Adding Value to Client Relationships
- 1. Adding Value to Client Relationships Examples from 2 decades of selling to surgeons 09/03/14 Prepared by Mark Schleiche1r
- 2. Introduction “Representing implantable medical devices effectively and successfully requires much more than showing up on time and having the case go well…….” Mark Schleicher circa 2013 09/03/14 Prepared by Mark Schleiche2r
- 3. Topics of Discussion In this presentation we will examine how client relationships can be initiated, fostered, developed and enhanced. Using actual examples from early in my career to more recently. 09/03/14 Prepared by Mark Schleiche3r
- 4. Background Info: Example 1 1992 – Webster Orthopedics Drs. William S.T.Jackson – H.M.”Mac” Reynolds Pill Hill (Merritt/Providence/Peralta Hospitals) Oakland, CA Busiest orthopedic practice in Northern CA – 300 hips and 200 knee replacements annually. First group to RFP top 4 device companies in attempt to “Regain control over implant/instrument costs and economies of scale through contractual arrangements and procedural volume commitments.” Smallest of 4 companies involved (Intermedics Orthopedics) Intermedics had the newest/most expensive technology 30% marketshare 09/03/14 Prepared by Mark Schleiche4r
- 5. Strategy of 3 competitors = number crunching and lamenting over potential lost margins. OOuurr SSttrraatteeggyy = Utilize strong client relationships to schedule meeting with: - Drs. Jackson/Reynolds - OR/Hospital Administration - Purchasing This meeting uncovered 3 main issues: 1. Cost of instruments 2. Cost of implants considering volume 3. Staff training 09/03/14 Prepared by Mark Schleiche5r
- 6. Solutions: 3 other competitors willing to lower pricing on implants and instruments from 16 to 24% IInntteerrmmeeddiiccss SSoolluuttiioonn:: 1. Instrumentation Costs = Hospital would no longer purchase instruments. All inst. on consignment. Hospital agrees to $150 per case fee to cover all instruments and shipping costs. 2. Implant Costs = 15% across the board discount. 5% additional discount at 50% marketshare. 3. Training of Support Staff = Proposed monthly in-service training based on survey of nurses and techs. Asked for and received OK from Drs. Jackson/Reynolds to become a Center of Excellence for our technologies and participation in peer to peer training of surgeons from outside the bay area. 09/03/14 Prepared by Mark Schleiche6r
- 7. Results: Client Relationships led to a big win for all parties. Ability to drill down to specific areas of concern uncovered the real issues to be addressed. Consistent outreach to Purchasing and Hospital Administration prior to negotiations led to contract award. 09/03/14 Prepared by Mark Schleiche7r
- 8. Background Info: Example 2 1999 – Dr. Hooman Madyoon – Chief of Cardiology St Joseph’s Medical Center Stockton, CA Asked to cover Central Valley territory on top of current responsibilities (San Jose/Monterey) Established good working relationship with Chief of Cardiology, Dr. Madyoon. Asked to bid on dual-vendor contract. Sat down with Dr. Madyoon, VP Materials and Hospital CEO and my manager. At this meeting CEO states “We are tired of all these companies coming and going in the cath lab. We currently issue 400 P.O.s per month - we would consider a sole vendor contract if (1) your company has all the products required to do an entire case, (2) you can limit the number of P.O.’s to a manageable amount and (3) you manage to gain acceptance from all 18 cardiologists to use your products exclusively.” 09/03/14 Prepared by Mark Schleiche8r
- 9. SSttrraatteeggyy:: 1. Use well run Product evaluations to continue building credibility relationships with cardiologists and Dr. Madyoon’s influence to gain acceptance of products from all 18 cardiologists. 2. Identify historical purchasing data with help from VP Materials. 3. Enlist help from corporate finance department to evaluate different billing scenarios that would permit a sole-vendor arrangement and limit the number of purchase orders generated. 4. Offer participation in clinical trials and access to newest technologies. 09/03/14 Prepared by Mark Schleiche9r
