Other Articles

The Match Process…Part II: Interviews
By Elizabeth Hofheinz
This week we are checking in with medical students Matt Popa and Scott Tucker, who are moving through the residency match process. Learn their thoughts on scheduling interviews, the interviewers, and how they handled unusual questions.

How a Recession Might Affect Orthopedics
By Robin Young
With Citibank and Merrill Lynch waking up from their sub-prime party and realizing with growing horror that they wrecked the house and with stocks signaling a recession, it’s time to consider how past and imminent recessions might affect orthopedic product manufacturers, surgeons and hospitals. Here’s our analysis.

FDA Homes in on Postmarket Off-Label Marketing in Spine
By Walter Eisner
Staff shifting at the FDA from premarket to postmarket offices has raised the agency’s expertise level to monitor off-label marketing of spine devices. What’s it mean for you?

Nucleus Replacement: Perspectives Regarding the Gap in the Continuum of Spine Care and Degenerative Disc Disease
By Matt Menze
Confucius said, “Do not use a cannon to kill a mosquito.” In spine, the admonition could become, “Do not use fusion to treat an early stage degenerated disc.” Nucleus replacement may become an alternative for early stage degenerative disc disease.

So You Want to Write or Edit a Textbook…
By Elizabeth Hofheinz
While not financially lucrative, writing or editing an orthopedic textbook brings other rewards. The chance to contribute to the field and establish oneself as an expert are just two of the benefits of participating in this interesting process.

Biggest Order Ever for a Stem Cell Product
By Robin Young
To load $224.7 million of stem cell products, more than one semi-tractor trailer will have to back up to the loading dock on Aliceanna Street in Baltimore, Maryland. Last week the Department of Defense issued a landmark purchase order for stem cell products. The business of stem cells is gaining momentum. The implications are huge. Read on.

Fallout From Arkansas
By Walter Eisner
Dr. Chan’s guilty plea in Arkansas adds fuel to the fire of the remaining civil cases. Blackstone Medical is clearly in the plaintiff lawyer’s crosshairs. Read about the fallout from Arkansas.

Nailing the Rotator Cuff Market
By Dev Joshi
Rotator cuff sprains and ruptures count as two of the top five reported shoulder diagnoses in the PearlDiver database. Out of 3.7 million patients in the PearlDiver extremities database, 1.6 million are there due to shoulder pain complaints. What’s it all mean? Read on.

Recruiting Residents: Formal Strategies and Gut Instincts
How to home in on the residents who will be most successful in your program? Read what the experts have to say. Sharing their wisdom and experience are Dr. Robert Pedowitz, Professor and Chair of the Department of Orthopedics and Sports Medicine at the University of South Florida, and Dr. Ken Yamaguchi, the Sam and Marilyn Fox Distinguished Professor of Orthopaedic Surgery at Washington University School of Medicine.

Stem Cells Beat HA for Knee Pain Relief—Updated Chondrogen™ Results
New one-year data shows that a single, direct injection of Mesenchemal Stem Cells (MSC) beats multiple injections of hyaluronic acid (HA). Beyond pain relieve, the study also delivered evidence that stem cells reduce subchrondral sclerosis and osteophyte formation in OA patients. The evidence FOR stem cells keeps piling up.

Mike Mahoney: A Steady Hand for DePuy
New DePuy Group Chairman Mike Mahoney has one goal: make DePuy the clear leader in orthopedics. How? OTW talked with Mahoney and DePuy Spine’s Gary Fischetti. Here’s what they had to say.

How to Get the Surgeon’s Attention
Understanding relationship dynamics and having the chutzpah to put your best creative foot forward can garner you real success as a sales rep. Find out how to bring inventiveness to the sales process so as to attract and retain the surgeon’s attention.

Death Spiral
Since January, ReGen Biologic's stock has fallen from $0.95 per share to $0.04 per share. The number of shares outstanding is up 45% in 9 months. In one case, the company paid a $24,000 vendor bill with 68,572 shares of stock. Still, a couple of particularly savvy orthopedics investors have bought roughly 7% of the stock. Can ReGen survive?

Diving in to the Future
Since 1996 total knee procedures have risen 77% to 455,000 annually. A study presented at AAOS estimates that by 2030 that number grows to 3.48 million knee replacements a year! If infection rates continue to rise at current rates, however, that future will not be nearly as rosy for either patients or industry. Read on.

Selling Yourself: Career Advancement for Sales Reps
Are you considering becoming a distributor or do you plan to advance within a company? Either way, you need to be ready. You will want to know how to make product line choices, hire a sales force, and lead others, among other things.

Mission Unaccomplished: Are the Wheels Coming Off at the FDA?
The FDA is no longer able to fulfill its mission and its wheels are coming off. So says the FDA’s own Science Board in a scathing report. We looked under the hood of the report and here’s what we found.

“Back” to the Future Part II: Technology and the Vertebral Compression Fracture Market
In Part I, our inquiring analyst, Matt Menze, highlighted opportunities for spinal implant manufacturers in the vertebral compression fracture (VCF) market. Now he tackles the thorny issue of new and emerging VCF technologies. What’s on the horizon? Read on.

As a sales rep, you’re not painting, sculpting, or writing a screenplay. Why, then, might creativity be an important quality for you to possess?

“Because,” says Mark Blair, President of Bontan Medical, “it’s your entrée with the surgeon.”

“To acquire access to a surgeon, one must do a little extra work and think a little harder about what inventive ways you might obtain contact,” advises Blair. “This doesn’t begin with the surgeon, mind you, but his or her gatekeeper. This person, who often takes the job of protecting the surgeon’s time very seriously, is having to screen an eager 15 or 20 people per day who want to get in front of the doctor. She has got to look out for the surgeon; otherwise, there will be no time for operations.”

