Monday, March 14, 2011

Big Time

Everytime I hear one of those stories about  corporate managers interviewing prospective candidates, it makes TSB think of Peter Gabriel when he sings;

Big Time, I'm on my way I'm making it Big Time
Big Time, I've got to make it show, Yeah, Big Time
Big Time, so much larger than life
Big Time, I'm gonna watch it growing, Big Time
Big Time, my car is getting bigger, Big Time, my house is getting bigger
Big Time, my eyes are getting bigger
And my mouuth...................................................

It's been brutally quiet in the industry, of course unless one thinks that the Duck Key meeting is exciting.  It use to be called the Motion Preservation Meeting, but now that Motion Preservation is on the back burner, its called "Current Solutions in Spine."  How many of these meetings can the industry have?  When do some of these people work?  But that's a topic for a later date.   After speaking to a few of my colleagues today, it's time to start a rant on behalf of the people.  You know the real people that carry the burden of generating revenue.  Recently, an industry insider was conveying the gist of an interview that this individual had with a prospective employer for a job.  Ironically, TSB knew the interviewing manager and the history of the company quite well.  What was funny was the criteria that had been established by the company in order to be considered a viable candidate for the position.  Before, elaborating on the interview, let's preface this by saying that TSB knows what sales are all about since I have been in sales so long, that I have probably forgotten more than some people will ever know.   For those wacky investors that have no concept of the selling process in today's pernicious environment, spare us your diatribe.  So here it is, the interviewing manager wanted to know how many surgeons can this prospective candidate bring to the table in a 30, 60, and 90 day period?  I love those conversations, because every time I meet one of these people I feel like ripping off their heads and shoving it up their ass, and then asking them if they could pull their head out of their ass. That's almost as good as asking a candidate what kind of revenue will you generate in the first 30, 60 and 90 days when you are interviewing someone for an executive management position.  Granted, one wants to know whether someone has the necessary skill set to get the job done, but TSB would like to know what ever gets accomplished during that period of time?  The prospective candidate was also asked if they could take the interviewer around and introduce them to their pool of surgeon candidates.  Of course, you would oblige considering that as a candidate you haven't been tendered an offer and will do anything to compromise your contacts just to please this person.  If anything, some people in this industry need a swift boot in the ass. They are so desperate for revenue that they are going to extremes that skate boarders don't go to in the X games.  I mean Charlie Sheen isn't that desperate.  How many times have we heard of VP's from early-growth stage companies going behind the distributors back in an attempt to cut a deal with their sub rep?  Nouns like integrity and ethics no longer exist.  The more one analyzes our industry, the more one can understand why we are viewed no different than Wall Street. Adjectives like, shameless, greedy, nefarious and desperate are just a few words that rightly describe us. And then we wonder why surgeons view many of you with disdain?  Are things really that bad out there for some of these companies? Are they as desperate as they sound?  Are some of you as desperate as you come across.  And what does this say about the people they represent?

TSB's advice to the prospective candidate was, "don't bother pursuing this." This isn't an opportunity, this is a death sentence, indicative of another person in a management position that has no clue as to what the dynamics are like in today's healthcare environment.  Hey, if grand slams were that easy to hit, we'd all be hitting them.  And then you have the lack of support that most of these companies exhibit.  Example:  ever attempt to go out and sell your product without some product information, or literature, to give your prospective customer?   You've got to love the response that one receives whenever there is a request for literature.  "We've run out, and, we are working on a new brochure?  WTF?  You mean, no one thought about that before you ran out of literature?  I'm I supposed to leave my iPad with them? My favorite is, we'll send you a PDF file and you can then print them yourself. WTF?  Who do you think pays for the paper?  The cartridge?  My time?  It's bad enough that we average $70-$100 per week for gas, X amount of dollars on roads that may have tolls, and buy lunch for people we would never think of ever sitting down and breaking bread with.  What many of these business oracles fail to understand is that, "this is the cost of doing business."  It's like requesting samples, it's the cost of business.  The sample costs the company barely zilch, and you make it back tenfold, and then when you leave, they have the audacity to deduct the sample from your check.  So fellow bloggers, as you continue your quest in search for your next job, one has to ask themselves, "are you ready for another throw down?"  TSB wants to know what our bloggers think?

