C E L E B R AT I N G 2 5 YE A R S • 2 0 1 8
Here’s to many more 25s! Congratulations Repertoire.
We thank you for your continued dedication and partnership.
www.sekisuidiagnostics.com © 2018 Sekisui Diagnostics, LLC. All rights reserved. Because every result matters™ is a trademark of Sekisui Diagnostics, LLC.
CONTENTS Publisher’s Letter
Repertoire Turns 25.............................................................. 4
Perspectives
The More Things Change.................................................. 6 A Relationship-Driven Industry..................................... 7 Market Forces that Shaped POL How past trends and news can predict the future of the physician office lab........................10
Resources
Pama updated CPT codes 2018...................................12 Physician Office set ups: Family Practice ....................................................................15 Internal Medicine ...............................................................16
Pediatrics .................................................................................17 OB/GYN ...............................................................................18 Equipment sales Successful equipment sales calls for a broader look at the customer’s wants and needs..................19
Medical Distribution Hall of Fame
Inductees 2001-2018..........................................................20
25 Years of Repertoire Turbulent decade: the ’90s Cost-consciousness came to dominate the industry in the late 1990s........................................48 The 2000s: A Sales Odyssey .........................................50 The 2010s ...............................................................................53
repertoire magazine (ISSN 1520-7587) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2018 by Share Moving Media. All rights reserved. Subscriptions: $49.00 per year for individuals; issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Repertoire, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Lawrenceville, GA and at additional mailing offices.
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25 Years 1993-2018
3
PUBLISHER’S LETTER
Repertoire Turns 25 In the fall of 1993, my oldest son Scottie Adams was born. Coincidentally, so was
Repertoire magazine. Seeing my 25-year-old son recently start in the industry truly puts the magazine at 25 in a different perspective. Back in 1993, I graduated from Liberty University. At the same time, two knuckleheads named Chris Kelly and Brian Taylor were launching what would end up being the better part of my career. I cannot imagine the fear and excitement they both must have had going out in a true entrepreneurial spirit and starting Repertoire. Both had young families and they were the household providers. At the risk of sounded cheesy, what an American story about having a vision and making it happen. I also cannot imagine what the manufacturing community thought when those two showed up to HIDA asking for support. My favorite story from that meeting and their first real attempt to push the magazine came from Scott Fanning, who was with Midmark at the time. Brian and Chris were both Welch Allyn guys, so they competed with Fanning for years prior. If memory serves me, Brian pitched Fanning and Scott told him: “I’ll give you a check for two ads, but I don’t want to be in the first issue,” to which Brian replied, “Why?” Scott’s reply: “Because if it sucks, I don’t want Midmark associated with it.” Classic Fanning. And for 25 consecutive years, both Welch Allyn and Midmark have supported the magazine without fail. However, Repertoire wouldn’t be Repertoire without the Thills. I would like to personally thank Mark and Laura Thill for their years of service to the publication. I hear from our readership almost every month how thankful they are for the content we put out each issue, and that wouldn’t be possible without the Thills. At the end of the day, Repertoire is about our readers – the distributor salespeople who carry a bag and improve our healthcare community daily. It has been our goal for 25 years to improve the relationship between manufacturer and distributor. Hopefully, we have done that. Thank you for allowing us into your homes and lives. We are truly blessed. It’s been my honor to be the publisher the past four years. I wouldn’t want to be anywhere else.
Scott Adams
Dedicated to the industry, R. Scott Adams Publisher
repertoire is published monthly by Share Moving Media 1735 N. Brown Rd., Suite 140, Lawrenceville, GA 30043 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia; www.sharemovingmedia.com
editorial staff editor
lthill@sharemovingmedia.com managing editor
Graham Garrison ggarrison@sharemovingmedia.com editor-in-chief, Dail-eNews
Alan Cherry acherry@sharemovingmedia.com
(800) 536.5312 x5271 director of business development
Alicia O’Donnell aodonnell@sharemovingmedia.com (800) 536.5312 x5261 sales executive
Lizette Anthonijs
art director
Lizette@sharemovingmedia.com
Brent Cashman bcashman@sharemovingmedia.com
25 Years 1993-2018
Jessica McKeever jmckeever@sharemovingmedia.com
Mark Thill
4
vice president of sales
•
(800) 536.5312 x5266
www.repertoiremag.com
publisher
Scott Adams sadams@ sharemovingmedia.com (800) 536.5312 x5256 founder
Brian Taylor
Subscriptions
www.repertoiremag.com/ subscribe.asp or (800) 536-5312 x5259
2018 editorial board Richard Bigham: IMCO Eddie Dienes: McKesson Medical-Surgical
btaylor@ sharemovingmedia.com
Joan Eliasek: McKesson Medical-Surgical
circulation
Doug Harper: NDC Homecare
Ty Ford: Henry Schein
Laura Gantert
Mark Kline: NDC
lgantert@ sharemovingmedia.com
Bob Ortiz: Medline Keith Boivin: IMCO Home Care
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PERSPECTIVES
The More Things Change
By Brian Taylor It’s hard to believe that Repertoire is 25 years old. It’s
amazing to think that what started out as an idea to keep distributor reps informed on new products has morphed into a trusted and relied-upon journal that has maintained its relevance for all these years. I started in the industry in 1974 as a sales rep for Welch Allyn, and a few years later as a manager on the East Coast. To put distribution into a historical perspective, my sales rep in New York City had more than 100 distributors in the five boroughs of the city! We had one on virtually every street corner in Manhattan, because doctors didn’t see reps in the area. Instead, they would walk down to the corner from wherever their office was and order supplies from the local distributor which often times was a drug store. The point here is that the market dictated what the distribution channel looked like at the time. And it still does. Back then, there needed to be a broad spectrum of dealers to handle the very diverse needs of so many individual physicians – group practice was in its infancy in those days. Oh how things have changed – or have they? Certainly, the sheer number of distributors has shrunk tremendously. Some through attrition, but mostly through merger and acquisition. As managed care and group practices grew, the channel and reps had to change as well. Some did so more successfully than others. The customers’ needs changed and the sales rep-physician relationships changed dramatically. Each time there was a major shift or trend in the industry, the role of the distributor rep got harder in my eyes. Once upon a time, a rep could be successful based merely on his/her personality and the personal
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relationship they had with the doctor. As groups grew in number and stature, supply chain logistics became important and reps had to step up their game. Business conversations became the law of the land. And today, if a rep isn’t fluent in the current alphabet soup of MACRA, HEDIS, POL, ASC and on and on, it may be time to polish up the resume. Since I retired almost three years ago, I am amazed by two things in particular. First, I am so aware of the pace of change in the industry. In Once upon a only a few short years, many of time, a rep could the people that I knew in distribution are no longer around or be successful in positions that I knew them based merely on his/her personality to be in. Second, I am amazed at how adaptive the really good and the personal reps are. They have maintained relationship they their own relevancy by learnhad with the ing and responding quickly to doctor. As groups the rapid pace of change that grew in number is happening. It is truly excitand stature, ing and encouraging to see the resourcefulness and resiliency supply chain of this group. logistics became It seems that it has been important and that way throughout the years reps had to step I spent in the industry. The up their game. good reps usually got better with change. So my hat is off to this group who have found ways to stay successful and continue to bring answers to the questions and challenges their customers face each day. Cheers to you all!
A RelationshipDriven Industry By Cindy Juhas, Medical Distribution Hall of Fame Inductee Twenty five years ago I was just getting my feet wet as
the new Marketing Manager at F.D. Titus & Son. I was focused and intent on doing a good job … maybe a little too intent. During that period I kept getting phone calls from this guy Chris at some new industry rag called Repertoire. I was too busy to call him back. I can’t remember how many unanswered calls I got from Chris and Brian, but I know it was a lot. At a HIDA meeting later in the year, I was in line to get into some event and there were two guys standing in front of me that were chuckling. One turned around and introduced himself. “Hi, I am Chris Kelly from Repertoire and this is Brian Taylor.” I was horrified and had no place to run! Needless to say, Brian and Chris held no grudges and I learned a valuable lesson about returning phone calls. We became fast friends and built a long-standing professional relationship that has continued with the current Repertoire/SMM leadership team.
I believe one of the reasons for SMM’s continued success in the industry is that the leadership – first with Brian and Chris and now with Scott and John – stays very close to the industry. They get to know, respect, and listen to all of the industry leaders including distributors, manufacturers, GPOs and providers, disregarding size and potential ad dollars. Just like Chris and Brian were relentless in trying to get to know and hear from me way back when, I see Scott and John doing the same thing today. I have watched our industry change in many ways over the 40 years I have been in it, but one thing has not changed. This is a relationship industry and relatively small. Openness, honesty, and trust are the foundation, and SMM has always embodied those attributes. I am proud to be a part of this great industry and proud to have had a great relationship, after a rocky start, with Repertoire/SMM. Congrats!
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25 Years 1993-2018
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PERSPECTIVES
Market Forces that Shaped POL How past trends and news can predict the future of the physician office lab By Jim Poggi Twenty five years ago, a dark cloud had formed over the pri-
mary care market and everyone in the lab business. It’s name? Clinical Laboratory Improvement Amendments (CLIA). Bringing all labs that performed lab tests for patient diagnosis under the same regulations seemed like it could doom the POL. There was a new sheriff in town and a new vocabulary: “waived” tests, POL personnel requirements, and the prospect of lab inspections in the POL. What did it all mean? Could the POL withstand the rigors of inspection, personnel regulations and proficiency testing? It didn’t seem possible. Enacted in 1988, CLIA was not implemented until 1992. In 1993, most distributors and manufacturers decided to hedge their bets and focus on other products and markets and wait for the dust to settle over CLIA. Yet one distributor saw opportunity and ran with it, working counter to the conventional wisdom and creating an impressive business and lab product portfolio in primary care.
Where were you in 1993? I was at Technicon, which had recently been acquired by Bayer, in chemistry marketing and tasked with selling our systems through distribution. The ’80’s were good, but the ’90s did not look so promising. I had a lot of primary care distributors and they were all worried about CLIA and reducing their lab focus. I had a lot to lose. In addition to CLIA, consolidation was becoming a big force
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for change. It was just beginning to gather momentum among manufacturers and distributors. Chances are, if you worked for a distributor or manufacturer then, your world changed due to consolidation. The number of distributors since then has slimmed down considerably, particularly among regional In addition to CLIA, players. Many of the biggest consolidation brand names in lab manufacwas becoming turing have also formed new, a big force for bigger, more consolidated comchange. It was panies. A few new companies just beginning have entered the fray, particuto gather larly on the molecular side of momentum the business.
among manufacturers and distributors. Chances are, if you worked for a distributor or manufacturer then, your world changed due to consolidation.
Where was the technology?
As impressive as we thought it was then, it was primitive compared to today. Lateral flow tests for pregnancy and strep were new. There were no flu or RSV tests. Tumor marker tests like PSA were in their early market stages and promised exciting developments. PCR had just entered the market and was used by the biggest and most sophisticated labs for a narrow range of tests.
We had no clue how fast and easy PCR/molecular would become or the massive menu of tests it would bring to the lab market. It would be 10 years before the human genome was mapped. If you had a PC, it was bigger and slower than today and it probably crashed at least once a day. Mine did. Medical records were paper and consumed a massive amount of space in the average practice. On the treatment side of things, statins were just beginning to make a meaningful impact on treatment of lipid disorders and digoxin was the principal treatment for heart failure. Today, over 25 million Americans take statins and CDC estimates that more than another 20 million SHOULD. Digoxin has been replaced by newer, more effective drugs as front-line treatment for heart failure.
Where were our customers?
story? “In office testing presents an excellent opportunity to improve practice revenues.” We put $10 bills in blood collection tubes to prove our point in dramatic fashion. We knew we could improve patient care, but except for diabetes, we did not tell the story that way very often.
So, what happened anyway? Despite the concerns of manufacturers and distributors alike, CLIA spurred progress in many ways. We learned the vocabulary of CLIA and learned to compete in new ways with new products. As a result, the number of POLs has grown considerably from about 91,000 POLs in 1993, to over 121,000 POLs in 2017. Our business has grown and the range of products we sell has grown as well. Manufacturers climbed
We now tell a story about clinical value, better patient care and satisfaction, improved access to test results and new ways to improve quality of life for the patient. We sell more products, and we sell smarter than ever before.
IDNs were a glimmer on the horizon. Some rural areas shared labs and services to improve access to care, but the overall trend was not yet established. Over 60 percent of all physicians were in an independent medical practice; over 50 percent of all physicians were in solo practice. If you called on a 10-physician practice, you were calling on a BIG customer. Nurse practitioners and physician assistants? Not a factor in those days. Today, only about 36 percent of all physicians are in independent practices and about 17 percent of all physicians are in solo practice. Consolidation and IDN ownership of physician practices have been major changes.
What were we selling? There were three popular unitized chemistry reagent systems on the market targeted at small practices with easy to use, “one test at a time” formats. There were a handful of benchtop chemistry systems available, and most of them had been developed for hospital use and were marketed in the physician office market as a secondary market opportunity. If you wanted hematology, there were only two choices: the dominant player and the upstart. There was one dominant immunoassay system and only one distributor offered it. We sold FOBT tests and latex pregnancy tests. Microscopes were still a big deal. Our
on the CLIA waiver band wagon and brought us new tests for flu, RSV, coagulation, chemistry, molecular assays and even the first waived hematology system. Tests became easier to use and more customer friendly. Suppliers and independent consultants embraced the challenge and dramatically improved customer training and support. EMR has largely replaced paper patient records and patient portals make results easy to retrieve. We now tell a story about clinical value, better patient care and satisfaction, improved access to test results and new ways to improve quality of life for the patient. We sell more products, and we sell smarter than ever before. What will PAMA and MACRA bring? With the backdrop of CLIA and a look back over 25 years, I predict PAMA and MACRA will make us stronger, wiser and more customer and patient focused. If the past predicts the future, these new market forces will shape us and our customers in exciting new ways that continue to improve the lab business and our service to our customers and the patients in their practices. Bring it!