Try using empathic humor to break the ice. Maybe you could say, “I know you have nothing better to do today than trying to meet my needs, but I was hoping to get five minutes of Dr. X’s time.” You could also say, with the appropriate facial expression that conveys that you know you are being ridiculous, “On the off chance that Dr. X decides my sales call is more important than Mrs. Jones’ hip replacement, I can hang around for a few minutes.” Says Blair, “The front office staff is busy and stressed. If you can bring some levity, something unusual into their day, then you make yourself stand out. They will remember you and perhaps pave the way for you.”

And when that paved path leads to the surgeon’s door—or the scrub sink—you should be ready to separate yourself from the pack yet again. Going back to the gatekeeper for a minute, let’s say you know that Dr. X has a thing for motorcycles. You could bring in a cutout of a motorcycle, smile, and say, “I know Dr. X has a passion for motorcycles, so I’m recommending to our machine shop that the next implant look like this.” You’ve really locked yourself into the gatekeeper’s mind now. Says Blair, “Plan ahead and find out what the surgeon’s interests are. If you know someone has raced at Daytona, get on the Internet, find something new about the race or bikes, and bring it to the surgeon. You’ve already separated yourself from every other person he or she will see that day…and probably that week. All orthopedic implants can seem pretty similar to surgeons. It’s up to you to be the different variable in the equation.”

So how do you find out information on a surgeon’s interests? Advises Blair, “It’s not like you can grill the gatekeeper about the doctor, as she will usually want to protect most of that person’s information. You could, however, ask for a standard bio of the surgeon. While you are in the waiting room, examine the type of magazines lying around as that usually gives you a hint as to their interests. If you see Auto Aficionado, you can ask the gatekeeper, ‘I saw Auto Aficionado magazine. Does Dr. X like racing?’ Be mindful of what you ask and how. As long as the gatekeeper doesn’t feel threatened or like they’re revealing too much about the doctor, he or she will share some information with you. Then, when you do have the meeting, you can bring in information on the latest race car technology and hand it to the surgeon along with the information on your company’s implant.”

And don’t forget to put the Internet to work for you. “There is information available on the Internet about many surgeons. Much of it is free, but if you are so inclined, you can access paid websites that will give you information such as where the person trained and his or her past work history. Some surgeons are also artists, so you might find information about their exhibits online. Others are sailors whose community newspaper did a story when they won the local race. Be attuned to what if any research the doctor has done and look up his or her papers on Internet. Then you can engage the surgeon in conversation about this and ask his or her opinions of others who are doing similar work. One thing I often do is when I see an article from a spine magazine that mentions the institution where the doctor trained, I make copies of the article, highlight the salient points, and send the copy to the receptionist to forward to the surgeon. I return to the office later and ask the receptionist what the surgeon thought of xyz article. She then can say to the surgeon, ‘The rep who sent you the xyz article is here.’ Do all these things and the doctor will really get a sense that you are trying.”

Continues Blair, “If, after leaving your information twice you haven’t gotten a return call from the office, it’s likely time to schedule a meeting. Once you have interacted with the front office staff on a couple of occasions, they should have no problem scheduling a breakfast or lunch meeting for you. If, however, you walk in cold and ask for a meeting, 99% of the time you won’t get it. Let’s say you have scheduled a luncheon. Bring your system into the conference room, set it up, and go over the highlights. Ask the surgeon, ‘What are your thoughts on the system?’ No surgeon will say it’s perfect so you are likely to hear something like, ‘Well, your caps are too short.’ Take this information in and ask him how much longer they should be. Let him know that your company’s machine shop could custom make one for him within two weeks. Sometimes companies take too long to do this, but you want to be quick so as to show that you have an outstanding level of service. You also want to send it to the surgeon soon so that he can vividly recall it.”

Another way of connecting with the surgeon is to be the student. The surgeon is always the medical expert in the room. Why not take advantage of an opportunity to learn something? Advises Blair, “Most surgeons love to teach others about their profession. Yes, they are on a limited schedule, but they will likely take a few extra minutes if they are wearing their instructor hats. You could say to her, ‘I have a little knowledge of this area, but if possible, could you explain those X-rays and the abnormality involved?’”

And if you’re striking out? “Let’s say the surgeon likes you, but the products you’ve brought in don’t meet her needs,” says Blair. “If you have asked open-ended questions, she will reveal her specific interests. If you have established a good rapport, you could say, ‘I think I have what you need. Maybe I could bring it to you in the next week or so.’ Then upon your departure you should tell the gatekeeper that Dr. X wants you to return with another product and that you should be back within the next week.”

Sprinkled throughout the year are other opportunities to interact with surgeons. States Blair, “When I attend conventions I spend most of my time in the exhibit hall where I might just ‘bump into’ surgeons I’m hoping to meet. Speaking with him or her in that informal atmosphere makes things a little bit easier. It also gives you the chance to say, ‘I have been dropping things off at your office but I’m not sure you’re getting them. Whom should I see?’ Then you can go back to his office and say, ‘Dr. X asked me to drop this off to you.’ This puts you in a much better position.”

Success in sales requires so much more than having a good product. Understanding relationship dynamics and having the chutzpah to do something different will put you in a unique position to attract the surgeon’s attention. Concludes Mark Blair, “Going the extra mile to distinguish yourself is a must. Even if this is not your year to sell to a particular surgeon, next year could be completely different. The surgeon’s relationship with his current reps might change and you could again be up to bat. Whether you can get to bat, however, may heavily depend on how you approached the doctor in the first place.”