It is often said that people don’t quit their job, they quit their boss. What people tell me most often is that they want to leave because they are not making as much money as they’d hoped. I’ve been trying to reconcile these two things in my mind lately. I think both may be true.

There comes a time in every interview process when potential first-year income must be discussed. It is always tricky to predict in year one what someone will make in a new sales position. There are so many variables: the condition of the territory and existing pipeline, the learning curve, work ethic, and sometimes just dumb luck.

One rep I hired stepped into his manager’s former territory. The way the rep described it, wherever they went in the first few months, there seemed to be a purchase order waiting for them. Even the manager was amazed. In the few years he’d worked the territory himself, the business had never come so fast or so easy.

When the rep got to training, someone asked him how he was doing. He shrugged and laughed, “Oh, I dunno, pretty good, I guess. I think I’m number one in the country.”

Fortunately, he’s a solid rep and did not let let it go to his head.

I also think it can swing the other way. Maybe things don’t completely tank, but  timing isn’t perfect, maybe the learning curve is a little steeper, the competition is a little fiercer, and in most cases the territory needs a little TLC. With dedication and commitment, such challenges will be overcome in time.

Some people stick around to see it through and some people don’t. One successful orthopedic rep I spoke to this past week said, “It really takes two years to really hit your stride in this business.” I pretty much agree with him. It’s unfortunate when people give up or make a change before they can really see they payoff of their hard work.

Coming full circle, I think a good manager can make a difference in whether someone sticks it out beyond the first tough year. When a new rep “hits the wall” (and they all do), a good manager is there to peel them off it and get them going again through encouragement and support. Without management input, it may be hard for a rep to see the light at the end of the tunnel. Lacking support and adequate monetary rewards, the rep may start looking for something better.

Sometimes they might find it. Many times, they will soon find themselves back in a similar predicament. Herein lies the danger of making career decisions solely based on money.

In sales, it is often said that if you win a customer on price, you will loose them on price. Likewise, good career decisions are based on more than just money. Management, company culture, support, training and development, quality products, daily satisfaction- these are the things that are critically important because they will sustain you through the inevitable ups and downs that come with every career in sales.

“Effort only fully releases its reward after a person refuses to quit.” ~ Napolean Hill

I originally heard this phrase – “culture as work” – many years ago  when I was a college student living abroad in Paris. In French, it is “culture comme boulot,” which sounds better (as most things do) when spoken in French.

It means the effort of creating and refining a culture. It’s a challenging thing to do on a massive societal scale. Even within a company it is hard, but essential, work.

Last week I was able to take part in the national sales meeting for one of the company’s divisions, and I think I caught a glimpse of a sales culture evolving.

I sat in on a meeting with the sales managers, early in the week, before everyone else arrived. A consultant, who also happens to be an exceptional sales trainer, was coaching us on the use of an assessment used during the hiring process. The discussion was intertwined with lessons on the selling methodology used by this division.

As the conversation progressed, I noticed how the selling methodology provided a common language for the sales managers to discuss and compare issues. It offered a set of expectations and desired behaviors to reference when figuring out how to coach reps. Reflecting upon this, it made me think about how adopting a common sales methodology is critical for any company hoping to develop an effective sales culture.

There are a number of sales systems to choose from, and many of them could effectively form the basis of common understanding in a sales organization. The hard part of the culture-building is the continual learning and reinforcement that it takes for everyone in the organization to buy-in and become fluent in the chosen method.

What was exciting to observe last week is that all the sales managers seemed to have reached a high level of fluency in this method. With the skills they’ve mastered, they are capable of coaching and leading their sales representatives to greater success.

Perhaps because sales requires a good measure of leadership, and leadership is in many ways involves selling (or at least a healthy dose of persuasion), that it makes sense that a sales culture can and should arise from a chosen sales methodology. Like anything worthwhile, a sales culture isn’t built overnight. It takes time and dedication to a certain set of beliefs before they take hold. But in the end, this challenging, incremental, culture-building work is essential for any sales organization that wants to thrive.

A few weeks ago, I saw a ranking of sales representatives according to percentage of quota. I was happy to see that a number of reps I recruited in the last couple of years were near the top of the rankings.

And then, of course, there were reps who were below quota, some significantly. In a year like 2010, it would be easy to think that making quota was difficult given the economy. And, yet there were those who trumped the prevailing logic and grew their business substantially.

Looking at it from a 30,000 foot perspective, I wondered, what is the difference? Certainly everyone wants to be over 100%. They want to maximize their income. They want to succeed. They have similar training and the same products, so why the broad disparity in outcome?

