Why Isn't Your Relationship With the Doctor Leading to Sales?

You know that relationships are the lifeblood of medical sales. You've been told a thousand times to build rapport, remember birthdays, and follow up diligently.

But I had a client last year named Eric who learned that none of that matters if you're building relationships with the wrong people.

Eric sold surgical devices. He'd spent six months building a great relationship with a surgeon at a large hospital. The surgeon loved Eric's product. Told Eric he wanted to use it.

But nothing happened.

"I don't understand," Eric told me, frustrated. "Dr. Roberts wants my device. He's told me that three times. Why isn't this closing?"

I asked Eric who else he'd talked to at the hospital besides Dr. Roberts.

"Nobody," Eric said. "Dr. Roberts is the one who decides what to use in the OR."

That was the problem. Dr. Roberts wasn't the one who decided. Not anymore.

In today's medical sales, having a great relationship with one doctor isn't enough. You need relationships with people you've probably never even met.

Let me show you what that actually looks like.

Who Actually Makes the Decision?

Eric thought Dr. Roberts made the purchasing decision for the OR. That used to be true. Ten years ago, maybe even five years ago.

Not anymore.

I had Eric pull up the hospital's organizational structure. We found out there was a Value Analysis Committee that approved all surgical equipment purchases. Seven people on it. Dr. Roberts was one of them. But he was one vote out of seven.

"Who are the other six?" I asked.

Eric had no idea. He'd never asked.

We found out: another surgeon, a nurse manager, a materials manager, a pharmacy director, a finance person, and a hospital administrator.

"Have you talked to any of them?" I asked.

"No," Eric admitted. "I didn't know they existed."

That's why his deal wasn't closing. Dr. Roberts wanted the product. But six other people had never even heard of Eric.

I had another client, Michelle, who made the same mistake. She'd built a great relationship with a cardiologist at a hospital system. The cardiologist wanted her device.

But the hospital system had centralized purchasing. Decisions were made at the corporate level, not by individual doctors at individual hospitals.

Michelle's cardiologist had zero authority to buy anything.

"I wasted nine months," Michelle told me. "I thought I was selling to the decision maker. I wasn't."

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What Do You Say to People Who Aren't Doctors?

Eric eventually got meetings with the other Value Analysis Committee members. But he didn't know what to say to them.

His pitch was designed for surgeons. Clinical outcomes. Surgical technique. Patient recovery.

When he tried that pitch on the finance person, she looked bored.

"How much does it cost?" she asked.

Eric told her the price.

"That's 20% more than what we're paying now," she said. "Why would we switch?"

Eric didn't have an answer. He'd never thought about it from a cost perspective.

"Because it's better clinically," he said.

"Show me the ROI," she said.

Eric had no ROI data. He had clinical data. That wasn't what she cared about.

After that meeting, I worked with Eric on creating different value propositions for different stakeholders.

For surgeons: clinical outcomes, ease of use, patient recovery times.

For finance: total cost of care, reduced complications, shorter hospital stays, fewer readmissions.

For nurses: ease of use, training requirements, workflow impact.

For materials managers: inventory management, expiration dates, storage requirements.

Same product. Different value story for each person.

Michelle learned the same lesson. Her clinical story worked great for cardiologists. It didn't work at all for hospital administrators.

"I kept talking about clinical outcomes," she said. "And they kept asking about budget impact. We were having two different conversations."

Once she learned to speak their language, they listened.

Do Nurses Actually Matter?

Eric made another mistake. He ignored the nurses.

"I'm selling to surgeons," he told me. "Not nurses."

But the nurses used his device in the OR. Every single time. They were the ones who opened the packages, handed instruments to surgeons, and dealt with any problems.

And Eric had never asked them what they thought.

I made him talk to the OR nurses. He learned his device had a packaging problem. The outer wrap was hard to open. The nurses hated it.

"Did you tell Dr. Roberts?" I asked.

"No," one nurse said. "We just deal with it."

But it meant the nurses weren't fans of Eric's product. And when the Value Analysis Committee asked the nurse manager for her opinion, guess what she said?

"The packaging is a pain. The current product is easier to use."

Eric lost that deal. Not because of clinical outcomes. Because the nurses didn't like the packaging.

"I never thought nurses mattered," Eric said.

They matter more than you think. Especially in hospitals. They're the ones using your product every day. If they hate it, they'll find a way to communicate that.

Michelle had a better experience with nurses. She spent time asking them about workflow. What made their day easier? What made it harder?

"Your device takes three fewer steps to set up than the competitor," one nurse told her. "That saves us time in every case."

Michelle used that in her presentation to the Value Analysis Committee. The nurse manager nodded along. Michelle got the deal.

"Talking to nurses was the best thing I did," Michelle said.

How Do You Even Find These People?

Eric asked me this after realizing he needed to build relationships beyond just the surgeon.

"How do I find out who's on the Value Analysis Committee?" he said. "Nobody tells me that."

You ask. But you don't ask the surgeon. You ask people who know.

I had Eric talk to the materials manager. "Who's involved in purchasing decisions for surgical equipment?" he asked.

