Home > Uncategorized > How Not to Sell a Product to an Academic Physician

How Not to Sell a Product to an Academic Physician

Today I sat in the infection control committee at Grady Memorial hospital and listened to two sales pitches for products meant to decrease surgical site infection.  I am a tough sell at these meetings.  Some might even say that I am the asshole in the room.  But really the issue is that I say what everyone else is thinking but are too polite to say.

The first pitch was from Ethicon, who was marketing their antimicrobial impregnated suture.   The presentation shows convincing evidence that the suture, placed in a petri dish surrounded by bacteria, does in fact inhibit bacterial growth.   There were many claims made that it also decreased the rates of wound infections in comparison to using typical suture.  When I questioned what data there were to suggest this, I was told that the data was all in my handouts.

I looked down at my handouts and found no data whatsoever.  I found a bibliography of about thirty articles that investigated the product.  I pointed out that there is no data, just a list of articles.  I was reassured that these data support everything that they are saying.
At this point I was kind of pissed.

“So basically you want me to do your work for you?  You are coming here to convince me to convert from non-antibiotic suture to more expensive antibiotic suture on every surgery I do.  If the data clearly support that decision then your sales pitch is easy.  Just describe the data and if its clearly efficacious to do this and the cost is reasonable, then we will switch.  But you aren’t doing that.   You are just telling me your product is good and I should buy it, and then giving me a list of a ton of articles that you claim supports you.  Wouldn’t it have been better for you to come here with a powerpoint that actually described these data, and thus convinced me that what you say is actually true?”   But they didn’t do that.  Instead they just referred to “the data” but never actually said “what the data was”.  In the end they agreed that they would need to have their MSL, or Medical Science Liaison, visit with us to further discuss the data.

MSLs are doctors who work for industry who have the scientific background that sales reps typically lack.  Thus they are good for explaining the science behind a product rather than just repeating a sales pitch.    In this case, given that they were pitching to a room of 20 academic physicians in a infection control committee and trying to land a contract that would represent hundreds of thousands of dollars annually, they should have brought an MSL with them in the first place.

So this afternoon I looked up all the data.  Some of it is supportive of using the suture.  A large number of trials say it does not work.  Several meta-analyses, which combine smaller trials into one big result, do support the use of the suture.   The data was mixed, but infection is a huge concern for us and the suture is only about 10% more expensive than what we use now.  So if Ethicon had just presented that data they might have landed a deal.  But instead they kind of hid the data, and thus left without closing.

The second pitch was from a company that was selling an antibiotic solution used for irrigating surgical wounds prior to closure.  This product was currently being testing in a multi center trial for efficacy.  The rep was trying to sell it as something we should put into use at Grady.

“So basically you are currently running a trial to see if your product works, and you would like us to use it in every patient not knowing the results of that trial?”   Again, I’m the asshole in the room.

“Well we have great data that shows it is non-toxic, so you can only benefit.  And the cost of a wound infection to the system is huge.”

Those kinds of arguments bug me because its trying to play on fear.  He is right that wound infections costs the hospital a lot of money, not to mention the patient who has to deal with it.  But to institute an expensive hospital wide program lacking any data to say that program will work is just wrong.   And once you do it, its very hard to ever roll it back, because it is very hard to ever know if it worked.

It would be great if manufacturers just presented the data, but they never do that.  They spin it, or sometimes they hide the fact there is no data at all.   The sad thing is that I think that at least one of the vendors could have landed a huge contract today if they had just presented like they were talking to a group of intelligent physicians rather than to people who are just going to believe whatever they say.  They just got a lot of questions they couldn’t answer and a room of very unconvinced doctors.

Categories: Uncategorized
  1. Filt
    July 10, 2015 at 5:32 am

    “you are coming here to convince me to convert from non-antibiotic suture to more expensive antibiotic suture on every surgery I do. If the data clearly support that decision then your sales pitch is easy…. I looked up all the data. Some of it is supportive of using the suture. A large number of trials say it does not work. Several meta-analyses, which combine smaller trials into one big result, do support the use of the suture. The data was mixed, but infection is a huge concern for us and the suture is only about 10% more expensive than what we use now. So if Ethicon had just presented that data they might have landed a deal.”
    So basically even though you state that data was mixed and large number of trials said the suture didn’t work, and it is an antibiotic-suture yet with these inconclusive results you would support switching to it, instead of non-antibiotic based, thus supporting the rise in antibiotic resistant bacteria having no scientific ground for it.
    Where is logic here?

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  2. July 10, 2015 at 6:27 am

    That is certainly the issue. There are data in support of it and some that is not as supportive. It is difficult to know what is right and what is not. Either the suture indeed does help to prevent infection or it doesn’t, and for some reason the studies aren’t coming up with the same results, even when they seem to have similar designs and patient populations. It may be that it is useful in some types of incisions and not in others. From what I have read so far, it does not seem useful to close the fascia with antimicrobial suture, but may be more useful at the skin level (which makes some sense.)

    Resistance is also an issue, as you mention. That said, the same could be said for routine antimicrobial prophylaxis given prior to skin incision in every surgery. It may contribute to resistance, but also significantly decreases infectious morbidity in surgery. As such we consider it to be a worthwhile use of antimicrobials.

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  3. July 21, 2015 at 3:24 am

    Someone has to be the one to say those things! It’s a little crazy to me that companies would pitch to a hospital, where accuracy is very important, and not have the proper research done.

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  4. November 4, 2015 at 8:52 am

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