From Dental to Devices: Lessons in Customer-Centric Healthcare Sales

Stewart Gandolf

Hello everyone, Stewart Gandolf here for another podcast for healthcare success. I am doing this one at the Amtrak station on the way to San Diego, going down to Brighton SEO. And it's just kind of a function of my life that I'm doing it from a train station. So, Ajoy Mahtab is with us today, and he's very forgiving of me for doing his podcast interview from a train station. Hopefully you are, too. Welcome, Ajoy.

Ajoy Mahtab
Hi, Stewart. You're nothing if not busy, I can tell you. But thank you for doing this. Thanks for taking the time to actually sit down with me, even though you're sort of in transit.

Stewart Gandolf
Oh, my gosh. Anybody who knows me well knows I am not a morning person. My first meeting started today at seven. Now, fortunately. I was in my bed at 6.30, so I just woke up, got some coffee, but I've been on the phone ever since, and will be for the rest of the day. I'm doing our conference car leadership meeting, by the way, from the train in a few minutes here. Anyway, enough about my crazy travel. Ajoy, glad to meet you. I met you through Mark Holter's, Medical Device Summit in San Diego, and I'm really excited to hear your thoughts today. You've got quite a background. I know it, but our audience doesn't, so please tell me a little bit about your background as we get started here.

Ajoy Mahtab

Sure, Stewart. Hey, so it was really great meeting you at the conference. I love the fact that you chaired it, got some great ideas from you as we heard the other speakers. I was lucky enough to be talking there as well. Let me just dial back a little bit. So, probably a little over 25 years ago, I completed my MBA, came out of Kellogg at Northwestern, was a marketer by passion, marketer by blood. So, looked around for jobs in the field. And ended up joining Johnson & Johnson, way back when. Thought I'd do that for a couple of years but literally came to realize I fell in love with healthcare, I fell in love with what we do, I love our role in helping providers and payers deliver amazing care to patients. I love solving puzzles, so as a marketer, you know, the problems that our healthcare providers face every day, I love building solutions, I love building best-in-class organizations and teams in the process. And I've worked in a number of categories, so, you know, many, many years later, 25 years later, still in healthcare, but I've spanned across… well, I started in the OTC medicines business for J&J, but then I moved over to devices, so I worked in diabetes. I worked in the surgical space. I actually left J&J, joined Becton Dickinson, and looked after some of their medical surgical stuff, so working in hospital wards with nurses, doctors, and staff there. What else? Oh, I worked in lab diagnostics, and then for the last few years, I've actually been in dental, so I joined Dent's by Sirona, I was the commercial general manager for their orthodontics business, so the aligners, braces, and the wires, and also their endodontics business, so the root canal business. But I've been doing that for about 4 years. I actually left them at the end of October of last year. Started up my own little, small consulting firm. I've been on advisory boards and been consulting. It's called Strate-gility consulting, so strategic agility, right? Doesn't quite flow off the tongue, but it makes sense when I think about what I try to do, because really, my passion is helping amazing leaders and teams thinking through strategic agile pathways. and delivering profitable, sustainable growth at the end of the day. So, and most importantly, you know, love to have fun along the way. So, hopefully, this will be a fun conversation, and we'll see where the ideas go from here.

Stewart Gandolf

That's awesome, yeah, I'm sure it will be. So, one of the fun facts, Joy, as we got to know each other, you know, we were sort of comparing the secret dental card versus the secret medical card, and they're different worlds, so I'd love you to share, some top-line ideas about what separates them, because we're going to be talking about a lot of things today, but… And I think you've got so much experience in so many different categories, but any fun insights you learned while you were in dentistry versus.

Ajoy Mahtab

Yeah, well, oh gosh. So actually, you know what? It's funny, because when you think about it, we always sort of focus on differences, but let's start with what's common, right? So, I worked in retail with, you know, folks running healthcare categories in retail. I worked with the general HCPs. I worked with, you know, surgeons and specialists, and then with dentists, both general dentists as well as specialists in the dental area. And what I realized is, at the thread of it, at the basic of it, they're sort of driven by this purpose, right? So, whether it's the hospital, whether it's non-acute environment, whether it's an independent dental practice office, they're really about, I want to deliver superior patient care. Even if they're different motivating factors. Now, when you think about dentists, what I find amazingly unique about that space is they're not just healthcare professionals, but they almost act like small business owners. And so, they are first and foremost healthcare professionals, right? They're very often thinking about, how do I make sure that I'm delivering a great patient experience and a great clinical outcome for my patient? But they've got to manage the operational issues of an office. They've got to manage organizational management with their staff. You know, we all know about staff turnover in the industry, and so they're dealing with the sort of day-to-day problems. And if manufacturers like us, or partners like you guys, can really help alleviate some of that stuff, I think it makes their lives that much easier, where they can then focus, sort of, on the patient, instead of having to worry about…you know, did that order go in right? Did I get what I needed to get? Did my shipment arrive on time? You know, there's almost 200,000 independent dental offices across North America. And so it's a very different go-to-market thinking that's required when we talk to them and when we deal with them, and what they're really looking as, you know, the definition of success, versus when you're talking about sort of large hospital chains with big value committees who can think through stuff, and there's another department that's sort of managing the procurement. And worrying about all the administrative logistics sides of the business. So, the dentist really has to be sort of the jack-of-all-trades, as well as the master of one, which is clinical outcomes for their patients.