The materials manager told him the whole structure. Who was on the committee. When they met. What their process was.

"Why would she tell me that?" Eric asked.

"Because you asked," I said. "And because there's no reason to hide it. It's not a secret."

Michelle used a different approach. She asked her champion cardiologist, "Who else needs to support this decision for it to happen?"

He told her: the department head, the hospital CFO, and the corporate purchasing team.

"Can you introduce me?" Michelle asked.

He did. That's how she got access to the decision makers.

"I never would have thought to ask for introductions," Michelle said.

Most reps don't. They think asking for help is weak. It's not. It's smart.

What Do You Actually Track?

Eric had been tracking his interactions with Dr. Roberts in his CRM. Every call. Every email. Every OR visit.

But he wasn't tracking anyone else because he wasn't talking to anyone else.

After we started working together, his CRM looked completely different.

He tracked:

• All seven Value Analysis Committee members
• When the committee met
• What their individual priorities were
• Who supported his product and who didn't
• Who influenced whom on the committee

"This is so much work," Eric said.

Yes. But it's also how you actually close deals in complex organizations.

Michelle tracked relationships across an entire hospital system. Six hospitals. Different decision makers at each level. Corporate purchasing team. It was complicated.

"How do you keep all this straight?" I asked.

"I write everything down immediately," she said. "If I wait, I forget."

That's the reality. Building relationships in modern medical sales requires serious organization. You can't just remember stuff. You have to track it.

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Can You Break In Without Relationships?

Eric asked me this. "What if I'm new? I don't have relationships with anyone yet."

That's fine. Most reps don't start with relationships. You build them.

But you have to be strategic about who you build them with.

Eric's approach when he started was to talk to whoever would give him time. That meant he spent six months talking to Dr. Roberts and nobody else because Dr. Roberts was friendly and gave him access.

That was a waste of time.

A better approach: identify the decision makers first. Then build relationships with them. Even if it's harder.

Michelle came into her territory with zero relationships. But she did research first. Figured out the organizational structure. Identified the key decision makers.

"Then I went after those people specifically," she said. "It was harder than talking to the friendly doctors. But it was time better spent."

Her first year, she closed three major deals. Eric's first year, he closed zero because he'd spent the entire time building the wrong relationships.

"I wish I'd started strategically," Eric said. "I wasted a year."

What If You Have Limited Access?

This is a real problem. You can't get meetings with everyone you need to.

Eric couldn't get a meeting with the hospital CFO. The CFO's assistant kept saying he was busy.

"How do I build a relationship with someone who won't meet with me?" Eric asked.

You find other ways to provide value.

Eric found an article about reducing surgical costs that he thought the CFO would find interesting. He sent it via email with a brief note: "Thought this might be relevant to your cost reduction initiatives."

The CFO replied: "Thanks for sharing. This is helpful."

It wasn't a meeting. But it was contact. Eric did this a few more times over several months. Eventually, the CFO agreed to a 15-minute call.

That 15 minutes turned into support for Eric's device at the committee meeting.

"I didn't need a friendship," Eric said. "I just needed him to know I understood his priorities."

Michelle had limited access to the corporate purchasing team. They were two states away. She'd never meet them in person.

So she built relationships remotely. Emails. Phone calls. LinkedIn. She found out what they cared about (standardization, volume discounts, reliable supply chain) and demonstrated her product delivered on those things.

"I've never met them face to face," she said. "But they approved my device for the entire hospital system."

Access is a constraint. It's not an excuse.

How Long Does This Take?

Eric's deal with Dr. Roberts took 18 months from first meeting to contract signature. That's how long it took to build relationships with all seven Value Analysis Committee members and get consensus.

"I thought it would take three months," Eric said. "This is exhausting."

Welcome to modern medical sales. Deals take longer when more people are involved.

Michelle's hospital system deal took 14 months. But it was worth it. Once approved, her device was deployed across six hospitals. Huge contract.

"If I'd tried to rush it, I would have lost," she said. "You can't force consensus. You have to build it."

What Actually Matters?

After working with Eric, Michelle, and dozens of other reps, here's what I've learned:

One relationship isn't enough. You need relationships with everyone who influences the decision.

Different stakeholders care about different things. Clinical outcomes. Cost. Workflow. You need different value stories.

Nurses matter. More than most reps realize. They can kill your deal even if the doctor loves your product.

You have to track everything. Names. Roles. Priorities. Relationships between people. It's complex. You need a system.

Deals take longer now. More people involved means more time. Be patient. But be deliberate.

And you can build relationships without existing connections. But you have to be strategic about who you target.

Eric went from zero deals in year one to hitting 120% of quota in year two once he learned how to build the right relationships.

Michelle went from middle of the pack to top 10% in her region once she learned how to navigate hospital systems.

Both of them said the same thing: "I wish I'd learned this from day one."

If you're building great relationships but not closing deals, you're probably building relationships with the wrong people.

Figure out who actually matters. Then build those relationships.

Ready to learn how to do this right? That's what RepPath is for.

Joe Licata
RepPath