How to sell stuff...to me!
I am an orthopaedic surgeon and working at a major trauma centre enables me to operate on the whole body including such things as total hip replacements for trauma and periprosthetic fractures etc. It is an awesome job but one of my biggest frustrations is kit. Not just the kit we have necessarily not being up to scratch but there is so much kit available, where do we start? You can't try it all. This got me thinking about how to sell your products.
Just a little declaration at the beginning; this is not a dig at sales reps but more at the system that exists for training them (that we, as doctors, perpetuate). I have many friends who are reps and I've made friends of reps. I have an enormous respect for them and could never do their job but I wanted to share an idea that may be helpful to both of us:
In my world we have to provide evidence for everything we do from the operations we perform and their outcomes to justify the time that I'm not in theatre et cetera. The NHS is asking for this information so that it knows it's getting its value for money. All the consultants I know provide way over and above what they are paid for and all of that can be evidenced. So why do we buy kit that has none or at least very little poor quality evidence? This can be because it is so new and that's entirely reasonable but where is the onus to prove that it does work? For some new implants such as total hip replacement there are very strict rules about introducing new products. Those rules cannot and should not be rolled out to every product but there is another way.
How is it best to sell stuff? Is it best to tell me that your screw has this amount of torque or is it best to tell me that it actually works, with evidence?
I'm not sure at the moment most sales reps have been taught how to sell things properly...bear with me! This is not a diatribe against reps.
Kit I buy has to be reasonably priced but not necessarily the cheapest and it has to have a low complication profile.
So here's my thoughts - as a consultant I would be revulsed to think of a rep getting back into his car and punching the air saying "Yes. I've sold another one and got my bonus." If I was a rep I would want to know that my product worked too and I could sell it based on that fact. It would be a phenomenally powerful sales tool for you to come to me and say "my product aims to fuse the PIPJ. It has been put in 105 fingers and 104 of them have fused and we've only taken out two". I would buy that product.
I would propose that we should be working more closely with company reps to document every product that goes into our patients. This data could be shared with the companies that produce the kit so they could have the data to take to other surgeons. That way we could have a database to catch early failures and reps would have a massively powerful sales tool. It could work very simply by working out exactly what the plate or screw or nail was meant to do, as a primary outcome measure, and collecting data over the course of 12 to 24 months and then also collecting data about complications. I would suggest that with all the work that we have in the NHS etc. it might not be feasible for us to run these databases so why can't companies do it? There are very easy ways to get anonymised data and databases are not difficult to make run if you choose the right data to put in.
It probably hasn't happened yet because we as clinicians cannot take on the responsibility of something as huge as this but what are the obstacles that you would see to suggesting companies to do it with us? It's in everyone's interests after all.
So...a quick update from two cases that I've blogged about previously, the 3D jigs young chap and the radiocapitellar arthroplasty.
The former is doing better han the latter but not because of the arthroplasty but because of the Essex-Lopresti lesion causing severe stiffness of rotation.
The man with the intra-articular osteotomy has a near full range of motion and almost no pain.
The radiocapitellar joint itself functioning very well for elbow flex/ext:
The distal end of his forearm is more challenging however!
I've just caight up with this young man now and 1 week post op he's doing relly well. Minimal pain, straight out of his volar slab:
Early days but it's looking promising. Into a removable splint to gently get going. No lifting anything more than a pen for 5 more weeks. He's a great patient; motivated, young, doesn't smoke and knows what it's like to not have a great result first time so is following instructions to the letter!!
I work at a Major Trauma Centre in Southampton and we cover an estimated catchment area of 1.9 million patients for Southampton and South Hampshire and 3.7 million patients for specialist services such as tertiary referral elbow surgery and complex trauma reconstruction.
As such we receive some difficult and fascinating referrals and plenty also land on our doorstep due to road traffic accidents from the high-speed road network in this area.
One such patient had a slightly more simple initial presentation with a wrist (distal radius) fracture but the lunate fossa subsided after fixation creating an intra-articular step:
This produced significant pain and the patient ended up requiring going back into a cast for pain relief and not being able to work.
http://www.materialise.be are an innovative, bespoke 3D printing company that is leading the way in many areas of this new technology, including patient specific joint replacements and now personalized 3D printed glasses/sunglasses!
For this case Materialise used CT scans of the patients good and bad wrists to plan the osteotomy (cuts in the bone), build/3D print jigs (to tell me where to cut intra-operatively) with all the screw holes pre-drilled, ready for the new plate (DVRa - ZimmerBiomet) to be applied.
It takes the guesswork out of intra-articular osteotomies – “making a difficult case simple”.
So far I have approved the plans and am awaiting the jig, which will arrive next week for the operation the week after.
Here is a selection of the images:
Note: The osteotomy could have been much more complex due to some dorsal extra-articular malunion after the first operation. I have elected to address the intra-articular portion of the malunion only, for simplicity’s sake. There is a reasonable likelihood that I will have to remove the plate once the osteotomy has united to protect FPL and FDP.
We are now underway with our 6 month trial of using a sole supplier (mostly) for upper limb trauma kit. We held a table top "beauty pageant" of 5 companies and ZimmerBiomet (ZB) and Acumed won through. All the upper limb surgeons were involved and had their say and democracy spoke.
The trial is going well and the support from ZB is continuing to be exceptional. Keep it up guys - it is appreciated. In particular Matt Underwood is proving his worth ten times over.