I interviewed one rep recently who ranked highly on this report. At one point, he told me he felt overwhelmed by a number of challenges and changes in his area. He shared his concerns with one of the senior reps, who told him that despite the everything, he still had a great opportunity to build his business and make something of his own. The rep took the advice to heart and focused on achieving success and growth, instead of focusing on limitations and challenges.

Low and behold, he doubled his business this past year.

At this time of year, when we all have a chance for a new beginning, it’s worth taking a step back to consider just how plentiful our opportunities are. Watching a short documentary called “The Red Wagon” about Haiti, I could not help thinking of how easily we can take opportunities for granted.

My sister, a nurse, visited Haiti within a month of last year’s earthquake. The progress towards rebuilding since that time has been meager, the economy is barely functioning, and now cholera is menacing the country.

In the film, they document the building of a make-shift move theater. The film also documents the retrieval of bodies from the morgue for proper burial, a weekly ritual which my sister took part in while she was there. With so many Haitians in need of desperate help, the elaborate funeral, complete with a small band playing, and the building of a movie theater, struck me as either extravagant or frivolous. However, this was my own poverty of concept.

What my sister helped me understand was that these projects are actually a way of putting money in the pockets of the living. The band, the grave diggers, the people painting the movie theater, the woman singing in the hall outside the morgue are most likely receiving some compensation for their contributions. While this is not stated in the film, it is what my sister observed while she was there. The government and the economy are so completely broken that there is an entirely different dimension to the notion of job creation. If any jobs are created, it is usually on an ad hoc level.

Understanding this brought me to a new realization of just how hopeless it could be to live in a country where there are so few jobs of any kind, in contrast to the United States, where even in difficult times there are still many avenues for improvement and advancement.

It makes me wonder what would happen – in our careers, families, communities and economy – if this year we strove to recognize, appreciate and act on the many opportunities we have? If we put our energy into realizing our potential instead of focusing on limitations?

I don’t know about you, but I am tired of this recession, and think it is high time we shook it off. Maybe it seems far-fetched to think that by changing our attitudes we can turn the economy around, but I think we could all contribute in our own small way.

So this year,  when I find myself tempted by pessimism, I will think about “The Red Wagon” and feel fortunate that a lack of opportunity is for most of us a failure of imagination rather than our inescapable reality.

“Whether you think you can or think you can’t…you are probably right!” ~ Henry Ford

Consider making an donation to benefit relief efforts in Haiti: through the St. Luke Foundation for Haiti or other organizations.

In the November issue of Discover, the article “Reckless Medicine” opens with a dramatic story about Lara Keeton, who suffered debilitating complications from synthetic mesh that had been implanted to correct minor urinary incontinence. She experienced raging infections and 16 subsequent surgeries to remove the mesh and repair the damage it had caused. Keeton later learned that the problems she experienced were widespread among patients who’d had surgical mesh implants like her.

The article suggests that poor treatment decisions like Keeton’s can result from lack of adequate research, “misleading marketing” by drug and device companies, and flawed decision making on the part of doctors. It states that the Institute of Medicine determined in 2007 that “‘well below half’ of the procedures doctors perform and the decisions they make about surgeries, drugs, and tests have been adequately investigated and show to be effective.”

Without question, it is extremely important that medical device companies and representatives maintain an ethical commitment to the well-being of patients. There are instances unfortunately when this does not happen, but there are also many instances when sales representatives are providing valuable information to surgeons about products and treatments that result in enhanced outcomes for patients.

Moreover, I’ve interviewed a number of sales representatives who have been willing to risk their relationship and business with a surgeon to prevent a product from being used incorrectly.

Case in point, a representative I interviewed this past summer described a conflict with a surgeon in the operating room. The surgeon was insistent about using a particular product off-label in a case. As all of the other staff in the operating room looked on, the rep showed the surgeon the warning label and told the surgeon in no uncertain terms not to use the product.  For a rep to challenge a surgeon like this is difficult, but if it is essential, the confrontation should not be avoided.

The rep said, “It caused some turmoil between us. When I saw him a week later, he had settled down and admitted it wasn’t the right thing.”

The best sales representatives are knowledgeable about clinical studies. They engage in an open and honest dialogue with surgeons about the the strengths and limitations of their products. When reps and surgeons work together in this way, they work together to support the best outcome for patients.

In the end, the Discover article offers a important reminder that surgeons, sales reps and medical device companies need to “first, do no harm.”

