Why isn't Biotronik doing better?

[Anonymous]

I think you may finally have your answer, or something close. By the end of 2012, they WILL be doing MUCH better. It will almost exclusively be on price. The perception of devices being generic has overshadowed the last five major GPO contracts I've been a part of. The real danger is one that nobody talks about; the vertical integration of the health care system. Watch this year how many of the Cardiology practices you service become wholly owned by the hospitals in which they practice. The choice will never "really" be taken away from the implanter, but the system will support those who play along.
It's all gonna change, and it's already started.

 

[Anonymous]

Look...the first thing you have to do is remember that the only place there are absolutes is here on CP. Those absolutes are:

1) Medtronic reps are full of themselves.
2) All Boston devices are falling apart.
3) St Jude reps are cover up artists.
4) Bio reps are expensing trips to the strip club.
5) Sorin reps, like Sasquatch, MAY exist but no one has any evidence.

These are absolutes - caricatures - that make for a good time here on these threads. When we put those aside, we remember that we have friends in this companies and that some of their products are actually quite good.

Based on that premise, you ask me how the Sunshine Act is going to effect Bio's business model. Now, I am assuming that you are using the above caricature of the dirty Biotronik rep to implicate that the Sunshine Act is going to mean the end of of Biotronik. Well, I am here to tell you that - believe it or not - some of us just earned the business by being good reps, showing up on time and prepared. In fact, I think a lot of us Bio reps operate that way, and so I suspect our hold on our 4% of the US market is pretty solid.

The rest of your comment has some things in it I totally agree with. The growth of the tachy market was overestimated. Whether or not 'Boomernomics' happens will tell us how much.

There was a mad dash to field the largest sales force, and I thank God for that everyday - I was part of that. As the market leaders, the Big 3 set the tone for what 'service' meant. Doctors became accustomed to large teams supporting them, and agreed to volume commitments with the team that seemed to be doing the best job. So, those teams grew, and the cycle continued. This, by the way, was and always has been the main valid reason for NOT using Biotronik. Lack of coverage as compared to the 5,6, or 7 man teams already in place.

Now, Biotronik is expanding while the others contract. I am watching my Big 3 competitors stumble as the 3 that are left scramble to cover the load that was once the responsibility of 7. Doctors were spoiled, and really don't give a crap about the belly aching - they gave them hundreds of patients to follow, and so they better figure it out or else.

Biotronik may never be considered 'big'. I think a lot of us that are here appreciate it for that. But in my experience, it has been big enough to provide for me and mine, and without all the recalls and conference calls and etc...

Well put...BIO is postured to grow and take advantage of Big 3 weaknesses but the stigmas and business model needs to change to the following;
- Decides how big you want to be and have an infrastructure growth plan
- Get rid of "Old Thinkers" lets face it..most of the leadership are the guys still chasing the big money days that BSX wasn't willing to pay anymore.
- Show stability in hiring talent rather than just providing opp's for those who can afford to take a risk.
- Provide a more corporate posture versus a perception of independent bag carriers. You will never attract big accounts due to thier fear of not providing support on a large, dependable scale.

BIO has a big decision to consider, How big do I want to be? Not a bad spot to be in...but until they illiminate a little of the "Eat what you kill" mentality I'm staying where I'm at...no offense.

 

[Anonymous]

a) customer service and support (2 posts up covers it well).
b) general satisfaction with current suppliers
c) lack of innovation
d) unknown product quality

they aren't pushing the boundaries on any design or coming up with new technologies, just following. So they aren't going to get the interest of many innovative, influencial physicians. This keeps marketshare low.

Beyond that, the product quality is really an unknown (hard to say how good or poor). If you believe the 'no recalls in 45 years' is proof of high quality, lets rewind 12 months, would you still believe this about STJ? You'd say there no reason to use Bio since STJ is available. Lack of recalls does not prove high quality. It just tells you that your volumes are low enough in relation to your product quality to not be causing undo headaches at the follow up clinics. Bio doesnt have the support structure for reporting and following their products and it hasn't done the long term post market studies to know how good their product quality really is. The big 3 are being forced to do this in the US now. I don't know how Bio will be able to enroll 2000 products in 2 years for post market survelliance unless every implant is part of the study. So they'll continue to fly under the radar and be the low cost follower.