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25 Years 1993-2018
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RESOURCES
Pama updated CPT codes 2018 Infectious Disease Tests
12
Test - Panels Basic Metabolic Panel (9 tests) Comprehensive Metabolic Panel (17 tests) Electrolyte Panel (4 tests) Hepatic Function Panel (10 tests) Lipid Panel (6 tests) Renal Function Panel (12)
CPT 80048/QW 80053/QW 80051/QW 80076 80061/QW 80069/QW
2017 Fee $11.60 $14.49 $9.62 $11.21 $18.37 $11.91
2018 Fee $10.44 $13.04 $8.66 $10.09 $16.53 $10.72
Change -10% -10% -10% -10% -10% -10%
Cardiac/Liver/Other Tests Albumin (Serum) Albumin (Urine) ALP ALT Aspirin Therapy AST Bilirubin, direct Bilirubin, total BNP CK,MB CK/CPK GGT LD Microalbumin (Quantitative) Microalbumin (Semi-quantitative) Total Protein Troponin I
82040/QW 82042/QW 84075/QW 84460/QW 85576/QW 84450/QW 82248 82247/QW 83880/QW 82553 82550/QW 82977/QW 83615 82043/QW 82044/QW 84155/QW 84484/QW
$6.79 $7.10 $7.10 $7.27 $29.47 $7.10 $6.88 $6.88 $46.56 $15.84 $8.93 $9.88 $8.28 $7.93 $6.28 $5.03 $13.50
$6.11 $7.78 $6.39 $6.54 $26.52 $6.39 $6.19 $6.19 $41.90 $14.26 $8.04 $8.89 $7.45 $7.14 $6.23 $4.53 $12.47
-10% 10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -1% -10% -8%
Lipid Tests HDL LDL Lp(a) Apolipoprotein Total Cholesterol Triglycerides
83718/QW 83721/QW 82172 82465/QW 84478/QW
$11.24 $13.09 $21.26 $5.97 $7.88
$10.12 $11.78 $21.09 $5.37 $7.09
-10% -10% -1% -10% -10%
Diabetes Tests Fructosamine Glucose on home use meter-type device Glucose Tolerance Test, each additional specimen > 3 Glucose Tolerance Test, initial 3 specimens Glucose, quantitative blood type Hemoglobin A1c
82985/QW 82962 82952/QW 82951/QW 82947/QW 83036/QW
$20.68 $3.21 $5.38 $17.66 $5.39 $13.32
$18.61 $3.28 $4.84 $15.89 $4.85 $11.99
-10% 2% -10% -10% -10% -10%
Renal Function Tests BUN Creatinine Creatinine (Urine)
84520/QW 82565/QW 82570/QW
$5.42 $7.03 $7.10
$4.88 $6.33 $6.39
-10% -10% -10%
Individual Tests Amylase Calcium Ferritin Iron
82150/QW 82310/QW 82728 83540
$8.89 $7.08 $18.70 $8.88
$8.00 $6.37 $16.83 $7.99
-10% -10% -10% -10%
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Magnesium Phosphorous Prostate Specific Antigen (PSA) TIBC Troponin T Uric Acid Lead Vitamin D
83735 84100 84153 83550 84512 84550/QW 83655/QW 82306
$9.19 $6.50 $25.23 $11.99 $10.56 $6.20 $16.61 $40.61
$8.27 $5.85 $22.71 $10.79 $10.09 $5.58 $14.95 $36.55
-10% -10% -10% -10% -4% -10% -10% -10%
Therapeutic Drug Monitoring Tests Theophylline Digoxin Lithium
80198 80162 80178/QW
$19.40 $18.21 $9.07
$17.46 $16.39 $8.16
-10% -10% -10%
Drug of Abuse Screening (Visual Qualitative) Drugs of Abuse (per screen - 1 test or 10 tests)
80305/QW
$14.96
$13.46
-10%
Thyroid Tests TSH Thyroxine, total T3 Uptake
84443/QW 84436 84479
$23.05 $9.42 $8.87
$20.75 $8.48 $7.98
-10% -10% -10%
Pregnancy Tests hCG (Qualitative Serum Combo) hCG (Qualitative Urine)
84703/QW 80125
$10.32 $8.67
$9.29 UNK
-10% N/A
candida, DNA Direct Probe Cervical/Urethral, culture for N. gonorrhoeae gardnerella, DNA Direct Probe trichomonas, DNA Direct Probe Chlamydia H. pylori Hepatitis C Herpes Influenza A&B Influenza A&B (Molecular) Lyme Disease Mononucleosis Rheumatoid Factor RSV Strep A Syphilis
CPT 87480 87081 87510 87797 87810 86318/QW 86303/QW 86694 87804/QW 87502/QW 86618/QW 86308/QW 86430 87807/QW 87880/QW 86592
2017 Fee $27.51 $9.09 $27.51 $27.51 $16.44 $17.76 $19.57 $19.74 $16.44 $116.73 $23.36 $7.10 $7.78 $16.44 $16.44 $5.86
2018 Fee $24.76 $8.18 $24.76 $30.03 $35.29 $18.09 UNK $17.77 $16.55 $105.06 $21.02 $6.39 $7.00 $14.80 $16.53 $5.27
Change -10% -10% -10% 9% 115% 2% N/A -10% 1% -10% -10% -10% -10% -10% 1% -10%
Infections Urine Screen, non-culture kit Urine, colony count Urine, presumptive identification of bacteria Urine, antibiotic susceptibility test
81007/QW 87086 87088 87184
$3.52 $11.07 $11.10 $9.46
$29.98 $9.96 $9.99 $8.51
752% -10% -10% -10%
Allergy Percutaneous (prick or scratch)
95004
$6 - $8
$6 - $8
0%
Infectious Disease Tests
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RESOURCES Urinalysis/Microscopic/Miscellaneous Tests Semen Analysis Strip Urine Tests, manual w/out microscopy Strip Urine Tests, manual w/ microscopy Strip Urine Tests, automated w/out microscopy Strip Urine Tests, automated w/ microscopy
CPT 89300 81002 81000 81003 81001
2017 Fee $12.25 $3.50 $4.35 $3.08 $4.35
2018 Fee $11.03 $3.48 $4.02 $2.77 $3.92
Change -10% -1% -8% -10% -10%
Vaginal/Other BTA Stat (Bladder Cancer) Fecal Occult Blood Test Bacterial Vaginosis Immunochemical Fecal Occult Blood Test (iFOBT) Trichomonas Wet/KOH Prep (for yeast, bacteria, cells, etc.)
86294/QW 82270 87905/QW 82274/QW &G0328/QW 87808/QW 87210/QW
$26.92 $4.46 $16.76 $21.82 $16.44 $5.86
$25.57 $4.38 $15.08 $19.64 $15.29 $5.82
-5% -2% -10% -10% -7% -1%
CPT 85025
2017 Fee $10.66
2018 Fee $9.59
Change -10%
85018/QW 85014/QW 85610/QW 85730 85044 85651 85652
$3.25 $3.25 $5.39 $8.24 $5.91 $4.87 $3.70
$2.93 $2.93 $4.85 $7.42 $5.32 $4.38 $3.33
-10% -10% -10% -10% -10% -10% -10%
Hematology Tests Complete Blood Count (including WBC differential & platelet count) Hemoglobin Hematocrit Prothrombin Time (PT) Activated Partial Thromboplastin (APTT) Reticulocyte Count, manual Sedimentation Rate, manual Sedimentation Rate, automated
NOTE: This information was provided as general reimbursement information only. It is not legal advice, nor is it advice about how to code, complete or submit any particular claim for payment. Although we provided this information to the best of our current knowledge, it is always the healthcare provider’s responsibility to determine and submit appropriate codes, charges, and modifiers. The coding and reimbursement information is subject to change without notice. For the most current reimbursement information, please visit the CMS website at www.cms.gov The Centers for Medicare and Medicaid Services (CMS) has issued the final clinical lab fee schedule reimbursement figures under the Protecting Access to Medicare Act (PAMA); the new reimbursement guidelines will go into effect January 1, 2018. Please see both the attached Clinical Lab Testing & CPT Codes on the more popular tests and the entire CMS reimbursement schedule by CPT Code downloaded from their website. In summary, reimbursements can be reduced by as much as 10% per year 2017-2019 and 15% per year 2020-2022 which could effectively reduce reimbursements by as much as 50% in 5 years. Most of the tests saw 10% reductions for year one; however, Strep A and FLU went up by 1%. In any event, this will surely have a negative impact on the physician office labs that receive significant portions of their revenue from Medicare and traditionally run higher volume point-of-care (POC) testing. NOTE: This information was provided as general reimbursement information only. It is not legal advice, nor is it advice about how to code, complete or submit any particular claim for payment. Although we provided this information to the best of our current knowledge, it is always the healthcare provider’s responsibility to determine and submit appropriate codes, charges, and modifiers. The coding and reimbursement information is subject to change without notice. For the most current reimbursement information, please visit the CMS website at www.cms.gov
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RESOURCES
Physician Office set ups Family Practice LAB EQUIPMENT _____ Allergy _____ Centrifuge _____ Chemistry _____ Glucose Analyzer _____ Hematology _____ Incubator _____ Microscope LAB REAGENTS _____ Allergy _____ Chemistry _____ Glucose Strips _____ Hematology _____ Urinalysis Strips LAB DIAGNOSTICS _____ A1c Testing _____ Allergy _____ Chlamydia _____ Drug Test Kits _____ Culture Plates _____ FIT/FOB _____ Flu Test Kits _____ H. pylori _____ Mono _____ FOBT _____ Pap Smear Kits _____ Pregnancy Tests _____ Rheumatoid _____ RSV Tests _____ STD Tests _____ Strep Tests _____ Cholesterol LAB SUPPLIES _____ Alcohol Preps _____ Biohazard Bags _____ Capillary Tubes _____ Cervical Scraper _____ Culturette _____ Cytology Fixative _____ Dispettes _____ Glucose Tolerance _____ Kimwipes _____ Lancets _____ Microscope Slides _____ Microscope Slips _____ Plastic Labware _____ Scopette _____ Sensitivity Disks _____ Slides _____ Specimen Collectors _____ Stains
_____ Urine Tube _____ Blood Collection Needles _____ Blood Collection Tubes _____ Timers _____ Tubes EQUIPMENT _____ A mbulatory Blood Pressure Monitor _____ Autoclave _____ Audiometer _____ Blood Drawing Chair _____ Bone Densitometry _____ Carts _____ Colposcope _____ Cryosurgical Unit _____ Defibrillator _____ Doppler _____ ECG _____ Electrosurgery Unit _____ Flexible Rhinolaryngoscope _____ Fetal Monitor _____ Foot Stool _____ Headlight _____ Holter _____ I.V. Stand _____ Instrument/Mayo Stand _____ Lights (Exam/Surgery) _____ Mayo Stand _____ Nebulizer _____ Oto/Ophthalmoscope _____ Oxygen Tank _____ P ortable LED Light Source _____ Power Exam Table _____ Pulse Oximeter _____ Rigid Sinus Endoscope _____ Scale _____ Spirometer _____ Sphygmomanometer _____ Sphyg Parts _____ Sphyg Wall Mount _____ Stethoscope _____ Stethoscope Parts _____ Stress Test (Treadmill) _____ Suction Pump _____ Stools _____ Trash Can _____ Tympanometer _____ Ultrasonic Cleaner _____ Utility Cart _____ Vital Signs Monitor
_____ Wheelchair _____ X-Ray View Box PAPER/DISPOSABLES _____ Capes _____ Drape Sheets _____ Gowns _____ Table Paper _____ Towels and Dispenser _____ Towel Swabee HOUSEKEEPING _____ Can Liners _____ Cleaners _____ Disinfectants _____ Tissues _____ Soaps, Dispensers _____ Toilet Tissue _____ Towel, Roll _____ Water Cups SURGERY _____ Administration Sets _____ Betadine _____ Biopsy Forceps _____ Biopsy Needles _____ Blades, Scalpels _____ Caps, Masks, Hoods _____ Disposable In-Grown Toe Nail Removal Kit _____ Distilled Water _____ I.V. Infusion Sets _____ I.V. Needles _____ Procedure Trays _____ Saline _____ Scissors _____ Skin Markers _____ Skin Punches _____ Solutions _____ Spinal Needles _____ Steri-Strips _____ Sterile Water _____ Sterilization Supplies _____ Surgeon’s Gloves _____ Surgical Instruments _____ Suture _____ Tenaculum GENERAL SUPPLIES _____ Ace Bandage _____ Alcohol, Peroxide _____ Applicators _____ Band Aids _____ Bulbs/Batteries _____ Cotton Balls
_____ Disinfecting Spray _____ Enzymatic Cleaner _____ Exam Gloves _____ Gauze Sponge _____ Glutaraldehyde _____ Hand Sanitizers _____ Instrument Cleaner _____ Instrument GERMICIDE _____ Lubricating Jelly _____ Needles/Syringes _____ Otoscope Specula _____ Sharps Collectors _____ Silver Nitrate App _____ Skin Care Lotions _____ Spirometer Mouthpieces _____ Spirometer Paper _____ Sterilization Monitors _____ Sterilization Pouches _____ Surface Disinfectant _____ Tapes _____ Thermometer, Sheaths _____ Tongue Blades _____ Ultrasound Gel _____ Underpads _____ Vaginal Specula _____ X-Ray Envelopes UROLOGY _____ Catheter Trays _____ Catheters _____ Drain Bags _____ Self Caths _____ Xylocaine Jelly INJECTABLES/RX _____ Bicillin _____ Carbocaine _____ Delestrogen _____ Depo-Estradiol _____ Depo-Medrol _____ Depo-Provera _____ Flu-zone _____ Gamulin (RMOgam) _____ Kenalog _____ Narcaine _____ Neosporin, Polysporin _____ Xylocaine
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RESOURCES
Physician Office set ups Internal Medicine LAB EQUIPMENT _____ Allergy _____ Centrifuge _____ Chemistry _____ Cholesterol _____ Glucose Analyzer _____ Hematology _____ Incubator _____ Microscope LAB REAGENTS _____ Allergy _____ Chemistry _____ Glucose Strips _____ Hematology _____ Urinalysis Strips LAB DIAGNOSTICS _____ A1c Testing _____ Allergy _____ Chlamydia _____ Drug Test Kits _____ Culture Plates _____ FIT/FOB _____ Flu Test Kits _____ H. pylori _____ Mono _____ FOBT _____ Pap Smear Kits _____ Pregnancy Tests _____ Rheumatoid _____ RSV Tests _____ STD Tests _____ Strep Tests _____ Cholesterol LAB SUPPLIES _____ Alcohol Preps _____ Biohazard Bags _____ Capillary Tubes _____ Cervical Scraper _____ Culturette _____ Cytology Fixative _____ Dispettes _____ Glucose Tolerance _____ Kimwipes _____ Lancets _____ Microscope Slides _____ Microscope Slips _____ Plastic Labware _____ Scopette _____ Sensitivity Disks _____ Slides _____ Specimen Collectors _____ Stains _____ Urine Tube _____ Blood Collection Needles 16
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_____ Blood Collection _____ Pipettes _____ Timers _____ Tubes EQUIPMENT _____ A mbulatory Blood Pressure Monitor _____ Autoclave _____ Audiometer _____ Batteries, Bulbs _____ Blood Drawing Chair _____ Bone Densitometry _____ Carts _____ Colposcope _____ Cryosurgical Unit _____ Defibrillator _____ Doppler (Vascular) _____ ECG _____ Electrosurgery Unit _____ Flexible Rhinolaryngoscope _____ Fetal Monitor _____ Foot Stool _____ Headlight _____ Holter _____ I.V. Stand _____ Instrument/Mayo Stand _____ Lights (Exam/Surgery) _____ Mayo Stand _____ Nebulizer _____ Oto/Ophthalmoscope _____ Oxygen Tank _____ Portable LED Light Source _____ Power Exam Table _____ Pulse Oximeter _____ Rigid Sinus Endoscope _____ Scale _____ Spirometer _____ Sphygmomanometer _____ Sphyg Parts _____ Sphyg Wall Mount _____ Stethoscope _____ Stethoscope Parts _____ Stress Test (Treadmill) _____ Suction Pump _____ Stools _____ Trash Can _____ Tympanometer _____ Ultrasonic Cleaner _____ Ultrasound Equipment _____ Utility Cart _____ Vital Signs Monitor _____ Wheelchair _____ X-Ray View Box PAPER/DISPOSABLES _____ Capes
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_____ Drape Sheets _____ Gowns _____ Table Paper _____ Towels and Dispenser _____ Towel Swabee HOUSEKEEPING _____ Can Liners _____ Cleaners _____ Disinfectants _____ Tissues _____ Soaps, Dispensers _____ Toilet Tissue _____ Towel, Roll _____ Water Cups SURGERY _____ Administration Sets _____ Betadine _____ Biopsy Forceps _____ Biopsy Needles _____ Blades, Scalpels _____ Caps, Masks, Hoods _____ Disposable In-Grown Toe Nail Removal Kit _____ Distilled Water _____ I.V. Infusion Sets _____ I.V. Needles _____ Procedure Trays _____ Saline _____ Scissors _____ Skin Markers _____ Skin Punches _____ Solutions _____ Spinal Needles _____ Steri-Strips _____ Sterile Water _____ Sterilization Supplies _____ Surgeon’s Gloves _____ Surgical Instruments _____ Suture _____ Tenaculum GENERAL SUPPLIES _____ Ace Bandage _____ Alcohol, Peroxide _____ Alcohol Based Hand Gel _____ Applicators _____ Band Aids _____ Bulbs/Batteries _____ Cotton Balls _____ Disinfecting Spray _____ Enzymatic Cleaner _____ Exam Gloves _____ Gauze Sponge _____ Germicidal Cleaner _____ Glutaraldehyde
_____ Hand Sanitizers _____ Instrument Cleaner _____ Instrument Germicide _____ Instrument Lubricant _____ Lubricating Jelly _____ Needles/Syringes _____ Otoscope Specula _____ Sharps Collectors _____ Silver Nitrate App _____ Skin Care Lotions _____ Spirometer Mouthpieces _____ Spirometer Paper _____ Sterilization Monitors _____ Sterilization Pouches _____ Surface Disinfectant _____ Surgical Gloves _____ Tapes _____ Thermometer, Sheaths _____ Tongue Blades _____ Ultrasound Gel _____ Underpads _____ Vaginal Specula _____ X-Ray Envelopes UROLOGY _____ Catheter Trays _____ Catheters _____ Drain Bags _____ Self Caths _____ Xylocaine Jelly INJECTABLES/RX _____ Bacitracin _____ Benadryl _____ Bicillin _____ Blobutin _____ Carbocaine _____ Dip-Tet Toxoid _____ DTP _____ Duracillin _____ Flu-zone _____ Imferon _____ Immune Serum _____ Kenalog _____ Linocin _____ M.M.R. Vaccine _____ Neosporin _____ Polysporin _____ Pnu-Imune _____ ProHIBit _____ Silvadene Cream _____ Tetanus Toxoid _____ Tuberculin PPD _____ Vistaril _____ Xylocaine
Pediatrics LAB EQUIPMENT _____ Allergy _____ Centrifuge _____ Chemistry _____ Cholesterol Test _____ Glucose Analyzer _____ Hematology _____ Incubator _____ Microscope LAB REAGENTS _____ Allergy _____ Chemistry _____ Glucose Strips _____ Hematology _____ Urinalysis Strips LAB DIAGNOSTICS _____ Allergy _____ Chlamydia _____ Culture Plates _____ Mono _____ Flu Tests _____ FOBT _____ Rheumatoid _____ Strep Tests LAB SUPPLIES _____ Agar Culture Plates _____ Alcohol Preps _____ Biohazard Bags _____ Blood Collection Needles _____ Blood Collection Tubes _____ Capillary Tubes _____ Cervical Scraper _____ Culturette _____ Cytology Fixative _____ Dispettes _____ Glucose Tolerance _____ Kimwipes _____ Lancets _____ Micro Slides _____ Microscope Slips _____ Plastic Labware _____ Scopette _____ Sensitivity Disks _____ Specimen Container _____ Stains _____ Urine Tube EQUIPMENT _____ Audiometer _____ Autoclave