Stewart Gandolf

That makes a lot of sense, and it's funny, DSOs, the big dental groups, typically have that management function in place, but the individual practices, they're still, like you said, they have to do everything. And on the medical side. There's so much, you know, it depends on what kind of specialty you're talking about. Is it private practice? Is it part of a health system? So, it varies a lot. But the idea of… it just feels like, in dentistry. They have to worry about the business maybe more on average, and they have to think about, you know, a lot of times there's a significant cash component, and so do things make economic sense? Because they're providing everything, right? So, it's a little bit different, it's a little bit different mindset, and…Maybe some of those things will come up as we talk a little bit deeper here. So, let's talk a little bit, as we move forward here, the, We talked about the various roles you're trying to target from a B2B standpoint, and really today, you know, I want to talk about how to win the hearts and minds of your healthcare professional audience, whether that's PAs, MPs, MD, MDO, DDS, or whomever. But, you know, if you're working, again, and you're talking about different side businesses, right, a dental practice is very different than a hospital. For the sake of this part of the conversation, let's talk maybe about maybe large organizations where they do have multiple roles, and just, you know, an office manager and a dentist. You know, they might have a head of sales, they might have CEO, they might have… As Chief Medical Officer. There's a bunch of people that might be involved. Tell me a little bit about your insights about that and managing for those appropriate roles.

Ajoy Mahtab

Yeah, no, it's a really good way to think through the various facets that combine to create the optimal outcome, right? And so, when I think about organizations and what they're trying to achieve. Each layer and each level almost have a different role to play. And so, on both sides of the table, I think… what works… Not so well is when everybody's kind of trying to do the same thing. Everybody's trying to build that relationship, everybody's trying to make that transactional sale, everybody's trying to drive a deep relationship. without thinking through the various pieces of the puzzle, and who might be the most appropriate counterpart to really reach out to and connect with, right? So one of the things that I kind of took a big step back when I was running my business was Should I really focus on Each piece and layer of that larger dental organization, and think through what would matter most to that layer, and then who would be the right person from our side to make that connection and make that conversation turn into a really great one, and a continuing one down the road. And so, let's… let's break it down a little bit for you, Stewart, for your audience. let's start at the very basic, right? My sales territory reps, best in the business at really maintaining and managing that independent office-level relationship, right? They were in there for support, they were in there with clinical support, and help. They were making sure that things were running smoothly, they were there and available to answer questions, they were there to educate them about what was coming down the pipe. At the broader base level, though, at a dental service organization level, right, at the organizational level, where they're trying to create standardization, where they're trying to put educational courses together that actually will allow them to improve the overall organizational level, they really want to work on A slightly higher level conversation. with, sort of, people who have the resources and the ability to put that into practice. So, my directors, my clinical leaders, they were the ones who were having that conversation. What are you guys really trying to achieve next year? Is there a productivity improvement target that you're looking to get? Should we get our finance guys to run some calculators with you guys to see where we could actually drive some better productivity from each office location? That drives the overall average higher. Right? Key opinion leaders become a really important part of this business, right? So, when you're talking to the visionaries. You better be having your highest level executives engage that conversation, because not only do you want to tell them what you have from a vision perspective, but you want to make sure you're hearing their vision and what they're trying to achieve, both at the organizational level, and then from a delivery to patients at the end of the day, which is what we're really all here for, right? So… I'll give you some examples from my background, and this is not just limited to the dental part. When I was running Ethicon sutures, for example. we actually were trying to establish a new standard of care for antimicrobial sutures, right? So, we wanted to make sure that we were influencing and working with the top KOLs across the world On how we could try to reduce the risk of surgical site infections by making an antimicrobial suture a standard of care in high-risk surgeries, for example. But it wasn't just about getting your best customers, right? If we had just ried on our sales guys and said, hey, go find people we can put on our advisory board, we would have probably got our highest volume or most welcoming sales customers. what we tried to do is we said, let's take a big step back, work with our medical leaders and our executive leaders to go find those KOLs, key opinion leaders, who, for example, the CDC is calling up and saying, what do you think the standard of care should be? You know, we had the ex-head of NICE, the European Authority, on, you know, of what we should have as a standard of care. And so, by bringing these luminaries together and driving that significantly higher level conversation, we actually ended up getting APIC, the Association for Prevention of Infection Control. They were actually the association that partnered to rewrite and establish the proposal and recommendation for using antimicrobial sutures as a practice. So, you want to make sure that you're bringing in the right people and having the right level of conversation to truly impact Clinical outcomes to truly bring better stuff to market, and really, at the end of the day, change the conversation to be a triple win, right? I always call it a win for the company, a win for the customer, and then a win for the patient at the end of the day. That's really what makes sense.

