poor middle management is to blame. the job of an rm is becoming outdated . integra Rms are only good for forecasting calls and tagging along awkwardly during surgeon dinners. most often they provide no surgeon relationships and arent the strongest “clinical expert” in the region aka the development of clinical specialists and rbl ......great example... every Rm in the west....name one Rm across eo or wr that it doesn’t apply here..jack, heather- embarrassment, tonie,josh, trevor, christ even the avP wouldn’t be able to cover a case or attend a dinner without starring in silence and mumbling a few regurgitated bs lines they heard on a conference call. no successful company has a system like this so who cares anymore. nothing will change and we all will try to hold on as long as we can until a big change happens. integra is too dumb to adapt to the changing marketplace and will be left behind. well we already been left behind by at least 10 years where we should be. the last relevant study was more than 11 years ago tell me how that happens.