Intro: Hello and welcome to the podcast for InsideMedDeviceSales. My name is Pat, I am your host, and it is my responsibility to introduce you to some people that can help you get to where you want to go. We're going to meet current medical device reps and learn how they got started, what the process was like for them, what their day to day activity is like, and what some of their biggest challenges are. We'll also hear about some interesting cases that did not go as planned. We will also speak with hiring managers where I will get to ask how they select candidates, what they look for, and how candidates can stand out over the competition? I will also introduce you to medical device recruiters. We will learn about the role they play in the process, different ways to highlight your strengths as a candidate, and the things all candidates should stop doing. Lastly, we're going to be speaking with the physicians that look to their reps for support. We will hear what it is they appreciate about their reps and the thing great reps do to add value to cases. So thanks for being here, let's get started.

Pat: Welcome to another podcast episode for InsideMedDeviceSales. Today, I have the pleasure of introducing you to Tom Catalano. Tom graduated from Purdue back in 1992 and immediately went into the military, where he was a Captain of the Infantry in the United States Marine Corps. After a seven-year career in the Marine Corps, Tom was able to step immediately into a medical device sales role when he joined Ethicon, which is a division of Johnson & Johnson. From there, Tom joined Medtronic as a sales rep in both the coronary and the peripheral vascular spaces. Following Medtronic, he joined Fox Hollow as a district sales manager in two different locations. After Fox Hollow, he was able to have the privilege of working for a couple of different startup companies in different roles as a sales rep, territory manager, and a Director of Sales. Following that, he rejoined Medtronic back in 2010 as a senior territory sales manager in the peripheral vascular space where he stayed for five years until jumping over to a new division in Medtronic, or I should say a different division within Medtronic, in the neurovascular space as a senior territory sales manager. Tom shares some great insight on possible companies to target to break into medical device sales, as well as sharing his vast experience on how to be successful once you make it into the space. So without further ado, ladies and gentlemen, Tom Catalano.

Pat: Tom, thanks for joining the podcast, I appreciate you being here.

Tom: Glad to be here.

Pat: I'm actually excited to talk to you because I know, well first of all, you’ve got a ton of great experience in the space so I'm interested to hear about that. But I also think you're doing it in a fascinating space too. It's something that I honestly don't know that much about so I am excited to learn more about It.

Tom: Great, happy to discuss it with you today. Currently I'm in the neurovascular space. It's the interventional space, essentially, what that means is everything we do is through the blood channels of the body. So instead of traditional surgery where a physician would cut down and open up the chest and do a surgical procedure we generally access the femoral arteries, which are down above the hip joint, and the physicians will tunnel in with wires and catheters and, as you can imagine, the bloodstream goes throughout the body. So my current space is neurovascular, but I have experience in cardiovascular and all peripheral vascular, so I’ve basically dealt with many disease states throughhout the body and dealing with them through the vasculature of the arteries and veins of the body.

Q: Okay. So let's take a step back and can you share with me just how your career in sales got started? Not necessarily medical sales, unless that was your first sales job, but just how you ended up in a sales position.

Tom: Sure. Well, actually, it was my first job out. I have a little bit of a different path than some. After college, I got a commission in the Marine Corps, went ROTC at Purdue University, and I spent almost ten years in the infantry of the Marine Corps and when I decided to make that jump out of the military, I connected with a recruiter

00:05:03 - 00:10:00

that specializes in placing junior military officers. The recruiter I used was Cameron-Brooks, for those that may be familiar with them. And essentially what they do is they talk about all the different jobs out there, the industries, and they try to match you up, and they host these conventions where they invite all kinds of different companies from different industries, and you go on multiple interviews over the course of a two day convention. And so I got to see a lot of different spaces, interviewed with Dell Computer, and this is back in 2000. So interviewed with Dell Computer, looked at a lot of manufacturing jobs, but the one job that appealed to me the most was sales. And the reason being is that, coming from the military, I was used to basically being in charge. In the military I was in charge of marines, but pretty much in charge of my own unit. And I could take that unit and the training of the unit in whatever direction I felt, as long as we accomplished our mission. And I felt sales is very similar to that. Your objective in sales, obviously is to make a number. But how you get there, how you go about doing things, is really up to you. You're responsible for your own schedule, there’s no office to report into. That was very attractive to me, so I gravitated toward sales. And as I looked at the many different sales opportunities I had, the one that really appealed to be the most was medical device. And the reason being is I felt like in med device, at the end of the day, I'm not just selling a widget, but I'm selling something to ultimately help people. And I think a lot of people in med device or even pharmaceutical sales, I think a lot of people are attracted to that aspect of the job.

