How to Increase Surgeon Adoption of Your Medical Devices

By Don Wright and James Thein

28%. This is the statistic derived from one of the largest medical device companies signifying the number of surgeons who adopted the product after going to the manufacturer’s surgeon training. In other words, almost three out of every four surgeons did not adopt the technology. Isolated example? No, it is more like the industry norm. What is needed is a better approach to surgeon training that will increase product adoption rates.

Let’s do the math. Using the above manufacturer as an example, let’s say 120 surgeons are trained in a year – one training class per month, ten surgeons per training. 34 are adopting the technology. If the device has an ASP of $5,000 and each surgeon completes 50 procedures a year, these 34 surgeons would generate $8.5 million in annual sales revenue. Now, if an additional two surgeons (per training class) would adopt the technology, $6 million in additional revenue would be generated – a 70% increase!

Here are some effective no-cost best practices that can achieve this end.

Before Training

Proper targeting and qualifying of surgeons is of utmost importance. Surgeons need to be carefully screened such that sales reps do not offer expensive surgeon trainings to unqualified surgeons.

Surgeons need to commit to performing a series of evaluation cases (we recommend a minimum of 5 to 10) within a specified timeframe. There is a strong correlation between product adoption rates and not only how fast surgeons complete their first case post-training but also how quickly they finish the entire case evaluation series. The surgeon should be willing to schedule the first case(s) before attending training with the goal of having at least one case scheduled within the first two weeks post-training. The longer a surgeon waits to perform a procedure the less likely he/she will adopt the technology.

Surgeon commitment should also include a formal letter from the company confirming their attendance at the training. The sales representative should confirm attendance with the surgeon’s office one month, two weeks and one week prior to the event. This will ensure they do not have any professional or family obligations that would prevent their attending.

Once a sales representative has a surgeon’s commitment he/she should ask the surgeon to identify potential patient candidates and review patient films. It is a good idea to have the surgeon bring patient candidate films to the training for consultation with the faculty trainer.

If the procedure and/or device are new, the sales representative should review and verify the credentialing and value analysis committee process (VAC) with the surgeon in order to get the necessary approvals. The surgeon should submit a request for privileges to the hospital before or immediately after the training, preferably before. Sales representative should be able to describe the credentialing and VAC process of the hospitals in their territory. If they cannot this should be considered a red flag to sales management.

Finally, it is most effective to limit the number of surgeons invited into training. A sales rep should never invite more surgeons than they can effectively support during and after completion of training. Additionally, the sales rep should submit a bio-sketch of their surgeon(s) for the faculty presenter who is delivering the training program

At Training

Physician training accomplishes two goals critical to increasing surgeon adoption rates. The first is increasing surgeon competencies with the new procedure and the second is creating a secure peer relationship between the surgeon and sales representative. In order to accomplish these goals the training must be meticulously planned and executed.

Sales representatives should accompany all surgeons to trainings and have dinner with them the night before the program.  They should invite no more than one or two surgeons – the most that should be assigned to any one table/station. This dynamic allows a sales representative to be fully engaged with their surgeons throughout the lab training.

The faculty presenter should be coached prior to the program presentation in order to reaffirm his/her understanding of the following: patient selection, and indications and surgical technique that ensure compliance and that are aligned with the company’s marketing messages. It is also necessary to make sure the faculty presenter is familiar with each attendee’s bio-sketch.

A company representative should open the program to set expectations for the surgeons. This includes competency needed to gain a certificate of completion, an overview the day’s agenda, an introduction of the faculty and delivering any product messaging about which the faculty might be uncomfortable addressing.

While the faculty presenter is lecturing, the training organizer should hold a meeting with the table trainers to review the lab exercise checklist used for certification and familiarize them with the surgeon bio-sketches. Ideally, the sales reps would function as lab table trainers if they were clinically competent to do so.

Surgeons should be required to demonstrate competency of both product and procedure by successfully completing a lab exercise checklist in order to earn a certificate of completion. Before leaving the lab the sales rep should reconfirm evaluation case commitments and schedule a follow up meeting.

An emphasis on faculty – attendee interaction is important. The faculty surgeon should float between the tables to answer questions, provide direction and review any films of evaluation cases that will be performed post-training.


The sales representative needs to review patient selection criteria and begin planning the first case(s) when meeting with the surgeon post-training. The sales rep should also meet with surgeon’s nurse/Physician Assistant and the surgeon’s scheduler if either is a different person. The reasoning behind this is that the nurse/PA does the chart reviews and needs to be aware that the surgeon is going to perform a series of evaluation cases on your product. It is important to review patient selection criteria and ask him/her to look for good patient candidates. Similarly, contact the hospital surgery scheduler. Make her/him aware that the surgeon is going to be evaluating your product and ask to be called when a case is scheduled.

It is also a good idea to notify the hospital’s Head Nurse/nurse coordinator that the surgeon is going to be evaluating your product. If uncertain about the Head nurse’s loyalties to competitors, it is helpful not to give too much notice in order to reduce the chance of any competitive counter-measures.

Sales reps should call the control desk to get the surgery schedule and find out what techs have been assigned to their case. In-service the surgeon’s clinical team one or two days prior to the first evaluation case. Sales reps should attend all evaluation cases. If a manufacturer is using a distributor sales model and the surgeon is a potential high-value customer, the manufacturer should provide, at a minimum, case coverage support for the first few cases if not the entire evaluation series.

The way in which a sales rep functions both pre and post op during the evaluation cases is crucial.  To drive proper pull-through and build OR team advocacy for a product, he/she should map out the entire OR pull-through process and be aware of the key stakeholders. The sales rep should know who to talk to, in what sequence and what to ask. He/she should anticipate common objections, know how to apply the information gained as well as how to delineate follow up activities that will differentiate your product from that of competitors.

Surgeon conversion must be viewed as a process and not as some event hinged solely on clinical training. If done correctly, incorporating these no-cost best practices before, during and post-training will increase your company’s product adoption rate and sales revenues.

James Thein and Don Wright are with the Perceptum Group Perceptum Group develops and delivers sales training, physician education, and leadership development programs exclusively for medical device, biotechnology, and specialty pharmaceutical companies. James and Don can be contacted at either or


Josh Sandberg

Josh Sandberg is the President of Ortho Spine Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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