_____ Batteries, Bulbs _____ Blood Drawing Chair _____ Casework _____ Cryosurgical Unit _____ Defibrillator _____ Doppler _____ Electrosurgery Unit _____ Exam Table _____ Headlight _____ I.V. Stand _____ Lights _____ Mayo Stand _____ Otoscope/ Ophthalmoscope _____ Oxygen Tank _____ Power Exam Table _____ Pulse Oximeter _____ Refrigerator _____ Scale/Baby Scale _____ Sphygmomanometer _____ Sphyg Wall Mount _____ Sphyg Parts _____ Spirometer _____ Stethoscope _____ Stethoscope Parts _____ Suction Pump _____ Tables, Stools _____ Thermometer _____ Trash Can _____ Tympanometer _____ Ultrasonic Cleaner _____ Utility Cart _____ Vision Tester _____ Vital Sign Monitor _____ Wheelchair _____ X-Ray View Box PAPER/DISPOSABLES _____ Capes _____ Drape Sheets _____ Gowns _____ Table Paper _____ Towels and Dispenser _____ Towel Swabee HOUSEKEEPING _____ Can Liners _____ Cleaners _____ Disinfectants _____ Tissues _____ Soaps, Dispensers _____ Toilet Tissue
_____ Towel, Roll _____ Water Cups SURGERY _____ Administration Sets _____ Betadine _____ Biopsy Needles _____ Blades, Scalpels _____ Caps, Masks _____ Hoods _____ Distilled Water _____ Electrosurgery Tips _____ I.V. Infusion Sets _____ I.V. Needles _____ Procedure Trays _____ Saline _____ Skin Markers _____ Skin Punches _____ Solutions _____ Spinal Needles _____ Steri-Strips _____ Sterile Drapes _____ Sterile Water _____ Sterilization Supplies _____ Surgeon’s Gloves _____ Surgical Instruments _____ Suture GENERAL SUPPLIES _____ Ace Bandage _____ Alcohol, Peroxide _____ Applicators _____ Band Aids _____ Band Aids, Cartoon _____ Bulbs and Batteries _____ Cotton Balls _____ Disinfecting Spray _____ Enzymatic Cleaner _____ Exam Gloves _____ Gauze _____ Growth Charts _____ Instrument Cleaner _____ Instrument Cleaning Brushes _____ Germicide _____ Lubricating Jelly _____ Mayo Stand _____ Otoscope Specula _____ Oxygen
_____ Needles/Syringes _____ Sharps Collectors _____ Silver Nitrate App _____ Skin Care Products _____ Spirometer Mouthpieces _____ Spirometer Paper _____ Sheaths _____ Tapes _____ Table Paper _____ Thermometer _____ Tongue Blades _____ Ultrasound Gel _____ Underpads _____ Vaginal Speculum _____ Waste Receptacles UROLOGY _____ Catheter Trays _____ Catheters _____ Drain Bags _____ Self Caths _____ Xylocaine Jelly INJECTABLES/RX _____ Bacitracin _____ Benadryl _____ Bicillin _____ Blobutin _____ Carbocaine _____ Dip-Tet Toxoid _____ DTP _____ Duracillin _____ Flu-zone _____ Imferon _____ Immune Serum _____ Kenalog _____ Linocin _____ M.M.R. Vaccine _____ Neosporin _____ Polysporin _____ Pnu-Imune _____ ProHIBit _____ Silvadene Cream _____ Tetanus Toxoid _____ Tuberculin PPD _____ Vistaril _____ Xylocaine
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RESOURCES
Physician Office set ups OB/GYN LAB EQUIPMENT _____ Allergy _____ Centrifuge _____ Chemistry Analyzer _____ Cholesterol Testing _____ Glucose Analyzer _____ Hematology Analyzer _____ Incubator _____ Microscope _____ PT Testing _____ Urinometer LAB REAGENTS _____ Allergy _____ Chemistry _____ Glucose Strips _____ Hematology _____ Urinalysis Strips LAB DIAGNOSTICS _____ Allergy _____ Chlamydia Tests _____ Culture Plates _____ Flu Tests _____ Herpes Tests _____ Mono Tests _____ Hemoccult _____ Ovulation Tests _____ Pregnancy Tests _____ Rheumatoid _____ Strep Tests LAB SUPPLIES _____ Alcohol Preps _____ Biohazard Bags _____ Capillary Tubes _____ Cervical Scraper/Brushes _____ Culturette _____ Cytology Fixative _____ Dispettes _____ Glucose Tolerance _____ Kimwipes _____ Lancets _____ Microscope Slides _____ Microscope Slips _____ Needles and Syringes _____ Pap Smear Kits _____ Plastic Labware _____ Scopette _____ Sensitivity Disks _____ Specimen Collectors _____ Stains and Reagents _____ Urine Tube EQUIPMENT 18
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_____ Autoclave _____ Batteries, Bulbs _____ Blood Drawing Chair _____ Bone Density Unit _____ Colposcope _____ Cryosurgical Instrument _____ Defibrillator/AED _____ Doppler (Fetal and Vascular) _____ ECG _____ Electrosurgery Unit _____ Fetal Monitor _____ Headlight _____ HysteroscopyVideo System _____ Hyfrecator _____ I.V. Stand _____ Laparoscope _____ Lights _____ Mayo Stand _____ Otoscope/ Opthalmoscope _____ Oxygen Tank _____ Power Table _____ Pulse Oximeter _____ Scale _____ Spirometer _____ Sphyg Aneroid _____ Sphyg Parts _____ Stethoscope _____ Stethoscope Parts _____ Suction Pump _____ Tables, Stools _____ Thermometers _____ Trash Can _____ Ultrasonic Cleaner _____ Ultrasound Unit _____ Utility Cart _____ Vital Signs Monitor _____ Wheelchair _____ X-Ray View Box PAPER/DISPOSABLES _____ Capes _____ Drape Sheets _____ Gowns _____ Table Paper _____ Towels and Dispenser _____ Towel Swabee HOUSEKEEPING _____ Can Liners _____ Cleaners _____ Disinfectants _____ Tissues
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_____ Soaps, Dispensers _____ Toilet Tissue _____ Towel, Roll _____ Water Cups SURGERY _____ Administration Sets _____ Betadine _____ Biopsy Forceps _____ Biopsy Needles/Punch _____ Blades, Scalpels _____ Caps, Masks, Hoods _____ Distilled Water _____ Electrocsurgical Electrodes _____ Endocervical Specula _____ Endocervical Curette _____ Endoscopic Video Camera _____ F.O. Cable _____ Flexible Grasper _____ Flexible Biopsy Spoon _____ Flexible Scissor _____ Forceps _____ Histobrush _____ Hysteroscope _____ Hysteroscopy Procedure Kits _____ Hysteroscopy Sheath _____ I.V. Infusion Sets _____ I.V. Needles _____ LED Light Source _____ Monitor _____ Procedure Trays _____ Retractors, OB/GYN _____ Saline _____ Scissors _____ Skin Markers _____ Skin Punches _____ Solutions _____ Spinal Needles _____ Steri-Strips _____ Sterile Water _____ Sterilization Supplies _____ Surgeons Gloves _____ Surgical Instruments _____ Suture _____ Tenaculum Hook GENERAL SUPPLIES _____ Ace Bandage _____ Adhesive Strips _____ Alcohol, Hand Gel _____ Alcohol, Peroxide _____ Applicators
_____ Band Aids _____ Boot Covers _____ Cotton Balls _____ Disinfecting Spray _____ Enzymatic Cleaner _____ Exam Gloves _____ Face Masks _____ First Aid Kit _____ Gauze _____ Gauze Sponge _____ Hand Lotion _____ Instrument Cleaner _____ Instrument Cleaning Brush _____ Instrument Germicide _____ Instrument Lubricant _____ Instrument Tray _____ Kling, Soft-Kling _____ Lubricating Jelly _____ Needles/Syringes _____ Oto/Ophth. Bulbs _____ Sharps Collectors _____ Silver Nitrate App _____ Skin Care Lotions _____ Surface Cleaner _____ Tapes _____ Thermometer, Sheaths _____ Tongue Blades _____ Ultrasound Gel _____ Underpads _____ Vaginal Speculum _____ Wound Closure Strips _____ X-Ray Envelopes UROLOGY _____ Catheter Trays _____ Catheters _____ Drain Bags _____ Self Caths _____ Xylocaine Jelly INJECTABLES/RX _____ Bicillin _____ Carbocaine _____ Delestrogen _____ Depo-Estradiol _____ Depo-Medrol _____ Depo-Provera _____ Flu-zone _____ Gamulin (RMOgam) _____ Kenalog _____ Narcaine _____ Neosporin, Polysporin _____ Xylocaine
Equipment sales Successful equipment sales calls for a broader look at the customer’s wants and needs. A medical equipment sale used to be just about sell-
ing a table or light, says Kurt Forsthoefel, director, medical marketing, Midmark. “But, in today’s marketplace, the sale is about helping the customer determine the right equipment and technology, as well as helping them identify the workflow that provides the best experience for both the medical staff and the patient.” Says Garrison Gomez, senior director of vital signs and cardiopulmonary devices, Welch Allyn, “Accuracy and durability are expected, but they’re no longer all that’s expected. It’s now a standard requirement for devices to be EMR-connected, in a secure fashion. To help improve today’s workflows and satisfy IT requirements, analog devices don’t make the cut. Customers demand secure, digital devices.”
An ‘ecosystem’ “Today’s healthcare providers need not only improved efficiency and throughput, but a holistic exam room solution that facilitates evidence-based care,” says Forsthoefel. A case in point is Midmark Clinical Solutions, a web-based workflow tool that helps customers determine the right space and the right equipment for their needs, he says. “Especially as the industry shifts toward value-based care, it’s important to create a point-of-care ecosystem in the exam space, which supports compliance efforts and focuses on patient satisfaction,” he says. “Today’s equipment and technology solutions must also marry longstanding value traits like accuracy and durability with the need for better outcomes.” Equipment such as the Midmark IQvitals Zone helps to standardize vitals acquisition by removing variability associated with manual measurements and reduces data entry errors by directly porting data to an electronic medical record, says Forsthoefel. “This not only improves the quality of care and accuracy of the measurements, but it also reduces errors. This makes the care provided more efficient (no medical assistant time
is required to enter the data) and more accurate (fewer errors) to help support better outcomes.”
Connectivity The point-of-care ecosystem goes beyond the direct interaction between patient and caregiver to include everything that happens within the practice or clinic as well as experiences that occur outside this environment, says Forsthoefel. “When viewed through this broad lens, it is easier to understand just how important interoperability – the ability of networks, devices and equipment to work together – is. Within the pointof-care ecosystem, there is a lot of equipment and software that need to ‘talk’ to each other to help deliver quality care. “Unfortunately, for most healthcare organizations, the point-of-care ecosystem is comprised of disconnected processes, devices and components, making it tough to achieve the level of interoperability mentioned above,” he adds. “Additionally, the isolated processes and disconnected data flows can create inefficiencies, communication breakdowns and human errors. “We see healthcare organizations looking for solutions that introduce new levels of connectivity and interoperability, which integrate processes, equipment and caregivers at the point of care to ensure a more satisfying and seamless care experience. They need equipment that can not only communicate directly to an EMR to avoid errors, but also EMRs that can share information between providers and networks with ease.” Says Gomez, “Interoperability can refer to connecting data between two devices, but connecting to the EMR is the most common scenario. EMR connectivity is not negotiable anymore. It’s a requirement and a necessity. No practice should invest in a device today that cannot connect to their EMR. Even if they don’t connect it today, they will almost definitely want to connect before the end of the device’s life cycle. The investments they make today should support that reality.”
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Inductees 2001-2018 George Blowers Welch Allyn 2001 Inductee
George Ransdell Ransdell Surgical 2004 Inductee
Ted Almon Claflin Co. 2012 Inductee
Jim Stover 2001 Inductee
Max Goodloe General Medical 2005 Inductee
Rob Saron Bovie Medical Corp. 2013 Inductee
Gil Minor III Owens & Minor 2006 Inductee
Bill McLaughlin Sr. IMCO 2014 Inductee
Pat Kelly PSS 2002 Inductee
Elliot Werber 2007 Inductee
Yates Farris IMCO 2014 Inductee
Ron Stephenson Indiana University 2002 Inductee
Lew Allyn Welch Allyn 2008 Inductee
Bob Barnes Durr-Fillauer 2002 Inductee
Bill Allyn Welch Allyn 2008 Inductee
Karl Bays American Hospital Supply 2002 Inductee
John Sasen PSS 2009 Inductee
DeWight Titus F.D. Titus & Sons 2001 Inductee
John McGuire Sr. Colonial Hospital Supply 2003 Inductee Haworth Parks Parks Inc. 2003 Inductee Bill McKnight McKnight Medical Communications 2004 Inductee
John Moran Welch Allyn 2010 Inductee Don Kitzmiller Midmark Corp. 2011 Inductee Scott Fanning Midmark Corp. 2011 Inductee Cindy Juhas Hospital Associates 2012 Inductee
Brian Taylor MDSI (now Share Moving Media) 2015 Inductee Brad Connett Henry Schein 2016 Inductee Dick Moorman Midmark 2017 Inductee Mike Carver GOJO Industries 2017 Inductee Tony Melaro Welch Allyn 2017 Inductee Paul Julian McKesson Medical-Surgical 2018 Inductee
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MEDICAL DISTRIBUTION HALL OF FAME George Blowers George Blowers is remembered for recognizing the need for profesWelch Allyn sionalism and training among distributor sales reps. He served as sales 2001 Inductee manager, vice president of sales and then executive vice president of
Welch Allyn. In 1987, at the Health Industry Distributors Association in Las Vegas, Blowers was awarded the HIDA Industry Award of Distinction. Much of his passion for training was purely selfish. “When I started going on the road, I discovered that the average distributor salesperson had 18,000 things to sell, each in five different sizes,” he said. “You couldn’t expect the guy to know that much about my product.” So he made sure they did. Blowers became active in the Medical Surgical Trade Association, an association of manufacturers. Ultimately he became chairman of its sales training committee, which was geared largely toward the education of distributor reps. Blowers showed his true colors to those that attended the seminars. Always well-dressed and punctual to a fault, he would dress in his Marine uniform to rouse the crowd. Blowers said, “I think salespeople got a kick out of it.” But he also believed that most reps could benefit from a little discipline, because most were way too comfortable doing their own things. Blowers will be remembered for his humor, passion for sales training, intuitiveness, generosity and his disposition.
2001
Jim Stover was second-generation leader of the William T. Stover Compa-
ny, Little Rock, AR; chairman of the Health Industry Distributors Association in 1982; president of HIDA from 1987 to 1993; and president of National Distribution & Contracting Inc. from 1993 to 2005. Stover was among the first to apply computer technology to inventory control and order processing in the late 1960s. Ten years later, the Stover Co. introduced the Stover Order System, which allowed customers and sales reps to place orders by punching in an order or scanning a bar code. Stover took an early, active role in the American Surgical Trade Association (later HIDA), and in 1982 became its chairman. It was during his tenure that ASTA’s Long-Range Committee moved to change the name of the organization to HIDA, a change that was ratified by the membership at the organization’s annual meeting in 1982 in Las Vegas. Stover sold his company to Alco Standard. In 1987, he moved to Washington, D.C., to become president of HIDA. During his tenure, the association published “Stockless Materials Management,” an in-depth study of the costs and benefits of stockless purchasing; and proceeded with its broad industry initiative on supply chain improvement, the Paradigm Project. In 1993, Stover moved to Nashville, Tenn., to become president of ABCO Dealers. Under his leadership, ABCO acquired StarLine Dealers Association and CIDA Inc., and formed National Distribution & Contracting, a holding company for distribution cooperatives.