66 comments:

  1. I just had a conversation with a VP and he asked me that exact thing! "We would need you to be able to pay for yourself within 90days. Put together a 30-60-90 day business on how you will convert docs over." I told him that that was never going to happen.

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  2. Hate the 30-60-90. It's like some bogus marketing gimmick that is far from realistic. Sure, they want to see that candidates can set a plan and know how to execute. But there are better ways of drawing that out than templated bullsh questions like that.

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  3. i want to know why marketing departments are so out of touch with reality? And why they never have literature? what are they doing?

    sincerely,
    dumbo

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  4. Sounds like an interview with the people at Si-Bone

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  5. Unfortunately the majority of marketing departments are populated with people that have never spent decent time in the field, let alone sold. Flying out to have dinner with a doc twice a year and maybe getting into surgery doesn't exactly prepare most for putting together literature that works.

    But as a number have stated, even when there is crappy materials, they never have any.

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  6. Sounds exactly like my interview with Titan Spine.

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  7. Hard to sell without the basic marketing materials readily available! Amen MM!!

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  8. hmmm sounds like my conversation with Zimmer Spine! Uh I don't care how good your relationships are, that bag is tired and dated.

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  9. Do you think Alphatec asks the doctors for a 30-60-90 when selling products to their PODs?

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  10. The further you get away from the OR, the dumber you get. Clearly the interviewing managers that TSB is talking about fall into this bucket. They are too busy becoming "spread sheet rainmakers" versus being in the OR trenches every day. Did they forget that it takes more than 90 days to convert any consistent business (unless you are paying them)

    The same people seem to have a new company name tag about every 3 years at NASS...

    What happened to this once proud industry?

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  11. 6:33 By chance is his name Paul Javelin, I mean Graveline

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  12. We had a VP from a boston biologics company speak to our group and told us first year expectations will be $700K and increasing to $1.7 million in two more years...and for a bone void filler?

    We did not know whether to be flattered or insulted.

    Many of these companies really do not know what they are trying to accomplish.

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  13. What do you guys think of restraint of trades? How valid are they and how enforceable are they on sales reps. I personaly think restraints are bullsht... there is nothing new that my current company showed me, (I new their products better than they did when I started working here) and my client base are 90% my previous company's client base... in other words, those clients follow me to the company I work for. They are quick to headhunt a replacement for me (I have given notice) that has a restraint, but want to enforce mine the moment I leave... (Sorry, English not my first language)

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  14. This tactic, happening at Lanx right now btw, proves that the value in this industry is in the relationship, not the product. Ninety percent of surgeons can put in 95% of products without any rep in the room. We are constantly ripping on "me too" product companies, but these can work well provided the right relationship comes with the products.

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  15. Just a suggestion - Tell these companies exactly what they want to hear. Negotiate the largest up-front offer you can get. You have at least two years making some coin, then move on to the next desperate spine company and do it all over again. You can make a great living, earn way above the average sales professional and return the loyalty favor in spades.

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  16. I had an interview for a regional manager position,which will involve hiring distributors. The manager wanted to have a 30-60-90 for hiring distributors. Which distributors will come over in how many days and how much they will bring and then he wanted to visit with them and see if they will commit before I'm hired. Really???

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  17. Most of these people asking for 30-60-90 plans have no f#*king clue as to what it takes to build a business, but then again, maybe we're really not building anything anymore. And then we wonder why the attrition rate in this industry is off the wall. Wheelers, dealers, stealers and healers.

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  18. Holy Alphatec!!!!!

    The marketing department is run by Kris Jaques with previous experience at GE!! Comedy! What a bum! Dry personality and zero ideas for marketing. Amazing these useless, never been in the OR, BUMS keep their jobs. What a joke!

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  19. Interesting post. I hire sales professionals, and have never asked for a 30, 60, 90 day plan. It is complete BS. I've had people come in to interview with a business plan. What a bunch of bull. Basically, these plans can't be accurate and are not useful in the least. You are right, hiring managers that ask for them are dumb asses and just want to be lied to.

    I search for honesty, integrity, work ethic, intelligence, and some level of industry experience. However, to be honest with you, too much industry experience often leads to people who can't develop business without consulting agreements, etc. If you hire for the relationship, then that is the maximum possible business you'll ever get (those relationships). Hire for skills and traits. With great products, skills, and traits, relationships take care of themselves.

