Digital Marketing for OEMs and CMOs Featuring Elvio Grimignano, Founder & MD, CommuniD

Good morning!

Hey! Good morning!

I need to put my video on board. I don't want to see my messy office.

On, blur.

It is. Oh, it is right. It's been a long night. My puppy was up like 3 times in the middle of the night, so I am pretty blurred out.

Puppies do that sometimes.

Yeah, they do. They're just like babies.

Right.

How do I get on? The talking circuit.

You just asked me.

Asking you.

Okay.

Go ahead. So all the committee drafts other than one out of the 12 fragments are either dropping tonight or have dropped. and I just did a post, and so that should draw a fair amount of attention to the 4th edition. and people should wake up if they haven't.

Okay.

So it'd be a good time to start talking about 4th edition.

elvio gramignano: I have one. elvio gramignano: Hello! Hello! elvio gramignano: Good morning. elvio gramignano: I don't know.

Grazie, call me Star.

elvio gramignano: Bene multo bene roy.

Everyone.

And Kinnoi. Still Leonard is tired. Because his puppy was up 3 times last night.

elvio gramignano: Yeah, I heard that I heard, because I was already in. But you. elvio gramignano: Steamy guys.

Hiding.

elvio gramignano: Yeah, no, I wasn't hiding. It's just.

Or at least I wasn't trying to hide. I was hidden, but not trying to hide.

Well, it looks.

elvio gramignano: What is okay. I was trying to get a little bit of a blurred background, but.

It is blurred.

elvio gramignano: It is alright. Okay. Fine. Perfect. Okay. No. Big deal.

No, that's not it.

elvio gramignano: And do you mind if I try to share once.

Go right ahead!

elvio gramignano: So elvio gramignano: so do you see my screen.

Yes.

elvio gramignano: Okay, perfect.

And I'm gonna try to share mine and see if I can do this without.

elvio gramignano: Yeah.

Downloads. Are you seeing my screen.

Yes, we can. We can. Okay.

So I have, Leonard to answer your question. Speakers booked through July the 25.th

Okay? And I need. I can't figure out how to switch my name to Leo. And I should know this. What's which pull down is that.

Try the 3 dots in the upper right hand corner of your picture and see if you can find it there.

Oh, that's right. So yeah.

Rename, excellent.

Oh, yeah, there it is. If I can get there. I am freaking tired.

It's okay.

Yes, because I hate being called Pete Leonard.

Okay.

I'm sorry. Try that. That's better.

Wow!

Yeah, I got a lot of traffic. It looks like on Linkedin last night while I was tending to puppy, and I got some traffic.

Oh, good Elvios! Yama pronti.

elvio gramignano: Prontissimi. elvio gramignano: and I don't know where you guys are. But here in the Uk. It's elvio gramignano: we are in the heat wave. elvio gramignano: Oh, it's it's summer.

Yeah, we're having all kinds of weather. Yesterday we had a tin paste. English. They yeah. And then. Now, today's beautiful.

elvio gramignano: Now here it's been a couple of days that we had really gorgeous weather, with 2425 degrees.

Beautiful.

elvio gramignano: And everyone is complaining because it's too hot.

25, everybody.

But.

elvio gramignano: I know, but you know England is not set for for hot weather, so there's no hair. elvio gramignano: He's used to it. elvio gramignano: There's nothing. So it's it's true that, like at night, it's difficult to sleep. elvio gramignano: and schools are not set for these temperature.

Yeah, here in Pakistan. It's like around 28°C, and the humidity is getting higher as well. So everyone's just like blasting their acs on for.

elvio gramignano: Yeah, yeah, yeah.

Gonna be a hundred degrees here today. That's hot.

elvio gramignano: That's hot. Yeah.

In golden.

Correct.

Wasn't that lovely?

103 here. Yeah, that's hot. You have humidity. Yeah, no, not so much. We're on the cusp of humidity, because the monsoons are about to start. Gross.

Ugh.

And Lord knows where Michelle is.

Yeah. Michelle Mitchell.

She likes. Oh, yeah, sorry, Michelle. A lot will be like in kindergarten, Michelle, M. And Michelle, M. Michelle, M. And Michelle L.

I'm home still.

Okay.

It won't be next week. Does that?