Stewart Gandolf

That's excellent input, and it's, intriguing. I love the way you thought that through. So as a company today, actually, I've been on two discussions with potential clients for B2B, and thinking through, because we do a lot of, you know, our company does maybe a third, at least 40% B2B, and 60% maybe B2C. When we're thinking about B2B, we're often thinking about, okay, what are our different personas within the organization, and so we talked a little bit about different, titles, but, you know, what we find is oftentimes we'll do a matrix of, okay, these are the personas, and these are the things that matter to each of these personas. So, it could be efficacy, it could be cost, it could be reputation, service. and dentistry, where they can make money. Do you have any thoughts on that? Like, in terms of each of these stakeholders have different…

Ajoy Mahtab

That might be the billion dollar question there, Stewart. So ,this is, this is where I'm going to…

Stewart Gandolf

Hold on, it's both a sales issue and a marketing issue, right? Like, our goal is usually to pick the brains of the customers and the salespeople who know what their customers really want, but they've got to be aligned, and so often they're not.

Ajoy Mahtab15:32
working together at all, so lovely.

That is terrific. Oh, my goodness. I think… I think I might just, have earned my paycheck with you on this one. So, so this is truly, and I'm being facetious here, but I will actually say, in all seriousness, this is where great partners like you guys. can really make a difference to the outcome. So let me… let me kind of encapsulate what you said and some of the findings that we had on our side. that really, really, really changed the game for us as a business, and the industry in total. So… One of the things that I found you know, to my good fortune, was when I joined Becton Dickinson, The company had invested at the behest of the CEO and the Chief Marketing Officer at the time probably the most in-depth and broadest segmentation study in the med device industry worldwide. It was incredible. So, working with a great insights’ agency partner, working with a great strategic marketing agency partner, and working with the internal brain power that we had in the organization. they went much, much deeper than what's my role, what am I responsible for, and how should you talk to me from a customer perspective, right? So, historically, and I think to a large degree, many organizations stepping into this space We'll start with size of hospital. Title of the person they're going to be talking to, And kind of… macroeconomic factors surrounding, and environmental factors surrounding the location, right? So, I'm going to go meet with the CFO of the hospital, I better be talking finance, right? What we found, actually, through this study is the titles could be directionally Informative, but not necessarily conclusive of that was what the customer would really want to talk about and value most.

Stewart Gandolf
That matters right there a lot, because you can go in with a meeting with an assumption and be completely off, if you don't bother to ask. Continue, I'm sorry.

Ajoy Mahtab

Yep, no, it's absolutely… you're absolutely right. And so, yeah, please, please, this is supposed to be a dialogue. So I would really, you know, caution people to go, hey, I already know, because of the person's title, or because of where they sit in the organization, what they should do, because then you start talking about what you've got, versus trying to understand what they really need and want, right? So, getting a little bit under the hood and talking about what they value, what are their pain points. What is most important to them? Opens the doors to a highly, highly informative conversation that then leads to actually delivering products without even talking about them. I used to always tell my team, don't sell products, solve problems. If you can understand the challenges your customer is facing, and how you can solve that problem better than anybody else, the products will come along for the ride. And that is really the approach we took. So, we… I was in charge of the IV catheter business. 90% of people go into a hospital get stuck with an IV. 40% of those IVs fail. They don't last as long as they're supposed to for all kinds of reasons. Infections. dislodgements, infiltration and extravasation, all these technical terms, but basically, the nurse has to replace the IV, right? And what we actually did was turned it sideways, and we said, what do you need from admission through discharge to care and protect and maintain that IV? And by talking about the patient and the continuum along that line. We were far better suited to talk about partnering with those hospitals to bring a complete solution to them that would then actually solve the problem that they were facing, which was that $28 billions of cost. that the healthcare industry faces annually because of these complications than worrying about the $4 widget that was part of the bundle bag, right? And so, again, you know, if you can really get to talk to the customer, understand what they truly value… By the way. Let's make it a little simple, too. 85% of your selling story is common. Right? But think about the headline and think about the most salient point that you want to focus on. That should be based on what the customer values, not on what you want to talk about.