Q: Absolutely, that’s a great point. And it's interesting that you have that military background. One of the other guests on the show, Jeff Kordenbrock, who he flew Cobra attack helicopters in the army and did that for awhile. And then his first job after he got out of the military was in device sales. But we talked about the relationship between the military background and medical device. I know I have come across paths with multiple people in the space, and I'm sure you have too, that have that military background. Can you just share a little bit, what do you think is the correlation? Why do people with a military background seem to have success in this space?

Tom: I have no doubt, it's discipline. I think sales in general can be a slippery slope for some, and those that aren't disciplined enough to get out there and make the rounds every day, even when things are going well, or the opposite, when things are going bad. I think some individuals that don't have the discipline to get out there and have that daily routine, make the rounds with the customers, even like I said when things are going well, I think it comes down to discipline. And I think companies, like I started out with Johnson & Johnson in a Division called Ethicon, and they really like and they recruit heavily from junior military officers and from the military. And I think that's maybe why we have a lot of people from prior military experience in med device sales, because companies like Johnson & Johnson. And Johnson & Johnson's a great company to start with too, because they have a very robust training program. I spent six weeks in New Jersey training with Johnson & Johnson and today, there are very few jobs that are going to invest that much time and energy training individuals to get them up to speed for the space. So for those that are looking to get into med device sales, look for companies like Johnson & Johnson. I know Stryker also hires individuals without a lot of experience, as kind of junior reps. But Stryker kind of goes a different route in they do a lot of their training OJT (On-the-job training). So, great opportunities to get in with med device, but a lot of times you're learning by fire with Stryker. But Johnson & Johnson has a very robust training program, as do many large companies that are in the med device space. They generally do a really good job on upfront training.

Pat: Actually, I think Jeff may have mentioned J&J also. And I actually, it wasn't my first job in med device sales, but I also was with Ethicon for awhile.

Tom: Oh, great.

Pat: So I’m familiar with the weeks at a time in New Jersey.

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Tom: Well funny story, so it was my first job out of the military, my roommate's, he had come over, it wasn't his first job in med device, but he had come over from a company called Kendall. And so I learned a lot from him, and we remained friends, and this is mind you, this was twenty years ago. And so who is my manager today? That's my roommate from J&J.

Pat: Are you serious?

Tom: Yeah. We work very well together. It's a large space, but it's kind of also very small space. So you, I think people tend to cross paths quite a bit.

Pat: Right. Which is another reason need to mind, your P’s and Q’s, because you never know who you're going to be working with five or ten years later?

Tom: Absolutely.

Q: So your first medical job was at Ethicon?

Tom: Yes.

Q: So can you, or do you remember one or two key learnings from that experience? What has stuck with you that you still think about or use today from that experience? Is there anything?

Tom: Oh, yeah. I think a lot of things I learned from my early managers really stuck with me. You know, a couple things are, I remember my first manager basically saying, you know, hey, what it comes down to is people buy from who they like. So to caveat that though, what I've learned over time is, you just can't go out there and be a nice person and think you’re going to move the ball. So you really need to figure out, you'd want people to like you, yes, that's very important. But at the end of the day, you have to figure out how to move people to action. So you’ve got to move them to that sale. The other thing too, is a manager, this kind of goes back to the discipline aspects of it, I had one manager that said, at the end of every day got to look back and figure out what you did that day, I hate to use the sports analogy all time, but what did you do that day to move the ball forward? So you have to have one or two things that you effectively did that day. It could have been the worst sales day of your life and you could look back on it and go, Oh my gosh, it was a horrible day, I didn’t sell a thing, I was in some horrible cases, but there should be one or two things that you did move forward in a positive way that you can look back on and affect. If you haven't done that then you really weren't effective that day in your job.

Q: Good advice. So you're working for Ethicon, at some point something decided or made you decide to start looking at something else. What made you decide to start looking into different positions.

