The Death of Medical Sales

Omar M. Khateeb
7 min readNov 16, 2020

To grow, we must suffer. The passage from one world into the next requires bold steps.

Medical sales reps are masters at the grind.

Show up early for surgical cases. Make relationships. Shadow prospective physicians. Sell.

That’s how our industry has driven adoption for decades.

We preach to physicians about our technology “augmenting their skills” by making their procedures more efficient, clinical interventions earlier, and drug dosage more precise.

“ Doctor, our technology is meant to enhance your skills, not replace you.”

Medicine is a culture rooted in skepticism, and rightly so. However, adoption happens when the truth can no longer be ignored and enough pain from the “old way” moves medicine forward.

That time has come for our industry.

I’ve spoken, interviewed, written, presented, and persuaded as much as I can over the years about life sciences (medical device, biotech, pharma) adopting the digital approach on social media.

It’s not enough to just have a company page and run ads. Our sales people need to be online as well. Our customers are online, having conversations in realtime, all day long.

Go Where Attention Already Is

Via @helloimnik

Attention is worth billions of dollars as Google, Facebook, Twitter, and others have shown. So where attention flows, so does energy.

Persuasion starts with getting attention and more specifically going to where the attention already is.

If you cannot get attention, you cannot persuade.

This also goes for trust, relationship building, gathering research, and a whole list of things that go along with sales and marketing.

You go where the attention already is.

So when we look at publications by clinicians on PubMed around social media, it’s clear that it is no longer a fad but a trend.

The reason is simple; physicians are losing more independence.

I saw this begin in 2012 when I left medical school and accelerate. According to the AMA, in 2018 47.4% of practicing physicians were employed, while 45.9% owned their practices, according to a new entry in the AMA Policy Research Perspectives (PRP) series.

Unfortunately, this trend was accelerated due to COVID.

The Physicians Foundation did a survey showing the majority of physicians (55%) expect a reduction in income over the next 12 months.

Of those anticipating an income reduction, most physicians (61%) expected a decrease of 25% or less, while 39% expected losses of 26% or more, the survey showed.

Notably, specialists were more likely to project larger losses than primary care physicians.

What do you think physicians who owned a practice or were part of a small group (aka Small Business) do when they have reduction in income and have to either sell their practice or close down all together?

They go to be employed by either a large practice (>50 MDs) and/or hospital system.

Which means they become employees. As employees, they have less independence.

Physician Psychology & Independence

Years ago I wrote about the Psychological Profile of Surgeons but this profile is largely applicable to all physicians in that they are used to being entrepreneurial and independent.

Culture built over centuries doesn’t go away. When independence is taken away in one area it will find a way to express itself somewhere else. Logically, physicians started with what made sense; more school.

The number of joint M.D./M.B.A. programs in America has grown from 6 to 65 in 20 years. (From 2011 and 2012 alone, the number increased by 25%.)

As the marketplace gets saturated with too many MD/MBAs, physicians have been adopting an asset that is free and more unique.

That asset is having a presence on social media.

Reality is the best trigger for changing behavior, so if you’re in the industry and reading this, do this:

  1. Search your prospective physician title on LinkedIn (e.g. cardiac surgeon and/or cardiothoracic surgeon) and see the number that pops up (31,000 in the U.S. alone)
  2. Go on Twitter and search #MedTwitter and #MedEd. See how many tweets in realtime physicians are sending out. Look at other hashtags such as #CardioTwitter or #SurgTwitter. The discussions will get more specific and increase in frequency.

The Big Change for 2021

COVID-19 did not create any new trends. It only accelerated existing trends by 5–10 years. This is the first time in human history where every single person is evaluating every aspect of life.

How do I educate my kids? How can I get healthier? Should we have a remote workforce?

For hospitals, here are some of those questions:

  • Why are we letting in medical sales reps who are not doing cases today?
  • Why are we letting medical sales reps who don’t even have products here?
  • Why are we letting in medical sales reps at all?

A recent survey of medical device leaders conducted by ExplORer Surgical revealed that fewer than 20% of medical device reps have been able to cover cases in person as a result of hospital restrictions, company reservations regarding risk, or their own concern about exposure to COVID-19.

  • More than 70% of the life sciences reps report they are engaging in remote support of their customers via video or phone.
  • More than 75% of respondents also feel that remote access and support is here to stay, and that it will be an integral part of their business model for the future.
  • 93% of executives felt hospital access and HCP interaction will never be the same as it was pre-COVID

You can deny this all you want but the day has finally come. This is just like the day when email finally took off in adoption. Physicians did not welcome reps walking into their office or surgical theatre to pitch products.

They simply asked you to email them.

Dwell on the past and you’ll lose an eye. Forget the past and you’ll lose both eyes.

Industry leadership is also being forced to change behavior due to the pain of reality.

Leadership and boards are now seeing the amount they spend on things like training and even sales prospecting. There’s a massive financial gain this year from not having travel and meal expenses from the field. And since hospitals are requesting more “digital” approaches to training and communication, that’s where the investment is going.

Do you think this will revert back when things “return to normal”?

This was a one-way ticket and it will not revert back. Once you see something like this and live it for a year you cannot unsee it.

Many peers have disagreed with me over the years and I welcome that. Disagreements are not threats but opportunities for learning.

How to Get Started

I am not advocating for reps to get on social media only to use the “old approach” and try to make it work in the new one. You cannot get online only to “show-up and throw-up” in a physician’s inbox.

Rather, connect and engage with physicians just like you would in the hospital. Hop in their posts, comment, ask questions.

Show that you are strong clinically and are just like them in that you can engage in a clinical conversation.

A key step in selling is developing trust. That starts gaining familiarity and increasing your visibility.

A great way to start is the following:

  1. Connect with physicians (not only in your territory but thought leaders in other areas)
  2. Make an effort to engage thoughtfully with their content (liking and commenting)
  3. Add any physicians who “like” that physician’s posts as that’s an indicator they’re active on LinkedIn (or Twitter)

Do this for a few weeks. At some point I recommend posting your own content, even if it’s just sharing an article. You can get ideas from these great physicians on social media:

You don’t have to be great at social media selling to start. But, you do have to start in order to be great.

Just start. The time has come to communicate and engage the way our customers do.

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