 

[Anonymous]

a) customer service and support (2 posts up covers it well).
b) general satisfaction with current suppliers
c) lack of innovation
d) unknown product quality

they aren't pushing the boundaries on any design or coming up with new technologies, just following. So they aren't going to get the interest of many innovative, influencial physicians. This keeps marketshare low.

Beyond that, the product quality is really an unknown (hard to say how good or poor). If you believe the 'no recalls in 45 years' is proof of high quality, lets rewind 12 months, would you still believe this about STJ? You'd say there no reason to use Bio since STJ is available. Lack of recalls does not prove high quality. It just tells you that your volumes are low enough in relation to your product quality to not be causing undo headaches at the follow up clinics. Bio doesnt have the support structure for reporting and following their products and it hasn't done the long term post market studies to know how good their product quality really is. The big 3 are being forced to do this in the US now. I don't know how Bio will be able to enroll 2000 products in 2 years for post market survelliance unless every implant is part of the study. So they'll continue to fly under the radar and be the low cost follower.

We have 2 Million actively implanted leads. When Boston was struggling to have something reliable on the market - they came to us to purchase our active fix p/s lead to call their own. Sorin will be buying every lead they market from us starting this year. I really wish we could fly under the radar, as you suggest, but we can't.Every time we approach a physician about a post-market registry - our competition says: "there they go trying to buy business again."

I have a very easy answer for your claim that we are not 'innovative'. Fidelis was innovative. The Teligen header was innovative. Riata the same. Don't mistake foisting ill-fated products on a hapless public for innovation. Shareholders drive your innovation cycle.

My view is that 8 out of 10 patients don't really need all the bells and whistles. A generic pacer or single chamber ICD will do. Physicians are agreeing with me, and so it really becomes a question of price. And that - that is a battle my little company can win.

 

[Anonymous]

Well put...BIO is postured to grow and take advantage of Big 3 weaknesses but the stigmas and business model needs to change to the following;
- Decides how big you want to be and have an infrastructure growth plan
- Get rid of "Old Thinkers" lets face it..most of the leadership are the guys still chasing the big money days that BSX wasn't willing to pay anymore.
- Show stability in hiring talent rather than just providing opp's for those who can afford to take a risk.
- Provide a more corporate posture versus a perception of independent bag carriers. You will never attract big accounts due to thier fear of not providing support on a large, dependable scale.

BIO has a big decision to consider, How big do I want to be? Not a bad spot to be in...but until they illiminate a little of the "Eat what you kill" mentality I'm staying where I'm at...no offense.

The company initiated a 5 year plan to have 500 reps back in 2007.
"Old Thinkers" are here, but I know it's common place for you guys to just fire people - but for better or worse - we try to stand by ours.
Corporate posture - it is widely known that Bio is committed to moving away from using independents...remember - it wasn't that long ago that STJ still had their indies.
Big accounts need to wake up if they think CRM support is going to be large and dependable. The RIFFs are cutting deep.

As far as 'illiminating' the "Eat what you kill" mentality - well, I am going to guess you work for Medtronic because you guys are they only folks who would think that having an Eat what you kill mentality is not only expected but necessary. So, believe me, I did not take offense.

 

[Anonymous]

We have 2 Million actively implanted leads. When Boston was struggling to have something reliable on the market - they came to us to purchase our active fix p/s lead to call their own. Sorin will be buying every lead they market from us starting this year. I really wish we could fly under the radar, as you suggest, but we can't.Every time we approach a physician about a post-market registry - our competition says: "there they go trying to buy business again."

I have a very easy answer for your claim that we are not 'innovative'. Fidelis was innovative. The Teligen header was innovative. Riata the same. Don't mistake foisting ill-fated products on a hapless public for innovation. Shareholders drive your innovation cycle.

My view is that 8 out of 10 patients don't really need all the bells and whistles. A generic pacer or single chamber ICD will do. Physicians are agreeing with me, and so it really becomes a question of price. And that - that is a battle my little company can win.

Whoa, partner .... your little company better watch out for another yet-smaller company called NayaMed with far lower overhead (less baggage) about to change market dynamics.

 

[Anonymous]

Whoa, partner .... your little company better watch out for another yet-smaller company called NayaMed with far lower overhead (less baggage) about to change market dynamics.