“Every day, surgeons are faced with uncertainties. Information is inadequate; the science is ambiguous; one’s knowledge and abilities are never perfect. Even with the simplest operation, it cannot be taken for granted that a patient will come through better off- or even alive.” ~ from Complications, A Surgeon’s Notes on an Imperfect Science by Atul Gawande

Almost every candidate who applies for a medical device sales position says that they’ve always wanted to be in medical device sales. Over time, it’s possible to become rather skeptical of this statement.

One hiring manager said to me, “People sometimes get this idea that medical device sales is a glamorous job. This job is about pushing video carts across slushy parking lots in the middle of winter.”

Breaking into medical device sales is not like hitting the lottery. Don’t expect to coast. Expect to work hard and be challenged to grow professionally like you’ve never been before.

If you really want to be in medical device sales, are you prepared to…

Wake up at 4:00 am in the the morning so you can arrive early for a 7:00 am surgery?

Compete against the most dedicated, skilled sales reps anywhere?

Cram the equivalent of med school into your brain in less than a year?

Put yourself on the hook for a patient’s well-being?

Work harder and longer than in any other industry to win your customers’ trust?

Despite the demands, there are plenty in the industry who thank their lucky stars (even in the wee hours of the morning) that they are part of this exceptional industry. Medical device sales exciting, challenging, intense, fascinating, meaningful,  and rewarding. Those who have succeeded in the industry will tend to think the satisfaction and rewards are well worth the hard work and sacrifices.

What are the greatest rewards of a successful career in medical device sales?

“Great achievement is usually born of great sacrifice, and is never the result of selfishness.” ~ Napoleon Hill

It is sometimes hard to explain to those from outside the medical device industry the role that a surgical sales representative plays in the operating room.

I used to say that the rep was like the quarterback, but I now think it would be better to say that the sales rep is like the coach, calling plays from the sidelines. The surgeon is like the quarterback, executing the plays. The first assist or surgical tech is like the center, and the instruments are like the football being passed to the surgeon-quarterback.

Okay, it’s easy to get carried away with this sports analogy, but the pieces seem to fit together well. Then again, maybe that’s just because the last time I was truly an expert on football was when I was in second grade and Terry Bradshaw was the quarterback for the Steelers.

When something goes wrong in the O.R., it is the surgeon and the sales rep who need to figure out how to set things straight, just like a quarterback and the coach might confer about plays or strategies to regain control of a game.

Like a coach, a sales rep needs to remain calm under pressure. He or she needs to have alternative plays and needs to be able to think clearly and respond quickly, especially when everything does not go as planned.  If a sales representative is able to handle the pressure, then he or she can gain respect of both the surgeon and the surgical team.

It would be hard to imagine a coach walking away from a team after one bad game, and yet there are sales representatives who are tempted to throw in the towel after a bad case. Some reps try to duck the surgeon’s frustration rather than analyzing what went wrong. No doubt, facing an upset, frustrated surgeon after a less than optimal case is not a whole lot of fun.

One rep I interviewed recently described a difficult case with a surgeon who was using his plating system for the first time. The surgeon disliked the instrumentation and had many complaints.  Rather than heading for the hills, the rep analyzed how the case could be improved the next time. Over the next few cases, the rep swapped out instruments and refined the set to best meet the surgeon’s needs.

“I kept trying to take his objections away,” he said. After dialing in the instrumentation and identifying a particular plate that suited the surgeon’s needs perfectly, the cases began to go smoothly. When the surgeon’s patients began having great results, it was like the team had mastered the play and was scoring every time.

I admire this rep’s tenacity. Working through challenging cases to win a surgeon’s respect and trust is tough, but it is definitely a winning strategy. If a sales representative and surgeon work well together to solve problems in the operating room, in the end it’s the patients who are the biggest winners.

What do you think of this analogy? Is there a better one?

“If any thing goes bad, I did it. If anything goes semi-good, we did it. If anything goes really good, then you did it. That’s all it takes to get people to win football games for you.” ~ Paul Bear Bryant

I’ve been reading “Talent is Overrated: What Really Separates World-Class Performers from Everybody Else” by Geoff Colvin. It’s a terrific read, engaging and chock full of great ideas for sales people.

One of the central ideas of the book is that people who are great at what they do are not born with innate talent. Colvin suggests that great performers work very hard to develop their skills and abilities in a particular way, through “deliberate practice.” This type of improvement effort is specific, uncomfortable, tiring and requires a lot of repetition. In order to improve, an expert teacher is often required to design learning exercises to work on discrete skills and provide immediate feedback.

Colvin uses examples from the worlds of music and sports to illustrate his point: namely, Mozart and Tiger Woods. His examples are hopeful and daunting at the same time.

What I like most about the book is how Colvin translates the research on performance into practical strategies for achieving great performance in any field. Here are a few ideas that might apply to sales.

