My 16 TOP secrets to selling surgical robots

16 hots tips for selling surgical robots - Steve Bell

Warning: Brutal truths incoming so strap in:

I have the infamous reputation of being the person that built and headed up the commercial structure of the second most successful soft tissue surgical robotics company in history after intuitive. I led an amazing team that took us from zero to over 150 robots in a few short years.

I don’t want to exaggerate - but that was Fucking hard.

A lot of people ask me “So how did you do it?”

Besides having an awesome and differentiated product, and having what I consider one of the best marketing teams on the planet working with me. I’d say I did a good job of hiring incredibly motivated and competent people that joined my cult. And yes it was a cult I created - ask any of them. And to be honest that is 90% of the battle - get the best people - motivate them - educate them - align them - and make them act like a cult.

But it is a little more technical than that. So I’m going to reveal 16 of my top secrets to how to sell surgical robotics and have success. Let’s dive in…

Know the field of soft tissue surgical robots inside out

I don’t mean a broad overview of what a da Vinci is. I’m talking hyper deep knowledge of laparoscopy, robotic procedures, the robots on the market. What drives customers, what are the gaps. What are the economics. What are the nuanced details in markets and the difference between robots to approach those markets.

You need to be border line insane about wanting to know about this market - I mean deeply deeply knowledgeable to the point of knowing every end effector used in every step of every procedure and why. Knowing intimately who the companies are - what drives them - what motivates them - what are their strengths and weaknesses - and how they do business.

You need to know how the economics and purchasing process works - end to end. And then what drives a successful program - not just what gets a deal signed. You need to understand the ebb and flow of the market, and the zeitgeist of what is happening day to day. It’s about obsession to details.

Unless you become a soft tissue surgical robotics "devotee" then just fuck off out of this business right now - period. You'll be wasting your time. There is no room for have a go heroes here. There is no room for amateurs. There is no room for back office managers that don’t deeply understand this - and I mean the deepest of the deep - about soft tissue surgical robotics. If you’re from Ortho - that's great... but get educated. This ain’t’ spine navigation - (I know I'm learning about that and it's hard because it's different.) This is serious laparoscopic (and more) procedural robotics. This ain’t sutures. This is serious product centric surgery. This ain't hand held staplers. This is massive capital equipment based programs that require nuanced approaches to business.

Wise up and get educated is the most important first step. Think you know this space? Please jump on a call with me and let’s put that to the test… seriously.

You get it?

Know your system better than the engineers that built it

I cannot stress this enough. YOU are the expert on your system. So you better know it inside out. You need to know how it works, what the specs are, how to get it to work if it’s not working - trouble shooting all the way.

You need to know every single specification in a detail that seems insane. And you need to know how those specifications become features... become benefits. And then how to maximise those benefits to make your system stand out.

How does it work? How does the telesurgery network work? How does the data and telemetry data work? How do the forwards and backwards kinematics work? What is the photon to glass route and timing on the imaging system? What’s the frequency the sensors in Joint 5 are working at? How do encoders work? What are the connectors and why? Batteries? Back up? Frequency of the electronics….

You getting it yet?

“Oh we are 30Kg lighter” will not cut it. Why? What does that mean - how did you get to that - what’s the plus and minus of that?

If you do not know every single trick that makes your system shine in dry demo, wet labs, clinical cases - then get back to school and don’t touch it until you know about it.

And that goes double for the management team. So team on the ground - get your manager - and their manager to set it up - run it - explain the details - and if they can’t do it… ask for another manager because they will not understand the nuances behind the sale.

They will be asking YOU dumb questions, and asking YOU to do dumb things in stupid timeframes.

You will get “So why did we not get that order?” In a vacant - glass eyed manner.

This is not about “sales management” as a manger - it is about “Surgical robotic programs support from the top.” Living and breathing it.

Know your system.

Know the competition better than they do

Be the competition.

You need to know everything about every competitive system out in the market place and every company you are competing with (you are selling against the company as much as the product in robotics.) You need to know them better than their own team. If anyone asks you the weight, size, motion scaling, field of view, rotational limits, lift load, power draw and on and on and on - You better know it. You need to know it.

You need to know why customers love them. You need to know why customers hate them. You need to know why they buy from them. You need to know their commercial tactics, their KOLs, their clinical studies, the instrument range, their future developments, their installed base. Who is using it an why.

