The level of service in medical device sales has shifted in major ways. Jim Chessie, Managing Partner at VB Enviro Care, identifies keys for sales reps to provide the highest level of service in today’s operating room as compared to previous years. In this episode, you’ll learn how the surgical team benefits when the rep sells to other stakeholders besides the surgeon, is more well-rounded, and becomes a rock star at inventory management.
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Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together, and here are some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.
Michael: Welcome to the “Paradigm Shift of Healthcare,” and thank you for listening. I’m Michael Roberts with my co-host, Jared Johnson and Scott Zeitzer. In today’s episode, we’re talking with Jim Chessie, currently a managing partner at VB Enviro Care, a company that deploys on-site clinically proven technologies and state-of-the-art tools that deliver peace of mind safety standards for indoor interactions and activity. Jim, thank you so much. I’m so glad we were able to work out getting you on the show. We’re all here. We’re making this happen for real. So, thank you so much.
Jim: Thank you, guys. Thanks for having me on.
Scott: Yeah. Jim, I know that right now you’re doing a lot of work basically vis-a-vis trying to keep indoors, sit a little bit safer in the time of COVID, but we wanted to talk a bit about medical device sales overall. I think between the two of us from an experience perspective, we definitely have over 50 years of selling medical devices if I’m probably right doing some rough math there.
Jim: We’re probably the north side of 60, Scott.
Scott: You know, you’re right. Now, I have to admit that. You’re right. We had Greg Rainey on the show, who both of us have worked with and continue to still work a bit with about a month ago. And we talked a little bit about it, but I wanted to delve in a little bit more and get, you know, your ideas, your take on this as well. So, why don’t we go back to the ’80s when you and I were first starting out and had a lot more hair and then kind of get us caught up to pre-coated. You know, how times have changed?
Jim: Sure. Sure.
Scott: Because in the ’80s I was young, stupid, and working hard. Then I just kept working hard, but I don’t know if I was still young and stupid.
Jim: Now, we’re older and stupid, Scott.
Scott: There we go.
Jim: But back when we started, just a little background for your listeners, I started in New York City and Scott started in New Jersey and we crossed paths a lot. Started back in the old days with the company, I’m sure some of the older guys remember, Medica. And boy, Scott, you and I talked a lot of times over the years how much fun that was back then, and it’s still fun, but it’s completely different than it was, you know, 30 plus years ago. That’s what we’re going to get into a little bit more in detail today, correct?
Scott: Absolutely. Yeah. You know, a very different time. I remember when we were selling back in the ’80s, there was an amount of differentiation between product in all sincerity back then. Somebody would come out with…I remember like when metal-backed tibial plates became available and then titanium versus cobalt-chrome, etc. Like those were major changes. Whereas now, I’m not so sure there’s as much. I mean, sure, everybody’s got differences in their systems, but they’re much smaller. Wouldn’t you agree?
Jim: Totally right. One of the misnomers about people who’ve been in this business a long time compared to what sales folks are going through now, they think like, it’s the old days and all you had to do is, you know, if you brought the best bagels you were going to get the business. No, that’s not the case, you really had to know your stuff. And back then the differences in systems, because I mean, keep in mind 30 years ago, that’s a long time. And a lot of the technologies have changed. A lot of them, I don’t want to use the word commoditized, but you know, like you said, the differences are subtle. But back then, you really had to know your stuff. You had to know, you know, like we remember the universal B instruments. We remember poly was just a thing that you put in, but you had to know the differences between them. Metal-backed patellas versus all-poly patellas, you really had to know your stuff. It was very different, but I wouldn’t say it was an easier time to sell the medical devices.
Scott: No, I don’t think so either. I think a lot more was on our shoulders, quite frankly, back then. You know, part of the commoditization side of things that is occurring…I think, first of all, for patients who would be listening to this, surgeons make choices with hospitals and patients and costs. There’s all variety of things that come into play. But ultimately, and I really mean this sincerely, it’s about a decision about whether you want to drive a BMW versus a Mercedes, etc. It’s a pretty good place to be in total knee implants and instruments, total hip, etc., etc., they are in a very good place. They’re very good products. It’s just a different conversation now, wouldn’t you agree?