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Jim Stover 2001 Inductee
DeWight Titus F.D. Titus & Sons 2001 Inductee
DeWight Titus, a pharmacist by training, molded his family’s com-
pany in Southern California – F.D. Titus & Sons – into a model for hundreds of other local and regional distributors in the 1970s, 80s and 90s. The company set a standard for growth, profitability, sales and service excellence, and manufacturer/distributor relationships, and led the country’s suppliers in learning how to adapt to and serve physicians in a growing managed care market. Titus is recognized for sharing his knowledge freely with friends and competitors alike. He served as the Health Industry Distributors Association chairman in 1983, and was two-time chairman of the HIDA Educational Foundation. He was largely responsible for rejuvenating the HIDA Educational Foundation and creating the HIDA Executive Conference. Titus began working in the pharmacy business at F.D. Titus & Sons in 1958. In 1972, he was called on to lead the company’s entree into med/ surg distribution. As president, he orchestrated a series of strategic acquisitions, and grew the company into a $170 million organization with customers in California, Nevada, Arizona and southern Oregon, prior to selling it to General Medical in 1994. He is credited with exercising an open management style, and fostering respect for manufacturers in the company. Titus seized upon the needs of emerging IDNs and physician practice management companies in the 1980s, helping them cope with the new rules of Southern California’s growing managed care market.
2002
Pat Kelly, an orphan, was a fighter from the early days, while growing up at
the Virginia Home for Boys in Richmond. A Marine and one-year high school biology teacher, he took his first medical distribution job with General Medical. He left to join Intermedco and became interested in starting a distribution company focused on physicians. He founded Physician Sales and Service in 1983 promising 24-hour delivery. Lacking branded products or an established customer base, the new company could hardly afford experienced salespeople. For that reason, Kelly began recruiting college grads with little or no experience selling medical products, and proceeded to aggressively train them on product knowledge and selling skills. Training young reps was to become part of the company’s culture. Early on, PSS distinguished itself as an equipment-driven company, and its reps expanded the market for physician-office-lab products. Success in Florida emboldened Kelly to expand the young company’s reach. He began opening up new centers, and then aggressively buying companies around the country. By the time he left PSS in 2000, the company had nationwide coverage and more than $1 billion in annual sales.
Pat Kelly PSS 2002 Inductee
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MEDICAL DISTRIBUTION HALL OF FAME Ron Stephenson, Indiana University professor of marketing, is credited
with teaching the industry how to read a balance sheet and raising the financial bar for distributors. Soon after Stephenson joined the staff at IU, the Medical Surgical Manufacturers Association asked the school to develop an MSMA-sponsored executive education program for distributors. Stephenson, who was working on projects for the National Association of Wholesalers, took on the task. At that time, the industry consisted primarily of owner/managers who had been star sales reps prior to starting their own companies. Stephenson soon realized that while these execs understood markets and customers, they were financially unsophisticated. It was clear that any training program would have to help them learn how to manage margins, etc. At around the same time, Stephenson made a proposal to take over management of the annual financial survey of the members of the American Surgical Trade Association (later called HIDA). Stephenson began conducting the survey around 1970, and continued to do so every year until 2000. The relationship between Stephenson and ASTA grew. He began conducting seminars for the association’s members, and did consulting work for some of them. In 1978, he conducted the first manufacturers’ seminar, a venue in which manufacturers meet distributors and learn how best to work with them.
Ron Stephenson Indiana University 2002 Inductee
2002-03
Bob Barnes With a career in healthcare distribution spanning the years 1952 to 1991, Durr-Fillauer Bob Barnes of Durr-Fillauer witnessed and created a great deal of change in the 2002 Inductee industry. Born and raised in Birmingham, Ala., Barnes attended the Alabama
Polytechnic Institute (which later became Auburn University). After graduating and spending a year and a half in the Army, he became a sales rep for American Hospital Supply. Soon after, he joined a much smaller company, Durr, which had just opened a branch in Birmingham. Barnes carried a bag for 13 years before becoming a regional sales manager and later, manager of the company’s entire med/surg division. Barnes both witnessed and facilitated the industry’s transition from personal, relationship-based, product selling, to systems selling. He encouraged his company (and, as HIDA chairman, the industry) to help hospitals reduce total costs – that is, the cost of acquiring, receiving and using products. He worked closely with Tampa (Fla.) General Hospital to create an inventory-reduction and low-unit-of-measure program, which became a showcase for Durr’s approach to the market. At the same time, he streamlined and automated his company’s relationships with key manufacturers. When Barnes died in 2006, he was remembered by colleagues as generous, cool under pressure, funny, popular, a mentor to young people and a lifelong learner.
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Karl Bays Selected at age 37 to be CEO of American Hospital Supply, Karl Bays was a American Hospital Supply big man with big ideas. Born in 1933 in rural Kentucky, Bays turned down an 2002 Inductee offer to play professional football to pursue a business career. He became a salesman for American and quickly made his mark there. He built the company’s presence in Europe and Asia prior to being selected CEO in 1971. Bays believed in establishing “ruthless priorities” for himself and others. His mantra was “set objectives, plan, organize, motivate and control.” He multiplied the number of American’s distribution facilities around the country, established a corporate program to reward customers for buying from American’s multiple companies, and developed the TelAmerican automated orderentry system, so customers could order products using IBM punch cards. But it was Bays’ personal touch that distinguished him from others. It is said that when he ate in the company’s cafeteria, he would make a point of sitting with people he had never met, often workers from the warehouse or offices. He also had a passion for staying close to the customer, and spent much of his time in the field. Bays had one final big idea – to create a healthcare company that encompassed not only manufacturing and distribution, but patient care as well. In 1985, he made an offer to buy HCA, the for-profit hospital company. The idea was revolutionary, and indeed, met with resistance from many of American’s customers. In the end, Wall Street rejected the plan. Instead, nearby Baxter Travenol bought American. Bays left one year later, and died of a heart attack in November 1989.
John McGuire was crucial in advancing the professionalism of distribution
firms and their sales reps. He was educated as an architect at the Illinois Institute of Technology, where he studied under Frank Lloyd Wright. But when it came time to pursue a career, he chose medical sales, becoming the third sales rep hired by Foster McGaw at American Hospital Supply Corp. In 1952, he left American to buy a faltering local Chicago supplier named Central Surgical. He promptly renamed it Colonial Hospital Supply, with the connotation of hard work and high ethics. (When he founded a subsidiary to focus on medical electronics equipment, he named it “Sentry,” calling to mind the Minutemen of Revolutionary War-era New England.) McGuire emphasized professionalism at all times, and demanded that his people dress and act professionally. At the same time, he is recognized as encouraging his people and creating opportunities for them to succeed. In 1981, Colonial purchased five Upper Midwest facilities of Will Ross, a national distributor of the time, doubling the number of employees and sales. Fourteen years later, in 1995, Colonial expanded into the non-hospital market. That same year, the company was sold to Bergen Brunswig. As he encouraged his own people, so too did McGuire encourage his peers. Always wearing a bow tie, McGuire was a mainstay at the American Surgical Trade Association gatherings. He served as the association’s chairman in 1978 and played a role in its metamorphosis into the Health Industry Distributors Association. He also was a vocal advocate of the health industry number system.
John McGuire Sr. Colonial Hospital Supply 2003 Inductee
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MEDICAL DISTRIBUTION HALL OF FAME Haworth Parks was a strong, decisive leader for his own company – Nash-
ville, Tenn.-based Parks Inc. – and the industry at large. Born in 1926, Parks played basketball at Vanderbilt University. Upon graduating in 1949, he went to work for Nashville Surgical. Fifteen years later, he and some partners founded a hospital distribution company. Parks quickly matured from successful (but financially unsophisticated) salesperson to savvy financial leader. He was an early advocate of computerization and electronic data interchange. His sales reps were among the first to take orders on handheld devices, then download them through the phone lines to the company’s computer. After focusing on hospitals, Parks turned the company into a physician distributorship. At its height, Parks Inc. totaled between $4 million and $5 million in sales. Generous with his time and ideas, Parks served as chairman of the Health Industry Distributors Association in 1988. It was a critical time for the organization, which had changed its name from the American Surgical Trade Association to HIDA six years earlier, and had only recently moved from Chicago to Washington, D.C. Parks felt that the association needed a full-time CEO, preferably someone with industry experience. He persuaded Jim Stover, who had recently sold his company, Alco Standard, to General Medical, to become HIDA’s CEO. Later, Parks became chairman of ABCO Dealers, the distributor buying group. ABCO was facing some challenges of its own, not the least of which was consolidation in the industry. Parks concluded that Milwaukee-based ABCO needed to make some changes, including a move to Nashville. As he had at HIDA, Parks recruited Stover to head up the organization. In 1997, at age 71 Parks sold his company to General Medical.
Haworth Parks Parks Inc. 2003 Inductee
2003-05 Bill McKnight McKnight Medical Communications 2004 Inductee
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A former hospital sales rep with American Hospital Supply Corp., Bill McK-
night launched Medical Products Sales magazine in 1969. It was the first magazine to target the medical distributor sales rep, and reflected McKnight’s belief that it was the distributor sales rep – not management – who largely controlled and moved market share. Several years after its launch, MPS became the official journal of the American Surgical Trade Association (later, HIDA). McKnight himself became a well-recognized figure in the industry, attending shows, accepting speaking engagements, playing the clarinet and getting to know salespeople and CEOs alike. After founding MPS, McKnight went on to start three other healthcare publications: Pharmaceutical Salesman, Purchasing Administration (for hospital purchasing agents) and Today’s Nursing Home. (McKnight owned a small nursing home chain in north suburban Chicago.) He sold his company – McKnight Medical Communications – in 1986. That same year he founded HMMC, an association of senior-level marketing and sales executives with medical products manufacturers.
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MEDICAL DISTRIBUTION HALL OF FAME George Ransdell is recognized as a pioneer in fostering computerization
among medical products distributors. A medical corpsman in the Navy during World War II, he founded Ransdell Surgical in Louisville, Ky., in 1958. He explored the benefits of electronic data interchange and automated inventory control for his own firm, and recognized the value of helping his customers automate as well. He introduced an automated inventory-control system for his customers called RSVP. Recognizing the threat that industry consolidation and group purchasing organizations presented to independent distributors in the 1980s, Ransdell and several others explored starting a national selling organization. To be called the American Medical Distributors Association, the group would have presented itself as a national seller to group purchasing organizations, and hence, compete with the national distributors. The organization never came to fruition, but Ransdell came to realize that the only way such an organization could compete with national companies would be by gathering data electronically from all its members throughout the country. In 1985, he brought Bill Bartoccini to Louisville to explore the use of automated systems to create a national selling organization. Out of those discussions was born Choice Medical Distribution. Choice signed on 21 distributor franchisees by 1993, but lost many of them to consolidation. Ransdell changed course and began offering the Choice automated system to distributors who otherwise could not afford to develop their own systems. The intent was that these distributors would offer automated systems to their customers, so that their customers could order electronically from the distributors. In this way, independent dealers could compete with what Ransdell called “the bigs.” Ransdell sold his company to Bergen Brunswig Corp. in October 1998. Its annual sales were $58 million at the time.
George Ransdell Ransdell Surgical 2004 Inductee
Max Goodloe Max Goodloe, founder of General Medical, pioneered the concept of a naGeneral Medical tional distribution company with a local sales and warehousing presence, so 2005 Inductee that customers anywhere in the country could rely on next-day service. He built
the company through a string of acquisitions that presaged similar strategies by others in the following years – including that of one of Goodloe’s employees, Pat Kelly, who later founded PSS in Jacksonville, Fla. At its peak, General Medical was the No. 1 physician supplier in the country, and the second hospital supplier behind American Hospital Supply. It reached $400 million in sales, employed 1,500 people, and had 80 distinct profit centers, including a number of manufacturing companies. He took the company public on the over-the-counter exchange in 1967; in 1969, the company became listed on the New York Stock Exchange. At the time, he was still personally writing more business than anyone else in the company. In addition to buying distributors to achieve his vision of making General Medical a national company, he also acquired several manufacturing operations. But Goodloe was slow to computerize, hard-pressed to find first-class talent to run the far-flung branches, and frustrated in his attempts to establish a strong presence on the West Coast. He sold the company to Whittaker Corp. in 1980. General Medical, which had employed five sales reps in 1960, had more than 500 reps in the field at the time of the sale. Goodloe died in 1990.
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Gil Minor III In 1963, Gil Minor III joined Owens & Minor – the company his great-grandOwens & Minor father had co-founded as a drug wholesaler in 1882. Minor III became president 2006 Inductee in 1981 and CEO in 1984. Under his watch, employees came to be called “teammates.” Minor’s own business card referred to him as “coach.” He believed that if Owens & Minor’s customers were successful, so too would the company be. And he made sure others in the organization shared that belief. Firm and uncompromising when it came to fundamental values, such as customer service and business ethics, Minor was by all accounts a gentle leader. And he wasn’t much for lecturing. Instead, he led by example, never hesitating to roll up his sleeves and get involved in thorny issues and problems. Under Minor’s leadership, the company developed sophisticated distribution tools, including WISDOM, its data warehousing system, and CostTrack, its activity-based costing module. Minor helped orchestrate more than 20 acquisitions in his 21-year tenure, transforming Owens & Minor from a regional player into a publicly traded, national one. (The company had been listed on the over-the-counter stock exchange since 1971, and was listed on the New York Stock Exchange in 1988.) It was also under his watch that the company made the painful decision in 1992 to leave its roots and sell its drug wholesaling business.
2005 -06 Elliot Werber had tremendous people skills, which he used to help himself
and others navigate through tumultuous times in the industry in the 1980s and 1990s. Born in Brooklyn in 1945, he was a college athlete, and after graduation, taught physical education and served as a high school basketball coach. He entered medical products sales first as a manufacturer, then a distributor. Werber sold medical products for Kendall for a time, then jumped to distribution, working for Max Henlein, owner of Bel Air Surgical in Los Angeles. Later, he became regional sales manager, then vice president of sales, for F.D. Titus & Son (which had acquired Bel Air). In 1994, DeWight Titus sold his company to General Medical. Werber stayed on with General Medical briefly, then left to head up sales for Quidel Corp. Soon thereafter, he returned to distribution, becoming executive vice president of Bergen Brunswig Medical Corp. He later assumed responsibility for companywide sales and marketing. Werber had an uncanny ability to listen to and empathize with people. In an age of uncertainty and consolidation, his personality and extraordinary leadership style helped ease the transition for scores of sales reps whose companies were bought by others, as well as for the manufacturers whose products they sold. He was diagnosed with leukemia in 1990, and died eight years later.
Elliot Werber 2007 Inductee
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MEDICAL DISTRIBUTION HALL OF FAME Lew and brother Bill Allyn represented the third generation of Allyns to
lead Skaneateles Falls, N.Y.-based Welch Allyn. Under their leadership from the late 1970s to the late 1990s, the company built a modern-day sales force, strengthened the company’s ties with distributors, stimulated new-product development, and improved the company’s relationship with its supply chain partners – including distributors – through a series of comprehensive operational improvements. During their years of leadership, they managed to maintain the company’s family culture. A graduate of the school of fine arts at Syracuse University, with a major in industrial design, Lew Allyn improved the design, look and feel of the company’s products. He was instrumental in new-product development, and developed the company’s international business, first in Europe, then in Latin America and Asia. Under the tutelage of sales leader George Blowers, Lew Allyn learned the value of increasing distributors’ product knowledge and creating win-win relationships with distributors.
Lew Allyn Welch Allyn 2008 Inductee
2008 -14 Bill Allyn Bill and brother Lew Allyn represented the third generation of Allyns to Welch Allyn lead Skaneateles Falls, N.Y.-based Welch Allyn. Under their leadership from the 2008 Inductee late 1970s to the late 1990s, the company built a modern-day sales force, strengthened the company’s ties with distributors, stimulated new-product development, and improved the company’s relationship with its supply chain partners – including distributors – through a series of comprehensive operational improvements. During their years of leadership, they managed to maintain the company’s family culture. With an engineering degree from Dartmouth and a master’s degree in business administration, Bill Allyn recognized the value to industry of the company’s fiber optic light source and was instrumental in launching Welch Allyn’s industrial division. In the mid-1980s, after witnessing a formal quality and just-in-time manufacturing program, he implemented the techniques at Welch Allyn. He was also instrumental in computerizing the company and in updating its machinery, leading to shorter manufacturing cycles, more efficient manufacturing processes, and improved product quality.
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One in three people with Atrial Fibrillation will have a stroke.1
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Blackshear, Joseph L., MD, “Appendage Obliteration to Reduce Stroke in Cardiac Surgical Patients With Atrial Fibrillation” <http://www.annalsthoracicsurgery.org/article/0003-4975(95)00887-X/pdf>, The Annals of Thoracic Surgery, 1996;61:755-759
2
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3
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC101077/
© 2018 Welch Allyn
MC15639
MEDICAL DISTRIBUTION HALL OF FAME John Sasen says his story is that of a person who never stopped dreaming,
and who always believed that change can only make a person better and stronger. His career was dedicated to training, education and sales, and he believed that seeking customer solutions and profitability are not mutually exclusive goals, though not always easily managed. Sasen began his medical career as a sales rep for Clay Adams (later, Becton Dickinson). As he rose within BD, he developed a deep commitment to distribution. Ultimately, he was named vice president of sales and marketing for BD Primary Care Diagnostics. He deepened the company’s ties with the Health Industry Distributors Association, and was instrumental in developing the industry’s first certified sales training program. After 20 years with BD, Sasen joined Physician Sales & Service at the urging of company founder Pat Kelly. Soon after joining, he helped mobilize the company’s sales force to move to the forefront selling physician office lab equipment and supplies. At the time of his induction into the Medical Distribution Hall of Fame, he was executive vice president and chief marketing officer for PSS.