You need to know in depth every single facet of every single competitor and how they position themselves to the world. You need to understand their WHY better than they do.

And that will help you to know where you fit into this complex web.

Know what you stand for - get that message right

A product is not enough anymore. You’re competing with Intuitive which is on a mission.

What does your company stand for? What do they mean? What is their place in the Universe? What is your place in the  user’s mind? Why should anyone give a flying fuck about you, your product and your company?

You better have that so internalised that if I cut open a vein and the blood spills out and I stick it under an electron scanning microscope... I can read what you stand for etched into every red blood cell.

If you do not utterly and totally believe in what you stand for - then stop asking others to believe in you. And if you’re a senior manager that even breaths near a robot - I’m talking to YOU. Distance management in robotics is a recipe for failure.

That message needs to roll from top to bottom of the organisation; and it better not be just a glib bullshit statement over a door frame. It better be an internalised message. It better be a worthy message. A message that will compel others to follow your cult. It better be what people believe.

And - you better have alignment of message from top to bottom of that organisation. And if anyone - and I mean anyone does not tow that line - even if it is the CEO. They need to go.

You cannot break that message - ever!!

And now you better be able to say that message in a concise pitch that you can tell me in 30 seconds. And everyone’s pitch needs to say the same thing - even if it’s their own different words.

Because if you cannot do this - you will not convince others to come along on a very tough and long ride with you.

Never sell on price - “You win on price - you die on price”

For everyone trying to beat Intuitive… the easiest default will be “we are cheaper.”

Firstly there is no such thing as a cheap robotics PROGRAM - period.

Second - if you are talking capital - you are screwed because everyone is giving capital up front in deals. How are you cheaper than ZERO? It’s also just a shitty way to sell for amateurs. If you want to sell on price get a job at Poundland (or the dollar store if you are in the US... or Euroland in Europe...) It means you have no clue how to sell value - F&Bs and outcomes. Differentiation and uniqueness. Price sellers go get to commodity companies and fast and have a good career there. The best of the best sales professionals hang around and read on.

If part of your robotic pitch is “We will reduce the cost of surgery” then you are delusional and on a short ride. That is a result of the rest of what you do not an input.

Just don’t sell on price.

Segment your customers

No!!! Surgeons, hospitals, sites of care and procedures are not one big homogenous blob. So stop thinking of them like that. Before you even build your robot you should be thinking - who is my solution for and why?

Do you have your procedures segmented properly?

Do you have your hospitals segmented properly?

Do you have sites of care, geographies, willingness and ability to pay?

Do you have price sensitivity / use sensitivity segmentation?

Do you have persona type segmentation?

Do you have competitive segmentation?

Purchaser team segmentation?

Payer segmentation?

If you do not have this drilled right down to the name of the customer and where in this complex map they sit - then shame on you. You’re an amateur. Go find another job.

This is not a game of hit n hope. This is a serious strategy of segmentation and targeting. Strategic plans that flow to details by the day to day targeting plans. Sequential step by step plans that move the goal along thjrough complex sell cycle.

If your plan is to”Sell to whoever is wanting a robot that shows interest…” Then holy shit.

Get your segments done now and know who you are going to sell to and WHY!

Target your segments with the right message

Once you have that detailed targeting map by segment - you need to build critical targeted messaging per segment.

What floats the boat for each segment?

Why is each segment needing?

What nuances are there for a thoracic vs a bariatric surgeon? You sure that’s even a way to segment?

Etc etc

Once you know what is their burning desire… what is their button. You need to have a crack team of marketeers design precise messaging and create awesome tools to deliver that message in a  360’ targeted way. If you even ask for a printed brochure - get off my blog now !!!!!!!! Go Retire.

You are selling 5 to 7 million dollar robotics program - you better have some high end digital assets to sell digital based products. And those assets better be tailored messaging, and in a culturally right messaging.

If you go to the USA with “All eyes on light. Bright future is knowing. Human progress at its best.” Be prepared to be kicked out of the room. That may work in China - that will NOT work in the USA or Europe. Right message - right customer - right culture - right language.

And bland, stupid, catch all bullshit messaging like the waffle above is NOT targeted and segmented messaging. It’s word salad crap that means nothing and shows you know nothing about sales and marketing. Fire that team that comes up with that garbage.