Tom: Yeah, it's a very good question because when I started kind of looking around and getting excited about different spaces is when I started to first feel comfortable at Ethicon. So I'm not, I'm one of those individuals, and I think actually probably a lot of people in sales are probably more alpha types, and so as you get out there and you see what other people are doing and different spaces, different disease states and different companies, you kind of, once you get to that, you know what you're doing, you're moving the ball, you've had success, you kind of want more. And the Ethicon, although it's a great training ground, I started looking at what I was doing as more of a commodity sale. We sold suture, mesh, drains, a lot of things are used in many different procedures. But I didn't feel like I was really there in the procedure, needed by the physician to help. The physician properly used the product in the case. And I think that the more specialized you get, the more you feel that special, I guess feeling, with the physician when you're in a case, you feel like you're really doing what you wanted to ultimately do, and that's help people. So the more involved you are in the case, the more complex the case is, the more gratifying it is, at least to me. And so I was with Ethicon and one of the mentors actually that I came to befriend and he helped me along, was a guy named Rick up in Spokane, Washington, and he worked for Medtronic and he was a pacemaker rep. And he really took me under his wing and he gravitated to me as well and he helped me find my way. And I know he wanted me to get over to Medtronic pacing, which I never did land job in Medtronic pacing.

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But he did help me establish relationships with other key individuals and I eventually did move over to Medtronic, but in the cardiovascular interventional space. But it was that, and then from there, I think it's really about following the new technologies, and I moved over to the interventional cardiology space right when drug coated stents were coming out.

Pat: Good timing.

Tom: Yeah, yeah, good timing. And did that for about three years. And then the peripheral vascular space was just starting to kind of take-off and I took the chance at that point to go to a startup company, Fox Hollow. And that was, atherectomy was new, it was one product that physicians needed training on and they really wanted you in the cases. So that was an exciting time and actually spent a long time in the peripheral vascular space and then about four years ago moved over to the neurovascular space, where we deal with stroke and brain aneurysms.

Q: Okay. So you mentioned the gentleman named Rick in Spokane, Washington that helped you. Were you also in Washington at the time? How did you two connect?

Tom: Yeah, so we connected in the hospital, and I think that's one of the most important things is when you're out there you're, on any given day, you'll probably cross paths with probably five, ten, fifteen other representatives. Some you know, I mean big companies, you may cross the five, ten, fifteen big company like Medtronic or Johnson & Johnson, you may cross five or ten in a given hospital on any given day. But it's really, even with my direct competitors, I feel it’s important to really network best you can. Now there's going to be some personalities you don't get along with. There are going to be some people that you don't like the way that they do business, and that's fine. But I always tried to look at it this way, everybody's got a family to feed, and yes, we're competitive, yes, we’re sales reps and we have to get as much of the businesses we possibly can, but everybody's trying to provide for their family. So when you look at it from that perspective, I tend to be one of those reps that makes, or tries to make other friends, whether they're in my space or in other spaces, because to your earlier point, you never know who you're going to work for some day. So I think that's very important. That's exactly what happened with Rick up in Spokane, is that I was selling, actually that’s when skin glue first came out, the Dermabond, and now there’s a bunch of different products out. Skin glue was new, one of the procedures we use it on was very popular were pacemaker insertions. And so I worked with, he helped me actually sell it to his cardiologists that were inserting the pacemakers. So we worked together a lot, we helped each other out. And I think that's also another big benefit to being friendly and working with other reps is you can help each other out and share context and everything in the hospital so very important, networking.

Q: Great point. So let's go back to when you were starting to interview for medical sales jobs. Was Ethicon the only medical device company you interviewed with at the time, or just kind of walk me through that process. What was the interview process like when you're talking to med device companies?

Tom: You know, I interviewed for actually three positions. One was at Ethicon- Endo, which is an endoscopic division, one was Ethicon, Inc., which was the suture, mesh, drains job I ultimately took. And then there was another company, Davis & Geck, which is another suture company that was at that conference. And to be quite honest, I don't know if it was because it was my entry level, I was just coming out of the military, the interviews were very straightforward and what you would expect to be your classic interview. So a lot of, what makes you tick questions, a lot of, what were some of your worst experiences, what were some of your best experiences. So they were very question driven, kind of right down the script of a textbook interview. I honestly can't differentiate the med device questions from the non-med devices, it’s kind of too long ago, it’s all kind of blurred in together for me. But what I have noticed over time, though, is from that entry level med device interview