Stewart Gandolf

Funny, I can think of one point my mother was getting treatment for breast cancer. The IV was a thing for her, and she's old now, right? And so, they kept sticking her, and they couldn't figure out, and the worst part was they had to come back and do it again.

Ajoy Mahtab

And I was like, no, no, both my hands are all bruised and terrible looking, and…

Stewart Gandolf

From the patient's point of view, they don't really care that it's common to have a failure.

Ajoy Mahtab

Exactly. That's… and I'll give you a similar one, just like what you said. I had… I talked to somebody who gave… who had a child, like, gave, actually, childbirth in the hospital, and when I talked to her, she said, oh, I got stuck four times, and I was like, you were in labor! What you remember is the little IV stick, and she's like, yeah, but it kept happening, and I was getting annoyed.

Stewart Gandolf

I think during your talk, I believe you talked also about the selling the whole system versus a specific component. Isn't that part of what you guys did as well?

Ajoy Mahtab
I'm sorry, I missed the questions.

Stewart Gandolf
Back in your talk, I think you spoke about, when you were presenting this, you were trying to sell it bigger picture, too, beyond, like, in other words, like, you're selling a specific component, but the whole line, everything through it, was that… Correct.

Ajoy Mahtab

Yep, and Stewart, you know, again, I will say, we didn't go in and try to sell the system. We went in and said, let us help solve your problem, right? And what we found, a little serendipity as well, was hospitals were inviting us in. Because we were actually better able to help them with their problem than they were able to do on their own. And so, I'll give you… I'll give you a classic example, right? Initially, we would go into a hospital and go, hey, you have an infection problem. Your infection rates are higher than your peers. But that's about all the information you could kind of give and gather when you were looking at it from the outside in, right? when we actually got into their systems, we were able to say, hey, guys, in building number 4, on the 6th floor, from the midnight to 4 a.m. shift, we're seeing a spike in infections. What's going on? And they would literally be like, oh my goodness, the head nurse just resigned two weeks ago. So, it was just an incredible partnership that was driving value for them, solving their problem, addressing their things, and guess what? That hospital that I was just mentioning. The following year, when they did their Press Ganey scores, right, the surveys, did you like the hospital food, what do you think of the process, blah blah blah, their customer satisfaction rates from the patients who had IVs went up 13 points. So, they actually had a question in there that said, what did you think of the nurse who took care of your IV catheter? And that satisfaction score was 13 points higher the following year.

Stewart Gandolf

Congrats.

Ajoy Mahtab

Program in place.

Stewart Gandolf

That's amazing. I want to pivot a little bit. Continuing Ed is such a big part of healthcare, and, you know, I remember the day when we would teach about In my earlier years, teaching about how to do a good CME meeting. But now, I think that is everywhere, whether it's in dentistry or medicine. There’re so many options. Any advice on how to stand out there and make it more effective?

Ajoy Mahtab
Oh, wow. We might have to think through this one together, Stewart. I bet you've got more ideas.

Stewart Gandolf
I ask you the tough questions, not the easy ones. There's no… there's no slow walls here.

Ajoy Mahtab

Well, clinical education is a… is a bit of a…I'm going to not call it a double-edged sword. But it's a, you know, what are you doing for me, and am I going to do a comparison to see where else I can get it and for how much, right? So, if you start to think of this as a cost. they're going to see it as a thing that they should then go out there and price shop or compare against somebody else. If you're doing it based on what we talked about, right? If I can find out what you truly value and what you truly need, and what your pain points are, and I start to tailor it to that. Is it, you know, how do I make myself more clinically effective? Which can be product training, etc. But there's lots of places you could go to get that, right? Is it about office workflows, efficiencies, and profitability of your office? That's a different…set of educational material. May not be clinical in nature, but it actually helps the doc be a better doc, because it frees up time. Could it be things like in-person peer-to-peer sharing? One of the craziest things that I found was we would have live events and bring together, you know, 50 docs, 100 docs, ranging from, you know, the top KOLs in the industry, all the way to people who'd got, you know, out of school just a few months earlier. And the peer-to-peer networking was ranked as some of the best reasons for them to come together. So, it's not just about, hey, I can get that same stuff by watching a YouTube video. Not making fun of YouTubes, because we're on there, sorry, but the reality is, information is easy. relationship building, networking, and idea sharing is much more difficult. And it's, I think, incumbent on organizations and… like yours and manufacturers like ours to really bring those venues to life. create those abilities for them to do that sharing, to do that. Give them the platform, right? They know this stuff better than we ever will. They're trained in it. We just, you know, we stayed at a Holiday Inn Express last night kind of situation. But the reality is, by them being able to share with each other, they all end up better for it, and they actually value that as an offering that we can continue to bring to them as a total population.