John Sasen PSS 2009 Inductee
John Moran As national sales manager for Welch Allyn, John Moran cultivated strong, Welch Allyn lasting and productive relationships with distributors around the country, using a 2010 Inductee combination of humor, strong listening skills and a genuine desire to find solu-
tions to benefit both his company and the distributor. A Vietnam veteran, Moran lived a life of service to others. What’s more, his word was as good as gold, according to those who knew him. And his voice mail messages were legendary. A Chicago native and 1968 graduate of Xavier University in Cincinnati, Ohio, Moran joined Welch Allyn as the company’s seventh salesman in 1974, reporting to sales leader George Blowers. He became manager of Welch Allyn’s newly created Midwest region and several years later, was asked to move to the company’s headquarters in Skaneateles Falls, N.Y., to manage the Northeast region. He became national sales manager and then vice president of sales. In September 2005, he was named vice president of channel relations and in January 2009, was named vice president of corporate distribution.
Don Kitzmiller was key in building Midmark Corp. from an upstart exam-
table and medical furniture company into the market share leader. He created a culture dedicated to distribution, and exemplified energy, enthusiasm and fun in the process. Midmark salespeople were hired for attitude; negativity was not an option. At Kitzmiller’s urging, Midmark took it upon itself to become a teacher of selling skills to a generation of distributor sales reps. Together with colleague Scott Fanning, Kitzmiller devised creative, challenging and profitable promotions. He championed sometimes outrageous trade show exhibits in an effort to differentiate Midmark from other manufacturers. And he excelled in building long-term relationships with distribution executives around the country. Don Kitzmiller believed that “you can’t look neat if your shoes look beat, and you can’t look fine if your shoes aren’t shined.” Those who called him on the phone would always be greeted with a “Top of the day, Don Kitzmiller.” Negativity was not an option.
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Don Kitzmiller Midmark Corp. 2011 Inductee
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MEDICAL DISTRIBUTION HALL OF FAME As vice president of sales and marketing for Midmark Corp., Scott Fanning
recognized the importance of distributors in helping the company achieve success against long odds in the market. With colleague Don Kitzmiller, he realized that in order to win the support of distributors, Midmark had to differentiate itself from other manufacturers. Fanning taught selling skills to thousands of distributor reps, bringing intensity, enthusiasm and fun to each session. He taught Midmark – and the industry – the importance of helping distributors look good in front of their customers. Fanning also understood that people buy from people they like, and that people are drawn to fun. It was part of what he called “having the customer at ‘hello.’” Scott Fanning never said “No” to a customer, and he wrote the book on “owning the relationship” with the people he called on. He was said to have a competitive drive that was second to none, and he passed on his love of gambling – cards, horses, anything at hand, really -- to a generation of distributor reps and others in the industry.
Scott Fanning Midmark Corp. 2011 Inductee
Cindy Juhas Passionate about everything she did, Cindy Juhas couldn’t hear “no.” She Hospital Associates preached the value of training for manufacturer and distributor sales reps, not to 2012 Inductee mention customers. Hundreds of sales reps sold at a higher level because of her.
As a founder of Professional Women in Healthcare, Juhas had a profound impact on women in the industry. She was selected as the Health Industry Distributor Association’s first female chairperson in 2002, and received the association’s Industry Award of Distinction in 2007. Juhas was creative in her business, Hospital Associates, and quick to adapt to changing market conditions. She recognized that for programs to succeed, they had to serve the customer, manufacturer and distributor. She served as a model for other independent distributors. Cindy Juhas was said to have one of the loudest laughs in the industry. But people seemed to love hearing it. “She lives in bright colors,” it was said of her.
When Ted Almon hooked his chain onto something, he wasn’t going to fail.
At 28, he acquired a failing regional distributor named Claflin Co., and grew it into a successful regional acute-care distributor, one of the last independents in that market. In 1986, he adapted the “just-in-time” inventory management technique from the Japanese auto industry to create one of the first stockless purchasing programs in healthcare. As chairman of the Health Industry Distributor Association, he spurred the Paradigm Project, the first critical look at the healthcare supply chain. He served on the boards of two local hospitals, was an appointee of the Rhode Island Governor’s Healthcare Reform Commission, and served on a variety of industry and business task forces dealing with health reform. Almon had courage, confidence and conviction, without the arrogance to which he might be entitled. He was also supercompetitive. It is said that playing golf with him was enjoyable, so long as you were his partner.
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Ted Almon Claflin Co. 2012 Inductee
MEDICAL DISTRIBUTION HALL OF FAME Somewhere on a wall in Bovie Medical Corporation’s Clearwater, Fla., facil-
Rob Saron ity is a registered trademark of which President Rob Saron is particularly proud. Bovie Medical Corp. It reads Dedicated to Distribution®. Saron has been dedicated to distribution for 2013 Inductee
years. Witness the creative promotions, the crazy costumes at the dealer trade shows, and the personal attention he and his team pay to their distributor partners. That dedication has paid off, allowing the relatively small Bovie – formerly Aaron Medical Industries – to play like one of the big boys. Saron never forgot the four key points of Scott Fanning’s “Seeing is Believing” program in Chicago: 1) own the relationship, 2) tell the best story, 3) pound the beaches with it, and 4) turn your salespeople – your direct sales force or your distributors’ reps – into dolphins, that is, let them be creative geniuses.
Called a champion of independents, Bill McLaughlin Sr. joined IMCO in 1989,
when the organization had about 50 distributor members, 90 vendors, combined sales of $120 million, and a staff of three. By 2013, the organization had 170 distributor locations, 212 vendors, combined member sales of $4 billion and a staff of 21. His mission for IMCO was clear from Day One: To play a vital role in helping regional distributors compete with the nationals. McLaughlin ensured that IMCO remain selective in adding members, in order to minimize overlap. He designed promotions – most notably, the Winner’s Circle – to allow members and vendors to promote on a national level during select periods of time. He grew the organization’s private-label program, and initiated a training program to help members improve their selling skills, business acumen and product knowledge. McLaughlin was noted for being a strategic thinker, for being a strong but fair negotiator, for being a “herder of cats,” and – for his tenacity – a “dog with a bone.”
Bill McLaughlin Sr. IMCO 2014 Inductee
Yates Farris As a sales rep and then sales manager for Winchester Surgical Supply, then IMCO as vice president of primary care markets for IMCO, Yates Farris was remark2014 Inductee able in his genuine concern for others, according to those who knew and worked
with him. Farris built a sense of accomplishment and camaraderie among the reps at Winchester, many of whom built successful medical sales careers because of his mentorship. He joined IMCO in 1995, a crucial time for independent distributors, as consolidation was rampant. His experience, knowledge of distribution, relationship-building skills, enthusiasm and generosity helped the organization and its individual members thrive. A staunch student and defender of distribution, Farris had the ability to communicate its value to manufacturers. He was a terrific salesman, leader and friend to many in the industry.
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MEDICAL DISTRIBUTION HALL OF FAME
2015-2018 Brian Taylor MDSI (now Share Moving Media) 2015 Inductee
What began as a faxed newsletter to distributor reps in 1993 grew into a
company dedicated to training supplier and providers on successful supply chain strategies. Behind that newsletter – now called Repertoire magazine – was Brian Taylor, who, with Chris Kelly, founded Medical Distribution Solutions Inc., or MDSI (now Share Moving Media), publisher of distributor-oriented publications, electronic training tools (Education OnLine, or EOL), databases and more. While operating an independent rep firm, Southern Sales Associates, Taylor and Kelly got the idea for the newsletter from a mentor and former boss – George Blowers, executive vice president, Welch Allyn. “For an old-school guy, George had some pretty modern insights,” says Taylor. “He’s the one who said, ‘If you’re not in front of [the distributor reps], someone else is.’” Blowers suggested that the two fax a newsletter to their distributor reps, as a way of staying in touch while educating them on the products that Southern Sales Associates represented. “We bought a used fax machine. It was cool at the time – technology,” recalls Taylor. “And we got lots of responses.” In fact, the newsletter created work, as distributor reps began asking Southern Sales to come out and work with them. That field work translated to sales, and underscored the need for educating distributor reps on products and selling skills.
It could be the summers spent longlining swordfish on a commercial fish-
ing vessel off the North Carolina coast. Or, the years spent getting to know, understand and integrate sales reps from multiple independent distributors whom his company acquired while growing its presence in the medical market. Perhaps it was hours spent as a kid in his grandfather’s leather tannery – Surpass Leather Company – in South Philly, a tough part of town. Or a pick-up basketball game while he was a senior at the University of North Carolina, facing a tough, competitive freshman – Michael Jordan. Whatever the reason, Brad Connett is cool under pressure. That trait, plus his thirst for knowledge, desire to lead and help others succeed, and the ability to laugh, have made Connett, vice president and general manager, Henry Schein Medical, a respected figure in the industry.
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Brad Connett Henry Schein 2016 Inductee
The Anniversary Is Silver. The Legacy Is Gold.
Henry Schein Medical congratulates Repertoire for 25 sterling years of serving health care distributors with the latest trends, intelligence, and news. Henry Schein Medical is dedicated to providing customers with a superior experience through expert advice, strategic resources, and integrated solutions that enable the best quality patient care and enhance efficiency and productivity. No matter where health care is headed, our Team Schein Members will continue to benefit from the information, communication, and education they can only get from Repertoire.
We wish you many more years of success!
MEDICAL DISTRIBUTION HALL OF FAME
Dick Moorman Midmark 2017 Inductee
Could Dick Moorman ever have been anything but a salesman?
“My father would drive to Indiana to buy melons,” recounts Moorman, vice president of distributor relations for Midmark. “He would buy a whole car trunk full and then have me load up my coaster wagon and go door to door in Minster (Ohio), selling those melons. “As a young child, we would hunt night crawlers for bait. I would load them up in that same coaster wagon and take them up to Bud’s Bar/gas station and sell them to Bud for a dime a dozen. He then sold them to all the local people for 50 cents a dozen. In junior high I got a job at the local Mobil gas station. We were given bonuses at Christmas based on how many wiper blades and window-washer fluid we could sell. That was back in the days of full service at the pumps. “In middle school, before school, I carried milk baskets for Denny Monnin, and sold milk, juice, etc. along the route in Minster Machine and the pattern shop. We had an established route in there. I’d deliver a pint of chocolate, a bottle of orange drink, and I picked up the used bottles.” (This was in the days before vending machines.) “My first weekly paycheck was $3.38.”
Mike Carver believes he is one of the few who were destined to go into med-
ical sales. “I knew when I went away to college, that I would end up in the medical supply industry,” he says. “All I wanted to do was to carry a bag, like my dad.” He graduated from the University of Tennessee in 1973 with a degree in business administration. When home for the holidays and during summers, he worked at Medical Arts/General Medical, where his father, Gene Carver, had worked his way up to partner and general manager. “I loved being around all of the sales guys,” he says. “They always had a story to tell, they were funny, they had nice cars, they dressed well, they were good-looking type guys, and they all seemed to do well financially and to be happy.” Forty-three years later, he couldn’t be happier with his decision to pursue medical sales. “I am truly a blessed man to have been able to spend my career in medical sales,” he says. “It would be hard to perceive anyone loving their friends or having any better relationships in the industry than I do. Meaningful relationships remain the priority for success.”
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Mike Carver GOJO Industries 2017 Inductee
MEDICAL DISTRIBUTION HALL OF FAME
Tony Melaro Welch Allyn 2017 Inductee
Door-to-door insurance salesman Angelo Melaro knew practically every
one of Olean, New York’s 20,000 citizens. His wife, Gloria, raised three kids, went back to school when she was 50, got an RN degree, and worked as an OR supervisor till she was in her 70s. No wonder their kid – Tony Melaro, director of national accounts for Welch Allyn – turned out the way he did: energetic, hard-working, focused, enthusiastic, born to sell…and funny. “I didn’t care for the insurance business,” says Melaro, reflecting on his father’s career. “But I was attracted to the people part. He had so many friends. He went door-to-door selling life insurance, like the Fuller Brush man. That’s a tough job. I always respected that he was pounding the pavement. I think he was successful because of his personality. He was outgoing, wasn’t afraid to talk to people. He engaged himself with people. “And my mom waitressed early on, to make money. Then she got her RN and served as OR supervisor at the local hospital.” Melaro graduated with a biology degree in 1979 from Potsdam State in Upstate New York, and was living with a couple of friends in an apartment in Syracuse. To make rent money while mailing out resumes, he got a job with North American Van lines, the moving company. One day he found himself with two or three other guys moving George Blowers, who had just retired as executive vice president at Welch Allyn and was moving to North Carolina. They got to talking, and in November 1979, Melaro began his training at Welch Allyn’s facility in Skaneateles.
Paul Julian gets things done. He built McKesson Medical-Surgical into a
nationwide distributor for the non-acute market. He did it with speed, efficiency, discipline, leadership and focus. He was a key player in McKesson’s 1997 acquisition of General Medical, the 1998 acquisition of Red Line Healthcare (now McKesson Extended Care), the sale of its acute-care business to Owens & Minor in 2006, and its acquisition of PSS World Medical in 2013. He also played a key role in strengthening and expanding McKesson’s presence in pharmaceutical distribution and operations, both in the United States and abroad. “He has brought tremendous discipline to our industry vis-à-vis the focus he has demanded within McKesson, which has set healthy bars within the marketplace,” says Stanton McComb, president, McKesson Medical-Surgical. “He reshaped the industry with dozens of massive acquisitions, e.g., US Oncology, PSS World Medical, Per-Se/RelayHealth, Celesio, to name only a few.”
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Paul Julian McKesson Medical-Surgical 2018 Inductee
Top 5 Reasons to Love Repertoire Magazine 5. Who doesn’t love pronouncing the title of a magazine with a French accent? 4. A true partner who knows and loves the healthcare industry like McKesson does 3. It’s something we actually look forward to finding in the mailbox 2. A magazine with sales reps in mind 1. Everyone loves a Millennial!
Happy 25th Birthday! Congratulations Repertoire! McKesson Medical-Surgical sends a heartfelt congratulations to the team at Repertoire. Here’s to many more years of success! © 2018 McKesson Medical-Surgical Inc.
MEDICAL DISTRIBUTION HALL OF FAME
Hall of Fame Quiz Editor's Note: For full features on each of the inductees (and help with the answers to the quiz), visit the Repertoire Magazine archives online at www.repertoiremag.com
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How could distributors fail to love this Florida-based Hall of Famer, whose manufacturing firm has the following registered trademark: Dedicated to Distribution®? Would dress as a U.S. Marine Corps drill sergeant to conduct memorable sales training seminars for distributors in Sagamore in Upstate New York. (Additional clue: Was awarded the Distinguished Flying Cross and two gold stars for his service in the Pacific in World War II.) Referred to as the passionate “mother bear” for the independent distributor. Also called a “dog with a bone” for his determination on behalf of independents. Drove 198,000 miles a year in his first two years as a medical salesperson, but quickly learned how to be more efficient in his travels. During his tenure at HIDA, oversaw publication of seminal work on “Stockless Materials Management.” When he started his newsletter, he thought fax machines were the coolest. But he caught on to electronics, and was among the first in the business to develop online training programs for medical sales reps. Learned how to defend himself as a small kid in an orphanage, explaining to Repertoire: “Anytime a kid picked a fight with me, I’d grab him. I’d wrap my arms around him as best I could. Then I would sink my teeth into whatever part of his body was handiest. And keep them there.” Learned how business operates while working for Captain John Juni on a commercial fishing boat off the North Carolina coast. The lessons came in handy as he helped Henry Schein grow from an East Coast player to a national one.