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to interviews I might have had of late is, back then, it was like I said, very straightforward interview question driven, and as I moved up and became more specialized and started working or interviewing with startup companies, more the higher level where the positions where they’re requiring multiple years of experience, it’s really about selling yourself. And so a lot of those interviews are not very scripted, they're very unscripted. And what I always try to do in those interviews is do something different. Try to make my interview and my interview experience different from the multiple people they’re going to be looking at for the for the interview. So whether it's putting together a presentation that highlights what I've done in the past, getting some of the physicians that I worked with involved in the interview process, or having some of the managers I worked for in the past, just doing something different that sets me apart. But is very much, you going out there and selling. The one thing I'm very proud of is that coming out of the military with Cameron-Brooks using that recruiter, I have yet, and I've had probably five or six positions now over the last twenty years, I've never used a recruiter since. So it kind of goes back to working where I would network, find a position I wanted, get my name in the ring through my networking channels, and then fortunately, I landed the position or I didn't land the position. But I have yet to use a recruiter in the last twenty years other than that first recruiter. So networking is extremely important and especially in the interview process. If you have somebody from the company that's pulling you in getting you lined up for the interview, you have a much better chance of landing that position than the recruiter pool.

Q: Absolutely, good point. So you mentioned now you're working with things like stroke prevention. Can you just kind of tell us about your current role? What exactly are you doing?

Tom: Sure, so stroke’s basically broken down into two segments. There’s ischemic stroke, where a patient or person throws a clot, whether it's from afib (atrial fibrillation) from the heart, or they have disease in their carotid artery. But they throw a clot and it goes up into the brain and gets wedged, and it restricts blood flow into the brain. That’s called ischemic stroke. And then the brain slowly starts to die. That part of stroke is really, just ever since about 2015, data came out that shows there's a huge benefit for physicians to go in actually try to retrieve that clot within a certain time window. That time window is slowly expanding now, depending on different imaging and diagnostic tools that we have, we can treat patients out to twenty-four hours, depending on the viability of the brain.

Pat: Twenty-four hours after the stroke actually happened?

Tom: Twenty-four hours after the stroke, depending on where the clot went and also all the collateral flow. Just like, the body’s an amazing thing and even though there may be a blockage, sometimes a body can compensate for that blockage for a period of time. So that's definitely the growth in our segment is in the ischemic stroke side. And actually that's about 75%, 80% of the strokes that occur on any given day are ischemic strokes. Then the other side of it is hemorrhagic. So that's when somebody has aneurysm in the brain that typically they present after they rupture. The symptoms of ischemic and hemorrhagic are actually pretty similar. You might have seen some marketing on FAST. So Facial droop, and Arm, so someone raises their arm and it's called a drift, so they can't raise the one arm, and then Speech, and then Time. So FAST is the acronym we use for stroke. The symptoms can kind of mimic each other. But the hemorrhagic side is when an aneurysm ruptures or an aneurysm doesn't rupture and we find it through other diagnostic tools, and we go in there and treat that aneurysm. Usually we’ll go in and try to either coil it off with some coiling devices, or we have a new device called Pipeline where we put it over the neck of the aneurysm to try to heal it, or heal that artery so the aneurysm goes away. So those are really the two different spaces. We’re trying to treat ischemic stroke just like thirty years ago when cardiologists were trying to identify a heart attack and get patients to the hospital as quickly as possible.

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so they can open up those vessels. Stroke is really the same way, it’s just a little bit harder to do because when someone has a heart attack, everybody identifies chest pain, numbness in the arm, we got that person's having a heart attack, we’ve got to get them to the hospital. Stroke’s a little different. Sometimes it's masked by, some people might think somebody's on drugs, or sometimes people have a massive stroke and they just collapse, or some patients have a stroke in the middle of the night. But it's not a painful episode for that patient. It's a very numbing experience for that patient and they can't communicate, so it's a little harder to identify stroke. But we want to treat it exactly like we do heart attacks and get those patients to the hospital as quickly as possible.

Q: So with the nature of that type of case, are your cases scheduled, are they all emergent, how does that work?

Tom: So ischemic stroke is all emergent. So what we try to do there is work with the physicians through flow models and other tools. If a new technology comes out we’ll work with them on flow models and get them trained up that way. And then sometimes we do put ourselves on call. So if a stroke comes in we'll tell the physician, give us a call, we’ll come in help the staff prepare the new product for the procedure. So that side of it is absolutely emergent. If somebody ruptures an aneurysm that's also emergent, but they usually wait a period of time to allow the patient to get through the basal spasm period. So there's usually, if a patient comes in with a ruptured aneurysm, we generally have about twenty-four hours before they'll go in and treat that. So it's something we'll find out about last minute, but typically, they won't do that in the middle of the night, it'll be scheduled the following day. And then there's elective aneurysms. So patients that have aneurysms that want to get them treated but they haven't ruptured yet, those are purely elective. So we'll find out about those cases a couple of weeks out.