Get strong - compelling - segmented - targeted messaging that is utterly meaningful about why that individual should trust into you, buy into you, and dedicate the next five years of their life to get this program with you working. Make it impactful, meaningful, personalised and emotionally compelling.

If you don’t understand this. You don’t get the challenge you’re up against.

Plan your sales territory - go deep. Don’t go wide

You will spend vast amounts of time, money and effort chasing rainbows to have your ass handed to you on a plate by Intuitive. Everyone will of course want to test your robot, do a study for you, try it out, come on a course, be a proctor and have a nice dinner. But few will want to go to bat for you to actually BUY a system. It will be so hard for them to not internally decide not to go with the safe bet of intuitive.

“No one gets fired for going with IBM.” Remember that. And Intuitive’s system is proven and works and everyone knows it has a massive machine of a company behind it. You are an unknown risk. No matter what the customer says to your face.

You have limited resources of time, people and money. Closing a deal can take 500 call points (meetings, emails, calls, demos, group meetings, follow ups, etc etc etc) to reach all the stakeholders and get full alignment to get ink on the paper.

Chase down too many dead ends and you will soon be bankrupt.

How many people have spent 3 months locked in a room just mapping out their global sales territories by segment? Doing that hard groundwork? Then landing on the most likely prospects to convert.

Or is it out of the house on a Monday morning and run from hospital to hospital to see your mates from when you worked at previous companies selling them trocars on price?

Leave it out!!!!!

This is not selling a bag of syringes. This is going to take a massive targeting effort to find the real prospects - distributors - hospitals - buyers that will be serious and will not just be using you as a stalking horse to get a better deal from Intuitive - the Intuitive they always intended to buy from anyway - but had to be shown to be looking at other things. And well fuck you if you don’t do the deep investigation and then allow yourself to be the patsy. You deserve it. See you at Chapter 11.

You need to do deep research before committing to a detailed and targeted selling process into that account. You better know it is a genuine and real competition that will not be derailed because you don’t have an ORL application and the ENT surgeons holds all the cards. And you didn’t know. And you don't have that clearance.

You need to have a very specific plan of how you get down to 10 real prospects that are willing, able and committed to seriously consider you. With enough surgical support, nursing support, purchasing support across the board so you don’t get shafted at the 11th hour. And that work kept you busy out of other accounts while competition went in unopposed. Because you didn’t do your research and planning. You were busy old school selling.

You get it yet?

This is not windshield time to see your friends - get that into your heads. This is spend some serious time targeting - planning and then building a day by day - week by week - month by month - quarter by quarter - plan of what you need to do to move that deal along in those serious accounts. Old school medtech sales and a round of golf, or nice dinner is not working here - trust me.

This is an institutional change of practice purchase. Get it?

And when you’ve got that global, region, country, territory plan - stick to it!!! Do not go off chasing every tire kicker that “wants a go” on your robot. Or you will be spinning your wheels to bankruptcy.

Bespoke Salesforce

There is no preset sales process for your robot.

Salesforce’s presets will not help you here. You need a bespoke CRM which is going to help you meticulously follow your particular sales funnel.

And if you are using - “Your own excel” or “Your own black note book” or “It’s all in my head and I just use my Outlook calendar.” Then imagine me just staring at you silently as I think you’re an idiot.

This is probably the most complex sales process in the business. It has so many touch points and users, and stakeholders, and things that need to be ticked off pre sale - training - post sale and implementation. You better have a bullet proof system that keeps you on track. And you think you are smart and can juggle this in your head…. Right…

Those that “do their own thing” be prepared to be saying forever and a day “Oh the deal has slipped but will close next month.”  Right until you get fired.

Get a bespoke system that will guide you, your management, your teams, your marketing, your service engineers, your trainers and you clinical sales team. Just do it and don’t argue

Be systematic in your approach

Why do the above? Because all of that means you need to be systematic in your approach. The plans are versions of a systematic approach. Identify the customer, vet the customer, know who the stakeholder are, know who holds the power, convince all the surgeons, nurses, purchaser, CSSD, EBME etc etc. Can they buy? Will they buy? Can they pay?

What emails do you need to do?

What calls do you need to make?

What visits do you need to set up?

What demos are required?

What case visits need to be arranged?

What hospital roadshows need to be set to up?