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  20. 8:42---AMEN!!!! There are few of us left out there that recognize and surround ourselves with people who are skilled and have a strong moral compass. It may cost a bit more up front, but the ROI makes it well worth it.

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  21. thank you 8:42! it's refreshing to hear that there are some level headed people out there! Coming from an ortho/sports rep who would like to pursue a career in spine it is pleasant to hear that some people are willing to hire reps w/o spine doc's in their back pocket. I have a great work ethic, value my relationships and love what i do but to consistently hear that you will not get into Spine w/o being a surgeons nephew or bringing over relationships is disappointing. Thanks for morale boost!!!

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  22. 11:08 - Don't get into spine. I repeat, DO NOT get into spine.

    Seriously. And if you do actually have morals, then DO NOT GET INTO SPINE.

    How can I say this more clearly?

    If you're not content in ortho/sports, then look at the hundreds of other positions with other companies. I promise you - your family and your morals will thank me.

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  23. I think 12:23 is afraid of competition? Or maybe they are hopelessly cynical. Anyway, 12:23 maybe you should get out of spine. There are plenty of morally bankrupt companies, surgeons, and industry professions. But, there are also many such as TSB and many people on this blog who are decent and honest. It is not a unique industry. Like anything else, you will find good and bad here.

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  24. anyone know what is going on at NUVA?

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  25. I'm not a big fan of Robin Young, and know TSB finds him repulsive in many ways, but this weeks news letter is very telling. With such a small percentage expected growth in the spine sector (quoted by someone else, not Robin, though he did agree), and most of the growth coming from biologics, companies are faced with buying rep relationships especially with the lack of new technology support from 3rd party payers. That being said, there are those who can and do flip surgeons, but for the most part it's a small number of life long friends. The companies looking for those kinds of relationships do not have long term vision, and likely poor vision in general. A 30-60-90 day plan is short term at best. I hope there are enough people in a hiring position to read this post in particular. Word to the wise, quit looking for the quick fix. You might look good for the short term, but when the sprinkling of new business is used up and your looking for growth, the type of person who can flip a little business ain't going to get you there and you will be looking for a new job shortly because you can't make the business grow. And, by the way, you will loose all of those base customers if you do another flip, and they will be gone forever.

    My biggest pet peeve is one surgeon reps. Yah, they bring a book of business, but it's business for sale. And it's epidemic nationally. For those of you surgeon brokers reading this, get a clue, protect yourself and develop a business. You will have much more security, and though it may not matter now, some day you will need others to think of you wisely and not some surgeons whore.

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  26. Dear 2:06 in response to your post, TSB does not find Robin repulsive, au contraire, I find him knowledgeable yet entertaining but obviously self-serving, but then isn't our blog self-serving? One must admit the onslaught of stem cell articles are entertaining. Lloyd Blankfein would be proud of this market maker. But, don't spend your day attempting to analyze TSB, you really don't know me. As for your biggest pet peeve, and I quote Tony Viscogliosi from the 2008 Spine Technology Summit, "I envision one surgeon per one rep, or was it one rep per one surgeon." You're absolutely correct in your assessment of sales people bringing a book of business, and it is an epidemic, unfortunately, our industry has a Wall Street mentality, everyone thinks they are going to hit the jack pot. By building companies on this platform we compromise long-term viability in exchange for short-term results, but then there are many companies in our industry that have survived this way, and then we wonder why people bounce around from job to job. You know what they say, "every dog has its day." Peace

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  27. I've interviewed with two companies in the past week......Nuvasive and Depuy. Both used this same tactic.....who can you convert business from. As I am a current rep in the area, I told them I have good relationships but will not disclose who because I am competing with them now.

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  28. I totally agree with 12:23 completely. If you are halfway content in another sector, dont switch.
    I spoke to someone recently who was looking at his options. I honestly told him, he probably didnt want to be in spine. He told me at least 4 other people had told him the same thing.

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  29. 12:23 here.

    I'm not so naive to think that business outside mine are full of roses, wine and rule-abiding people.

    The problem about being an ethical rep in spine (in my opinion), is that you're in the minority, and often times at a disadvantage.

    What's worse (and this blog proves this to be true), it's become a game of the pot calling the kettle black. Everyone thinks the other guy is the one "bending the rules" and compromising morals.