Pat: Okay.

Tom: So we have a mix of everything in this space.

Pat: Okay. Yeah, I didn't realize you take call.

Tom: Well, it's kind of voluntary call.

Pat: It's still call.

Tom: Yeah, it's still call, exactly.

Q: Is there anything about your current role that surprised you once you got into it?

Tom: In my current role, I would say probably, in my current role, no. I pretty much knew, I have been in the interventional space for years, for about fifteen years in the interventional space. I had, for a brief period of time, worked with my boss's boss now, we had worked together at a company called Concentric Medical, which was a stroke company, a startup company. And so I was very familiar with the space, so I knew exactly what I was getting into in this space. But the med device space in general, what really shocked me is how involved we are in the cases. And I think that's a great thing. I love being involved in the cases. But my one message I would like to get out there to those that are interested in the space is, yes it's cool to be in that case and all that, but you really have to earn it. You have to bring value to the case or otherwise physicians will find a way to do the procedure without you being there.

Q: That's a great point. Can you expand on that a little bit? How do you do that, how do you bring value to that case?

Tom: Absolutely. I think the number one thing is to always be focused on what's the best thing for the patient. And I don't care what you're selling, but there's no device out there that's the best thing for every patient and you have to be honest about that. So I always try to challenge myself and if I honestly think that my device is not the best thing for the patient, I have the conversation with the physician up front. Say, hey, look, you know our device is great, it's got great data, but this particular case may not be the best application for our product. And if it happens to be a competitive product that I think is probably the right thing for the patient, then I think it’s at least worth having that discussion with the physician. And you'll earn so much credibility with a physician just by having that conversation, even if they decide to go and still use your product, that's on the physician, but we have to be honest with ourselves and make sure that we're not pushing or trying to sell devices for applications that might not be the best application for our product.

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And I think that's the number one way to earn credibility with physicians.

Q: That’s a great point. So you mentioned you were surprised by the amount of involvement. What exactly is your role in the OR? How do you describe that?

Tom: You know what, it varies. I work, and this is probably common for most evolving spaces, but I work with a very large practice in downtown Indianapolis and they are probably one of the largest in the country as far as volumes of patients they treat, and these physicians are on the cutting edge of all the new technologies that are coming out, and a lot of the industry they bring the new technologies to them. So when I'm in those cases, I really feel like I'm more like a safety officer, to kind of use a military analogy. There I'm just looking to make sure that I'm just an extra set of eyeballs when we're doing the procedure. I'm looking for things that I see that I don't like what I see. It’s very important that you mention it when you see something. Or I'm helping the staff out, preparing or, they're obviously doing all the work, but in a lab like that, I'm more of a safety officer. But there are other smaller shops that don't do the procedures as often and those physicians and staff rely on us heavily. So there, what I do is I take the knowledge that I gained from the physicians I learned here in town or in Indianapolis, and I may be in a case up in Fort Wayne or South Bend, one of the smaller towns in Indiana where they don't do as much volume, and I'm kind of sharing my experiences with the products and the procedure with those physicians because they just, quite frankly, don't do the volume and see the number of procedures as the other physicians do. And they greatly, they value that and they appreciate it very much.

Pat: Oh, I'm sure. Like you mentioned, bringing value to a case, if you're in cases on a routine basis with a group that's one of the largest in the country, they obviously see a lot of different types of cases which you then get the experience and the knowledge and now you can carry that to somebody that doesn't see that kind of volume, and I'm sure they appreciate that.

Tom: Oh, absolutely.

Q: So who are your customers? Are they neurosurgeons, are they vascular surgeon who are they?

Tom: So there's three groups that I will work with: one is interventional neurosurgeons, so there's a pool of them, also work with interventional neuroradiologists, so the radiologists who go for a fellowship in neurology, or I'm sorry, in neuro. And then there's also, I work with, it’s kind of a new breed of physicians, interventional neurologists, so these are neurologists that go for an interventional fellowship. It’s kind of the opposite of the interventional neuroradiology discipline. So I work with all three of them. I tend to be, a lot of my territory is interventional neuroradiologists, and that's the big group in downtown Indianapolis. But that is probably one of the groups that’s on the decline as far as the numbers out there in the country. And the one group that is really growing rapidly is the interventional neurosurgeon, so neurosurgeons that do an extra fellowship to learn how to do the interventional procedure.