How do you effectively run those demos?

What purchasing meetings need to be done and in which order?

Etc etc

It’s a system. The capital sale of a complex soft tissue surgical robot is a multi department, multi specialty, multi stakeholder sell like nothing you have ever experienced. And if you are not systematic, it will be chaotic and you will leave a crack open in the door for a very well oiled Intuitive to get in. And they will - systematically and taking about  1/3 of the time it takes you… hitting all the highlights… and beating you to the deal. Period.

You are not that smart. They are.

You are not that great wheeler dealer you think you are. They are a sales animal.

You cannot wing it... certainly not for this complexity of sell.

Build a system - make sure it works - rinse and repeat across the whole commercial team.

It’s a team sport - not an individual competition

I really don’t care who you are. You cannot do this alone, and certainly not multiple times to get sales in a meaningful timeframe. You will need a full team to get to close a deal.

And that includes senior management and maybe even the CEO of a small company to be in every account at one point or another.

There is no “magic sales rep” that will just close accounts and let you know when the deal is sealed. It will take the implementation teams, demo teams, software and data teams, legal teams, contracting teams, finance, tender teams, management, clinical teams, logistics teams, service teams, sterilisation services teams… and more.

You need to work out - “who leads” and systematically coordinates all of this to make a genuine deal happen.

Note: Having a national corporate team do a bundle deal and “oh we will give you a robot as part of our bundle ” is a total recipe for disaster. This is not about “gifting” robots - it’s about hospital teams fighting to get it through their system so that once it’s in “They’ll goddamned use it.” That is a critical part of the stickiness of the process.

Free - dropped in systems are easy but useless. If your plan is just drop the first 100 hundred in… Then expect about 40% to 50% to be underused and about 20% to come back.

This is about you and your customer team fighting tooth and nail to get that system in - with the utter gut belief by the users that they want it, and they will use it. If not - it’s a hollow sale and not a program. It's a trial.

Expect it to be a long process - plan for 12 to 24 months

So Steve… how can we get some quick sales in and get to 50 systems quickly?

You can’t. Every sales plan I’ve seen so far has been delusional. You might - if you are super lucky get 1 or 2 systems in “quick” but even those will take 6 months to just get all the contracts and paperwork done. Get the training done, get the proctors sorted, deliver the kit and get going.

You can get the sale quickly in a few places- but that’s not getting a sustainable robotics program.

Capital sales of this nature is an extremely long process for many many reasons. Such as - you need to wait for the tender to come out - or be awarded. You need to get multiple departments to try the thing. You need to get all of the hospital C-suite to buy in. And that takes forever just to get them in the same room.

You might need a major capital appropriation committee (VAC) to sign off that meets every quarter and your slot is in 9 months. They might need to trial 3 or 4 systems - each for a quarter before they make a final decision… etc etc etc.

Suck it up - this is a long process even when you know exactly what you are doing. Expect 12 to 24 months average - with some deals being 3 years plus. And at the end of that long - expensive process - expect to lose more than 50% of the time. Way more than 50% of the time.

Just suck it up!!! Face reality. Set realistic targets for your teams with realistic time lines - not investor time lines.

And make sure you have $500 Million to $1Billion of lifetime cash to stay alive until you get traction.

Every system you sell at the start will be "given" in one form or another. And that means every system will dig you a deeper and deeper cash hole. So decide how many you want to sell and "why?"

Sell the vision not the product

Time and time again I see people get confused about selling features and benefits. Often it is a “show up and throw up session” about joints and DOFs and frequency response, and lines on a screen and - blah blah blah. That all comes later!!!!!!!!

No one gives a shit about your product until they give a shit about what it means to them.

I will never buy an android phone. Samsung is probably way better than Apple. I’m sure it has more NITS, and Pixels, and Ram and megapixels, and all that. IDGAF.

My bag is that my phone talks to all my other Apple products seamlessly, and I don’t have to do anything. Convenience. I am sold on the convenience as it makes my life easier.

If there is one thing I have learned about selling robots for surgery - “What’s in it for me?”

First to publish?

First in the state?

Allows me to operate without changing my style?

Keeps the urologist happy?

Allows me to use in the ASC?

We want to be different?

I don’t know - but each stakeholder will have some button. And you need to sell around their comprehensive vision ,and then bring in all those points to how this is the solution to get that vision realised.

