Honestly dude, you seriously are an idiot if you think contracts do not play a major factor in the overall success of a new product - entering a space in which the company - did not already have a presence.
Then you mention products (very few) being sold off contract by Ethicon and Covidien - when the vast majority of their products are indeed on contract and well entrenched in hospitals. They don't "sell shyt" - they fight the contract battle.
So if contracts are as insignificant as you claim, why the phuck does Covidien and Ethicon have the vast majority of their products on gpos and spend millions in order to do so?
Can you sell a product off contract? Absolutely. My territory does a million in thunderbeat sales and I know several reps that do above and just slightly below a mil. But on a national level - with no contracts - get the phuck out of here.
Then again - all you mentioned from the very beginning was the clinical aspect - when hospitals are governed by in large - by admin/materials management - which dictates what doctors will use - or else I'd have nearly 2 million in thunderbeat sales.