Q: Okay. How would you describe your interactions with these customers? Are they the same, or do you interact differently based on their specialty?

Tom: With the physicians, while I guess they do have a different perspective, and I think that's very important to keep in mind. So interventional neuroradiologists are very imaging focused. So I mean, they're radiologists, they’re trained in the diagnostic imaging and the imaging aspect of it. So if I know I'm working with the interventional neuroradiologists, we may discuss more of the diagnostic imaging component of the procedure. Whereas an interventional neurosurgeon, imaging's not a big focus. If they can at least see what they need to do, they're just going to go ahead and move forward, they're not going to worry so much about the imaging aspect of the procedure. And then interventional neurology is kind of the same thing. They are the ones that are probably most attuned to the patient, being neurologist, and the patient care, both pre and post procedure. But again, they're not going to be as focused on the imaging aspect of the procedure, nor are they going to have as much of a background on the surgical aspects of the procedure as well.

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And I always try to keep that in mind, so I know what's important to them. I think that's a very important aspect of the job, is knowing what's important to the physician you’re working with. Because they all want good outcomes for their patients, but they may go about it a different way, in regard to the procedure itself.

Q: Okay. What would you say is the most challenging part of your job?

Tom: Time management. As you could probably take away from my discussions on my current job, I'm in a lot of cases. And that's a good thing. You're in a case, generally, you're in a case selling your product. So that's a very good problem to have. But the problem is cases take a lot of time. Some of our procedures can take multiple hours, cases rarely start on time. So you show up, you're getting ready for a case and then you get bumped or it just takes forever to get the patient ready for the procedure. So if all you're doing is your cases, and you're not out there really selling your product outside of that, you're not really going to be effective in the long run. Covering the case is kind of a byproduct of the sale, you know, but you have to get in front of the physician, or new physicians I should say, and sell your product or sell your procedure to get to the case. Once you get the case, that sales kind of done. You need to be out there selling to new physicians, the new products, and so forth. And I think it is good to be in cases. It's kind of easy to talk about new products with the physician when you're in the case with them, but you need to challenge yourself outside of that. Because if you're always in cases, usually it's with the same physicians, and you're not out there talking to the physicians that are not in cases, because you're not going to be everything to everybody all the time. So you have to challenge yourself and get out there with the physicians that aren't using your product as much and drive that. And the good thing about the space too is that as you grow your territory, if you need clinical help, a lot of times companies will hire usually techs or nurses out of the lab to be clinical support personnel, and they can help cover cases for you. Which really, now I have a clinical support person and someone to help me out on the stroke side as well, so I have two team members that really helps me not cover as many cases so I can actually be out there selling. But definitely time management, it can be a bear.

Q: Good. How would you, and I don’t want you to give away trade secrets or anything, but how do you differentiate yourself? Either you as the salesperson or your product? I imagine you're not the only company in this space, so you have some competitors. So what are some of the things you do so you're the guy that gets the call for that case.

Tom: You know what, this is going to sound weird, but I always try my hardest not to sell, if that makes any sense. But I always try hard not to sell, and to go back to our earlier conversation, I really try to stay patient-focused and ask a lot of questions about the patient. Why did the patient come in? How did the patient present? The day after the case, I always text my physicians, how's the patient doing, are they going home yet? And if I can be patient and not always be in front of my physician selling something new, I try not to do it. And it's hard to do because there's, as you can imagine, as you know, there's a lot of pressure from our companies to always be selling the latest product or getting conversions. And if you're on a list for not selling a certain product, there's always a lot of pressure. But if it's not the right time, and I don't feel, if I feel like I've been selling too much to a certain physician or to a certain hospital, I try to just back off and be patient, stay patient focused. And I think another main thing is be authentic. You know, be yourself, don't try to be somebody else. Or if you've seen another sales rep that is very successful, they have a different technique or style, don't try to mimic that, just be yourself. Be authentic and stay patient focused. I think if you do those things, you'd be very successful in this space.

Q: All good advice. How would you say your role has changed over the last five or ten years, or has it changed?