Stewart Gandolf

Excellent. Another topic that we talked about a little bit offline, and I, you know, love this, and Joy, as you probably remember, or may remember. I started off in this business for 10 years as a speaker on the road, working individually with individual doctors of every specialty. And that was priceless. I wish I could just take that knowledge and give it to my team, like, suck it right out of my brain, because you know, I… it's one thing to say, yeah, I know how to market to doctors, it's another that I've actually done that for 10 years on the road with them. In small groups, and so I led speak… I spoke at the large session, small session, had a lot of interactivity. And I have my own thoughts on this, but I would love to hear your thoughts about the mistake people make when they're trying to communicate with HCPs, because I feel like A lot of times, people forget they're people, too, and they talk to them like robots, but I'm curious what your thoughts are.

Ajoy Mahtab

Oh my gosh, yes, so true. It's funny, because I watch… I watch some of my team, and, you know, part of the coaching is kind of, how do you get better at exactly that, right? So, I think… You know, I'm very, very basic and simple-minded when it comes to how do you get results, right? So, if I really think about what am I trying to get across. If I go into a scripted story cell, Not going to work. If I think about what my product is and how great it is. You forget the fact that there's 5 other people coming in right behind you saying their product is great and what it is. If you talk about how amazing you are as a partner, but you have seven other people saying they're amazing partners, it becomes this sort of me, me, me, me, me kind of situation, and it never really helps you stand out from the rest of the crowd. So, I think the mistake that many, many organizations make is they go in with a product-centric, let me tell you why my stuff is good for you, versus flip it around. Flip it around and really go in there and say, what are you facing? you really look for. And then as marketers, our job isn't just to sell what we have, it's to bring that understanding back to all the partners. I used to joke with people and say, marketing actually doesn't do anything, right? Marketing is supposed to be the magical thing that gets things done. We have great agency partners. They're actually the ones who make all the great stuff come to life. We have great R&D partners. They're the ones who can really design and manufacture stuff. We have great operations partners, they're the ones who make sure it's in the hands of the docs when they need it, right? But marketing, we've got to have, you know, our eyes open, our ears open, and really understand at the basic, like, what is the customer looking for that we can then help with. I'll give you another story. Oof, this goes back a ways. So, I was looking after an endoscopic surgical business. And there's a thing called a circular stapler, right? So, think about, you know, people who have colon cancer, for example, right? You have to cut out the cancerous bowel, and then you resect that colon, right? A colectomy. So, you bring the two pieces of colon together, and you staple that line with this thing called a circular stapler. Well, it's a high-risk procedure, because if that bowel leaks, if the staple line doesn't fit properly and the bowel leaks, it's very, very dangerous for the patient. So, making sure that you minimize leaks is the objective of every company when they're trying to design the next-gen stapler. Well, it was with J&J, and J&J is very, very astute at designing great stuff that gives great clinical results. Our stapler? Clinical trial, clinical study. Had less than 2% leaks. The closest competitor, we were, like, 3 times better than them, right? All in the 5-6% range. And so, we were patting ourselves on the back, we were talking about how great our stapler was, we were going into chiefs of surgery and saying, you should be standardizing to the J&J stapler, because we have this. Well, I was in an emerging market, and I was talking to the chief of surgery of a hospital. And he said, Ajoy, your J&J Stapler, bar none, best in class, right? As a matter of fact, your statistics are probably conservative. I would say you're probably even better than that, as far as reducing leaks goes. Here's my problem. I have a 2-year waiting list of people lined up to get surgery. Your competitor, that I can obtain locally, is 40% cheaper than you. So, I can save 5% more people. Or I can serve 40% more people. What do you want me to do? And Stewart, I didn't have an answer. I did not. I literally sat there across the table and go, you know what? I… I have to understand how to get this to be a better, more affordable stapler, versus reducing that 1.9% to 1.8%. It's not doing you any good. Understanding what he was trying to get done. help me come back and sit down with my R&D team and say, guys, this is what we have to do from a design perspective. It's not about just showing slightly more clinical superiority anymore. There's a totally different remit that we are facing into. That's the kind of stuff that is just… That's why I love healthcare. It's moments like that where you go, oh my goodness, this is why we're here.