Jim: Absolutely. Back when we started, you had to know your stuff, you had to know your technologies, you had to know your clinical histories, you had to know your product line very, very, very well. But nowadays, you have to…I always say the big difference between then and now is you have to be a more well-rounded sales rep. And what I mean by that is you’re not just selling to the surgeon. We used to talk to the surgeon, if they thought it was medically advantageous for them to use the product, we brought it into the hospital. We used it. And now, the best sales reps and sales professionals I work with, Scott, and you can verify this are…and it’s become cliché now, but they speak to the janitor of the hospital, the same way they speak to the CEO, because there were so many people it used to be so position-focused back then.
You’d have to appeal to the, OR, the OR cost committees, materials management, administration. You gotta be able to sell to all of them. You may have the approval from the doc, but the doc is kind of at the behest of the hospital, which system are they gonna use? What’s cost-effective for the greater good of the organization that they belong to? So, that’s the challenge that the rep has now. They have to not only be salespeople, product expertise, but they’re gonna be marketing specialists. They’ve gotta be business-oriented people. And it’s very tough now. It’s a tough thing to do, but I mean, it’s a great place to be. It’s an awesome place to be. That’s why some of the reps now, younger reps that I’ve talked to, I mean, I talk to these folks and I think, “Wow, you really know your stuff because you have to survive in this environment now.”
Scott: Yeah, it was a different type, you know, like my training is biomedical engineering and my conversation would be very focused on biomechanics, biomaterials, specific features and benefits accordingly with the surgeon. And to your point, I never really spoke much to purchasing other than this is what he picked and purchasing basically rolled their eyes and did what they had to do. And I mean that with love to all the purchasing agents out there, and it’s not the case anymore. I don’t think that the surgeon is as empowered as he or she used to be. And the conversations are much more complex with many more people. It’s not enough anymore that the surgeon’s right. That’s for sure.
And along those lines, because to use the word commoditization, you’re right, it’s not just a brick. There are differences between the systems, they’re just not as big. And because of that, the economics of it as well as the fact that there aren’t major changes, you know, the surgeon can’t really go into the purchasing person and go, you’ve got to use this because it is definitely better than this for the following reasons. It’s much more nuanced, right?
Jim: Well, you mentioned that you came from a biomedical background. I came from a different way. I came from a nursing background. I worked in the operating room. So, my goal…I mean, you know, you could kind of like soar with your strengths and manage your weaknesses. We’ve talked about that before. My strength was servicing a surgical procedure. You can really bring value to a surgical team by helping them get through a case. Like with your background, you differentiated yourself because you knew the biomedical technology behind all of these various products. I knew how to take people through the service side of things and help them get through a case.
And, you know, some of the greatest times I had in this business was you know, late night cases in New York City. You know, there was a train wreck case and I was able to help that team get through it. And that’s how I brought value to that team. Now, you have to do everything that we just said. You have to have the biomedical engineering background sort of, you have to have the service orientation, you have to have the business side of things, you have to be able to bring value that really wasn’t expected back then, but is today.
Scott: Yeah. You know, let’s talk about that. You know, I remember doing a lot of…you know, I was in a lot of ORs over the years helping in any way that I could. Some of it was just as simple as just telling one of the scrub techs like what the next instrument was because that particular scrub tech wasn’t really an ortho scrub tech and I just kind of helped the process along. Again, to all the patients that the surgeon knows very well what to do, how to do it, etc., and so do the support staff right next to the patient. But there’s a lot of people that are involved in this process even down to the point of just walking down the corridor to go pick out the appropriate component that the surgeon chose. So, it was just a lot of steps to this and any way that a sales rep in an OR could help just get the flow going just because it’s very specific to that particular device manufacturer would always be helpful.
Jim: I think the general public when they hear that topic, they’re kind of shocked. They, you know, “Why is the rep in the OR?” But if they really understood what they do, we don’t tell the surgeon how to do the procedure. We may ask a particular question on a device or whatever, but it’s ultimately the surgeon’s decision. They’re very well-versed in how to do that procedure. What we’re there for is for inventory management. People don’t realize that when you bring a loaner in for, let’s say a big revision case, big nasty case, you may have several thousand pieces of equipment there. There is no way you can ask a nurse or a scrub tech or somebody to keep that all straight. You’re basically enhancing the procedure or helping the success of that procedure by providing inventory management, a little bit of guidance, keeping the ORs staff and everybody one step ahead of the surgeon. So, there’s tremendous value that having the rep in the OR brings
Scott: And that’s perfectly explained for everybody kind of listening here. And so, and I remember being very involved with that ’80s, and then, you know, towards the end of the ’90s, I got much more into marketing and I started doing a lot of web and application development. So, I wasn’t even selling anymore. You stayed in the game so to speak, and you know, what’s it like now, Jim? You know, are you seeing that the reps are still doing very similar stuff in the ORs? I’m talking pre-COVID, we’ll even have a separate post-COVID segment. Maybe give me both answers on that question. Like, is it a similar thing that’s happening? Are they there at 11:30 you know, at night helping out the stuff with all that inventory, because you know, some crazy case came in in the middle of the night?
