Developing novel strategies to add value, increase credibility and drive improved patient/procedural outcomes for your clients and stakeholders.

1. Adding Value to Client Relationships
 Examples from 2
decades of selling to
surgeons
09/03/14 Prepared by Mark Schleiche1r

2. Introduction
 “Representing implantable medical
devices effectively and
successfully requires much more
than showing up on time and
having the case go well…….”
Mark Schleicher circa 2013
09/03/14 Prepared by Mark Schleiche2r

3. Topics of Discussion
 In this presentation we will
examine how client relationships
can be initiated, fostered,
developed and enhanced.
 Using actual examples from early
in my career to more recently.
09/03/14 Prepared by Mark Schleiche3r

4. Background Info:
Example 1
1992 – Webster Orthopedics
Drs. William S.T.Jackson – H.M.”Mac” Reynolds
Pill Hill (Merritt/Providence/Peralta Hospitals)
Oakland, CA
 Busiest orthopedic practice in Northern CA – 300 hips and
200 knee replacements annually.
 First group to RFP top 4 device companies in attempt to
“Regain control over implant/instrument costs and economies
of scale through contractual arrangements and procedural
volume commitments.”
 Smallest of 4 companies involved (Intermedics Orthopedics)
 Intermedics had the newest/most expensive technology
 30% marketshare
09/03/14 Prepared by Mark Schleiche4r

5. Strategy of 3 competitors = number crunching and lamenting over
potential lost margins.
 OOuurr SSttrraatteeggyy = Utilize strong client relationships
to schedule meeting with:
- Drs. Jackson/Reynolds
- OR/Hospital Administration
- Purchasing
This meeting uncovered 3 main issues:
1. Cost of instruments
2. Cost of implants considering volume
3. Staff training
09/03/14 Prepared by Mark Schleiche5r

6. Solutions: 3 other competitors willing to lower pricing on
implants and instruments from 16 to 24%
IInntteerrmmeeddiiccss SSoolluuttiioonn::
1. Instrumentation Costs = Hospital would no longer purchase
instruments. All inst. on consignment. Hospital agrees to $150
per case fee to cover all instruments and shipping costs.
2. Implant Costs = 15% across the board discount. 5% additional
discount at 50% marketshare.
3. Training of Support Staff = Proposed monthly in-service training
based on survey of nurses and techs. Asked for and received
OK from Drs. Jackson/Reynolds to become a Center of
Excellence for our technologies and participation in peer to peer
training of surgeons from outside the bay area.
09/03/14 Prepared by Mark Schleiche6r

7. Results:
 Client Relationships led to a big
win for all parties.
 Ability to drill down to specific
areas of concern uncovered the
real issues to be addressed.
 Consistent outreach to Purchasing
and Hospital Administration prior to
negotiations led to contract award.
09/03/14 Prepared by Mark Schleiche7r

8. Background Info:
Example 2
1999 – Dr. Hooman Madyoon – Chief of Cardiology
St Joseph’s Medical Center
Stockton, CA
 Asked to cover Central Valley territory on top of current
responsibilities (San Jose/Monterey)
 Established good working relationship with Chief of Cardiology,
Dr. Madyoon.
 Asked to bid on dual-vendor contract.
 Sat down with Dr. Madyoon, VP Materials and Hospital CEO and
my manager.
 At this meeting CEO states “We are tired of all these companies
coming and going in the cath lab. We currently issue 400 P.O.s
per month - we would consider a sole vendor contract if (1) your
company has all the products required to do an entire case, (2)
you can limit the number of P.O.’s to a manageable amount and
(3) you manage to gain acceptance from all 18 cardiologists to
use your products exclusively.”
09/03/14 Prepared by Mark Schleiche8r

9. SSttrraatteeggyy::
1. Use well run Product evaluations to continue building credibility
relationships with cardiologists and Dr. Madyoon’s influence to
gain acceptance of products from all 18 cardiologists.
2. Identify historical purchasing data with help from VP Materials.
3. Enlist help from corporate finance department to evaluate
different billing scenarios that would permit a sole-vendor
arrangement and limit the number of purchase orders generated.
4. Offer participation in clinical trials and access to newest
technologies.
09/03/14 Prepared by Mark Schleiche9r