- 10. RReessuullttss:: · Conceived and awarded innovative Sole-Vendor contract agreement allowing St. Joseph’s Medical Center unlimited use of Cordis products for 1 P.O./month. · This 3 year 90% compliant contract (First of its kind in the U.S.) achieved $1.4M in new business annually, saved St. Joes $400,000 per year and effectively blocked competition. · Negotiations involved CEO,VP Materials and 18 cardiologists. 09/03/14 Prepared by Mark Schleiche1r 0
- 11. Unanticipated Benefits to Patients/Cardiologists/St. Joes/J&J By using the same products over time, Cardiologists became more adept at delivering/deploying stents. As time progressed, patient and procedural outcomes showed dramatic improvement – Restenosis rates cut in half. As cardiologists skills improved they used less product, improving bottom line for company. CHW/Premier started paying attention to results at St. Joes and began to consider adopting this new cath lab model for other CHW facilities. 09/03/14 Prepared by Mark Schleiche1r 1
- 12. Full Disclosure…….. Several initiatives and efforts came together in the conception and delivery of this unique contract, namely: My Manager rallied the troops in the finance department and with Cordis executive management to bring this contract to fruition. He also went to bat for Dr. Madyoon and secured clinical trials participation and COE status. Dr. Madyoon lived up to his word and helped gain the commitment of his fellow cardiologists to make it all work. I had the pleasure of witnessing 1,500 PCI cases using only my products, and the knowledge that we measurably improved the delivery of cardiac care at St. Joseph’s Medical Center. 09/03/14 Prepared by Mark Schleiche1r 2
- 13. Background Info: Example 3 2008 - Dr. Edward Bradbury Orthopedic Surgeon Watsonville Community Hospital Boardmember of Tenet Hospitals has ASHR (Anterior Supine Hip Replacement) He leaves hospital after 2 days – Within 30 days plays golf – 4 months later speaks at Zimmer National Sales Meeting. Mark Schleicher has an idea, writes it down and places in suggestion box at Zimmer National Sales Meeting. Turns out some folks at Zimmer Corporate had my idea way before I did……Zimmer had already proposed an alliance with Tenet and with OSI (They make a special OR table that is required to perform Anterior Supine Hip Replacement. OSI Table cost = $100,000 09/03/14 Prepared by Mark Schleiche1r 3
- 14. Dr. Edward Bradbury continued OSI table is critical to ASHR. Allows for much smaller incisions Muscle groups are retracted not split, resulting in much less blood loss, earlier release from hospital and much less rehab time Traction used to gain access for special retractors that provide excellent visibility. Acetabular reaming can now be viewed live with fluoroscopy for first time. 09/03/14 Prepared by Mark Schleiche1r 4
- 15. Back to Dr.Bradbury…… Dr. Bradbury already using new Zimmer implant designed for ASHR I mentioned that a high-ranking boardmember from Tenet had spoke at our meeting, and was helping each facility procure the OSI table if requested. I offered to sponsor D. Bradbury for cadaver lab training on ASHR. Dr. B jumped on board and within 2 years tripled his hip volume and his reputation as “the hip surgeon in town”. 09/03/14 Prepared by Mark Schleiche1r 5
- 16. In his own words….. Mark recognized early on that my preference toward the newest technologies available helps me differentiate my practice from others in the community. His efforts to provide bio-skills cadaver-lab training in anterior-supine hip replacement and reverse-shoulder surgery have helped me market and grow my practice. His professional demeanor and personality created a climate of communication with my staff that we all appreciate. I am also aware that Mark took on some extra duties at the hospital, which assured our trauma systems were up to date and complete. Whenever we had an issue with a product or a difficult surgical challenge, Mark would get to work, research the problem or issue and present a logical solution. He helped us save time in the OR, and through his efforts to train the OR staff, we became more efficient. Finally, we somehow managed to have some fun as well. For all these examples, I would highly recommend Mark Schleicher for any opportunity. 09/03/14 Prepared by Mark Schleiche1r 6
