Death of the Orthopedic Sales Generalist

I was talking with a successful sales executive today and realized that orthopedics sales are changing. The shift is gradual, but at the same time, permanent.

The realization:  I believe that the Generalist Orthopedic Sales Rep will be replaced Specialists. I am not going to get into the definitions of direct sales, independents, W2s or 1099s. I am going to address the type of work performed.

Disclaimer: Sales pros. Please don’t get mad at me. I don’t create the future, I just notice it and share it. 


The typical Pre-Covid orthopedics sales rep wore many hats.  He did everything. We all know him.  Let’s call him Gene.

Here is a typical day-in-the-life of Gene.  [ Read full article here ]

Summary of Gene’s Day

  • Case Support – 34%
  • Selling – 7%
  • Case Preparation/Admin – 18%
  • Driving/Down Time – 41%

Before Covid hit us, Gene performed some or all of these activities:

  1. Training – Gene helped to train the surgeon on a new procedure at a cadaver lab
  2. Inventory/materials management – Gene delivered implants and trays into the hospital
  3. Gene was involved with contract negotiation on the local level
  4. Case prep – Gene trained or briefed the OR staff on the case
  5. Case support – Gene was a key problem solver during the case, and a “box opener”,  and he strengthened his relationship with surgeon with his product knowledge.
  6. Selling – Gene talked with the surgeon for 5 mins in the lounge or the scrub sink to upsell the latest devices or share new product news
  7. Inventory/materials management – Gene gathered up the unused implants after the case
  8. Inventory/materials management – Gene sometimes returned the next day to pick up the cleaned trays
  9. Travel – On average, Gene spends 41% of his time driving and downtime according to this analysis).


Today, Gene is less useful, and he is gradually being replaced by Specialists. This is byproduct of the Orthopedics 3.0 movement that I wrote about earlier. [read here].

I see specialists replacing many of the areas of Gene’s work.  Let’s refer to all of these specialists as Shawn

A separate Shawn will do each of these activities:

  • Contract negotiation will be done by a centralized Shawn inside the company.
  • Materials management will be completely done by warehousing, logistics operations augmented with an AI and sensors that track everything managed by a single Shawn.
  • A Shawn will conduct product training by VR mostly, with fewer hands-on cadaver labs. 
  • OR support will default to the very best Shawns. Shawn will attend cases for first-time surgeon users. Shawn may also swoop in to cover a difficult case. Many orthopedic companies already created “Clinical Specialists” for such cases.
  • Shawns who are virtual sales experts will leverage new technology from Avail MedSystems, ExplORer Surgical and Enhatch to provide instant OR support from home. [ Read – Virtual surgery support is available RIGHT NOW in Orthopedics. ]

Open questions

  • How will the selling commission structure be recast?
  • How will an inventory sales specialist be compensated?
  • How will the the virtual support rep be paid, especially if he/she can cover 2X more cases per day?
  • Who gets credit for winning the new customer and how is it incentivized? the new digital marketing guru who got the new customers attention, the rep who first contacted the new customer, the trainer who taught the new technique, the sale manager who visited the new customer, the rep who covered the first few cases?

What do you see?