Bring it. Competition is good for everyone.

 

[Anonymous]

Whoa, partner .... your little company better watch out for another yet-smaller company called NayaMed with far lower overhead (less baggage) about to change market dynamics.

Can you give me a link to their US products page?

 

[Anonymous]

The company initiated a 5 year plan to have 500 reps back in 2007.
"Old Thinkers" are here, but I know it's common place for you guys to just fire people - but for better or worse - we try to stand by ours.
Corporate posture - it is widely known that Bio is committed to moving away from using independents...remember - it wasn't that long ago that STJ still had their indies.
Big accounts need to wake up if they think CRM support is going to be large and dependable. The RIFFs are cutting deep.

As far as 'illiminating' the "Eat what you kill" mentality - well, I am going to guess you work for Medtronic because you guys are they only folks who would think that having an Eat what you kill mentality is not only expected but necessary. So, believe me, I did not take offense.

Great post. I think BIO will benefit in the long run by retaining a share of its "old thinkers". I have been in the business only 2 years and work for BSX. We seem to have very few experienced senior managers. I have not met any who came in at my level (FCR) got promoted to SR and built a territory. I'm on my own...

 

[Anonymous]

Great post. I think BIO will benefit in the long run by retaining a share of its "old thinkers". I have been in the business only 2 years and work for BSX. We seem to have very few experienced senior managers. I have not met any who came in at my level (FCR) got promoted to SR and built a territory. I'm on my own...

Are you an idiot ? You have been in BSX 2 years and have not seen any promotions to SR ? Senior reps/managers cost MONEY. Did you ever think this annomaly in wages just might have something to do with base salary ? U gotta be a blond female.

 

[Anonymous]

Well put...BIO is postured to grow and take advantage of Big 3 weaknesses but the stigmas and business model needs to change to the following;
- Decides how big you want to be and have an infrastructure growth plan
- Get rid of "Old Thinkers" lets face it..most of the leadership are the guys still chasing the big money days that BSX wasn't willing to pay anymore.
- Show stability in hiring talent rather than just providing opp's for those who can afford to take a risk.
- Provide a more corporate posture versus a perception of independent bag carriers. You will never attract big accounts due to thier fear of not providing support on a large, dependable scale.

BIO has a big decision to consider, How big do I want to be? Not a bad spot to be in...but until they illiminate a little of the "Eat what you kill" mentality I'm staying where I'm at...no offense.

Wow! Glad I was able to spark such interest in an otherwise dead thead....now....lets get to the heart of the matter....BIO leadership and their reputation. I know many of them and I can tell you the general customer feedback as one of the biggest turnoffs is the leadership characters. There is an overewhelming lack of respect for those you and I all know in the industry and the customers do not want their names associated with them.....clear and simple! Now that the Sunshine Act is in place this issue is even more prevalant. Because BIO is small in comparison to the Big 3, BIO leadership stands out more and their reputations are limiting the growth of BIO. They have been successful at holding onto the acct's they rep'd with BSX, STJ and MDT but that's equivalent to rep's switching hats and company's buying rep's from other company's but that's about it.

I can tell you I hear very little about BIO rep's or product...but BIO leadership is a popular subject amongst customers. Just a glimpse into the customers brains.....BIO employs leadership that tried to convince customers their recalled products were fine when they worked for the Big 3. When their market share dipped, they went to BIO and salvaged a few relationships, many of which go deeper than business.

 

[Anonymous]

Wow! Glad I was able to spark such interest in an otherwise dead thead....now....lets get to the heart of the matter....BIO leadership and their reputation. I know many of them and I can tell you the general customer feedback as one of the biggest turnoffs is the leadership characters. There is an overewhelming lack of respect for those you and I all know in the industry and the customers do not want their names associated with them.....clear and simple! Now that the Sunshine Act is in place this issue is even more prevalant. Because BIO is small in comparison to the Big 3, BIO leadership stands out more and their reputations are limiting the growth of BIO. They have been successful at holding onto the acct's they rep'd with BSX, STJ and MDT but that's equivalent to rep's switching hats and company's buying rep's from other company's but that's about it.