Tom: Yes,

00:40:03 - 00:45:02

I think it's really changed in the sense of what I'm doing and who I'm selling to. So in the beginning, working for Ethicon, I sold a lot to either the OR managers, the OR material management personnel. Yes, we had to get physician buy-in, but we weren't in a lot of cases. It was more about office calls with the physicians, get their approval, and then maybe do a conversion, but a lot of selling to nurses, and techs, and management personnel. And as I kind of moved up through cardiology into the peripheral vascular, now neurovascular space, I'm very physician focused in my sell. Generally, in my space, if a physician wants something, they get it. It's a new space, there’s new technologies coming out, there are very few physicians that do the procedures that we do. So generally, there's only going to be one or two, maybe three at a given hospital within a system. And so number one, you're dealing with fewer players, the hospital is trying to make these physicians very happy where they get what they ask for, which is a nice thing. But I think a trap that some reps fall into is they forget to sell to everyone else. So they do a good job with the physician, but they forget they need buy-in from the hospital as well, they need buy-in from purchasing, they need buy-in from the lab managers as well. So I think that's a potential trap. But to get back to your question, I think that the biggest change has been who I’m selling to and at what level. That's where the progression has been.

Pat: It's interesting that you mention the admin, the purchasing, CFO, CEO because back when we both got started, I know I never spoke to a purchasing manager, much less a CFO of a hospital. But now, they are very involved in this process, and you have to engage with those people.

Tom: Very involved. And the other aspect of that, too, is when I moved over to the space because it is such a new space, I say new, the space is generally, they started coiling aneurysms in ’96, that’s in the world, so affectively…

Q: Can you explain that, when you say coiling an aneurysm, what’s that mean?

Tom: So they've been doing neurosurgery where they'd actually remove part of the skull, go in and they would clip an aneurysm in the brain. They've been doing that I don't even know how long, probably thirty-five, forty years on that. Now the interventional treatment, where we go in, again through the femoral artery, we tunnel up with wires and catheters up to the brain. And how they treat it is we would pack the aneurysm from the inside. We pack it with a bunch of metal coils, usually made out of platinum. And what that does is it prevents the aneurysm from rupturing again. So it would thrombose off, and it would prevent a bleed or a rebleed for that patient.

Pat: Okay.

Tom: So they've been doing that since about, in the US, since the early 2000’s. So even though we're in 2019 now, that’s nineteen years, in medical device that’s generally still a new space as technology develops. Now ischemic stroke is even younger than that. We started doing this probably in late 2007, 2008, but really that technology hasn't taken off until 2015, as I mentioned earlier. So this ischemic side of stroke is very new. And so in this space, with it being new, when I first came over there were very few, in fact, I had no contracts with any of my hospitals, if you can believe it. So we had product, we offered it at courtesy pricing, it was loaded in the system, and that's how we sold it.

Pat: Oh, wow.

Tom: But I've been very aggressive with contracts. So I came from a space where all our contracts were signed at higher levels of the company, so we couldn't affect pricing at all. And I came over here, and I'm like, there's no contracts at all? I thought it was crazy, I went around and signed a lot of individual local level contracts, so I think it's very important.

Q: So with this space being relatively new, compared to medical sales in general, is there something that's driving this space right now? It seems like, I came from the cardiovascular device world where the trends were in the algorithms of the devices and the information you could garner from it. Is there something in this space that’s kind of driving right now?

00:45:03 - 00:50:02

Tom: Yeah, there's two things. As I mentioned, there’s two sides of the neurovascular space. On the hemorrhagic side, so the aneurysm side of stroke, the big driver is how we treat those aneurysms. As I just explained, traditionally we would go in and we packed that aneurysm with coils to prevent it from bleeding again. Our company, we came out with a revolutionary device, called the diverter, and instead of packing the aneurysm with coils, we actually place this metal mesh stent-like device over the neck of the aneurysm and it diverts the majority of the flow away from the aneurysm and it allows that aneurysm to shrink over a six months to a year time period. And eventually the aneurysm shrivels up and goes away. So it's a new way of treating aneurysms. And it's, a lot of companies now are developing very similar technologies and coming out with it. On the ischemic stroke side of it, as I mentioned, it was a lot of data came out in 2015, now the procedure is very, a lot of physicians have the procedure down, they’re very effective with it. New technology continues to come out for it. Now, the big hurdle is getting more patients that suffer ischemic stroke to the hospital in time, because we do have time window, sometimes out to twenty four hours, but it's still a challenge to get patients to the hospital, to the right hospital in that given time window. But those two things are the two drivers in the space.