1. Find a great sales coach, mentor or manager. Both Mozart’s and Tiger Wood’s fathers were expert pedagogues who knew how to focus their sons’ efforts for maximum learning. Sales people would also benefit from seeking input from the best in their field, rather than trying to figure out everything on their own.

Many top performing reps I’ve spoken to often make identifying the best reps one of their first steps at a new job. They find out what works for the best reps and try to replicate it.

2. Focus on one area for improvement at a time. Rather than setting broad goals, focusing on one area for improvement leads to greater results. For example, instead of trying to get more referrals, sales people could work on refining the way they phrase their referral requests and tracking the results of different ways of asking. Tracking the results is a form of feedback, which Colvin indicates is crucial to the learning process.

3. Pre-call planning and post-call analysis. Top performers continually measure their own performance against specific criteria. They see their performance as something within their control and continuously try to improve it. One of the best ways sales reps can do this is to evaluate each and every sales call, either by themselves or with the help of a manager. Most reps know that pre-call planning and post-call analysis are a good idea, but few seem to implement it regularly. Reps should ask themselves if they achieved the goals they set forth in their pre-call planning- why or why not?

4. Continual reading and learning in your field. Spin Selling, Strategic Selling, Solution Selling- Colvin would probably say it’s all good. What really matters is learning continuously to fill one’s mental repository with a wealth of knowledge. Let’s face it, selling in the real world is rarely textbook, but having many different strategies and tactics to draw upon from a variety of methodologies provides a sales rep with many options to drawn upon in different circumstances.

5. Plan well your work and work your plan. Colvin points out that top performers work strategically with a desired outcome in mind. Although sales reps probably do not need to plan for the next century in their territory, there should be some key annual goals that are reflected in their daily activities. Essentially, is hard to be a top performer by simply working hard; you must work smart.

These are only a few ideas that could be applied to improving sales performance. There are many deeper lessons to be had in this excellent book. Because sales performance is measured in quantifiable terms, it is a field well-suited to the application of Colvin’s ideas. What more concrete proof of measurable improvement is there than exceeding quota and increased revenue?

“Hard work outperforms talent when talent doesn’t work.” ~ author unknown, as seen on a t-shirt

At a national sales meeting a few years ago, one very successful rep described how he’d grown his territory. He talked a lot about the importance of listening to his customers’ needs, rather that pushing products on them.

“Let your competitors be the ones to ‘Show up and throw up’,” he said. The room erupted in laughter. I’m sure it struck everyone as funny not only because of the image, but also because it’s something everyone in the room had been guilty of at one time or another.

Most sales reps grasp the idea of asking probing, open-ended questions pretty readily. It’s not too hard to figure out a good list of stock questions that will help to uncover a prospect’s needs and pain. Becoming a good listener- now there’s the real challenge.

Active listening is about more than paying attention to the words coming out of someone else’s mouth or waiting your turn to speak. It is about fully acknowledging the speaker’s point of view and demonstrating understanding. It’s a great skill that can surpass small talk for building trust in a relationship because listening is a vital way to communicate respect.

William Glasser, author of books on the psychology of relationships, sees listening as a way of satisfying people’s inherent desire for power.

He writes in Choice Theory, “…at a minimum, we want someone to listen to what we have to say. If no one listens to us, we feel the pain of the powerless, the kind of pain you feel in a foreign country when you are trying to get information and no one speaks your language.”

If a sales rep’s goal is to provide a solution to a customer’s problems, what better way to begin the process than empowering the customer through truly listening? An empowered customer is one who is motivated to take action because they feel a positive outcome is possible. These are the kinds of customers who champion the product, find the money when there is none in the budget, and coach the sales rep to success.

Are you a good listener? Take this quiz and find out.

“To listen well, is as powerful a means of influence as to talk well, and is as essential to all true conversation.” ~ A Chinese Proverb.

Salespeople rely on conversation in many forms to advance their objectives: to build rapport with prospects, to discover information, and to move the sales process forward. Although the gift of gab comes naturally to many of those who are drawn to sales, there are always areas for improvement.

Having a great conversation is really about listening. When you demonstrate that you are interested and engaged, rather than just waiting your turn to speak, the other person in the conversation opens up.

Here are thirteen ideas for making your next conversation a great one:

1. The basics: greet the person warmly, by name. Good eye contact is key. Smile.

Even if you are on the phone, the person will “hear” the smile in your voice.

2. Get permission to talk.

Ask if it is a good time to talk. This is especially important on the phone when you don’t have visual cues for what the person is doing. If not, find a mutually agreeable time, rather than forcing a conversation when the other person will be rushed and distracted.