- 17. Background Info: Example 4 2008 - Dr. Morteza Farr/Akram Farr P.A. General Orthopedic/Spine Surgeon Watsonville Community Hospital Dr. Morteza Farr and his wife Akram (Also his P.A. and manager of all 3 offices) move to Santa Cruz and open office. I meet them both one night at Watsonville Hospital – they were waiting for a Stryker courier to bring special wrist fracture tray. I discussed the fact that I had all Zimmer trauma trays on consignment and sterile in the house. They were hesitant, I had just met them 15 minutes before. Finally Mort says “Alright – let’s get busy” 09/03/14 Prepared by Mark Schleiche1r 7
- 18. Mort and Akram Farr “Initially, we used Stryker for most of our general ortho implant products. Mark’s personality and professional skills created a shift in our implant choices first to Zimmer Spine, then on to Zimmer trauma products. We were pleased as our comfort level steadily increased and our surgical outcomes improved. We see many trauma cases in our practice, and many times we called on Mark to suggest and provide solutions with very little notice. Mark’s capacity to deliver and support these cases shows his ability to work effectively under extreme conditions.” “Mark also uses all of the assets available through Zimmer to help us manage and grow our practice. He recently encouraged Dr. Farr and me to attend a cadaver training session in August to learn the anterior-supine approach to hip replacement. We have now completed 10 cases, and already see the benefits to our patients. We also utilize the Zimmer re-imbursement hotline to assist our staff with spine coding/billing issues. When we opened our new practice in Santa Cruz, Mark made sure we were invited to several guest speaker/dinner meetings and ortho clubs. This helped us get acclimated to the orthopedic community, successfully network our practice and make new contacts.” 09/03/14 Prepared by Mark Schleiche1r 8
- 19. 2 quick examples directly related to well-developed relationship with Dr. Arthur C. Lee - Chief of Cardiology, Kaiser Permanente South Bay Area and O’connor Hospital. 1999 – 2002 Developed strategic alliance with Cardiologist Arthur C. Lee (Chief of Cardiology – Kaiser Permanente South Bay) and Design Engineers at Cordis Corporation, for the evaluation of new products and prototypes prior to build-out. Dr. Lee’s inputs improved performance of these catheter-based balloon and stent products, and helped streamline the process of innovation. 2000 — 2002 Partnered with Dr. Arthur C. Lee and O’Connor Hospital San Jose, to establish a preceptorship program for the education and final training of 20 Cordis Cardiology sales reps. This program allowed each rep to spend an entire week with Dr. Lee (largest interventional volume in northern California). Trainees experienced all phases of Dr. Lee’s practice, including the use of Cordis and competitive products, cardiac cath-lab protocol and etiquette, film review sessions and patient/family care issues. This program was highly regarded by Cordis Cardiology sales trainees and Cordis management. 09/03/14 Prepared by Mark Schleiche1r 9
- 20. TTooddaayy iitt’’ss aabboouutt ddiiffffeerreennttiiaattiinngg yyoouurrsseellff ffrroomm tthhee ppaacckk ((WWiitthhiinn AAddvvaaMMeedd GGuuiiddeelliinneess ooff ccoouurrssee)) TToo ddoo tthhiiss yyoouu’’llll nneeeedd ttoo:: Keep a keen eye out for opportunities to shine Identify what your competition is NOT doing Just because its never been done doesn’t mean it shouldn’t be attempted Start at the top – If you’re not calling on the C-level players you will miss the bus. Utilize new technologies and training to improve the skills of your clients and their support staff Take time to interact with CPD/Materials/Purchasing/OR Supervisors/Managers/Scrub Techs/Circulators – Identify champions that want to improve their skills and make it happen……. 09/03/14 Prepared by Mark Schleiche2r 0
- 21. Thank You! 09/03/14 Prepared by Mark Schleiche2r 1