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Using a blue-and-yellow checked sports jacket and pants as props, created sigmoidoscope expert Dr. Ben. Seized upon the needs of emerging IDNs and physician practice management companies in the 1980s, helping them cope with the new rules of Southern California’s growing managed care market In his early days in sales, this Vietnam vet was said to show up at distributors’ offices wearing a high-gloss jacket, white pants and white shoes, leading distributor reps to call him the Good Humor man. This Hall of Famer – said to have one of the loudest laughs in the industry – joined F.D. Titus & Sons in 1982, and for a while was a shared rep with the Clay Adams division of Becton Dickinson. Told Repertoire, “One out of 10,000 people is a horse’s rear end, but the manufacturers, customers and distributors I met are the greatest bunch of people in the world.” For over 20 years, has hosted the annual “Friends of the Healthcare Industry” event to support a food pantry for residents in need in Knoxville, Tennessee. Studied architecture under Frank Lloyd Wright at the Illinois Institute of Technology, then became the third sales rep hired by Foster McGaw at American Hospital Supply – before buying a faltering local Chicago supplier named Central Surgical in 1952. This Hall-of-Famer is famous for demanding very fast and short business dinners. Says one observer, “If the dinner does not wrap up, he will wrap it up for you.” Gathered the entire factory crew in the middle of a cornfield to applaud distributor reps as they got off their bus for a training session – a demonstration of his desire to “own the relationship.”
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The joke at his company: “We’re bringing in people so young they need their mother’s permission.” (Additional clue: Was offered a spot on the Chicago football team, the Cardinals.) Pioneered the concept of a national distribution company with a local sales and warehousing presence. (Additional clue: Told recruiter he attended Massey University – a fictitious school – so he could fly B-25 bombers in World War II.) Many salespeople like to talk, but perhaps this Hall of Famer’s greatest strength was his listening skills. (Additional clue: Wanted to pursue air traffic control and warning in the Air Force, but – due to his colorblindness – became a medic instead.) Taught the distribution industry how to read a balance sheet. Of this person, Jana Quinn said “One thing I learned from him was to really be present, that the most important moment is the one you’re in, and that the person you’re talking to is the most important thing at that moment.” (Additional clue: Graduated from Pan America College on a basketball scholarship.) This Vietnam vet discovered his first love – selling – in grade school, when he gave a convincing science-fair presentation on a line of vitamins and mineral supplements. (The president of the company for whom his father worked wanted to buy some.) A pioneer in automation, whose sales reps took orders on handheld devices and then downloaded them through phone lines. (Additional clue: Was a center and forward on Vanderbilt University basketball.)
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Of the two brothers who oversaw the greatest growth of Welch Allyn, he was responsible for the cool look and feel of the company’s instruments – no surprise, having attended the college of fine arts at Syracuse University. Long before there was Repertoire, there was Medical Products Sales, founded by this former American Hospital Supply sales rep Saw automation as a way for independent distributors to compete against what he called “the bigs.” Worked as a hyperbaric diving specialist and rescue diver before spending 20 years at Becton Dickinson and 19 at PSS. As a sales rep, he was able to convince customers that white was the best color for analyzers, failing to mention that white was the only color the company offered. Bought a distribution company at age 28, and about 20 years later launched one of the country’s first stockless purchasing programs at the same hospital where he had been born. Made a painful decision to exit the company’s wholesale drug business, and went on to acquire more than 20 companies in the 21 years he led the firm. Of the two brothers who oversaw the greatest growth of Welch Allyn, he was responsible for developing the company’s R&D program and operational improvements.
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CELEBRATING
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Years vol.16 no.3
March 2008
Making the little things add up to big sales numbers. vol.16 no.8
August 2008
Landing Capital Equipment Orders
Ticketto
Sell Rates vol.26 no.4 • April 2018
repertoiremag.com
April 2018
Infection
Infection Rates Down — Providers are making progress on reducing healthcare-associated infections
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Down Providers are making progress on reducing healthcareassociated infections
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YEARS
Turbulent decade: the ’90s Cost-consciousness came to dominate the industry in the late 1990s Repertoire got its start in the 1990s, a turbulent decade. The prior decade saw the birth of DRGs, and the 1990s saw
a growing cost-consciousness among payers and providers. Consolidation among distributors and manufacturers ushered in a new era in the healthcare supply chain. Technology took off, both in the form of new medical equipment and products, and business technology, such as sales automation, practice management software and, of course, the Internet. Despite the turbulence, many of the observations made during that decade in these pages ring true – and/ or prescient – today. Some are downright frustrating, because the hopes for improvement back then have yet to come to fruition. Here are some examples from the pages of Repertoire in the latter half of the ’90s.
Will price pressure recede?
Leveling the playing field
A lot more to say
“The industry standardization that the Efficient Healthcare Consumer Response (EHCR initiative launched at
“Overcoming the price issue will certainly be one of the major challenges discussed at this year’s [HIDA] trade show in Fort Lauderdale. While it may never go away completely, the shifting focus to quality, value and true cost will certainly temper the price issue.” – The editors, August 1996.
“I think distribution is the key to success in the relationship between manufacturer and customer long-term. It has been proven over and over again that distribution can take cost out of “ It’s become very important, the system….We believe distribution will have a lot more to say than it has on both sides of the fence, in the past 20 years, mainly because to look at outcomes and distribution is gaining channel power. to prove that though your We’re getting down to a few key playproduct may cost more on a ers. Regardless of who has control line-item basis, it is actually over who, at the end of the day, the more economical to use in best we can do as a manufacturer, a distributor or a customer is to figure the long run. ” out how we can do it together.” – Pat – Jerry Olive, contract administrator, Kelly, founder, PSS, whose company Health Services Corporation of America (now MedAssets) was looking forward to $600 million in sales in 1997. August 1996. the HIDA convention in Las Vegas in October 1995) can develop, coupled with low cost hardware and plug-and-play Wipe out distributors? software, will make it an easy and low-risk entry into elec“The role of the distributor in realizing the potential tronic commerce for any medical distributor, regardless of $11 billion in savings that EHCR found buried in ineffisize. And the best part is that by participating in this new cient supply chain management is crucial. As the June 10 environment, the smaller company will ‘neutralize’ what Wall Street Journal article set forth, standardization is heretofore has been an ‘electronic’ advantage held by their at the heart of ending the ‘logistics nightmare’ in the larger competitors.” – Mike Warnstaff, president of Cenhealthcare industry. But contrary to Tenet Healthcare’s tral Independent Dealer Association (now NDC), FebruJerry Rayburn, the cost savings are not going to come ary 1996. from wiping out distributors. Mr. Rayburn, who is
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quoted in the article, implies that efficiency means buying directly from the manufacturer. In reality, this will put providers into new lines of business that have nothing to do with their core competencies – hardly the recipe for efficiency.” – S. Wayne Kay, president and CEO, Health Industry Distributors Association. July 1997.
Outcomes data “We are finding more and more manufacturers providing us with outcome data, especially the companies concerned with price erosion in their particular market, who are looking to maintain a margin they can live with. It’s become very important, on both sides of the fence, to look at outcomes and to prove that though your product may cost more on a line-item basis, it is actually more economical to use in the long run. I think a lot of these decisions depend upon clinical proof, and clinical evidence which can be provided to us.” – Jerry Olive, contract administrator, Health Services Corporation of America (now MedAssets), July 1997.
A tall order…then and now “You’ll notice that today’s sales reps need to juggle a lot of balls. More so than in the past when a rep’s job was to take a product, feature and benefit it to death, toss in the appropriate CPT code, and collect the commissions at the end of the month. Now, today’s rep needs to have a greater understanding of the entire process, not just the sales cycle. He/she needs to understand the cost pressures driving managed care today; needs to understand reimbursement arrangements; needs to know the difference between an IPA and PPO; needs to provide products that improve outcomes and patient satisfaction levels; needs to uncover ways to improve utilization for the customer; needs to listen to the customers’ problems and concerns (and not to be on either of those lists); needs to know the latest in technology and relate it to the changing needs of his/her customer; and needs to continue building solid relationships based on trust and confidence.” – Brian Taylor, editor/ publisher, Repertoire co-founder, July 1997.
A better way of compensating reps “I believe there could be a better way to compensate some of the account managers who call on the megacustomers. With that being said, we still don’t have the
correct formula. It doesn’t necessarily mean less pay, it just has to be different. It needs to be more aligned with the goals of the customer. If their goal is to lower inventory, maybe we pay our account managers on fewer orders which are larger, or for keeping inventories at a certain level….Developing a pay structure on accounts like these, which is aligned with the incentives of the customer, will be one of our big challenges in the years ahead.” – Cindy Juhas, vice president, primary care and integrated systems, General Medical (now McKesson Medical-Surgical), April 1997.
HMOs fall down “The managed care revolution is responsible for bringing many very positive changes to our healthcare system. It has shifted the emphasis from treatment to prevention. It has eliminated unnecessary hospital stays and limited the use of very expensive technology. Billions of dollars of inefficiencies have been squeezed from the system….So what’s the problem? The problem is, in paring costs and making healthcare more efficient, the managed care companies have trampled on sacred ground. When the actual consumers of healthcare talk about managed care, they are not concerned about how well their managed care plan is reining in costs and saving them money. Right or wrong, the perception is that cost is the company’s worry or the government’s worry. They are talking about the service they are getting and their satisfaction with that service, which is where the managed care companies have fallen down.” – Chris Kelly, editor/ publisher, Repertoire co-founder, February 1998.
The good and bad of consolidation “Distributors with whom Repertoire spoke say they are finding good and bad aspects of consolidation [of manufacturers]. On the plus side, they say that a wellplanned merger can: 1) help their companies focus on fewer vendors, 2) open up new product lines previously unavailable to them, 3) result in more sales support, not less. But on the negative side, they are finding that: 1) the best, most experienced manufacturer sales reps often get dumped, 2) communication between newly merged vendors and their distributors drops off the table, 3) competition is stifled and the balance of power skewed, and 4) the possibility of getting exclusives may fade away.” – September 1998.
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YEARS
The 2000s: A Sales Odyssey Some changes occur overnight, others take years, if not decades, to unfold. And many times, changes that ap-
pear imminent never materialize. Healthcare – and healthcare distribution – has its share of all these, as evidenced by stories reported by Repertoire throughout the 2000s.
The impossible dream of e-standards In 2000, Repertoire reported on a change that still hasn’t fully materialized. “Hopes are high that an e-standards work group can accomplish what others before have only dreamt about, namely, agree on the nuts-and-bolts of how products should be named and numbered.”
Cimtek down In late summer 2000, the industry saw what had by then become an increasingly common site – the death of a dot-com. In this case, it was Cimtek Commerce, which had billed itself as a distributor-centric portal at the time of its founding in June 1997. In fact, Cimtek was a partner with the Health Industry Distributors Association on HIDAHELP.com™.
GPOs found themselves in hot water in the beginning of the decade. In July 2002, Repertoire reported that lawmakers on Capitol Hill had grilled GPO executives about what the New York Times called various “excesses.” Another dot-com flameout The end of 2000 saw the flame-out of another dot-com. This time it was Promedix, a specialty medical products e-procurement site. Repertoire wrote in January 2001, “Ventro’s decision in December to close down Promedix… wasn’t an indictment of business-to-business electronic marketplaces so much as an indictment of B2B marketplaces that aren’t based in existing businesses.”
On Sept. 11, no supplies needed In November 2001, two months after the Sept. 11 tragedy, Repertoire spoke to some New York-based sales reps about that day. “On the morning of the 11th, [Allegiance, now Cardinal Health, rep Greg] Mascola was on Route 80 in New Jersey when he heard about an accident at the World Trade Center. Crossing a bridge, he saw bright white smoke coming from the North Tower. As he was unloading his truck in Elmwood Park, N.J. – his last stop of the day – he heard about the second crash.” Mascola and a colleague were asked to drive a rig to the triage center at Liberty State Park, escorted by a Montgomery, N.Y., police car. “The
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scene at the park was hectic. ‘There were hundreds of ambulances, safety workers and state police,” says Mascola. “Tarps were set up with stretchers and medical supplies.”…The two Allegiance drivers waited at the park until 8 p.m., but not one survivor was brought there. Finally, a site commander told them that their supplies wouldn’t be needed…
Supply chain foibles exposed In June 2002, Repertoire reported on a new book, The Health Care Value Chain, by Lawton R. Burns, professor of health care systems in the Wharton School at the University of Pennsylvania. The report wasn’t flattering. “Within healthcare, information on the value or cost added at each link is severely lacking,” Burns wrote. “Indeed, the current state of knowledge on product value/cost among producers may be so low that meaningful knowledge sharing is impossible. Moreover, there is some consensus that multiple links may perform duplicative functions or wasteful, non-value adding functions due to this lack of information or reluctance to share information.” How far has the industry come in the past 10 years?
GPOs in hot water GPOs found themselves in hot water in the beginning of the decade. In July 2002, Repertoire reported that lawmakers on Capitol Hill had grilled GPO executives about what the New York Times called various “excesses.” U.S. senators gave GPOs 90 days to present a proposed code of conduct. The Health Industry Group Purchasing Association set out to accommodate lawmakers, and called on members to disclose to members the amount of administrative fees they received from contract vendors based on total GPO purchases and those of the individual member; to disclose any investments they make in companies with whom they contract; and to put strict limits on gifts or other favors received from contract vendors. The Medical Device Manufacturers Association said that wasn’t enough, and insisted that GPOs refrain from the following activities: 1) accepting administrative or marketing fees from vendors, 2) serving on any vendor’s board, 3) creating incentives for purchasers to select certain products by bundling unrelated products or by encouraging the use of particular distributors, 4) entering into private-label arrangements with manufacturers, and 5) signing sole-source contracts.
Remember PDAs? Docs were going high-tech in the early 2000s, as reported in January 2003 Repertoire. Though what was considered hightech 10 years ago, it wouldn’t cut it today. “[M]any physicians have emptied their pockets of the booklets and notepads so critical to Doctors [Ben] Casey and [Marcus] Welby, and replaced them with a single, palm-sized electronic device called a personal digital assistant (PDA),” Repertoire reported. “The portable computers allow doctors to input or access patient demographics, prescription orders, lab results or clinical data – all without leaving the patient’s side.”
New vaccine shows promise The waning days of 2002 saw the development of a vaccine for the papilloma virus. The vaccine, developed by Merck and Co., was said to be nearly 100 percent effective in preventing cancer-causing papilloma infections and about 74 percent effective in protecting women from genital herpes, Repertoire reported in January 2003.
Docs slow to catch on to needle safety Hospitals early on recognized the wisdom and necessity of converting to safety needles and needle-free devices. Doctors? Not so fast, reported Repertoire in February
2003. “[S]ome medical associations initially advised physician clinics to hold off on safety conversions until they could confirm that the new regulations applied to them, according to Jim Berdela, director of marketing and distribution management at Becton Dickinson. In addition, many doctors misinterpreted the law. Many thought, ‘If I try a safety device and don’t like it, I’m not required to use it,’” said Berdela, adding that it was only in recent months that OSHA clarified to physicians that they must comply with safety laws.
Mistrust? Scandal? In our industry? Mistrust was in the air in 2002. Scandals at Enron, WorldCom and Imclone shook the nation’s belief in business integrity, reported Michael Richardson of Strategic Pricing Group in Repertoire in February 2003. And the healthcare supply chain wasn’t immune. “One principle source of distrust is the lack of pricing integrity throughout the supply chain,” he wrote. “What do I mean by pricing integrity? Pricing that is consistent, structured and defensible.”
GPOs philosophical about events GPO executives put on a bright but philosophical face as 2003 dawned, reported Repertoire in March 2003. “GPO executives are downright optimistic about the long-term effects of everything that happened, if for no other reason than that events have shed some much-needed light on exactly what it is that GPOs do,” Repertoire wrote. Amerinet CEO Bud Bowen had this to say: “Clearly, [group purchasing] is a business, which, to the vast majority of people in this country, is unknown. So it shouldn’t be surprising that in light of the New York Times reports, the Senate staffers looked at this and said, ‘I’ve never heard about this. What’s this all about?’ There continues to be a great deal of misunderstanding and misperceptions about the business. People can always spin an issue the way they want it to be spun. The group purchasing industry – which is still pretty much a cottage industry – allowed itself to be represented by someone outside the industry. When that happens, you can expect exactly what happened to occur.”
Self-distribution Self-distribution was in the air in early 2003. But then again, when hasn’t it been? “Over the past few years, hospital CEOs and others have maintained that hospitals should stick to what they know – patient care – and stay out of what they don’t know – such as logistics,” Repertoire reported. “That argument has worked to distributors’
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YEARS advantage. But at least one health system is questioning that line of reasoning. The Sisters of Mercy Health System has taken matters into its own hands. The St. Louis-based system has created a self-distribution model, which they say is saving them millions of dollars a year. And the program is still being rolled out.” That program today is ROi.
devices. The guidelines are voluntary and are not intended to be legally binding. Still, medical device manufacturers are being urged to share them with their dealers and distributors, and to encourage their dealers to adhere to the same standards as manufacturers.”
Digitalization in the cardiac market Physician practices in a ‘cauldron’ Physician practice management companies crashed and burned in the early 1990s. But physician practices were facing new pressures in the early 2000s. Goldman Sachs Vice President Chris McFadden raised some prescient points in July 2003 Repertoire: “[T]he real issue is this: How do you take undercapitalized and undermanaged practices, which are confronted by outside challenges, such as HIPAA, and allow the physicians to focus on providing better care, while someone else handles all these other issues? The new model might resemble an ASP [application service provider] model, not an equity one, in which the physicians outsource staffing, hosting, etc. It’s still early, but the cauldron is boiling over with many of the same issues that were emerging in 1989 and 1990.” That cauldron still boils today.