    I talked to a competitive rep just recently who was bemoaning how so many doctors in the area were "paid off." Meanwhile, he's on his way to a case with a doc that's recently switched all his business to this rep's company because he signed on as a consultant.

    It's insanity.

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  30. so what's wrong with having one or two surgeon relationships that are strong. I have done it for many, many years and it keeps the disributors from assuming that they can over time take over your business. sign contracts with the smaller companies, get paid without overides, and save your money. that is the business, like it or not, that is the way it is.

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  31. to all of you bloggers stating that you must suck as a spine sales rep if you complain about competing with paid consultantcies, PODs and royalty agreements... You need to get a clue and face up to reality. It is a different world out there and you gotta pay to play. I have about 25 spine surgeons in my territory and I can name for you less than 5 of them that could be "sold". It gets even better, those 5 surgeons that will let you do a sales call are the slowest surgeons around volume wise. Good luck making those quotas! The big cutters are all bought and paid for.
    Its almost comical to think you can flip a busy spine guy without buying him or hiring his relative. I had an O.R. director flat out say to me the other day he feels guilty for the way he sees Medtronic funneling thousands of dollars to their 3 busiest spine docs.
    Then you go to another hospital that has their 3 spine partners all using Nuvasive on every single case (oh and don't forget the monitoring money they make) These bozos will monitor an in-grown toe nail now, when before Nuvasive came along they would only monitor the most myelopathic and stenotic spines if at all!

    yeah you show me how to convert that business.......keep dreaming and keep bringing in that Olive Garden lunch to all the docs, nurses and PA's, They will be the ones saying , "who was that guy and which one of the thousands of spine companies was he with?" "He said heis company was reprinting their brochures so I can't remember which company it was", "too bad, I really thought he was a nice guy....He doesn't stand a chance getting his metal in here"

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  32. This idustry is a joke. It really is

    What new technology is out there?

    Nothing

    Name a technology that can make a surgeon, who is on the payroll with company x, use "your stuff" every now/then.

    I'd love to know what the experts think is new & exciting out in the field

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  33. The candidate is fortunate to have you in his corner. Good looking out. "This isn't an opportunity, this is a death sentence." had to learn the hard way

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  34. Innovation replaced by immitation has ruined my fascination.
    What other medical field is good to get into ?
    Any healthcare consulting companies recommended out there ?

    billy jean has got my love

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  35. 7:14pm, do you live in Chicago?

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  36. If the DOJ had any balls, they would stop dicking around and go after these companies BIG TIME, you hear us Senator Grassley.

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  37. Wow, what a bunch of whiners! The easiest thing to do when your a loser is point the finger at the other companies for "buying" their surgeons. It's the basic response you've been taught since kindergarten...We all should be winners and get a trophy and if not then someone else is being UNFAIR! Most of you are so entitled you think by showing up you deserve the business. You are the problem in the industry and with this country. Maybe you should try something less competitive like your daddy's business?
    Standing in an OR does NOT make you a doctor!
    It does NOT entitle you to a six figure income!
    It does NOT make you the expert!
    It does NOT guarantee you and income!
    It does NOT make you anything but lucky to have an opportunity.
    Stop crying and start selling b/c I plan on firing you when I find you or taking more of your borrowed business.
    BTW...All those soccer trophies above your bed don't make you a winner. They're the reason you can't compete...and why your girlfriend's fat!
    Just sayin'

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  38. 7:48
    I didn't know Charlie Sheen knew about the TSB. Welcome!

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  39. Get to work you whinny ass pukes...do it for you and your children.

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  40. Charlie and TSB .Winning, how many of you are envious of Charlie, he's made a boat load of cash, and lives by the credo of limos, grey goose, and hookers read it and weep.

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  41. May Charlie Sheen bestow upon Bacterin the monikor Warlock when he comes out of his Winning craze, We love you man

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  42. although not spine, this reminds me of a globus move

    http://www.memphisflyer.com/NewsBlog/archives/2011/03/15/smith-and-nephew-sues-fired-engineers-for-breach-of-contract-other-offenses

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  43. Any idea what the attrition rate actually is in Spine? No guesses, please.