Q: Thank you. Can you think back, and it doesn't have to be from your current role but just in your time in the device space. Can you share some cases that just didn't, they didn't go as planned, and maybe you weren’t, not that you weren’t prepared, but it's not something that you expect.

Tom: Yeah. Well, I’ll keep things a little generic.

Pat: Please.

Tom: I mean, stuff's going to go wrong all the time, and it's the worst feeling. I don't want to say all the time, but stuff does go wrong, Murphy's law, and it's the worst feeling in the world when it's your product that kind of caused it. Because sometimes it's just you know, we would never admit it or say it out loud, but sometimes it is a user error. But sometimes it is the product too. And a lot of times, if you're selling a product in a new space with a new procedure, there’s just many things that could go wrong. I know one time, a long time ago when I first was getting started, a physician perfed (short for perforate,which means he poked a hole in) an artery of the heart. And so you can imagine that's not a good feeling, and I think we we're in that case, I think it was like an eight o'clock in the morning case and I think we left that room about five, six o'clock at night. So just trying to keep that patient viable and whatnot, so stuff does go wrong. And it's like I said, it's the worst feeling in the world. You want to just grab your things and run away, but you obviously cannot do that. And you have to help the physician to the best you can with coming up with recommendations on how to resolve the issue and help the patient, and hopefully, you get through it without too much harm to the patient. You definitely learn a lot in those cases though. And you learn what to watch out for. And it really is, it's a reminder that if you do see something going wrong, you have to say something. Sometimes it's uncomfortable. Sometimes you just don't want to make the physician mad. But if you see something that you don't like, you have to speak up.

Pat: And I think most physicians would prefer that you say something that you think is not right and you be wrong rather than not saying anything and then an hour later, it's something that's now it's a critical situation.

Tom: Absolutely.

Q: So Tom, what advice would you give someone that thinks medical device sales is where he or she wants to be?

Tom: You know, I would say, through obviously all the social media we have today, I would start reaching out. I get calls quite a bit, and that's why I really applaud what you're doing here with the podcast, because I get people reaching out through LinkedIn, or just they know somebody who knows me and they give me a call, reach out and ask me for advice on getting into med device sales. I would just do that. Use social media, use company websites. I mean, there are a lot of big medical device companies

00:50:03 - 00:52:45

like Johnson & Johnson that I mentioned before. And scour their websites for job opportunities, job listings. If you happen to be in a very similar space, where you're around hospitals, stop reps in the hall and ask them what they do. And if you network with them or have the opportunity to reach out to some and it's doable, I would try to shadow. Go spend some time with the rep. I’ve shadowed a few other individuals, usually in an interview type of setting where they might be interviewing with our company, and the manager wants to kind of get a feel for the person. But shadow, get an idea of what the role is like, and what the procedures are like, and learn as much about the company and the space as you can.

Q: Good advice. What would you be doing if you weren't doing this?

Tom: I’d probably own and operate a food truck.

Q: What kind of food truck?

Tom: I don't know, I don't know. I love to cook, but I know running a restaurant is, with the margins they have, is probably one of the hardest jobs in the world. So I like the idea of getting up in the morning and get the food prepared and go out and hit the lunch crowd and then be done at two o'clock in the afternoon. I don't know if that's the way it works, but that's how I envision it.

Pat: I guess if you own it, you could make it work that way.

Tom: Exactly.

Pat: Alright, we're coming up on just under an hour and I don't want to keep you. But I do appreciate you being on here. Would you mind sharing a way for people to reach out to you if they have questions?

Tom: Sure, I mean if anyone's interested and wants to reach out, I’ll give my email address. It's a tkcatalano@gmaiLcom.

Pat: I will put that information in the show notes as well.

Tom: Perfect.

Pat: Is it okay if I put your LinkedIn information?

Tom: Sure.

Pat: Okay, I'll put all that in the show notes so if people reading through that they will have access your email and your LinkedIn profile just so they can find you.

Tom: Great.

Pat: We'll Tom, thanks again for doing this, I really appreciate it. Your experience is invaluable. I'm sure some people are going to learn a lot. And if I haven't said it before, thank you for your service.

Tom: Oh, you're very welcome, it was my pleasure. I learned a lot and thank you for doing what you’re doing. I think this is very valuable, and I hope, as you said, people can benefit from it and good luck to you in your endeavors.

Pat: Thanks Tom, I appreciate it.

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