The redemption of ‘disease management’ Where is disease management today? Consultant Sheila Dunn raised the question in October 2003 Repertoire: “The term ‘disease management’ got a bad rap right off the bat. First coined by a young managed care industry, then picked up by pharmaceutical companies in the 1990s, the concept was perceived by physicians to be a ploy to sell more drugs… Disease management is now on its way to a better reputation, freed from the perceived yoke of drug company control, finally being examined in scientific ways, and finding acceptance in the medical community. In most cases, that is.”
On our best behavior The 2000s saw the healthcare industry’s best attempts to be good citizens. Wrote Repertoire in November 2003: “Don’t be offended if you receive advice from your vendors about how to behave. They’re not slinging mud or casting aspersions. Instead, they’re probably just responding to the recommendations of the country’s largest association of medical device manufacturers. The Advanced Medical Technology Association, or AdvaMed, recently approved a Code of Ethics for manufacturers of medical
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2002-3: Quinton Cardiology Systems acquires Burdick; Welch Allyn and Schiller dissolve their relationship; Midmark and GE come on strong with cardiology products for the physician market. It was an active time indeed, and it signified big changes for distributors. From December 2003 Repertoire: “[B]eneath the buzz, a slow, steady force appears to be at work – that is, the continuing movement by physicians and clinic managers toward a digital office. The change has big implications for cardiologists, who have a reputation (like all physicians) for clinging to tradition. But it means big changes for distributor sales reps as well, who must recognize the impact that electronics and information systems can have on their customers.”
Private label creep It was clear by early 2004 that providers were willing to buy private-label products, even in clinician-sensitive categories. And GPOs were eager to respond. Reported Repertoire in February 2004: “‘Even five years ago, the brand preference requirements of the acute care setting were still pretty dominant,’ says Amerinet President Bud Bowen. ‘But today, hospitals are a lot more open to generic equivalents. At least they’ll look at them.’” Added Dale Wright, vice president of Amerinet Choice, “And this is occurring even in product categories you wouldn’t think of, including more invasive-type products.”
Reverse auctions Reverse auctions caught the attention of suppliers in 2004. “Do reverse auctions signal the death of buyer/ seller relationships by focusing on price to the exclusion of everything else, or are they merely a more efficient way of doing what buyers and sellers have been doing forever – haggling?” asked Repertoire in April 2004. “If suppliers are to play this game – as it appears they must – they will have to learn how to approach reverse auctions strategically, lest they get caught up in the competitive heat of the moment and offer prices they can’t sustain over the long haul.”
The 2010s How could the 2010s have been anything other than fascinating, considering what started the decade – the sign-
ing of the Patient Protection and Affordable Care Act by President Barack Obama on March 23, 2010? Repertoire articles reflected the bumps, turns, sudden stops and jumpstarts those in the industry made trying to navigate this new territory.
He called it January 2010: Nursing homes and other long-termcare providers may be adequately staffed today, but as we move closer to 2020, the aging population will far outstrip the workforce, said Brad Klitsch, senior vice president of marketing development for Direct Supply Inc. Add to that the generational challenges facing long-term-care providers. On the one hand, patients and residents are becoming more demanding, a trend that will only intensify as Baby Boomers start entering nursing homes. On the other hand, nursing home administrators and directors of nursing will have to learn how to communicate and motivate a younger generation of workers.
New to the healthcare lexicon February 2010: “The trend is clearly moving toward outcomes and performance-based care,” says Tom Schwieterman, M.D., director of research and development for Midmark. “Doctors will be increasingly incentivized and paid based on how well they manage their disease management programs,” he says. “I think the sales force is going to have to do a deeper dive into … disease management guidelines.”
for credentialing, vendors wish the whole thing would go away. One group trying to find the proverbial win-win is the Healthcare Industry Supply Chain Institute.
The decimation of primary care? April 2010: In a 2009 position paper called “Reforming Physician Payments to Achieve Greater Value in Health Care Spending,” the American College of Physicians criticized the current Medicare payment methodology. “Feefor-service payments create incentive for physicians to provide more services, not necessarily the services that are most effective for a particular patient” it said. Furthermore, fee-forservice reimbursement has decimated primary care by rewarding doctors who perform procedures, while financially penalizing those who provide more consultations, counseling and long-term health management.
Physicians punch the clock Cancer, reconsidered February 2010: “[W]hat we are learning – and this is very true especially in the molecular diagnostics space – is that cancer is a heterogeneous disease,” says John Blackwood, vice president and general manager of Beckman Coulter’s immunoassay business center. “Not all cancers are the same. So the question goes from, ‘Does the patient have cancer?’ to, ‘If they do, what is the likelihood that that specific cancer will spread or cause significant disease?’ That’s where cancer diagnostics is going today and in the future.”
The vendor credentialing tug-of-war March 2010: The vendor credentialing issue appears to be more of a tug-of-war – some might say quagmire – every day. While providers make their case for the need
June 2010: More physicians are breaking out of the mold of the independent, lone medical provider of yesteryear, and opting to punch a time clock instead. The employers of choice aren’t physician practice management companies, which were swallowing up physician practices 10 or 15 years ago. Instead, they are hospital-based integrated delivery systems.
Telemedicine: Ready for prime time July 2010: “I’ve been doing this 20 years, and every year, it’s ‘This is the year,’” says Steve Normandin, president of AMD Global Telemedicine, Chelmsford, Massachusetts. “But the industry has made more progress in the last 18 months than in the previous 18 years. You have a new
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YEARS generation of doctors who are much more exposed to technology. All the technology we’re using, 20 years ago was bleeding edge. Now we’re using Skype with our kids.”
Act 2 for retail clinics? September 2010: Growth of retail clinics has stalled. Back in 2006 and 2007, pundits were predicting that as many as 5,000 retail clinics would dot the country in just a couple of years. Today [in 2010], there are approximately 1,200 clinics in 38 states. Yet clinic operators aren’t glum. To date, clinics have accounted for 12 to 13 million patient visits. And they are looking toward a bright future, one that will likely see an emphasis on chronic disease management, as well as more partnering with hospitals and hospital systems.
The danger of opioids – already, in 2010 October 2010: Once used primarily to relieve pain following surgery or cancer, or at the end of life, opioids today are used widely to relieve severe pain caused by chronic low-back injury, accident trauma, arthritis, sickle cell, fibromyalgia and other conditions. With the increase in opioid usage, however, concerns have grown about abuse, addiction and diversion. The American Pain Society guidelines call for clinicians to continually assess patients on chronic opioid therapy by monitoring pain intensity, level of functioning and adherence to prescribed treatments. The society recommends periodic drug screens for patients at risk for aberrant drug behavior.
Should distributors be worried? November 2010: It’s unlikely that self-distribution [among health system] will ever blossom into a full-blown “trend.” Most IDNs seem satisfied to “buy” rather than “make” distribution expertise. And how many have the capital to make the necessary investments in facilities, equipment, labor and inventory? Still, distributors can’t afford to be complacent.
The good and the bad for lab January 2011: Political and market trends appear to be smiling on the lab market – including the physician
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office lab – in 2011. After all, the government has listed a number of services, including screening for breast cancer, cervical cancer, cholesterol abnormalities and colorectal cancer, that insurers must provide to their customers without a co-pay. And a major emphasis of healthcare reform is disease prevention and wellness, which certainly plays into the hand of the diagnostics industry. But some troubling undercurrents exist. An integral part of healthcare reform, after all, is cost-cutting. And that could mean fewer services across the board, even lab. What’s more, there’s the good old free market. Any Lab Test Now®, an Alpharetta, Ga.-based company, offers low-cost lab services to consumers at 123 locations around the country.
The power of now February 2011: For the sales rep, four things are more important than all others: relationships, communication, time and information. Without relationships, there’s no sale. But without communication, time and information, even the strongest relationships suffer. Starting with the personal computer a couple of decades ago, and extending through to smartphones and iPads, sales reps – like society at large – have been the beneficiaries of technology. Successful reps have learned how to make it work for them.
Facebook to Facebook April 2011: Sales reps who regard social media simply as another, more convenient, way to tell customers and prospects about new products or promotions may find themselves shut out. But those who regard Facebook, etc., as a way to learn about their customers, engage in a dialogue with them, and yes, deliver news about products and promotions, will be rewarded.
Who will service the docs? May 2011: If hospital systems and IDNs acquire physician practices or employ physicians in large numbers, who will service them? Will supply chain executives insist that their acute-care distributor service these new accounts, or will they back off and let the non-acute-care distributor continue to take care of that side of the business? Both
NEW PAMA CPT codes now available in the app
Pama updated CPT codes 2018 Infectious Disease Tests Test - Panels Basic Metabolic Panel (9 tests) Comprehensive Metabolic Panel (17 tests) Electrolyte Panel (4 tests) Hepatic Function Panel (10 tests) Lipid Panel (6 tests) Renal Function Panel (12)
CPT 80048/QW 80053/QW 80051/QW 80076 80061/QW 80069/QW
2017 Fee $11.60 $14.49 $9.62 $11.21 $18.37 $11.91
2018 Fee $10.44 $13.04 $8.66 $10.09 $16.53 $10.72
Change -10% -10% -10% -10% -10% -10%
Cardiac/Liver/Other Tests Albumin (Serum) Albumin (Urine) ALP ALT Aspirin Therapy AST Bilirubin, direct Bilirubin, total BNP CK,MB CK/CPK GGT LD Microalbumin (Quantitative) Microalbumin (Semi-quantitative) Total Protein Troponin I
82040/QW 82042/QW 84075/QW 84460/QW 85576/QW 84450/QW 82248 82247/QW 83880/QW 82553 82550/QW 82977/QW 83615 82043/QW 82044/QW 84155/QW 84484/QW
$6.79 $7.10 $7.10 $7.27 $29.47 $7.10 $6.88 $6.88 $46.56 $15.84 $8.93 $9.88 $8.28 $7.93 $6.28 $5.03 $13.50
$6.11 $7.78 $6.39 $6.54 $26.52 $6.39 $6.19 $6.19 $41.90 $14.26 $8.04 $8.89 $7.45 $7.14 $6.23 $4.53 $12.47
-10% 10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -1% -10% -8%
Lipid Tests HDL LDL Lp(a) Apolipoprotein Total Cholesterol Triglycerides
83718/QW 83721/QW 82172 82465/QW 84478/QW
$11.24 $13.09 $21.26 $5.97 $7.88
$10.12 $11.78 $21.09 $5.37 $7.09
-10% -10% -1% -10% -10%
Diabetes Tests Fructosamine Glucose on home use meter-type device Glucose Tolerance Test, each additional specimen > 3 Glucose Tolerance Test, initial 3 specimens Glucose, quantitative blood type Hemoglobin A1c
82985/QW 82962 82952/QW 82951/QW 82947/QW 83036/QW
$20.68 $3.21 $5.38 $17.66 $5.39 $13.32
$18.61 $3.28 $4.84 $15.89 $4.85 $11.99
-10% 2% -10% -10% -10% -10%
Renal Function Tests BUN Creatinine Creatinine (Urine)
84520/QW 82565/QW 82570/QW
$5.42 $7.03 $7.10
$4.88 $6.33 $6.39
-10% -10% -10%
Individual Tests Amylase Calcium Ferritin Iron
82150/QW 82310/QW 82728 83540
$8.89 $7.08 $18.70 $8.88
$8.00 $6.37 $16.83 $7.99
-10% -10% -10% -10%
Find the new codes in The Black Book
Other tools available for distributors are: vol.26 no.1 • January 2018
repertoiremag.com
January 2018
2 Minute Drill Videos
Podcasts
PAMA: The Stage is Set — How will the new rates impact providers, distributors and manufacturers?
PAMA: Jim Poggi, Tested Insights, LLC
The Stage is Set
How will the new rates impact providers, distributors and manufacturers?
YEARS acute-care and non-acute-care distributors have reason to be hopeful…and apprehensive. Hospital distributors have an “in” with supply chain executives, but they lack expertise in distributing to non-hospital sites.
undertaking will add administrative expense and create unnecessary workflow disruptions. The timing could not be worse, as many physicians are working to implement electronic health records into their practices.”
The 2.3 percent hot potato
Total cost of care
July 2011: With medical device manufacturers facing a 2.3 percent excise tax on sales beginning Jan. 1, 2013, the question comes up, “Who’s going to get stuck holding the bag?” Will manufacturers take the hit to their bottom line? Will they try to pass along the cost of the tax to buyers? Or will buyers and sellers come together to create efficiencies that will reduce the pain that the tax may inflict on any one member of the supply chain?
February 2012: Concerns about the cost of healthcare and the quality of healthcare – expressed in terms of patient outcomes – have never been as severe as they are today. Concepts such as “value-based purchasing,” “technology assessment” and “comparative effectiveness” are raising the stakes. And government and private payers are beginning to demand that providers address the total cost of care, rather than care delivered just in the acute-care facility, or the doctor’s office, or the long-term-care facility, or the home.
Drug shortages August 2011: Shortages of drugs – including injectables – are cropping up unanReps on nounced more than ever. “Litthe front line of erally every day I’m managing injectable shortages my backorder report,” says Industry-wide domino effect one field rep. “It’s a constant exacerbates situation battle.” The issue has become serious enough to capture the attention of federal lawmakers, who have proposed legislation that would give the market a heads-up when shortages occur or are anticipated.
vol.19 no.8
August 2011
Our own worst enemy? December 2011: For many years, our industry has resisted the obvious efficiency of rationalizing pricing between markets, said Ted Almon, president and CEO of Claflin Co., Warwick, Rhode Island. Yes, nearly infinite price discrimination can enhance profit, but does it do so at a rate greater than the cost of rebate administration, reconciliation, and auditing? And hasn’t it involved at least a bit of cost shifting too?
ICD-10: The complaint desk is open February 2012: “The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients’ care,” Peter W. Carmel, M.D., AMA president, was quoted as saying. “At a time when we are working to get the best value possible for our health care dollar, this massive and expensive
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vol.20 no.2
February 2012
ICD-10 system must be implemented October 2013, says the government. Payers seem ready. How about providers?
Payers, providers mix it up April 2012: A lot of ink has been shed about hospitals and hospital systems acquiring physician practices. But there’s another player elbowing its way to the table – insurers. With years of experience monitoring and paying claims, insurers have developed the management expertise and databases to affect how – and what – care is delivered, to whom, and with what results. They are starting to exercise their strength in the market, either by acquiring or merging with providers, or forming strategic partnerships with them.
Smartphone medicine
vol.20 no.5
May 2012
May 2012: True, many health apps are designed to help people track calories consumed, calories burned, miles run, etc. But increasingly, devices and accompaDevices and accompanying nying apps are helping peoapps are helping patients ple – particularly those with and physicians monitor health chronic conditions – monitor their health and communicate with their caregivers. The implication for physicians and physician office traffic could be huge.
Smartphone Medicine
Physician, stop thyself from doing stuff June 2012: In April, nine leading physician specialty societies published a list of 45 tests or procedures that they say are commonly used but not always necessary. The lists of “Five Things Physicians and Patients Should Question” are said to provide specific, evidence-based recommendations that physicians and their patients should discuss to help make wise decisions about the most appropriate care based on their individual situation. The nine organizations releasing lists as part of the “Choosing Wisely” initiative represent nearly 375,000 physicians.
Mid-level providers October 2012: If Repertoire readers think it’s tough getting time in front of the doctor, office manager or nurse, just wait until 32 million people enter the ranks of the insured, thanks to the Affordable Care Act. The issue at hand, of course, is larger than wait times for sales reps. It has to do with access to care. Will there be enough doctors to care for millions of people seeking preventive, diagnostic and therapeutic services? If not doctors, how about advanced-practice registered nurses, physician assistants and other mid-level providers?