10. RReessuullttss::
· Conceived and awarded innovative Sole-Vendor contract
agreement allowing St. Joseph’s Medical Center unlimited use
of Cordis products for 1 P.O./month.
· This 3 year 90% compliant contract (First of its kind in the U.S.)
achieved $1.4M in new business annually, saved St. Joes
$400,000 per year and effectively blocked competition.
· Negotiations involved CEO,VP Materials and 18 cardiologists.
09/03/14 Prepared by Mark Schleiche1r 0

11. Unanticipated Benefits to
Patients/Cardiologists/St. Joes/J&J
 By using the same products over time, Cardiologists became
more adept at delivering/deploying stents.
 As time progressed, patient and procedural outcomes showed
dramatic improvement – Restenosis rates cut in half.
 As cardiologists skills improved they used less product,
improving bottom line for company.
 CHW/Premier started paying attention to results at St. Joes and
began to consider adopting this new cath lab model for other
CHW facilities.
09/03/14 Prepared by Mark Schleiche1r 1

12. Full Disclosure……..
Several initiatives and efforts came together in the
conception and delivery of this unique contract, namely:
 My Manager rallied the troops in the finance department and
with Cordis executive management to bring this contract to
fruition. He also went to bat for Dr. Madyoon and secured
clinical trials participation and COE status.
 Dr. Madyoon lived up to his word and helped gain the
commitment of his fellow cardiologists to make it all work.
 I had the pleasure of witnessing 1,500 PCI cases using only
my products, and the knowledge that we measurably improved
the delivery of cardiac care at St. Joseph’s Medical Center.
09/03/14 Prepared by Mark Schleiche1r 2

13. Background Info:
Example 3
2008 - Dr. Edward Bradbury
Orthopedic Surgeon
Watsonville Community Hospital
 Boardmember of Tenet Hospitals has ASHR (Anterior Supine Hip
Replacement) He leaves hospital after 2 days – Within 30 days
plays golf – 4 months later speaks at Zimmer National Sales
Meeting.
 Mark Schleicher has an idea, writes it down and places in
suggestion box at Zimmer National Sales Meeting.
 Turns out some folks at Zimmer Corporate had my idea way before
I did……Zimmer had already proposed an alliance with Tenet and
with OSI (They make a special OR table that is required to perform
Anterior Supine Hip Replacement. OSI Table cost = $100,000
09/03/14 Prepared by Mark Schleiche1r 3

14. Dr. Edward Bradbury continued
 OSI table is critical to ASHR.
 Allows for much smaller incisions
 Muscle groups are retracted not split,
resulting in much less blood loss,
earlier release from hospital and
much less rehab time
 Traction used to gain access for
special retractors that provide
excellent visibility.
 Acetabular reaming can now be
viewed live with fluoroscopy for first
time.
09/03/14 Prepared by Mark Schleiche1r 4

15. Back to Dr.Bradbury……
 Dr. Bradbury already using new Zimmer implant designed for ASHR
 I mentioned that a high-ranking boardmember from Tenet had spoke
at our meeting, and was helping each facility procure the OSI table if
requested.
 I offered to sponsor D. Bradbury for cadaver lab training on ASHR.
 Dr. B jumped on board and within 2 years tripled his hip
volume and his reputation as “the hip surgeon in town”.
09/03/14 Prepared by Mark Schleiche1r 5

16. In his own words…..
 Mark recognized early on that my preference toward the newest
technologies available helps me differentiate my practice from others in
the community. His efforts to provide bio-skills cadaver-lab training in
anterior-supine hip replacement and reverse-shoulder surgery have
helped me market and grow my practice. His professional demeanor
and personality created a climate of communication with my staff that
we all appreciate. I am also aware that Mark took on some extra duties
at the hospital, which assured our trauma systems were up to date and
complete.
 Whenever we had an issue with a product or a difficult surgical
challenge, Mark would get to work, research the problem or issue and
present a logical solution. He helped us save time in the OR, and
through his efforts to train the OR staff, we became more efficient.
Finally, we somehow managed to have some fun as well. For all
these examples, I would highly recommend Mark Schleicher for any
opportunity.
09/03/14 Prepared by Mark Schleiche1r 6

