The COVID-19 pandemic has disrupted the sales representative role in the O.R., but not in the way you think.
Dr. Matthew Runnalls, M.D, CCFP (EM)
Covid-19’s wide-ranging impact has spared no industry, least of all the medical device industry. Although the assumption was that non-elective markets (i.e., cardiovascular) would be less negatively impacted than elective markets, questions remained regarding the extent to which the medical device sales representative would be impacted. Many assumed that with increasing restrictions, medical device sales representatives would be shut-out of the O.R. As a result, physicians would learn to live without the concierge-style support offered by the reps and the reps’ role would be diminished in the post-pandemic world.
A new study by ClearSight Health examined these very issues in the largest non-elective medical device market; cardiovascular. ClearSight Health surveyed 58 cardiovascular interventionists including interventional cardiologists, electrophysiologists and vascular surgeons in January and February 2021. The study showed that although in-person support by medical device reps during cardiovascular procedures predictably dropped during the pandemic, the void was largely replaced by virtual support. Moreover, this research reveals that cardiovascular physicians are embracing this unprecedented transformation to digital engagement, creating an opportunity for medical device representatives to be of even greater importance in the post-pandemic era.
Were medical device sales representatives shut out of the O.R during the COVID-19 pandemic?
The first stressor on the medical device sales rep was the massive drop in total procedures due to COVID-19. As different areas of the country were affected by the pandemic, facility administrators and public health officials curtailed many elective medical procedures. Although the non-elective nature of many cardiovascular procedures meant a certain protection from restrictions, all physician respondents affirmed a major drop in their volumes during the height of the pandemic. This drop averaged around 40% and was remarkably consistent across settings, regions and specialties.
Additionally, a slow-down in cardiovascular procedure volume drove a steep revenue decline for medical device makers. The cardiovascular medical device industry lost billions of dollars in Q2 and Q3 2020; the big 3 cardiology device makers – Medtronic, Abbott Laboratories, and Boston Scientific – lost a total of $2.5B in those two quarters compared to the previous year.
Not only were cardiovascular proceduralists hit with a drop in their procedure volume, but they also suffered from a steep decline in the support they receive from medical device companies. Procedural support is a critical part of many complex cardiovascular procedures – especially those reliant on advanced medical technologies. Nonetheless, in the COVID-19 pandemic, due to a mix of concerns over employee exposure, logistics of pandemic travel, and hospital infection control procedures, many cardiovascular physicians are performing procedures without the in-person support they used to get.
Overall, our respondents reported a 43% decrease of in-person procedural support during the pandemic, with all specialties reporting major changes. This overall trend was subject to regional differences and a varied response by different medical device companies. Regardless, the vast majority of physician respondents reported drops in procedural support, and 16% reported they were now receiving no procedure support at all. This prompts the obvious corollary, what replaced the in-person procedure support role?
Did physicians learn to live without medical device reps in the O.R?
Although procedure volumes and in-person support from medical device sales representatives dropped precipitously during the pandemic, the importance of the rep’s role in the O.R. remains unchanged - an indispensable support resource for complex medical procedures. The decline of onsite support has been almost entirely replaced by virtual procedure support through dedicated support systems linked to hospital wifi or sometimes through simple consumer devices and wireless networks. Physicians realize that virtual support from sales representatives is comparable to the support they receive in-person.
For years, medical device companies have tried to get both physicians and medical sales representatives to adopt online or virtual procedure support; however, these efforts stalled because the reps feared cutbacks to their physician engagements and physicians feared change. The pandemic has driven the sudden and rapid adoption of virtual procedural support that has led physicians and medical sales reps alike to experience the benefits of the new technologies. Today, physicians use communication technologies across their practice more than ever before; they are at the forefront of a digital transformation of the cardiovascular market. For example, for outpatient visits, 84% of physician respondents report using telemedicine. This is a remarkable 400% increase since before the pandemic. Virtual procedure support has also seen a massive increase, with 73% of respondents now using virtual procedure support on a regular basis. Overall, more than a quarter of all cardiovascular procedures are now supported virtually, a four-fold increase from pre-pandemic levels.
What does this mean for the future of the medical device sales representative in the O.R.?
Sales reps will return to the O.R. once more after the pandemic, and they will likely support the same number of procedures as they did before, according to surveyed physicians. However, these same physicians expect that future procedure support will include a sizeable virtual component and have embraced digital support technologies in their procedure rooms.
Not all medical device companies are ready to react to this change. ClearSight Health’s study reports that only 38% of medical device companies are currently providing any form of virtual procedure support to cardiovascular physicians. Moreover, as the technology becomes more sophisticated, there will be a widening gap between those companies with dedicated procedure support technologies with robotic arms and fast networks and those companies that have smartphones and Zoom.
The abrupt embrace of digital technologies is only just beginning. Both the changes brought on by the pandemic and industry forecasts show that cardiovascular interventionists are willing and able to take this technological leap. The medical device sales representatives that will thrive in this new world are the ones who can take this leap alongside physicians.