Jim: Well, Scott, from a service standpoint, one of the best things that I’ve seen evolve in the years that we’ve been in this business is the level of service that they provide. Before, when we get called for a case, and I hate to keep referring back to the old days, but that’s when we started, back in those days…
Scott: We are old, yes.
Jim: …we would get a call from the OR or the surgeon they need a particular product where I would drive to, you know, New Jersey, pick it up, drive it into the city, go cover the case, you know, do everything. I did everything. Now, they have teams that do that for them so they can provide that service. But the sales rep may have two or three people underneath them helping them service these cases, which brings tremendous value to the OR. These systems are getting more and more complex. They’re adding new and new products like, you know, I heard your podcast with Greg, he talked about robotics. I mean, wow, that’s a whole different level of service. You’ve got to have a specialized person to do that. The biggest change that I’ve seen is the level of quality of service that these companies provide, all companies. They have to do that in order to compete. And it’s also very good for ultimately the patient and patient care. So, that’s the biggest shift that I’ve seen over the years.
Scott: Yeah. You know, it’s funny I remember meeting with some of the younger salespeople and they weren’t the old school guys like us. They definitely had a lot better training from the perspective of, I don’t mean specifically on the product itself, but the overall, the ability to understand the economics, not just the features of the particular product. Their in depth understanding of that as well definitely is there. So, now, COVID hits and everybody’s worried about, you know, just limiting the amount of human beings in the hospital, let alone the operating room, what’s involved now? Is there even more pressure on the rep? Are they even allowed in? What’s going on with that?
Jim: I think a lot of the reps that are now starting to get back to, you know, servicing cases and covering cases and, you know, some places are opening up more rapidly than others and limiting the exposure in the OR, I totally get that in the world of COVID. It’s been tough, but go back to when we started early on, I mean, obviously, you want those cases, you want those done and you’re offering service, call me any time. How many times did we all fall into that trap? Call me anytime I’ll be there for all those cases. Well, what happens is you sell yourself into the OR, and you, I hate to put it in terms like this, but you sell yourself out. And what I mean by that is train the staff, train the techs, train the nurses so they know how to use that stuff if you can’t be there for the case.
And a lot of the sales organizations that I’ve worked with this past year, you know, with the COVID situation, they’re using this time to have Zoom calls with their OR staff, have off-site or even parking lot. I’ve actually heard of this parking lot in services to go over systems because the reps aren’t allowed back into the OR, you know, completely yet, so you gotta get creative. And a lot of the time, one of the great things that came out of the whole COVID situation, everybody had a lot of free time, work from home. A lot of the distributors companies and people that are worked with across this industry, they’ve used this time wisely. They’ll have, you know, daily training sessions. They’ll have, you know, product updates, that kind of thing.
And conversely, they’re doing that with their customers, the PAs, the doctors, the nurses. I heard of a podcast that…not a podcast, I’m sorry, a Zoom webinar that one of the companies that I consult for, they wanted to do just a routine product training. Thinking like ordinarily, we usually get like a dozen people that join, there were 65 people that signed up for that. So, you know, people who used that time wisely, you know, they’re going to get a jump on their competitors. And I see a lot of creative things that people are doing and those webinars are definitely one of them.
Scott: That’s just awesome. That’s just awesome. I think from a really big picture, it seems like I always say this, COVID brings out the best in the worst so to speak and shows the cracks. Is this affecting sales organizations, COVID, are things getting back to normal at all, you know, in terms of elective surgeries and how sales are being affected?
Jim: You have to ask yourself the question, what is normal?
Scott: That’s a very good point. Yeah.