Mean the Bay Area, or what? What is home for you? The Bay area.

No, the other side Atlantic side.

Okay.

All these note takers are joining the call. It's crazy.

Well, that's because you know so much.

So much information. You can't capture it all. You need your notes.

Okay, I'm gonna share my screen share. Hmm, hmm. okay. If you're not a member yet of Mlvx, please consider joining. Here's some information. You can go to members dot Mlvx mlvexchange.org. Why so couple of announcements next week? Stefan is going to be I, Stefan, gonna be speaking about clinical evaluation pathways for C marking. Is that correct?

That is very nice, very correct. Yes, I'm looking forward to this.

Okay, we're looking forward to having you. This is the Speaker Calendar. Stephan is. Next week. We will not have a call on July the 4.th For obvious reasons.

elvio gramignano: Use reasons. Yeah.

Sarah hockey Schaeffer, who works for Zeiss in Germany as head of global regulatory. We'll be talking about digital transformation and and patient safety really excited to have her. I met her at a raps event in Baltimore, and she's really dynamic and committed to digital transformation. And Zeiss is on the on the leading edge of that. So please join us for an enlightening thing Ronald will be will be presenting a Prc. Mini mass class, which ought to be fun. And then, Jose, I assume the topic is going to be 510 cybersecurity. But

he he's he's full of surprises. So. you know you you never know. But Jose is speaking. If anybody would like to get on the calendar please just message me, and tell me what you'd like to speak about, and we will arrange it. Also, we're coming out with a new publication as part of Mlb. Exchange, and this is really an opportunity for any one of you to reach an audience of greater than 10,000 with with your message, not saying they'll all read it. But what I am saying is, you'll reach them, and this is built on our audience here, and so we will be

rolling out the 1st issue. Once we have, you know, like 6 articles or 10 articles, or whatever, but it really is based on your contributions. So I'm relying on you to say, Hey, I'd like to write about this and and we'd love to feature you. And then, yeah, the last thing was that, and there are the links. Let's chat. If you're not sure if it's right for you feel free to let me know, and we will arrange a call I have to let everybody else in now. And while I'm doing that I would like to introduce Lvo today's speaker, Gramignano, who is from London, and we met recently, and he's doing some interesting stuff

with a topic that I know very little about ironically, since I'm a marketer is digital marketing for oems and contract manufacturing organizations, and that is not a client group that I have worked with. So I'm excited to hear what he has to share. And I'm going to shut up and just start promoting people.

elvio gramignano: Hey, thanks, Sean, and let me see if I can share, because I have a very long presentation for you guys. elvio gramignano: I'm sure that you will be happy. So, 1st of all, Elvie Gramiano from the Uk, but originally from from Italy, and thanks Sean for elvio gramignano: inviting me for this presentation for this meeting for me. Clearly, it's a great honor to be here and to talk to a selected number of of leaders and experts. Briefly, this is what I would like to share with you today. So I'll start with a brief introduction on myself. elvio gramignano: sharing a little bit of background of my experience. Then

elvio gramignano: I would like to reflect on one of the of the elvio gramignano: of what I believe is the most critical issue in the medical device sector trying to examine if there is a solution and which could be the solution. Then I will talk about the digital opportunity. And I would like to be clear here when I'm talking about digital opportunity. I'm talking about only of the digitalization of the commercial process. So sales and marketing. elvio gramignano: not to the digital application to products or clinical workflow. elvio gramignano: which is absolutely a very interesting topic, but is, I think, it's outside of the scope of this conversation. Finally, I would like to introduce the community model community is the company that I founded.

elvio gramignano: And just to clarify this is not a sales pitch I appreciate. It's more a sharing, a philosophy that I'm deeply passionate about. elvio gramignano: and I hope to receive some feedback from you suggestions and also criticism. I'm very open to any of these. So, talking about myself very briefly, I don't want to kill you with myself. I'm almost 60 years old, 59 right now, 16 elvio gramignano: in November, a lifetime dedicated to sales and marketing in the, in the healthcare sector, with a broad experience across large, multinational, small, mid-sized companies.