Stewart Gandolf

So, I have another question that, you know, talking about, getting your message through and trying to win the heart and mind of the, HCP is… and it's funny, as long as I've been doing this, even recently, a doctor reminded me of, like, you know, we were talking about why they're having such a hard time with salespeople. He's like, you know, I may be looking at somebody's scam, then I may be telling somebody else that their father's going to die, and then you… and there's… and I've got a list of salespeople waiting for you, and then you come in. So, he's like, I'm not trying to be rude here, but it's like, we are ADD by nature, we just have so much going on. It's like, when you're asking for just 5 minutes, that sounds… to me, you know, it's kind of the same thing for me, by the way. When people say, I just want a half hour of your time, it's like, my wife would like a half hour of my time. It's naive to think I'm just going to give a half hour of my time. So, like, any tips on the ADD thing? Because that's real, that's a big deal. Like, how to stand out in a fast way.

Ajoy Mahtab

Yeah, no, it's a great question. So, yeah, if you've ever been in pharma sales, guys, you know the story of you go in, they go, where do I sign? Show me your samples, get out! Yes. So, it's an interesting situation, right? Like I said, these guys have so much going on, and you articulated it beautifully, right? It's not just the one person that I'm meeting today, it's not just the one thing I have to think about today. We used to say, in an average week. your average HCP probably thinks about you for 9 minutes if you're the market leader, and probably about a minute if you're not, right?

Stewart Gandolf

We're not home.

Ajoy Mahtab32:21
And so, for us to really go in there and say, can I have a longer, more in-depth interaction. what are you bringing to the conversation, right? If you have Something that is truly worth listening to and talking about, they will make the time. My diabetes business was a perfect example of this, right? So, when we started going in, it was a pen-needle business. they were literally like, throw some samples to my… they didn't even… they didn't even come out. They were like, hey, you just deal with my front office folks, they have my authorized signature, drop off your pen needle samples, and off you go, right? But when we started talking about value to patients, and what we were trying to do, and how we would actually change the dynamics of the industry and the category benefits, you know, talking through that segmentation study that I had mentioned earlier. That's when our reps were rebelling against us as the marketing team. They were saying, are you kidding me? I get 5 words by doc once a quarter. I cannot waste that time talking about this segmentation study and asking them what they value. And we were like, well, we're going to have to do it, so we had to actually do a little bit of a top-down drive of, you will follow the process. Sometimes you have to be a little bit of the stick versus the carrot, I get it. But the interesting thing was, once they started going into these offices and doing what we asked them to do. They were calling us up and going, hey, I normally see my doc for 5 minutes. He canceled 2 subsequent appointments after mine, so he could keep talking to me, or she could keep talking to me for 40 minutes, 50 minutes. I was still in there, and we were just talking through. And they were saying, this is one of the first times somebody's actually come in and not tried to sell me something. They just come in and asked me what I'm trying to get done as a doc, and in my office, I'm happy to chat about that. When you have new products, when you have new procedures, these are all things that they want to actually learn and listen to, but you've got to make it worth their while. If you're going in there and being transactional, guys. You'll be out there before you even know it.

Stewart Gandolf

Yeah. So, the trend towards nurse practitioners and PAs is obviously a big part of where healthcare is going, and even, you know, the some people in that… in the business, I once worked with, Columbia University as a nurse practitioner program, and I remember one of the people I talked to thought it was dismissive to call them as an extender. So, the way we communicate, the way we think, any specific ideas there about, how to deal with MPs and…

Ajoy Mahtab

Yeah, yeah, so, by the way, they've always been important. It's just that organizations are slowly starting to realize they aren't.

Stewart Gandolf

That totally makes sense.

Ajoy Mahtab

Oh, it's funny. Yeah, people become aware of people's roles and start going, oh, wow, how about them? And you're like, we've always been around, guys! Anyway, so yes, you're absolutely right, though. We're focusing on the broader team is really important. So again, I was very lucky, and in the times I've had, much of my businesses have not been singly focused on only the doc does it. Some of my stuff was specialist at procedural and surgical. That's very much in the arms of the doc. If the doc says they want something, they'll get it, but… but you have to rely on the total staff understanding, incorporating, and embracing what you're doing to really make that solution happen. And so… The nurses play a critical role; the office staff plays a critical role. How do you deliver that outcome? How do you drive that improved patient experience? What really works well? And if you can approach it from improving their workflows, making their lives easier, getting administrative tasks out of their hands and taking it over. There’re so many technology tools, and Stewart, you're the expert on this, right? You guys know there are things out there that can really help them do the day-to-day, mundane stuff of their job. I've never heard a doctor, a nurse, a dental assistant, a nurse practitioner ever goes, yeah, I want to spend less time with my patients, I want to spend more time doing all this bookkeeping and filing stuff, right?

Stewart Gandolf

What about.

