Summary Number Two


Anonymous

Guest
We summarized Castle after about 30 days and found common experiences and common ground. I have learned a few more things in the past couple of weeks and I would like to re-summarize.

Castle's sales plan works well in areas that Direct Bill is attractive and there are large volumes of pain prescriptions. This would be in the South in States such as Alabama.

Castle has a very high percentage of Direct Bill customers (95%) at one point.

When the Big labs who were dominant started to fight and lose customer service levels it became easy to compete with them. Since then many small labs such as Castle have started to compete in the marketplace making it much more crowded. This is making it more difficult but not impossible for skilled and knowledgeable sales professionals. This does mean that the sales process is taking more time in some places.

Castle has hired and fired based upon a model that does not apply to the entire Country but rather to a small area. This has caused approximately 60 sales representatives to be hired and then quit or be fired within 60-90 days of employment. This turnover is eroding their reputation.

Recently there were raids on physicians in the South who were taking advantage of the direct bill system and over prescribing to make a profit. Two physicians were indicted. In some states direct bill is not allowed. Going forward direct bill may be a thing of the past putting Castle in a poor position.

Castle needs more experienced leadership to grow if they plan to expand. Castle has increased their sample volume but not even close to what they had anticipated. In order to grow across the nation they need experienced leadership who have experience in the market on a national level.

Castle will also have to invest in the sales representatives and give them time to cultivate their territories. The current KPI system has proven to be ineffective as a measure of effective sales representatives success.
 








Also Divisional sales managers should not have accounts. They need to choose one or the other. This is just common sense. If they are great sales people then that is what they should do. If they are great managers then move up and concentrate on developing your representatives. It is not uncommon for a manager to make less then the top sales representatives. That is a choice you make in your career, you can't do both effectively. They contradict one another if you are trying to do both.
 








Interesting AMA opinion on pass through billing:

AMA and other ethical guidance. In addition to the federal regulatory issues involved in "Pass Through Billing," the American Medical Association has denounced the practice. The American Medical Association, in Opinion E-8.09(2), stated "[a] physician should not charge a markup, commission, or profit on the services rendered by others." It further comments that "the physician who disregards quality as the primary criterion or who chooses a laboratory solely because it provides low-cost laboratory services on which the patient is charged a profit, is not acting in the best interests of the patient."5 (Emphasis added) This stance is strongly echoed by the American Society for Clinical Pathology ("ASCP"). In Policy No. 04-03, Self-Referral, Markups, Fee Splitting, and Related Practices, the ASCP expressly provides that it "strongly supports federal and state . . . measures to prevent clinical providers from profiting on their patient referrals for anatomic pathology and clinical laboratory services."
 








Interesting AMA opinion on pass through billing:

AMA and other ethical guidance. In addition to the federal regulatory issues involved in "Pass Through Billing," the American Medical Association has denounced the practice. The American Medical Association, in Opinion E-8.09(2), stated "[a] physician should not charge a markup, commission, or profit on the services rendered by others." It further comments that "the physician who disregards quality as the primary criterion or who chooses a laboratory solely because it provides low-cost laboratory services on which the patient is charged a profit, is not acting in the best interests of the patient."5 (Emphasis added) This stance is strongly echoed by the American Society for Clinical Pathology ("ASCP"). In Policy No. 04-03, Self-Referral, Markups, Fee Splitting, and Related Practices, the ASCP expressly provides that it "strongly supports federal and state . . . measures to prevent clinical providers from profiting on their patient referrals for anatomic pathology and clinical laboratory services."
I'm not a smart man but are you now telling me that we , at Castle, are NOT bringing common sense back to health care? I don't know if I can live with myself if I'm not bringing common sense back to health and serve The Why!!!
 
























We now have confirmation of what we suspected. The expectations at Castle were based upon a completely unrealistic scenario where doctors were doing to many tests. This set the rest of us up for failure.

The person who said "when it has been ninety days and you don't even have 15 samples a week" what are we supposed to do? He/She showed their ignorance. The pharmaceutical industry says it takes two to three years for a sales representative to develop a territory. That doesn't mean there are no sales in two or three years but to judge a sales representative on the number of samples in ninety days is like judging a horse race in the first 10 feet of the race.

You fired a lot of good people Castle. In the pharmaceutical/medical industry being fired in 60-90 days puts a huge black mark on your resume. This was the problem and I hope you at least acknowledge it now.
 








I belief that Castle has responded by having their medical director write an article about physicians that commit fraud by writing unnecessary pain prescriptions. They had a co-writer who is an ex-DEA agent to give it some more merit. Have they also taken down the silly employee descriptions such as "head twerker" "bearer of the flame" etc. etc. While they profited hugely from some from of the doctors who were committing the fraud it seems a bit of hypocrisy These are the things they are concerned about not the people who are employees of Castle.
 








Just putting common sense back into medicine folks.

Stop it! Its not nice to tease one another, or is it?

*%#+* GRASSHOPPPER IS BACK BITCHES! Take a shot at me now! I want tangle mentally with anyone from DVP and above. I have the mentality of a toaster oven. Go ahead and give it your best shot. I'm an easy target.

I love this site.
 








Just putting common sense back into medicine folks.

Stop it! Its not nice to tease one another, or is it?

*%#+* GRASSHOPPPER IS BACK BITCHES! Take a shot at me now! I want tangle mentally with anyone from DVP and above. I have the mentality of a toaster oven. Go ahead and give it your best shot. I'm an easy target.

I love this site.

Are you serious? This is why Castles board is so hot, NOTHING says "take me serious" like a schizophrenic off their meds!!!
 
















I belief that Castle has responded by having their medical director write an article about physicians that commit fraud by writing unnecessary pain prescriptions. They had a co-writer who is an ex-DEA agent to give it some more merit. Have they also taken down the silly employee descriptions such as "head twerker" "bearer of the flame" etc. etc. While they profited hugely from some from of the doctors who were committing the fraud it seems a bit of hypocrisy These are the things they are concerned about not the people who are employees of Castle.


If this medical director is the same physician that I just looked up, he got a 1.5 out of 5 star rating on healthgrades.com. Not a ton of reviews, but still very telling.
 
















I will and do take urine toxicology testing seriously. The results of these tests have a huge impact on people's lives and reputations. I doubt that the FDA committed months to an investigation as well as resources and man power because it is not "serious." Toxicology is extremely serious.