elvio gramignano: I worked in Europe, in the Us. In Brazil, in Japan, in Australia, in China, and I've been actively involved in the sale of 3 companies and the purchase of 2 companies. So I kind of elvio gramignano: I learned a little bit about elvio gramignano: about the sales of companies. And elvio gramignano: and in 2021, I founded community because I believe that the elvio gramignano: medical device industry is facing a very deep structural problem that can bring the evolution of our market into the same structure of the pharma market, where only giants are managing sales and marketing distribution, while all the mid-sized companies are simply focused on the 1st phase of the R&D basically finding molecules.

elvio gramignano: I think this is wrong. It's wrong for the patient, and it's wrong also for ourselves that are working in this industry. So I'm trying to elvio gramignano: to see if there is a way to support small and mid-sized medical device companies. elvio gramignano: although I think that the time is somehow running out. And let me try to explain elvio gramignano: if I try to understand what is happening right now. I think it's good to give an overview of what the medical device industry went through in these years. The medical device industry started in the seventies roughly.

elvio gramignano: and we can call the seventies eighties, nineties until the 2,000, the golden era, full of opportunities, minimal friction, and a medical device being in a happy place. All right. Low regulation barriers, high product prices. elvio gramignano: strong product differentiation. elvio gramignano: Then we have the turning point starting in 2010, and I think you will remember some of the big scandals, the French pip, the breast implants that were exploding in the airplanes, or the metal on metal scandal, and there were few others, and this was definitely shaking the public trust and the institution confidence.

elvio gramignano: Then, at a certain point of time, the the innovation started to slow, and and the industry in I appreciate the medical device is very differentiated. But elvio gramignano: we saw in most of those subsectors a technological plateau, and then the economical pressure that all the healthcare industry are facing with both in Europe and in the Us. With the 3 factors, aging population, increasing cost per single patient and less payers that is clearly creating complexity. elvio gramignano: This brought to what we are seeing today a commoditization of the solutions. So most of the solutions are basically all the same.

elvio gramignano: a falling of the prices, an increase of the regulations of the complexity of the regulation being the FDA cmarking Tga Pmda, Korean, FDA, Chinese FDA. You name them. And elvio gramignano: and one very important element, and many articles are showing that the cost of sales in percentage of revenue in our business is probably the highest elvio gramignano: across multiple technology markets. And when I'm saying the highest, I'm talking about 200 times higher than I don't know a nuclear power industry. So something that cannot really be justified with the nuances and the complexities of our market.

elvio gramignano: And and so among, let's say that the managers, the executive, we have started to say, Houston, we have a problem elvio gramignano: because we were seeing a significant margin erosion in all companies bringing to general 2 type of behaviors large companies. We're consolidating and buying small companies, while instead the mid-sized companies we're restructuring. elvio gramignano: The private equity investments have not declined, but clearly their nature has changed. Now they are searching for lower risk deals, platform building strategies. They are checking and scrutinizing a lot all their regulatory elements. That means that they are risking less

elvio gramignano: overall an unprecedented number of companies are for sales and don't find a buyer. elvio gramignano: And then the elvio gramignano: the realization that there is a power gap, a political power gap between the medical device and pharma, and the effect of this is that there is a much larger tax pressure on the Meta tech companies versus pharma, both in the Us. And in Europe. Europe is introducing a lot of new taxes for the medical device, what is not put in place for the pharma. elvio gramignano: and clearly there is a lower influence in the regulation evolution. Sean, I know you're a good friend of Basilacra. Basilacra would tell you that clearly nobody can understand

elvio gramignano: which was the trigger of the new Mdrc. Regulation, because the sea marking regulation seems to be designed to kill the European market manufacturers, and nobody understands why so overall, there is this political power is generating criticalities and pressure. elvio gramignano: Now. elvio gramignano: one of the big problems is that we have responded to those challenges in repeating the pattern of the old ways instead of trying to rethink of the problem and trying to find new solutions. elvio gramignano: And so the response has always been the focus on expanding product portfolio as the only way to drive sales assume that the product innovation alone will lead to market differentiation. And so no marketing, no marketing teams, no budget

elvio gramignano: reorganize internal facts functions. With the exceptions of of the sales forces that results in sales organization, they remain anchored to and to outdated practice. And when I'm saying outdated practice, I think you can understand what I mean. elvio gramignano: Heavy reliance on traditional distributors, legacy sales, techniques, minimal adoption of crms and sales trainings that in most of the cases are product focused and never focused on improving the sales skills of the people that is in front of the client now elvio gramignano: and here we are arriving to the point. Why I founded community because I think that digital tools offer an unprecedented opportunity for mid-sized and small and startup companies