Ajoy Mahtab

Let's get rid of the stuff that they don't want to do and do it for them in automated and technologically savvy ways, so that they really do get to spend more of their time that way. That's a big value driver, I think. So, I mean, if we can get HCPs and get these guys focused on their patients… And by the way, I'll give you a quick little secret here. When we talk to patients. Some of the dental procedures are pretty expensive out-of-pocket procedures, right? I mean, if you're getting aligners, you're talking, you know, $4,000, $5,000, $6,000 cost to the patient. When the doctors are telling them, you need to get aligners, the patients are scratching their head going, oh, you're just trying to make money from me. When the dental assistant, when the hygienist, when the office staff are kind of going, you know what, I've got this thing about, you know, malocclusion and oral health and straighter teeth actually help you, they're actually much more credible. Then they can hand it off to the doctor to actually have the clinical conversation. But the nurse can be a huge gatekeeper and open doors to greater transactional business as well, so don't ever ignore them, they're very important.

Stewart Gandolf37:18
So, fun fact, Joy, I don't think you know this, but years ago, I don't know, at least 10 years ago, we were hired by Invisalign, our agency. create a video on how to close, Invisalign cases. And it was targeted mostly towards the practitioner, and especially orthodontic offices. The following year, they came to us, and they said, can you do a CE, you know, program for design for the hygienists and the DAs on malicumes, and we actually did a video on that. Very topic, that's so funny. So that was a while ago, but that was a fun project, and I still like to refer to that once in a while. We're almost wrapping up here. Two quick questions. The second to last is for enterprise sales, where you're talking about multi-location, which, you know, our agency does a lot with. The…it changes, and I'll argue that as I work with, you know, we work with multi-location these days, mostly, almost exclusively, when we're working with providers. And after about 10 doctors, it starts becoming less democracy and more administrative, because you just have to. Like, when you have 10 doctors in 6 locations, it's still democracy. It's still really run by the doctors. But when you get to 20 offices and above, you know, it just falls apart. But I was curious to know any other… it's still always involved, so any… I have my own thoughts on this, but I'd love to hear your thoughts about how do you balance… you want to still talk to the stakeholder doctors, but the administrator side, too. Any quick secrets for us?

Ajoy Mahtab
Yeah, no, it's… and it's an important question, because As time has gone on, The relationship has become…Less of the driver, and the…the evidentiary conversation has become more of the driver, especially in big institutional sales, so you're absolutely right. And I'd love to hear your thoughts. You mentioned you had thoughts; I'm going to make sure you share those too, but… So, here's… here's my one…Sort of, you know, nugget for the group here. If a doctor says they really want a product, whether it be a surgeon, whether it be a general doctor. And they go to the institution and say, I have to have this. I promise you they'll get it. You know, organizations still believe the doctor is the final authority on what they're going to use. However. In today's environment, where they have to have a hundred of those conversations, they're going to pick and choose which ones they're going to fall on their sword for.

Stewart Gandolf

Right?

Ajoy Mahtab

So, if they go in and go, I have to have this specific device, because it's the only one that does what I want it to do. And there is no compromise. Even if it's 20% premium, they're going to get it.

Stewart Gandolf

But…

Ajoy Mahtab

when there's 5 other things that are equivalent in their minds, they're going to give on those. They're going to go; you guys go do the procurement thing and get me the cheapest one you can. I'm fine with that, right? And there's pressure on them, because there's budgets. Budgets are finite. If they're going to take premium on one thing, they're going to have to give somewhere else. They're doing that day in and day out, and they're making these decisions, so… How do you make sure that your product, whether it be through clinical evidence, whether it be through, you know, effective total cost of ownership displays, whether it be through an understanding that you do something differently and you actually can show that value proposition, is your product below the line? Which means you're going to be fighting in a big dogfight? Or is it above the line? In which case you're going to get chosen every day of the week, right? How do you make sure that you're thinking through your innovation, you're thinking through your value propositions, you're thinking through your positioning and messaging with agency partners? Make sure that you're thinking through, from the mind of the other side of the table, why they should choose you and only you. If they say, I will choose you. you're still open to getting swapped out. If they say, I will only choose you, or I will choose only you, that's when you've won the argument, right? And here's a little nugget for you as well. One of the things I came across by happenstance, and it was stupidity and ignorance that caused it, but I'm going to use it as wisdom now is, at some point, I was stuck in a conversation, and I couldn't get through to the procurement guys. And so, internally, I was moaning. I used a different word, but I was moaning. And somebody said, well, why don't you go talk to our own procurement people? And I was like, oh, lordy, lord, what an idea! I went to my own procurement team, and I said, do you guys always buy whatever's cheapest? And they're like, no, we have an evaluation criteria that we use. And I was like; I want to sit down with you and talk through how you decide When you're going to pay more for something.

Stewart Gandolf

Great, obvious idea, I love that, that's awesome. Awesome!