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  44. 7:48 Whatever Dude - you total douche. Level the playing field and see how you stand. Maybe you would be ok though since you were able to get into this biz with one of the big dogs that buys their surgeons. And don't even play that get out and sell card. You mean to tell me that everyday you're threatened because your competition is walking in the door behind you and your surgeon says, "you better start bringing me some value and service on these products because I'm thinking of going with your competitor and walking from my $50,000 - $200,000 quarterly payments from your company."

    And 7:14 - I'd like to subscribe to your newsletter. You speak the facts.

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  45. Maybe we could start a movement considering that outside of the two douche nozzles pontificating on this post most of us feel the same way, it's time for change and you know that the big boys won't like that and the ankle biters also. Come on DOJ throw some docs and CEO's in jail we've been waiting a long time.

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  46. 7:48
    You must work for Danek!! Winner!!

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  47. Glad to see you making my point, El Douche Nozzle. Hey, Let's start a movement, I mean level the playing field, no wait let's unionize and erase all competitive advantages. The fairness doctrine for the spine world, NOW! No, wait for all sales people, everywhere!
    Utilize the tools and resources available to you and then go bust your A$$ and earn your keep. I've seen more than my share of you tools come prancing in spend a year or two in the territory, glom off a senior rep and then jump ship for the first guarantee. Now that the economy is dipping, Obamcrap and pricing pressures, lower commissions, etc. you can't understand why your boss is breathing down your neck while your sales tank...Your entitled to better treatment and compensation than that! You deserve this income! If it wasn't for you...blah, blah, blah! Take your "Soccer Star" & "Fan Favorite" Awards from 2nd through 8th grade down. Put your Justin Bieber cuddle book away and tell the your chick with the kanckles the Brie and wine is doing her no favors.
    Winning!

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  48. Hey if we could buy Congressman and Senators, why can't we buy doctors. Talk about an entitlement class, and by the way spare us the Obamacare crap, as TSB would say just the facts......m'am or is it bitch because that's what some surgeon think of guys like you

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  49. Relax 2:19pm, I'm waiting for Globus to go public. Then I am done.

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  50. 7:48
    why don't you try going out and hiring a crew of hard working, documented workers and start a lawn care business. I mean really bust your ass knocking on door after door trying to get business. How much business do you think you will get when you are competing with Pedro and his merry band of illegals who does not pay payroll taxes on his employees???
    Right numnuts you will get ZERO business because you can't Fu*king compete with that sh*t!!

    You think spine is any different than that? Wow, I guess you are the only one out there that thinks you have some super special personality that will flip doc after doc onto your team. Or perhaps you are the one who will finally enlighten the surgeons as to how many threads are on your screw to get optimal purchase! As is said over and over on this blog ad nauseum....its a friggin comodity and any brainless, bimbo, relative or whatever can sell a screw.
    Its not whining, it is simply stating the facts. Your days are numbered in this business I guarantee it....that good ole boy surgeon buddy of yours will be part of a POD soon, in fact he is probably negotiating the deal with Alphtec as we speak!

    Remember these profound words of wisdom, "when it comes to money and pussy, you aint got no friends!"

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  51. Getting ready to get out of spine and the medical device industry soon because of this. Too much paying off surgeons and kick backs for my tasting. Don't get me wrong, as I am about to start my own business - I understand that this is business and it's pretty much everywhere, but I have a HUGE issue when it involves patients. Think about it folks, would you want to be laid out on an OR table and having a surgeon who's been paid off to open you up? Not know if you are getting the best possible device, procedure you can get? NO ONE IN HERE WOULD!

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  52. END OF THREAD....WINNER WINNER...DING DING DING!!!

    "Remember these profound words of wisdom, "when it comes to money and pussy, you aint got no friends!"

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  53. Fantastic thread TSB and co., high entertainment.

    'Where's the ethics? Where's the innovation? Shut-up d-bag and learn to compete!'

    Ah, the sounds of panic!

    Scarcity of patient benefitting, cost reducing innovation and capital is exposing the true reality (no better represented than in the POD model). The reality is your commission is at the direct expense of your surgeon / customer incomes, hospital operating margins, and insurance company profits (I'd mention patient care, but this isn't really the sentimental crowd apparently).

    Unethical reps and crappy me-too's are the least of your problems.