If you do find a good time to talk, be respectful of the person’s time, and be sure to thank them for it when you are concluding the conversation.

3. Repeat back what you’ve heard.

By paraphrasing what the other person has said, you prove you are really listening, interested and considering what they’ve said.

Just the other day, I asked someone what he was looking for in his next career move. He shared several things that were important to him. When I recapped his career goals, boy, did he get excited. It was evident to him that I was listening and I “got” him.

4. Ask their opinion on a subject that they have some expertise in, and everyone does.

Listen and consider their input carefully to show you really need and value their opinion. Try simple questions like: Have you heard…? What do you think about…? Can I ask your advice?

5. Make an observation.

This could be a compliment or simply stating something you’ve observed. Statements allow some white space in a conversation and give the other person in the conversation an opportunity to respond. Sometimes too many questions can lead to the other person feeling as though they are being interrogated.

6. Bring up something unexpected.

Such topics can arise from your due diligence and research on a company, person or product. Google and LinkedIn are great ways to get a snapshot of someone’s backgrounds and interests, though delving into more personal social networks like Facebook is not advisable.

7. Repeat something they said the you last time you spoke with them.

This is another great way to show you are listening. Post-call analysis allows you to capture useful information for subsequent conversations. CRM tools are great ways to retain this information.

8. Share something unexpected and interesting about yourself.

Toss it in, don’t drone about it. If this connects to something that you may have in common- people, places, experiences- all the better. Give them a chance to get to know you too.

9. Gentle joking or teasing.

A good sense of humor is welcome in any conversation. Gossiping or mean-spirited humor are not. Learn a few clean jokes to keep in your back pocket for opportune moments. Make fun of yourself rather than others.

10. Be upfront and honest.

Respectful disagreement may increase the other person’s trust in you. If they know you aren’t going to “yes” them, they will see you as authentic and forthright. This important to setting appropriate expectations. It is always advisable to “under-promise and over-deliver”

11. Ask provocative, insightful questions that make the other person think.

Thoughtful, open-ended questions fuel conversation. Many sales people have told me that creating a list of great questions is what super-charged their effectiveness.

12. Mirror the other persons body language, volume and rate of speech.

Perhaps you’ve heard that body language accounts for more than half of what is communicated in a conversation. It sends subtle cues to the other person that we are like them, which puts them at ease and leads to acceptance.

13. Close.

What list about having great conversations in sales would be complete without this? Closing is what brings energy and spark to the end of a conversation, and sets the stage for the next great conversation.

Having a great, one-on-one conversation is more about being responsive to the other person, through listening and body language, than being witty and dynamic. By being attentive, you are communicating to the other person that they are important and you value their insights. In turn, a great conversation can set the stage for a great relationship.

This baker’s dozen is only a beginning list of ideas for great conversations. What else contributes to a great conversation?

“The true spirit of conversation consists in building on another man’s observation, not overturning it.” ~ Edward Bulwer-Lytton

…it’s an ultramarathon.

As if 26.2 miles wasn’t enough. Now there are ultra marathons of twice the distance. Or if an Ironman isn’t enough for you, why not take part in the Ultraman, a 3-day, 320-mile endurance event?

These days, the definition of competition keeps getting stretched farther and farther. In order to compete successfully, in sales or in athletics, it often seems necessary to push through superhuman limits of endurance.

A few years ago, my sister and I did a half-Ironman, team triathlon. Fortunately, I was able to bamboozle my little sis into doing the bike and the swim. I only had to run a half-marathon.

The race was held in the small town of Clermont, FL. I think half the population turned out to support the race. For me, it was a privilege to be in a race with such exceptional athletes, some of whom I was nonetheless convinced were certifiably crazy.

In the restroom before the race, I watched a couple of young women mark huge black numbers on one another with a giant Sharpie. Since they did so many Ironman races, they apparently toted a mega Sharpie in their backpack at all times.

Later, over the loudspeaker, it was announced that one of the racers that day was in the midst of a six-race stretch: half-a-dozen Ironman races on back-to-back weekends. To a relative outsider like me, it was all rather unbelievable, and yet I was drawn in by the potent camaraderie among the athletes. Because they all knew well what it felt like to push their bodies to the limits, the triathletes all encouraged one another throughout the race.

Competing in the elite world of medical device sales requires a similar level of endurance and commitment. In order to thrive, sales representatives need to have a similar level of commitment and single-mindedness about their jobs.

Scratch that. It’s not a job… it is a lifestyle. Many people say so. Just like those women whose standard equipment included a giant sharpie, medical device sales representatives center their lives around their vocation. They have to, in order to compete effectively.