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Helping make sure the beat goes on
So there I was, having parlayed my PhD in chemistry into a not-as-exalted-as-I-wanted position in sales at one of the largest medical devices companies in the world. Whose name will not be mentioned to protect the innocent.
They were about $878 million to the good at the time. That’s not revenue. That’s profit. Yup. They were doing all right. And truth be told, so was I – not so much minding my own business as trying to figure out how to find more business for the company when this extraordinary opportunity presented itself.
Before you can understand, we have to have a heart-to-heart talk about something that most people have heard about – but really have no clue about, unless they have to have one implanted in them – and that’s defibrillators. Specifically, ICDs meaning implantable cardioverter defibrillators. These are an implanted version of the paddles you see shocking the heart back into shape in movies and TV shows.
They’re implanted in the heart going in high in the chest and below the collarbone.
And they monitor and regulate electrical pulses in the heart. Helping make sure that the beat goes on, as it were.
In the simplest terms, the heart is a pump made up of muscle tissue. The heart’s pumping action is regulated by an electrical conduction system that coordinates the contraction of the heart muscle to keep all the blood in the body moving smoothly. Too slow and the blood doesn’t bring oxygen to your body fast enough. Too fast and the blood can’t oxygenate in the lungs. Both cases are problems the ICDs can treat.
I’d been working in this field for about 6 years. One of the most sophisticated of the devices was the CRT-Ds, in not-so-layman’s terms, cardiac resynchronization therapy defibrillators. This is an ICD with an extra lead to pace both sides of your heart at the same time. Generally speaking, they have 2 core functions:
Two types of action, but accomplished with three leads to orchestrate the action. And when I say leads, I don’t mean something that generates good prospects. These are electrical leads that get attached to the heart and allow the implanted device to deliver the electrical impulses to the heart to treat the patient.
Should the aforementioned high-energy defibrillation be required, this is what happens. Similar to Pulp Fiction, if you remember the scene. Travolta and Uma Thurman.
He uses adrenaline, and these devices use electrical impulses, but the aim is roughly the same: to get the malfunctioning heart up and running again.
The device that presented such a great opportunity for me was called the InSync Sentry. It stood on guard for the heart in ways similar to other top-of-the-line CRT-Ds. And did one very important thing they didn’t.
First, a little context. What most don’t know is that it’s common for people who have been hospitalized as a result of a heart failure to have 15 to 30 pounds (that’s 7 to 15 liters) of liquid taken out of their system. Fluid. Water. You get the idea.
Much of this fluid accumulates in the lungs. What the InSync Sentry did was measure the impedance sent from one of the leads back to the unit installed just under the collar bone. Impedance means resistance, roughly speaking. And the signal would pass through the lungs on the way back to the unit.
Here was the thesis: the lower the impedance, the greater the likelihood that there was a higher level of some substance that was impeding the signal. And what would that be? Fluid in the lungs. Which meant that sooner or later, a heart failure hospitalization would be on the way. If caregivers could be alerted, they could take action to avert the crisis. For example, increasing the dose of the diuretic a patient was taking. Thus evacuating more fluid from the body without requiring a hospitalization.
But you have to ask yourself – why wouldn’t hospitals welcome hospitalizations? After all, they can charge a lot of money for the care they give. Here’s the catch. If a patient is re-hospitalized within 30 days of being released, the hospital can’t charge for it. They have to treat the patient for free. And being good corporate citizens, hospitals hate doing anything for free. So hospitals loved the idea behind the device.
What about doctors? Here’s another catch. If you have a patient who gets hospitalized, you have to do the rounds. Every day. That takes a lot of time. Which reduces the time doctors could spend on more worthy endeavors. Like golf. So doctors had good reason to like the Sentry as well.
This was a tremendous opportunity. We estimated a defibrillator and other similar devices market of around $2 billion at that time. And so good was the device, we thought we could get a much larger share of that market with this device.
I was part of the leadership team, in sales training. Doctors would have to believe beyond a shadow of a doubt in the utility of this device before they would recommend it to hospitals. This meant that the sales teams would have to convince doctors beyond a shadow of a doubt of the utility of the device, and doctors are notoriously picky in this regard.
The way sales forces are generally trained is through video modules that salespeople watch (and frequently take tests on). That can work for medications or devices that are easily understood and simple to explain and not novel.
Ours was a new and different animal that required a different approach. I insisted that the training budget be increased so we could do the training live. I got the money. And the roadshow was on for the 1100 members of the sales force in the U.S.
The two great advantages of a live presentation are:
Have you ever tried to talk back to a video? Doesn’t work.
The advantages of taking the training this one step further are obvious.
So were the results. Sales went through the roof, and the device generated $500 million in its first year. Variations on this device are still widely used.
For me, my heart skipped a beat when I was promoted to Director at the young age (for the company) of 37. So far, so good…
First, if you see an opportunity, jump on it and invest yourself in it fully.
Second, if the idea, product, service, or medication is so different – and it should be, if it’s a great opportunity – make sure that you don’t accept the same old way of marketing and training for it. Do them differently. Respect the difference.
Third, make sure you get rewarded properly for it. Many of us have doubts about our contribution – we were lucky, we were in the right place at the right time. Not true. The stories of people screwing up great opportunities are legion – and you know lots of them.
You did the work. You deserve the rewards.
