One of the greatest challenges that sales leaders face in the medical device industry is how to best manage their clinical field teams.  Often times they are as large as, or larger than, the traditional sales teams, and of course they represent a huge financial investment in terms of compensation.  Yet, it’s all too common that they don’t come close to fulfilling their potential because they are managed like a sales team instead of a clinical team.  At best that means a huge investment is underutilized, at worst it also sabotages the sales team that is generating the company’s revenue.  Here are the five most common mistakes sales organizations make with their Clinicals.

1. Unclear roles and responsibilities:  This is the big one that impacts nearly everything else with regard to Clinicals.  For Sales Reps, their roles and responsibilities are pretty clear: drive revenue.  Certainly the tactics may vary—create relationships with physicians, enforce contract compliance, support cases, etc.—but the end goal is always the same, to sell the company’s wares.

The roles and responsibilities for Clinicals are much more nuanced and vary widely across the medical device industry.  They can be clinical selling in conjunction with the professional selling of the sales reps.  They can be case support or HCP education or patient training or a hundred other priorities.  Obviously there’s a lot there, and most often sales leadership tells the Clinicals to “do any or all of those things that are needed to support the sales effort.”

That’s pretty ambiguous guidance.  That ambiguity is compounded by the fact that the typical profile of a Clinical is a nurse, a role with a lot of structure and direction.  Telling these people to do “whatever” is exactly the wrong thing to do, leading to a lot of paralysis, confusion, and frustration.

2. Role convergence:  An unfortunate result of the “Unclear roles and responsibilities” is role convergence between the Clinical and the Sales Rep.  Sales Reps know they should be driving revenue, and Clinicals know they need to support that effort; it’s easy to see how Clinicals will start to think their role is to similarly drive revenue.

This very often results in “divide and conquer” behavior, especially if the sales territories tend to be larger.  Sales Reps and Clinicals will split the territory with one driving revenue in one section, and one in the other section.  “You take the north and I’ll take the south.”  This obviously isn’t optimal.  A sales force has these two roles because they perform (or should be performing) two very different roles.  With divide and conquer, the accounts the Sales Rep takes gets more of the professional selling activities, but less of the clinical activities; the accounts the Clinical takes get the opposite treatment.  Don’t accounts need both?

3. Compensation and promotion expectations:  A natural consequence of “Role convergence” is that Clinicals often aspire to be Sales Reps.  Certainly compensation is a huge part of this.  Sales Reps make significantly more than Clinicals, so you have a bunch of Clinicals that start to complain that “I’m doing the same thing as a Sales Reps, but I’m making half as much.”  Clearly, this leads to issues.

Another closely related problem is Clinicals start to apply for Sales Rep jobs.  Certainly, every sales force has a few Clinicals who have really strong selling skills that would make them successful Sales Reps, but this is the exception rather than the rule.  Much more often, when Clinicals get promoted to Sales Reps they support the business by utilizing the account support skills that made them good Clinicals, but they aren’t very good at growing share or increasing penetration.  Over time sales erode until it’s one of the poorer performing territories on the team.  Now there’s a sales issue and an HR issue.

4. Mirrored territories:  A huge challenge of multiple field teams is how to align them.  Mirrored territories (Sales Reps and Clinicals cover the identical geographies) are nice because it avoids a lot of infighting over where the Clinicals spend their time.  When a Clinical supports multiple sales territories, it’s easy to predict that Sales Reps will complain that they aren’t getting enough of the Clinical’s time.  That’s the reason the Sales Reps isn’t hitting their numbers, because their Clinical is spending too much time in the other territory.

But mirroring territories has its own problems.  Sales territories are aligned to maximize sales, and that is totally appropriate.  The territory is cut to have the right amount of current sales, potential sales, workload, and all the other factors that are important.  But a territory that is designed to be optimal for a Sales Rep probably won’t be optimal for a Clinical.  If the territory has a lot of current business but less potential (a “farming” territory), supporting all the current business could be overwhelming for a Clinical.  If the territory has less current business but a lot of potential (a “hunting” territory), that could lead to underutilization of a Clinical.  Either way, the territory that makes a lot of sense for the Sales Rep might not work for a Clinical.

5. Sales rep as boss:  As the Sales Rep and Clinical work together, they very often fall into a natural hierarchy: the Sales Reps over the Clinicals.  Sales Reps are ultimately responsible for the success of the territory, and they are the ones developing the plan to achieve that success.  The Sales Reps then give direction to the Clinicals on what they need to do to support that plan.

Subtly or explicitly, the Clinicals will look to see the Sales Reps as their boss to a greater or lesser degree.  Yet, most Sales Reps are terrible people leaders.  The common characteristics that make great Sales Reps—competitive, refuse to take “no” for an answer, goal-oriented—often aren’t conducive to successful people managment.  Sure, just like there is a small fraction of Clinicals who can make good Sales Reps, there is a small fraction of Sales Reps who can make good people leaders.  Those are the ones who tend to get promoted to sales leadership roles.  But most just aren’t very good at that.  When they play that role with their Clinical, it often leads to significant dissatisfaction from the Clinical and major frustration from the Sales Rep, both of which can kill productivity of the territory.