I can tell you I hear very little about BIO rep's or product...but BIO leadership is a popular subject amongst customers. Just a glimpse into the customers brains.....BIO employs leadership that tried to convince customers their recalled products were fine when they worked for the Big 3. When their market share dipped, they went to BIO and salvaged a few relationships, many of which go deeper than business.

As a Biotronik rep, I only wish 'leadership' was the stumbling block. A doctor that is busy worrying about my VP has WAY too much time on his hands, and his focus is off. A good rep knows how to keep those interactions to a minimum, and when they do happen - it can be a joke between the doc and rep.

I'm just a small fry, but I have always been fascinated by reps who prop up their 'leadership' as a point of discussion - and I am blessed to work with physicians who give a Rat's Ass about who is in charge.

 

[Anonymous]

As a Biotronik rep, I only wish 'leadership' was the stumbling block. A doctor that is busy worrying about my VP has WAY too much time on his hands, and his focus is off. A good rep knows how to keep those interactions to a minimum, and when they do happen - it can be a joke between the doc and rep.

I'm just a small fry, but I have always been fascinated by reps who prop up their 'leadership' as a point of discussion - and I am blessed to work with physicians who give a Rat's Ass about who is in charge.

You missed my point. Of course we're all comfortable in our little box of friendly doc's and can joke about management. I'm challenging you to step out of your box and ask a non-friendly BIO doc why they don't use your product and tell me what you say. The other thing a I failed to mention is the lack of managerial experience in BIO. Good rep's don't make good managers and that's a fact and that's what you got.

So what is BIO's stumbling block?

 

[Anonymous]

You missed my point. Of course we're all comfortable in our little box of friendly doc's and can joke about management. I'm challenging you to step out of your box and ask a non-friendly BIO doc why they don't use your product and tell me what you say. The other thing a I failed to mention is the lack of managerial experience in BIO. Good rep's don't make good managers and that's a fact and that's what you got.

So what is BIO's stumbling block?

I have answered that about 5 times since this thread started, so I'll answer itmagains and add one more wrinkle.

1) Lack of coverage
2) Soft market
3) No real desire to 'pay' the 'cost of switching".
4) Last to market with an EP focus - "They have a fine pacer, but do they even have a BiV?"

The new wrinkle is....we were last to have a Fellow's Program. You cannot underestimate the power of being in their hands as they are learning. The people they admire teach them the ropes, and those people use the Big 3. Who wants to learn a new product right out of Fellowship? You just want to lay low and stick to what you know for the first few years out...then you grow accustom to your local [Big 3 Company] team, and by the time you have the confidence and skills required to branch out - you just don't. It's amazing we even have 4%....that's why I consider the fact that I HAVE sold Bio devices as a true representation of my abilities.

 

[Anonymous]

I have answered that about 5 times since this thread started, so I'll answer itmagains and add one more wrinkle.

1) Lack of coverage
2) Soft market
3) No real desire to 'pay' the 'cost of switching".
4) Last to market with an EP focus - "They have a fine pacer, but do they even have a BiV?"

The new wrinkle is....we were last to have a Fellow's Program. You cannot underestimate the power of being in their hands as they are learning. The people they admire teach them the ropes, and those people use the Big 3. Who wants to learn a new product right out of Fellowship? You just want to lay low and stick to what you know for the first few years out...then you grow accustom to your local [Big 3 Company] team, and by the time you have the confidence and skills required to branch out - you just don't. It's amazing we even have 4%....that's why I consider the fact that I HAVE sold Bio devices as a true representation of my abilities.

Ok.. so you answered all the "No Duh" stuff.... again. My response again is, Where's your management on these well known issues facing BIO? Are they knocking on doors to new acct's? Are they trying to change perceptions? Are they Visionarys'? Do they have a growth plan?

You said it best, "amazing we have 4%" "sold Bio devices as a true representation of my abilities." This is a direct reflection of the lack of leadership to remove obstacles for you to grow and be succcessful. Listen to your own words and you will see it points in one direction....BIO leadership is singularly focused on "just holding on"...not progress...not growth.

I disagree with your idea that Fellow's programs results in product loyalty. BIO is too small to invest in a Fellows program where the Fellow will most likely NOT land in an acct or group that is BIO friendly....those would be horrible odds to bet on and not even BIO would bet on that horse. Not sure you thought through that one...you need to be focused on short term gains, not long term, high risk crap shoots!