The art of sales is all but dead: It’s catalogues - codes and price. But not in soft tissue surgical robotics baby.

The best people at closing deals are the best story tellers that weave the company story and the customer story into intimacy. And to do that you need to know them and their needs and how that fits with you and your deliverable. How does your company and your product deliver on their desires?

So if your product is not differentiated at all, then the fall back in the customers mind will be - “hmm just like Intuitive?” - and that means they will go with the safe bet. Especially as that bet is better equipped and more reliable and more clinically proven than yours.

If you are an Intuitive clone - you better have something that differentiates you, because price will not cut it outside of home markets (China, north Africa, etc - Just saying.)

Know the sale does not stop at the sale - it’s about the program

One of the biggest surprises waiting for everyone is the “Hmm they are not doing many cases. In fact it’s slowed right down.”

That’s because in a robotics program the sale is the first and easy 10% of the deal. The hard 90% is the getting the program up and running, getting the cases up to speed, not having disasters, and then getting consistent case use and case load growth. Users will fall off the wagon and revert to lap easily. The hard part is keeping them using the robot. (You see why dropping it in from above, from purchasing, is not the way?)

Nothing will kill your sales more than other hospitals seeing your flagship site struggling to use your system and just doing a few random cases a month. If you want to be successful in sales - be successful in case implementation. Do not move on to the next customer until this customer is well and truly established and a heavy user. Go deep and get usage up.

That sales process is through the implementation team - where that “in hospital clinical team” will be selling within speciality to get more users to do more cases. And then trying to broaden across specialties to get at least three specialties on board to be able to keep the robot busy all week.

You think selling is hard…. Wait until you need to get a program to capacity.

If it tanks too much, an idle system is bad… But one being boxed up and sent back is worse.

If iot was "free" it will come back way way faster.

Beware.

Use the voices in the market to garner love

Bad news and disgruntled voices travel fast - so make sure users are happy - make sure KOLs are on board - make sure important buyers in health systems are delighted.

Look at linked in and the sycophantic posts of customers on the DV5 and you will immediately “get it.”

Why?

Because this is a sale by referral business. Interested users will pick up the phone to your current users and ask “How is it?”

A frustrated surgeon that has felt you sold and ran without support will tell that fast - and every niggle about your system. And they will give the “I wish we had gone with da Vinci.”

A delighted customer will heap praise on YOU, your company and even your product. Even if your product has gaps - a delighted customer will talk around that and say “it’s got massive potential."

Do NPS scores and do them regularly. And shower your early users with love. Have them speak on podiums. Create them as ambassadors… not just sheep like users to make you some money. Your motivation and their motivation must be aligned.

The voices of users and buyers that are delighted with you will resonate across the market. Love them - promote them - let them speak for you.

And get that message out. It creates a positive - virtuous circle.

Understand how to make capital sales - robotic capital sales

I sit on the sidelines and watch companies floundering because they have still not understood how surgical robotics soft tissue capital sales actually works.

I hear “Some of my team’s sold capital” - and they mean $30K advanced energy. Or $100K vision towers to one department.

Outside of Intuitive - I can name less than 50 people that really know how to do soft tissue robotic capital sales. I know about 20 that can do it well and consistently. I know 5 that have personally sold more than 10 robots. They are as rare as rocking horse shit. If you can find one - then hire them immediately and give them $1 million to join you, and then teach the others how to do it. Yep. They are that valuable and that rare. And they are being scooped up bu the day.

I’m not talking navigation systems - spine robots -  orthorobots linked to implants. I’m talking da Vinci head to head system sales. And if you say “it’s the same.” I will say “No it is not.”

This is a dark art. But most of it can be taught… but it takes time - patience. I know - I’ve taught a few people and also learned from the best.

Lack of understanding this super complex sales cycle will drive a level of frustration across your entire organisation from CEO down. No one will understand why targets are not hit, why deals are not closed, why Intuitive “beat us to it again.” It will cost businesses millions in effort for little to no reward. And that all stems from the basic lack of understanding.

Know how to do this. Find experts. Get systematic. Pay for the best.

These are opinions of the author and for educational purposes only. And of course the author is very happy to help and come and build you a sales process for about $1 million starting price… And remember I might teach you everything you know. But not everything I know. Hahaha.