person executing the work is incentivized to deliver profitably. These are not the same person. They often do not even know each other.
A CRO receives an RFP. The business development team responds. The proposal promises a monitoring plan with monthly on-site visits, a dedicated program manager, and a quality review cadence of twice weekly. The sponsor reads this and feels confident about execution oversight.
Then execution begins. The program manager assigned is junior and divided across three programs. Monthly on-site visits become quarterly because travel budgets are tight. Quality reviews are weekly, not twice weekly. The vendor is not breaking their contract. They are operating within its letter but not its spirit. The difference between what was proposed and what is executing is real.
This is not the vendor lying. This is the vendor operating under different constraints than what the proposal assumed.
Let’s be clear about what is happening. The proposal team is rewarded for closing deals. The execution team is rewarded for managing costs. These incentives are misaligned. And the gap between them is where execution problems emerge.
Kieran Engels has seen this across different vendor types. A CRO proposes a team with specific people. During execution, one of the named people leaves for another job. They are replaced with someone less experienced. The CRO fulfilled the contract by providing a replacement. But the execution capability decreased.
A site proposes a patient population and enrollment timeline. During execution, the patient population is harder to recruit than expected. Enrollment slows. The site did not breach the contract. They are operating in a harder environment than what the proposal assumed.
A specialized vendor proposes a novel analysis approach. During execution, the approach proves more complex than anticipated. Timelines slip. The vendor is doing the work they promised. But the delivery is delayed.
These are not vendor failures. These are proposal-execution gaps. And they are endemic to how vendor selection works.
The Infrastructure
The RFP-proposal process assumes that what is written in the proposal will be executed. But proposals are written by the people who sell. Execution is done by the people who deliver. These are different incentives operating on different timelines.
How does a sponsor address this? First, involve the execution team in the selection process. Not the business development team. The team that will actually do the work. This creates alignment. The people writing the proposal are the people who will execute it. Their incentives are the same.
Second, require specific staffing commitments. Not generic promises about a “dedicated team.” Specific names. Specific roles. Specific hours. And contractual protections if the named person is reassigned without cause.
Third, build feedback mechanisms that surface proposal-execution gaps early. A governance infrastructure with weekly feedback means that if the execution team is delivering differently than what was proposed, this becomes visible within weeks, not months.
Fourth, build governance infrastructure that clarifies expectations before execution starts. A proposal that promises a monthly on-site visit plan should result in a written monitoring plan that details which months, which sites, which activities. This forces specificity before the contract is signed.
Seuss+ works with biotech leadership navigating vendor relationships that have proposal-execution gaps. The first response is often to escalate to the vendor relationship manager. The vendor’s response is often technically accurate. But it does not close the gap between what was proposed and what is executing.
The real solution is systemic. Align the incentives of the proposal team and the execution team. Require specificity in proposals. Involve execution teams in selection. Build feedback mechanisms early.
This is the work of buying with your eyes open. It requires acknowledging that proposals are aspirations, not commitments. And commitments require specificity, accountability, and governance infrastructure to enforce.
Proposal vs. Reality
| Dimension | What the Proposal Said | What Execution Revealed | Governance Fix |
| Named Team | Medical Director: Dr. Smith (15yr PM experience). Program Manager: Jane Doe. | Dr. Smith reviews monthly. Jane manages 3 programs. Neither is the day-to-day contact. | Named primary contact with SLA for response time. Escalation path if primary contact is reassigned. |
| Timeline | On-site monitoring visits monthly | Visits happen quarterly due to travel budget constraints | Written monitoring visit calendar by program month, signed before execution starts |
| Methodology | Real-time EDC review with 24-hour response to flags | EDC review is weekly. Flags are reviewed within 5 days. | Specific escalation pathway. Named person responsible for response time. Weekly feedback to sponsor. |
| Risk Acknowledgment | Risk is managed through quality oversight | Vendor is managing cost, not risk visibility. High-risk issues surface late. | Governance infrastructure with daily/weekly escalation for high-risk areas. Clear definition of what triggers escalation. |
| Staffing Model | Dedicated program team | Team is shared across multiple programs. Availability is inconsistent. | Primary and secondary named contacts. Defined hours of availability. Escalation if availability falls below commitment. |
Clinical catfishing is not deception. It is the gap between incentive structures: proposal team rewarded for winning, execution team rewarded for managing costs.
Key Industry Data
70% of clinical trials experience delays, with more than half related to site activation. (Source: Tufts CSDD)
Nearly 80% of trials fail to meet their original on time enrollment targets. (Source: Tufts CSDD)
Cancer center median trial activation time is 167 days, compared to the NCI target of 90 days. (Source: AACI/NCI)
Daily trial delays cost sponsors between $600,000 and $8 million per day in lost revenue opportunity. (Source: Tufts CSDD)
Best performing clinical facilities achieve 5% to 10% operating cost improvements through clinical standardization and productivity gains. (Source: McKinsey)
Frequently Asked Questions
Four approaches work. First, involve the execution team in selection. Second, require named staffing with contractual protections. Third, build feedback mechanisms that surface gaps early. Fourth, build governance infrastructure that clarifies expectations before execution starts. Together, these reduce the gap between proposal and reality.
Yes, but only if the proposal is specific. Generic proposals like ‘dedicated team’ or ‘comprehensive monitoring’ are aspirational, not commitments. Specific proposals like ‘monthly on-site visits on these dates with these activities’ are commitments. Contracts should distinguish between the two.
First, document the difference clearly. Is it a material gap or a minor variation? If material, escalate to vendor leadership with specific examples. Clarify whether the proposal was committed or aspirational. If committed, seek remediation. If aspirational, adjust expectations and add governance infrastructure to catch future gaps early.
Yes. Markets change. Resources become unavailable. Constraints emerge during execution that were not visible during proposal. The question is not whether gaps are legitimate. The question is whether they are transparent and managed with the sponsor, or hidden until they cause damage.
Governance infrastructure surfaces gaps early through feedback mechanisms. A weekly call between sponsor and vendor allows the sponsor to see how execution is tracking against proposal. When gaps become visible, adjustments can be made while they are still small. Without governance infrastructure, gaps hide until they are expensive to fix.
About the Author
Kieran Engels is CEO and Co-Founder of Seuss+, a strategy and execution partner helping biotech sponsors optimize vendor relationships across clinical development. With more than a decade of experience in vendor governance, risk management, and clinical trial execution, Kieran works with biotech leadership teams to build the oversight systems that protect timelines, budgets, and data integrity. Learn more at seuss.plus.