Readmission reduction: The new game March 2013: The federal government is trying to change the rules of the game of U.S. healthcare. TraditionReducing ally, those rules have called Readmissions for providers to get paid for doing more procedures and providing more care. But spurred on by the Patient Protection and Affordable Care Act, the feds are trying to turn that formula around. One vehicle they are using to do so is the Hospital Readmissions Reduction Program. Repertoire readers might notice some changes in practice patterns among the hospitals, doctors’ offices and long-term-care facilities they call on. Home care agencies will be affected as well. vol.21 no.3 • Celebrating 20 years
March 2013
Hospital Readmissions Reduction Program could affect how hospitals, doctors, nursing homes and home health providers care for patients
to Shoreview, Minn.-based Merchant Medicine. Should doctors be worried? “I would say they ought to be more aware than concerned,” says Ken Hertz, principal, Medical Group Management Association Health Care Consulting Group. The retail clinic does indeed present competition to the classical practice model, offering greater price transparency and better hours. Retail clinics also address walk-ins far more efficiently than the traditional physician office. “These are all customer-centric issues,” he says. “At the very least, [physician practices] have to be able to handle appointments in a timely manner. They have to understand the competition and what they can do to provide a competitive advantage.” vol.21 no.7 • Celebrating 20 years
July 2013
Zero
Excess
Hospital and physician customers search for ways to eliminate wasteful spending and improve outcomes
Big D July 2013: If there is a difference between the way providers buy products today and how they did so in the past, it can be summarized in one word: Data. Today, with purchasing groups such as Premier, VHA, Amerinet and others as catalysts, millions of bits of data can be aggregated and massaged to help providers do what they have always wanted to do – link products to outcomes. “We’re helping our members prepare for and adapt to a post-reform world that increasingly links costs and quality, and pushes providers to be more accountable for the overall health of populations,” says Bill Marquardt, vice president of portfolio management, Premier healthcare alliance.
The patient-centered medical home September 2013: Change is coming to the nation’s primary care doctors, and specialists too. Some believe it’s the future of medicine. Others believe it’s what medicine always should have been, but for a dysfunctional fee-for-service reimbursement system. The change is called the “patient-centered medical home,” and observant sales reps will be able to detect it among their customers.
The retail clinic challenge March 2013: There are more than 1,400 MinuteClinics, Take Care clinics, Little Clinics, clinics at Walmart, and other retail clinics in the United States today, according
FDA and mobile apps December 2013: It’s a sign of the times. The Food and Drug Administration issued in September final guidance
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YEARS for developers of mobile medical applications, or apps. The bottom line is, the agency won’t pay much attention to the majority of apps, because they don’t pose a threat to consumers. However, it will turn its attention to that subset of apps that present a risk to patients if they don’t work as intended.
UDI … theoretically December 2013: It was years – no, decades – in the making. But in September, the U.S. Food and Drug Administration issued a final rule on unique device identification or UDI, as well as a global database for all medical devices. As expected, the highest-risk (class III) medical devices will be first out of the chute. Many low-risk devices will be exempt from some or all of the requirements in the final rule.
Tomorrow’s doctor March 2014: The American Medical Association wants to transform the way future physicians are trained. Judging from study grants AMA has awarded to 11 medical schools, sales reps can expect tomorrow’s doctors to be more team-oriented than many of those in past years. In addition, they will be technologically adept, community-health-focused, outcomes-oriented, and business-savvy. The study grants are part of AMA’s “Accelerating Change in Medical Education” initiative.
IV shortages June 2014: From adversity can come good things. Take the current shortage of IV solutions – particularly normal saline and dextrose solutions. It’s true that distributors and manufacturers had their accounts on allocation. But as of press time, no adverse patient effects had been reported. And the Big 3 manufacturers were hustling to meet demand (with help from a German-based company shipping solution from its Norway plant). Meanwhile, healthcare providers were instituting conservation strategies that may change the way they use IV solutions in the future.
vol.22 no.6 • June 2014
Work-life balance Repertoire survey finds readers pulled every which way to satisfy demands of work, play, career fulfillment and family
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For physicians, a bigger picture August 2014: Since October 2012, hospitals have been penalized for readmissions within 30 days of discharge of Medicare patients with pneumonia, heart attack and heart failure. Effective October 2014, the Centers for Medicare & Medicaid Services will add elective hip/knee replacement and chronic obstructive pulmonary disease to the list. “It brings us back to our roots,” says Tina Shah, MD, MPH, pulmonary and critical care fellow, University of Chicago, and a health policy researcher. “We all start out as internists, then we choose to learn about a particular area. The readmissions policy is reminding us that no matter what kind of doctor you are, you’re responsible for seeing the big picture,” that is, the patient’s overall health, not just the condition that caused him or her to be admitted to the hospital. vol.22 no.8 • August 2014
Care
Transition
As hospitals get penalized for readmissions, officebased physicians have an increased role in the handoff from acute to outpatient care
New battleground: Urgent care September 2014: Situated some place between physicians’ offices, retail clinics, and emergency rooms – in terms of the severity of illnesses treated as well as cost to the patient – urgent care centers are becoming part of the medical neighborhood. And even if some newly opened centers are quiet, hospital systems, private equity firms, insurers, doctors and private companies are betting that walk-in traffic will grow in the months ahead.
The clinically integrated network: A keeper? November 2014: Healthcare is heavy on acronyms. They come and go, but often, the concepts behind Thin Group them remain. It’s too early to k predict the fate of one such acronym – the CIN, which stands for clinically integrated network. But according to experts, the concept has lasting power. Sales reps would be well-advised to learn the lingo. “The driver for healthcare in a value-based vol.22 no.11 • November 2014
Hospital systems aren’t the only ones consolidating. Many physician practices are joining forces to form large integrated physician groups
environment is not one that is going away,” says Aimee Greeter, vice president, Coker Group, a healthcare advisory firm in Alpharetta, Ga. “I don’t think our fee-for-service system is sustainable. Whether it’s called a clinically integrated network or something else, I think the focus on value will be a lasting concept.”
Henry Schein and Cardinal Health February 2015: The recent acquisition by Henry Schein, Inc. of Cardinal Health’s physician office business demonstrates that the needs of the physician office differ from and those of the acute-care hospital, and that healthcare leaders Agreement reflects recognize as much, according unique supply chain needs of non-acute vs. to those involved. The two acute-care providers companies announced in late November that the physicianoffice-focused business of Cardinal Health’s Medical segment would be consolidated into Henry Schein’s Medical Group. As a result of the agreement, Henry Schein Medical gains service to more than 25,000 physician office customer locations, adds $300 million in annual sales, and brings on approximately 200 sales professionals.
vocabulary today. But the fact is, they probably will be, in the not too distant future. This isn’t to say there isn’t – or won’t – be a continuing place for other point-ofcare diagnostics, such as lower-cost lateral flow tests. But the accuracy of molecular tests as well as the attention being paid to personalized medicine and antibiotic stewardship, could push them into the mainstream, despite some concerns about cost.
vol.23 no.2 • February 2015
Antibiotics: Too much of a good thing? July 2015: Since penicillin was discovered in 1928, antibiotics have been a “critical public health tool,” according to the Obama Administration’s recently published “National Action Plan for Combating Antibiotic-resistant Bacteria.” But the emergence of drug resistance in bacteria is reversing their beneficial effects. The Centers for Disease Control and Prevention (CDC) estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the United States alone. “There is little doubt that antibiotics are overused in healthcare,” says David Fleming, MD, MA, FACP, professor of medicine and chairman, Department of Medicine, University of Missouri School of Medicine, and immediate past president of the American College of Physicians.
Molecular testing: Now appearing August 2015: “Polymerase chain reaction” and “DNA sequencing” might not be part of the sales rep’s
ICD-10 … for better or worse November 2015: After years of delay, the deadline for providers to implement ICD-10 codes finally arrived on Oct. 1. “Maybe hospitals ICD-10 will like it, maybe epidemiThough some ologists will too,” says codhealthcare stakeholders ing consultant, author and wish it wouldn’t speaker Betsy Nicoletti, MS, CPC. “But it won’t do one thing for physician practices, except slow them down.” Greg Dean, vice president, technology partners, McKesson Medical-Surgical, has a different perspective. “ICD-10 will increase specificity, which in turn provides more detail, and this can help to improve patient care and outcomes. Additionally, ICD-10 could benefit medical research, improve performance, create efficiencies, aid in policy-making, and help in creating new pay-forperformance programs.” vol.23 no.11 • November 2015
repertoiremag.com
Cometh...
Concordance: A national independent February 2016: The three independent distributors who announced plans in December to form Concordance Healthcare Solutions say they can service providers caring for about 70 percent Concordance of the U.S. population – and Healthcare maintain their independent Solutions An independent spirit while doing so. That with plans to go national means they’ll maintain local customer service, sales and warehousing, and continue to support the branded products that their customers prefer. At the same time, they vol.24 no.2 • February 2016
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YEARS intend to share their specific areas of expertise and add field reps when necessary in order to present a full-service offering – that is, one encompassing products and services for both acute care and non-acute care – to their IDN customers.
Interoperability: An impossible dream? April 2016: Individual providers – both inpatient and outpatient – have done a pretty good job of implementing electronic medical records within their four walls, but the system breaks down when a patient migrates from one provider to another. “Beyond technical barriers, there are business barriers, complex privacy laws, workflow challenges, and misaligned incentives that conspire to slow progress,” according to the Health Information Technology Policy Committee in a December 2015 report to Congress titled Challenges and Barriers to Interoperability.
MACRA reshapes physician payment May 2016: In January 2015, Health & Human Services Secretary Sylvia Mathews Burwell publicized her goals to to improve the nation’s health MACRA delivery system. One of those goals is to tie 85 percent of all traditional Medicare payPhysician payments are moving away from ments to quality or value by traditional models. Are your 2016 and 90 percent by 2018. customers prepared for the change? The feds took a big step in that direction by passing the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, signed into law by President Obama in April 2015. The legislation repeals the Sustainable Growth Rate (SGR) formula and provides predictable payment increases, at least for awhile. By 2019, CMS will have implemented a new two-track payment system for providers (Alternative Payment Models, or APMs; and the Merit-based Incentive Payment System, or MIPS), which continue the move away from fee-for-service reimbursement.
vol.24 no.5 • May 2016
repertoiremag.com
Jump
Social determinants of health December 2016: ProMedica and Concordance Healthcare Solutions have combined to take the concepts of post-acute care and population health to a
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new level. ProMedica’s Food at Discharge program ensures that patients in need get a three-day supply of nutritious food upon discharge. Toledo, Ohio-based ProMedica buys the non-perishable food items, and Concordance inventories, packs and ships them to each of ProMedica’s 12 hospitals. The program is designed to help patients deal with food scarcity and to potentially prevent readmission to the hospital due to poor or available nutrition.
Medical, meet dental. Dental, likewise. April 2017: In January 2017, Oakland, Californiabased Kaiser Permanente took medical-dental integration one step further, when it opened a pilot integrated medical-dental clinic in Beaverton, Oregon. The clinic, Cedar Hills Dental and Medical Office, makes Kaiser Permanente’s Northwest division “the first commercial health care organization to integrate [medical and dental] health records as well as offer coordinated services,” says Kenneth R. Wright, DMD, MPH, vice president of dental services for Kaiser Foundation Health Plan of the Northwest.
Obamacare: Waiting for the big explosion. Still waiting. May 2017: Healthcare reform is a moving target. Congress and the president had hoped to make a clean break from the past this spring, but were unable to do so. “We’re going to be living with Obamacare And for the foreseeable future,” said Speaker of the House How to carry on in Paul Ryan in late March, the midst of uncertainty following the Republican party’s decision to pull legislation to repeal the Affordable Care Act from consideration on the House floor. Meanwhile, the president tweeted, “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry.” So where does that leave the rest of us? In the face of uncertainty – either living with Obamacare for the foreseeable future and/or waiting for it to explode – how are providers and their distributors supposed to proceed? vol.25 no.5 • May 2017
repertoiremag.com
KEEP CALM … ADAPT
Businesses serious about telehealth
Stop making sense
July 2017: Telehealth may be talked about more than it is actually used, but that may change soon. According to a 2016 annual survey by the National Business Group on Health, nine in 10 large employers will make telehealth services available to their employees in 2017. As technology improves and coverage increases, your customers might come to you for help figuring out how they can get on board.
March 2018: The title of the afore-mentioned 1984 Talking Heads movie comes to mind when trying to interpret this winter’s flurry of healthcare-related announcements: • CVS Health to acquire Aetna. • Advocate Health to merge with Aurora Health Care. • UnitedHealth Group to acquire DaVita Medical Group. • Dignity Health to merge with Catholic Health Initiatives. • Ascension rumored to be talking merger with Providence St. Joseph. • Humana Inc./Kindred at acquire Home Division of Kindred Healthcare.
Tipping point repertoiremag.com
August 2017 Think Outside the Box — Successful equipment sales calls for a broader look at the customer’s wants and needs.
January 2018: It’s too early to tell how 3D printing will affect the medical device industry, but it could change the way in which devices are PAMA: The developed, manufactured Stage and acquired. Already, the is Set technology has affected the development and manufacturing of instrumentation, implants (e.g., cranial plates or hip joints) and external prostheses, such as hands. Some day, 3D printing may be used to create living organs. And when the U.S. Food and Drug Administration issues a draft guidance for the industry on the subject (as it did in May 2016), you know this thing is for real.
vol.26 no.1 • January 2018
June 2018: Healthcare providers have more information and power at their fingertips today than ever before. Online sellers, most recently, Amazon, In a point-and-click world, it’s up to the rep are making a bid for their busito make a difference ness. So, what does a sales rep bring to the table? A sense of understanding, empathy and compassion. A desire to learn and to serve, and a sense of accomplishment when they help their customers succeed. Throw in some technology, and you have a sales force that providers can’t be without. vol.26 no.6 • June 2018
repertoiremag.com
Step Up!
Step Up! — In a point-and-click world, it’s up to the rep to make a difference
Print, pack and ship
Selling in a point-and-click world June 2018
August 2017: Less than half of patient care physicians have an ownership Think stake in their medical pracOutside tice, according to an updated the Box study on physician practice arrangements by the American Medical Association (AMA). This marks the first Successful equipment sales calls for a broader look at the customer’s time that physician practice wants and needs. owners fell below a majority portion of the nation’s patient care physicians since the AMA began documenting practice arrangement trends. The share of patient care physicians with ownership stakes in a medical practice declined 6 percentage points to 47.1 percent in 2016 from 53.2 percent in 2012.
vol.25 no.8 • August 2017
repertoiremag.com
January 2018
vol.26 no.7 • July 2018
Back to School — It’s bad news for kids, but not so much for parents, doctors or sales reps
How will the new rates impact providers, distributors and manufacturers?
July 2018: Twenty-six years after the OSHA Bloodborne Pathogens Standard and 18 years after the Needlestick Safety and Prevention Act, It’s bad news people are still getting stuck for kids, but not so much for with sharps – doctors, nurses, parents, doctors or sales reps phlebotomists, environmental services staff, and others. Part of that is due to shortcomings in safety technology. But human factors – including inadequate staffing and a pressure to see more patients can result in a lack of concentration, a lack of knowledge or a failure to best prepare for adverse events – are also factors. repertoiremag.com
July 2018
PAMA: The Stage is Set — How will the new rates impact providers, distributors and manufacturers?
Jim Poggi, Tested Insights, LLC
Blunt truth
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Hall of Fame Answer Key 1. Rob Saron, president, Bovie Medical Corp, 2. George Blowers, VP sales, Welch Allyn, 3. Bill McLaughlin Sr., IMCO, 4. Dick Moorman, VP distributor relations, Midmark, 5. Jim Stover, William T. Stover Company; HIDA; NDC, 6. Brian Taylor, MDSI/Share Moving Media, 7. Pat Kelly, founder, PSS, 8. Brad Connett, VP and general manager, Henry Schein, 9. Tony Melaro, director of national accounts, Welch Allyn, 10. DeWight Titus, F.D. Titus & Sons, 11. John Moran, VP corporate distribution, Welch allyn, 12. Cindy Juhas, Hospital Associates, 13. Bob Barnes, Durr-Fillauer, 14. Mike Carver, Southland Medical Supply, GOJO Industries, 15. John McGuire, founder, Colonial Hospital Supply, 16. Paul Julian, McKesson Corp., 17. Scott Fanning, VP sales and marketing, Midmark, 18. Karl Bays, American Hospital Supply, 19. Max Goodloe, founder, General Medical, 20. Yates Farris, Winchester Medical, IMCO, 21. Ron Stephenson, Indiana University, 22. Elliott Werber, Kendall, General Medical, Bergen Brunswig Medical, 23. Don Kitzmiller, executive VP, Midmark, 24. Haworth Parks, Parks Inc., ABCO, 25. Lew Allyn, VP, Welch Allyn, 26. Bill McKnight, McKnight Medical Communications, 27. George Ransdell, Ransdell Surgical, 28. John Sasen, BD, PSS, McKesson Medical-Surgical, 29. Ted Almon, Claflin Co., 30. Gil Minor III, Owens & Minor, 31. Bill Allyn, president, Welch Allyn Statement of Ownership, Management, and Circulation PS Form 3526-R
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Your vision is our vision: better healthcare for all. Like you, we know that healthcare sales isn’t just another job. You’re working on the front lines, shaping decisions that influence the point of care. For 25 years, Repertoire has been helping you make the sale, providing you news that matters. Midmark is proud to partner with Repertoire to bring you the information you need to help create a better point of care experience. Thank you for your commitment to our shared vision.
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