 

[Anonymous]

Ok.. so you answered all the "No Duh" stuff.... again. My response again is, Where's your management on these well known issues facing BIO? Are they knocking on doors to new acct's? Are they trying to change perceptions? Are they Visionarys'? Do they have a growth plan?

You said it best, "amazing we have 4%" "sold Bio devices as a true representation of my abilities." This is a direct reflection of the lack of leadership to remove obstacles for you to grow and be succcessful. Listen to your own words and you will see it points in one direction....BIO leadership is singularly focused on "just holding on"...not progress...not growth.

I disagree with your idea that Fellow's programs results in product loyalty. BIO is too small to invest in a Fellows program where the Fellow will most likely NOT land in an acct or group that is BIO friendly....those would be horrible odds to bet on and not even BIO would bet on that horse. Not sure you thought through that one...you need to be focused on short term gains, not long term, high risk crap shoots!

We started a Fellows Program 3 years ago, so the die has already been cast in that 'crap shoot'. You're entitled to your opinion, but a Fellows Program really was necessary to come across as a full-fledged EP organization. Whether they end up in a Biotronik friendly environment or not, you have to be part of that germinal stage in their career or you really are late to the party when they are out.

Exactly which company should our managers model themselves after?

 

[Anonymous]

We started a Fellows Program 3 years ago, so the die has already been cast in that 'crap shoot'. You're entitled to your opinion, but a Fellows Program really was necessary to come across as a full-fledged EP organization. Whether they end up in a Biotronik friendly environment or not, you have to be part of that germinal stage in their career or you really are late to the party when they are out.

Exactly which company should our managers model themselves after?

So who pulled the plug on the Fellows program?... Management? Why? What's the point of the Fellows program if they don't end up in your pocket??

There's no company model for managers...either you're good or you're not. Either you have experience or you don't.

 

[Anonymous]

So who pulled the plug on the Fellows program?... Management? Why? What's the point of the Fellows program if they don't end up in your pocket??

There's no company model for managers...either you're good or you're not. Either you have experience or you don't.

The Fellow's Program is ongoing.

It is very difficult to explain these things to someone who has never been on this side of the business. Suffice to say, a Fellows Program AT WORST is a "me-too" offering...everyone has it so it's assumed that it needs to be there. At Best, it legitimizes who we are and ensures that some Fellows will have had a rep/company/product experience with Biotronik prior to going in to their practice. As I said before in a previous post, if they are being approached by a BIO rep for the first time after they have already graduated - it is imminently more difficult to sway them from the 3 companies that they learned to use back at 'the U'.

That last part also answers the 'what good is it if they don't end up in your pocket"? Think of it as an in-service meal for a physician who doesn't CURRENTLY use your product. You may not get them today, but if you're building a relationship - it may pay off down the road.

You sound very inspired by your manager. I hope when you become one, you can lead your folks as well.

 

[Anonymous]

The fellows program is ongoing, but remains impotent. It has not and will not be able to produce the desired results as designed. The KOL list of speakers is impressive, but after they pick up their checks for a speaking engagement, they return to their respective practices and fail to use Biotronik Products. It hurts but we all know this. I have taken several of my biggest EP's these meetings, and they all have come to the same conclusion. I dont think the impact in other parts of the country is any better. Why isn't Biotronik doing any better? They're doing great. They are profitable.

 

[Anonymous]

BIO runs so Lean that they can't retain Talent... they are trying to do what the Big 3 did a few years ago, replace Great Sales Reps with a bunch of 50K - 70K Clinicals and 20 yr olds. They are getting what they are paying for... a bunch of pathetic, unmotivated, under achieving, unprofessional "Talent" with a BS/BA degree in Popped Corn, Cotton Candy and Bearded Lady Ticket Sales from the U of Barnum and Bailey, who only answer the phone between 10 and 2, after a hour of expensed lunch with three glasses of White Zifandel.

That's Why it remains a 3 ring Circus with MDT, BSX, and SJM

That's why BIO does not do better... their "Interim" management does not know how to manage a CRM company, is Clinically uncomfortable around customers, cannot reasonably Manage Market Dynamics (sleeping with the wrong people drinking
the White Zif Kool Aid) let alone make it to the Big Top...