Jim: A lot of what I’m seeing, and this is just purely my own observation I don’t have you know, numbers back to this up or not, but ASC seem to be getting busier. They’re doing a lot more cases in the ORs. It’s loosening up a little bit in some parts of the country. There are still hotspots across the country. And you know, they’re not even into the phase two of the COVID reopening plans in those states. So, some places, you know, I hear, you know, parts of Texas, I spoke to somebody yesterday. They seem to be going like they were pre-COVID. I spoke to somebody in actually on Long Island a week or two ago, and they said, “Boy, it’s still pretty restricted.”
So, it depends on which part of the country you’re in. I do think that the one thing that COVID is doing now is repless model in the OR is being discussed again. You know, like any issue, Scott, you know, that’s so polarizing like that the truth lies somewhere in the middle. I think people are using this to…you know, and some people are gonna think, “Wow, this is great. We’re able to do this without the rep.” And then there are other people who are thinking, “Jeez, you know, I didn’t realize how much value our reps brought us.” So, that’s going to bring up a lot of discussion on that. That’s a pretty hot topic in our business right now.
Scott: Yeah. It really is.
Michael: So, Jim, to dig into those changes a bit more. What about distributors, where do they fit in? How are they affected by all these changes since coronavirus hit? And I’m guessing there are more complexities than there used to be. How are distributors dealing with all the changes?
Jim: Well, it’s like any business. Medical device distributor, depends on how they were set up. And what I mean by that is, you know, a lot of distributors, you know, depending on the nature of their agreement with the company that they’re representing, some companies are stepping up and helping their distributors, you know, weather the storm so to speak. And then other distributors who really didn’t for this, a lot of them, sadly, are going away. A lot of the larger companies are helping offset some of the costs. A lot of the distributors applied for the PPP loans. You know, they’re getting creative. But there are also people out there where, you know, in another part of my life, I’m actually a consultant for various companies, they’ll bring on other product lines to help offset the cost, things that can be sold during COVID. They might not be able to do the number of spine cases or a number of joint cases, but they’re able to introduce another product that is used during COVID that might not be so service-oriented, where you have to be there face-to-face.
It’s something that, you know, they can talk to their friends or do these webinars. Like I told you they had 65 people on it, they get creative. So, to answer your question, it depends on the distributor itself. Some distributors, sadly, guys, are not going to survive this. I’ve already seen some of them close down, but other ones who, you know, buckle down, work with their organizations, work with their salespeople, work with their support staff, they’ll weather the storm. They’ll be fine.
Scott: Yeah. You know, it’s interesting that you bring that up. Again, it goes back to, you know, that axiom along the lines of COVID brings out the best and the worst, those cracks. You know, that it might not have been a big deal as long as we just stay ahead of the game so to speak in terms of just sales, cash flow, etc., become very, very important for everybody, including the distributor.
Jim: Sure. It really shows great leadership. You know, I know that sounds cliché but the good leaders can talk with their people and kind of guide them through this and talk them through this. Anybody can sail a ship on calm waters, it takes a real leader to get through rocky waters. And the ones that can do that in this environment, they’re going to survive and do very well. And it all hinges on, you know, that person sitting at the top and I’ve seen some pretty creative, very good leaders in the distributors out there across the country.
Michael: Jim, we’ve looked at this, you know, from a couple different angles now. We’ve talked about what the sales rep is facing and what that individual needs to be doing to adjust, talked about the distributors themselves. Let’s talk some about the surgeons, you know, and some of the practices themselves, we obviously do a lot of work with orthopedic surgeons, with spine surgeons, with neurosurgeon, so we’re kind of in that space quite a bit, what does the surgeon himself or herself need to be thinking about as all of these changes are happening? You’re talking about how much more now the staff is having to really step up and kind of take on a lot more of this responsibility. Is that the main thing that they should be thinking about, or are there other challenges that this kind of new quote, new normal or always changing normal or whatever label you want to give it, are there things that they need to be thinking about in that space?
Jim: I think this is kind of forcing their hand maybe. Some people have jumped on board with, you know, thinking of this from a business standpoint, this is the new normal, I hate to keep saying that word, but we go back to this, you know, doctors now have to about before they used to just focus on surgery that they had to do and they came in and they did all the pre-op, post-op work, they did the case. Now, they have to think about things like, how are we capturing cases that may go somewhere else? How are we going to be more efficient in the OR? How are we going to work with the hospitals who have to pay the bills for all of these vendors coming in? So, I mean, they just got to be more open to kind of working together collaboratively with all of their teams, whether it’s the hospital, the ASC they’re working with, the staff they’re working with, the vendors they’re working with, got to get creative.