17. Background Info:
Example 4
2008 - Dr. Morteza Farr/Akram Farr P.A.
General Orthopedic/Spine Surgeon
Watsonville Community Hospital
 Dr. Morteza Farr and his wife Akram (Also his P.A. and
manager of all 3 offices) move to Santa Cruz and open office.
 I meet them both one night at Watsonville Hospital – they
were waiting for a Stryker courier to bring special wrist
fracture tray.
 I discussed the fact that I had all Zimmer trauma trays on
consignment and sterile in the house. They were hesitant, I
had just met them 15 minutes before. Finally Mort says
“Alright – let’s get busy”
09/03/14 Prepared by Mark Schleiche1r 7

18. Mort and Akram Farr
 “Initially, we used Stryker for most of our general ortho implant products.
Mark’s personality and professional skills created a shift in our implant
choices first to Zimmer Spine, then on to Zimmer trauma products. We were
pleased as our comfort level steadily increased and our surgical outcomes
improved. We see many trauma cases in our practice, and many times we
called on Mark to suggest and provide solutions with very little notice. Mark’s
capacity to deliver and support these cases shows his ability to work
effectively under extreme conditions.”
 “Mark also uses all of the assets available through Zimmer to help us
manage and grow our practice. He recently encouraged Dr. Farr and me to
attend a cadaver training session in August to learn the anterior-supine
approach to hip replacement. We have now completed 10 cases, and
already see the benefits to our patients. We also utilize the Zimmer re-imbursement
hotline to assist our staff with spine coding/billing issues.
When we opened our new practice in Santa Cruz, Mark made sure we
were invited to several guest speaker/dinner meetings and ortho clubs.
This helped us get acclimated to the orthopedic community,
successfully network our practice and make new contacts.”
09/03/14 Prepared by Mark Schleiche1r 8

19. 2 quick examples directly related to well-developed relationship
with Dr. Arthur C. Lee - Chief of Cardiology, Kaiser Permanente
South Bay Area and O’connor Hospital.
 1999 – 2002 Developed strategic alliance with Cardiologist Arthur C.
Lee (Chief of Cardiology – Kaiser Permanente South Bay) and Design
Engineers at Cordis Corporation, for the evaluation of new products and
prototypes prior to build-out. Dr. Lee’s inputs improved performance of
these catheter-based balloon and stent products, and helped streamline
the process of innovation.
 2000 — 2002 Partnered with Dr. Arthur C. Lee and O’Connor Hospital
San Jose, to establish a preceptorship program for the education and
final training of 20 Cordis Cardiology sales reps. This program allowed
each rep to spend an entire week with Dr. Lee (largest interventional
volume in northern California). Trainees experienced all phases of Dr.
Lee’s practice, including the use of Cordis and competitive products,
cardiac cath-lab protocol and etiquette, film review sessions and
patient/family care issues. This program was highly regarded by Cordis
Cardiology sales trainees and Cordis management.
09/03/14 Prepared by Mark Schleiche1r 9

20. TTooddaayy iitt’’ss aabboouutt ddiiffffeerreennttiiaattiinngg yyoouurrsseellff ffrroomm tthhee ppaacckk
((WWiitthhiinn AAddvvaaMMeedd GGuuiiddeelliinneess ooff ccoouurrssee))
TToo ddoo tthhiiss yyoouu’’llll nneeeedd ttoo::
 Keep a keen eye out for opportunities to shine
 Identify what your competition is NOT doing
 Just because its never been done doesn’t mean it shouldn’t
be attempted
 Start at the top – If you’re not calling on the C-level players
you will miss the bus.
 Utilize new technologies and training to improve the skills of
your clients and their support staff
 Take time to interact with CPD/Materials/Purchasing/OR
Supervisors/Managers/Scrub Techs/Circulators – Identify
champions that want to improve their skills and make it
happen…….
09/03/14 Prepared by Mark Schleiche2r 0

21. Thank You!
09/03/14 Prepared by Mark Schleiche2r 1