    We're in an every man for himself war for a tightening pool of healthcare dollars. I'm no economist, but I'd wager a rep shuttlin' boxes of indistinguishable, grossly overpriced pieces of plastic and metal for $180K+ a year doesn't reach the level of a priority, financially speaking.

    In the mean time, there's plenty more opportunities for name calling, useless philosophical rants and 30-60-90 day plans. Just know this business, this 'thing of ours', is a little like the Titanic, it's big, there's a lot of different types of people on it, and definitely not enough life boats. Time to start getting creative! Corruption will only speed the ride down.

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  54. 6:22 for the win! My sentiments exactly. Gaining business at this stage in the evolution/life-cycle of this market is like winning a ticket on the Titanic. It might be a plush ride, but it WILL be short-lived.

    Sell, be happy with less, or leave. None of these options need be viewed as wrong.

    God bless America.

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  55. .....the land I once loved made up of corporatista's, scammers, and jammers while the stupid tax payors behave like lap dogs, teaparty wadda ya mean, you say you want a revolution

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  56. Let's face it. Principals in the Spine Industry may be the sharpest engineers in the world, but they remain extrememly naive to hiring sales leaders. The best sales person absolutely does not make a successful manager. Just look at X-Spine. I remain puzzled how Joe Ryan could talk himself into a VP role, with virtually no other sales mgment staff (except some clinical specialists that think they are solid sales folks ((even though they weren't successful distributors). Is David Kirschman that naive, or just gullable?

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  57. Long day, a little levity is in order, as well as a shout out to the Charlie Sheen pull by 8:28 (nice brother):

    http://www.youtube.com/user/schmoyoho

    Love these guys videos, and Sheen in 'GO' mode is beyond inspirational. "...the road I was on made Jagger and Richards look like droopy armless children..."

    Free suggestion, book Sheen for your 2012 National Sales Meeting: EPIC WINNING!

    I mean he's got it all, the message, the presence, hell, even Tiger Blood and he's guaranteed to show the evening crowd what endurance really means.

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  58. 5:19--I just beat you. B*tch.

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  59. 8:11 PM here. Guess I should have clicked "reload" before I posted that. Nonetheless, #winning.

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  60. 6:43--If you knew how much JRyan was making you would understand just how naive and gullible Kirschman is--can you say "Nero?"

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  61. 6:08 and 6:43. I am confused about your comments regarding Joe Ryan. He has always struck me as a hard worker and has been extremely knowledgeable and professional in my dealings with him. Couple that with Xspine's growth and I would say he is doing a much better job than you give him credit for.

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  62. 10:28 Is that you Joe?

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  63. 11:31 - funny, but no it's not. I sell Xspine products and have known Joe for most of my time in spine. I'm not sucking up either as I'm posting anonymously. Just sharing my opinion.

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  64. It seems like a few examples are passed off to be the status quo, meaning most interviewers understand a 30/60/90 day expectation is not realistic. However, that does not make for a catalyst to stir up blog postings!
    The real issue is sales reps/Managers who deliver testosterone filled speeches of their sales prowess and then DEMAND a salary guarantee for 6 or 12 months!
    Give me a break. Many tend to try to make a career out of having one mediocre relationship with a surgeon. They have no clue how to add enterprise value unless it happens to also line their pockets in the short term ( which is incongruous)
    For every 1 spine exec who requests a 30/60/90 plan, there are at least 10 salespeople who want to get rich immediately at everyone ( including rest of company, investors, docs, patients, etc.) else's expense with self serving demands. I will admit that their are a few hard working folks who work hard selling in a coordinated fashion to help the company, their docs & patients along with themselves. Unfortunately, theses folks are the slim minority compared to the majority who think the "Art of Selling" is a new exhibit of paintings!!!!!!

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  65. Which companies can pay surgeons for their "recycled ideas" the best---makes up the Big 5...and guess what? I work for the 2nd place spine company. The team in Blue does it the best or more creatively

    Each year, It makes me want to vomit when I sit at our NSM awards dinner and have to stand up and clap for the rep/distributor of the year who has the top territory. And guess what? The surgeons that they cover (or shall I say, "sit on the back wall and write down usage") are our companies top paid consultants. Their names can be found on the first page of our surgical techniques

    Bravo. Great gig if you can get it. Maybe in my 2nd life

    There isn't a 30/60/90 day plan written that can flip that business. But a bigger check can :-)

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