And the surgeon practices and how they do things, it’s no different than what we just talked about with the distributors. A lot of practices have great practice managers that will guide people through this. I’ve seen and heard of a lot of practices who are struggling through this. They’ve never really been through anything like this. So, now, they have to think outside the box. You know, “How do we, how do we market? How do we build a good user-friendly website?” How do we do all kinds of things that they didn’t think of in 2019, they now have to rethink their approach to getting out in the market now.
Michael: Their list of responsibilities has grown exponentially pretty quickly here.
Michael: Jim, while we got you still, I want to talk a little bit about what you’re doing now. You and I had talked a little bit about Enviro Care, VB Enviro Care before. I’d love to hear a little bit more about what you’re doing there and that company’s role.
Jim: Sure. For me personally, this is a very exciting venture for me. I’m working with some people that I’ve consulted with and worked on various projects and we kind of came together. A lot of people in my position, distributors, med device people out there, when COVID first hit, there were PPE companies that came out of the woodwork. They wanted everybody to sell masks and gloves and gowns and bunny suits and all that. And the group that I’m working with, we made the decision, we’re not going to get into that game. Because let’s be honest, I don’t want to say dirty, but it just doesn’t feel quite right. You know, there are companies that do this, they’re working with their local authorities and you know, they’re doing a great job, but we came across a few people that weren’t doing a great job.
So, what we decided to do is if something should come along that can help post-pandemic, help people feel safe, help people get back to work and their lives and play, you know, all of that stuff. So, what we did was we actually teamed up with a group out of Oklahoma, a very exciting group down there. They’d been doing this for years. Basically, we have two product offerings. We have a misting service, I’ll tell you about that in a second, but we have an air disinfection system. The great thing about this is there aren’t a lot of these out there and we’re working with the best company that produces these. Everybody’s talking about HEPA filters and air filtration and air purification, and if you’re on Instagram or Facebook, at least on my newsfeed, like every other thing is a HEPA filter or air purification system.
This system has been around for a long time. There’s a good long clinical history, which is very important, right, Scott? How long has it been around? What’s the efficacy of this? And so, with this company, basically what it is, it is a system that looks like an air purification system but what it does is it has the filter that the air gets drawn into. But after it goes through the normal filtration system to take out dust and dander and pollen and the normal things that an air purification does, the system does. In a regular air purification system, if you have airborne COVID or airborne SARS or H1N1, it will shoot right through those filters and come out the other side just as strong as they went in. What we do is we actually add what’s called an electromagnetic plasma field that will eradicate those germs, so coming out the other side is clean, fresh, non-contaminated air.
The best way to describe this, to boil it down to simple terms, it’s a microbiology bug zapper. It will kill the bugs as it goes through it. A normal HEPA filter, a normal filtration, or air purification system, it’ll shoot right through. So, this does both, it picks up all the particulate, but it also eradicates the germs so you have a nice fresh air. The other system that we have is we have a misting service, but it’s not just a missing service. We’ve seen a lot of commercials on TV during COVID come back, you know, we use this, we use that. Whether you use VB Enviro Care or not, any business owner that uses any disinfection system, know the science behind it. There’s a lot of stuff out there that does a pretty good job, but may not do the best job. So, it’s an exciting new company. We’ve been working on it for a few months, but we officially launched July 1 and it has gone very, very well. So, thank you for asking.
Michael: That’s awesome. Certainly. So, I can see how that is certainly a next step for the work that you’ve been doing just in the time that we’ve known one another. Jim, thank you so much for coming on the show. I’m so glad that we finally got the chance to record and have this conversation. I think that this is just continually evolving landscape, and I think getting to hear all the different sides of how people are coming at making updates to the OR, making updates to the practice, it’s just really, really helpful for us. So, thank you so much.
Jim: Thank you for having me on. I really appreciate it. Thank you.
Announcer: Thanks again for tuning in to the “Paradigm Shift of Healthcare.” This program is brought to you by P3 Inbound, marketing for ortho, spine, and neuro practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.