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hahahha.  Yeah, hospitals order pacers out of a catalog.  Man, I don't know what type of "device sales" you started at (maybe selling gloves), but you don't know jack about it.  I used to work for a major device company and we didn't have one GPO contract, not one.  I set price, worked to get devices approved to be used in the ORs, got surgeons to use them, and came in for the cases.  Sometimes to BS, sometimes to show off my latest toy, and sometimes to tell the surgeon how to use it.