Ajoy Mahtab

It was the greatest conversation, because then I went back with all that ammunition to the customer procurement team, and I gave them all these things, and like. You know, that makes sense. So, there you go.

Stewart Gandolf

That's awesome. Well, I will tell you, in our world, we've been working as a marketing agency, for ourselves, and also for our clients. I have a slide, that we've came up with a few years ago. Which is taken from the scene of Frankenstein's monster, where the villagers have pitchforks and, you know, flames, and they're chasing down the monster. And I would… I always just say that… think of that crowd if you're, like, annoying your doctors. Like, they're going to come after you, the whole crowd. And as a cautionary tale, I mean, what I mean by that is, in a much more practical way, doctors always matter, and so it's really easy for administrative people to kind of forget about that. And it's like, you're… you're going to have a hard time if you forget that your stakeholders will always matter. And then the other thing is. Kind of where you said, like, negotiate specifically, but also, you know, some, in any given, you know, business, especially with multiple doctors, some doctors are going to be thought leaders within that business. And some are going to be detractors, and, you know, they're kind of on both ends of the scale. And so there might be 10% really for something, 10% really after, and then really everybody else is in the middle. And I would say engage both ends of that scale, because you have to deal with the Mayfairs as well as the pros, and everybody else will be influenced. I mean, you only have so many resources, and everybody only has so much time. So, that's… would be my nugget, would be to really think through who the… and then you… how do you find out who they are? You ask. And they all know. Every time I say something like that, when I'm talking to a committee. Whether it's for our own self, or whether it's for our clients, like, usually there's a handful of doctors that really will sway people for good and ill, and they all start nodding their head, like… and I go, and you're probably thinking of who they are right now. They're like, yeah, I want to bring them to the table. And it's really important, because otherwise. You know, it could be… you know, and avoid, if you don't talk to the naysayers, they're on… nobody says anything, but they do, then, you know, you think you put together this presentation, it's all logical, and it's dismissed in seconds. Like, I don't like that product. Okay, then, next topic on the agenda.

Ajoy Mahtab

So true!

Stewart Gandolf

You know, like, I think the salespeople in the market go have such an overinflated idea of how much their message is really getting through. I once had a friend slash mentor say, that rubber band snaps right back. You pull them all the way out here, and they're all excited, and then the next one is like, back to business with you, whatever. You're like a… Another metaphor is you're just a part of their passing parade in their very busy life, and you think you really related, and they've just moved on already. So, it really helps to understand who the stakeholders are. The last question is, it's a fun one, so we've talked about winning the hearts and minds, and my final question, I guess, is there anything else, like, just relationship building, or is something that we should think about? It matters either on an individual basis or on a scale basis.

Ajoy Mahtab

That's a good question. So, I'll wrap it up with the easiest way to answer that question, and that is… Understand and truly like the people you're working with. like the people you're working for, and like the reasons why you're doing it, right? So, if you're passionate about your customer, if you're passionate about the patients that they serve, if you're passionate about your own team… I've had some incredible bosses and mentors; I've had some incredible peers and teams reporting to me. they just make me better, and if you really love that stuff, you will always do the right thing. You don't have to cut corners; you don't have to feel like it's a drudge. My… some of my best friendships are with some of my dogs, you know? I enjoy spending time with them. If you don't, go find something else to do, guys. It's not worth it. We spend way too much time with the people we work with and the people we work for, which is our customers. then with our own families and friends, we may as well actually enjoy that side of our lifestyle, as well as the ones we have at home. So, yeah, I mean, it's a personal thing, but like I said, I fell in love with healthcare, I fell in love with a purpose-driven attitude that most of us have in this industry. We do it for all the right reasons, we do it for all the right outcomes. it just makes everyday fun. I mean, I just enjoy it. I will continue to do it as long as I can, and I will continue enjoying it. And if I stop enjoying it, that's the day I'm going to hang up my boots and find something else.

Stewart Gandolf

Yep, I get it. I totally agree. Well, Joy, it's been a… it's been a joy. First time you ever heard that, right? Like, in grade school, I heard beef stew a lot. Like, it was fun the first time I heard that when I was 3. But anyway, Ajoy, it's been really fun working with you today. I appreciate it. Thank you much, and we'll see you out there.

Ajoy Mahtab

Thanks, Stewart. I'm going to give a plug. You guys, connect with Stewart. I mean, the podcast is fantastic, but the stuff that these guys do. Really, really great stuff, so I hope that these are not just your existing customers, but prospects as well. So, plug for you.

Stewart Gandolf

Thank you, Ajoy, I appreciate it.

Ajoy Mahtab

Thanks, Stewart. Really enjoyed the conversation. Bye.