elvio gramignano: to rethink their commercial strategy, just not in terms of what they sell, but also how they sell it. The real differentiation remains the customer relationship. But the customer relationship is not bringing your customer to play golf elvio gramignano: is not sending him in a nice location for Congress. It's probably more important now how to provide information, deliver training, respond to needs, and how you show flexibility. So in my mind, what elvio gramignano: have been so far, the challenges, the reason that have stopped. The introduction of of the digitalization of marketing are now the elements that are

elvio gramignano: instead promoting this new tool. And so the 1st one is like they've always said, but the sales process is too complex, with too many elvio gramignano: stakeholders, and it's true. Yes, the sales often take 12 to 24 months, depending on the industry. But this is the time, and involves surgeons or physicians. Procurement, hospital boards, payers, insurance gpos, whatever. elvio gramignano: But this is the reason why digital can be incredibly useful to enhance and not replace the key, touch points and keep them engaged throughout the whole time of the process. Then we have talked about regulatory constraints. We can talk about this, we can talk about that.

elvio gramignano: But the reality is that digital can and must be smart, compliant, scalable, creating a process together with regulatory, in which you can communicate, and you can communicate being compliant elvio gramignano: then, in most of the cases they've told us, you know, in our market. elvio gramignano: Now our market is still dominated by face-to-face relationship articles are showing that this is not true. Absolutely. Physicians prefer to start to introduce digital elements to the face-to-face conversation, and because elvio gramignano: because everybody now is used to increase the touch points speed, the level of receiving information, being able to select what you're reading instead of, instead of receiving them from from a from a physical person.

elvio gramignano: and therefore it becomes very important to use a Crm. To organize this relationship with the physician. elvio gramignano: Then there is another very important element that is different to Pharma. You appreciate this, and is the use of digital procurement clearly in the medical device. This is still at its infancy, but this could be a very good example to start to prepare, and then there is clearly everybody is always there but marketing in the medical device is simply making brochures and events. elvio gramignano: and the generation of sales leads is only up to the sales force.

elvio gramignano: and it's probably time to to start to build a shared plan with the focus of generating leads that will be passed to the sales force. elvio gramignano: Last, one is clearly there is a huge gap in in the knowledge and in the understanding of the digital process. elvio gramignano: And here this may require a little bit of investment. elvio gramignano: And so in the small, very small marketing budget. That should also be the possibility of hiring or investing a little bit in in digital skills elvio gramignano: now. And and we're going to the point. elvio gramignano: to the community philosophy, if you want. We understand that

elvio gramignano: Rome wasn't built in a day. And and also we also understand that one model doesn't fit all. So we need to customize the thing, but start to implement elvio gramignano: little bites of digitalization step by step, using the famous De Ming principle of the plan, do check and act, could really help. elvio gramignano: And elvio gramignano: and this is where we're coming from. We're coming from the concept that is proposed by the little red book of selling of Jeffrey Gittmer, who's saying, basically 1 point customers buy when they are ready to buy, not when we are ready to sell.

elvio gramignano: And this is incredibly. This is incredibly true and has elvio gramignano: 2 implications. If you want that, 1st of all, the target customer need to be aware of our solution and think that this solution meet their needs. And then we need to make sure that the conditions are right for him to purchase. That means that there is a budget, or there is a tender or all the various elements of the of the hospital. Budgets are met elvio gramignano: now in some discussion of the salespeople trying to pitch the story from this point of view, they said, Oh, yeah, it's right. As a matter of fact, we're not selling anymore. But we are making sure that the conditions are right to enable the selling process. So what is changing in the New world is that

elvio gramignano: we are, we are not. elvio gramignano: We are not elvio gramignano: pushing, we are not selling, we are. We're not convincing, but we are we salespeople. Commercial people are making sure that elvio gramignano: that the person receives the appropriate information that all the stakeholders of the purchasing element are receiving the same set of information, and elvio gramignano: and somehow that we can nurture, though all those prospects throughout the long we said 12 to 24 months, the long buying process, and through this period we are ready to

elvio gramignano: learn and see the signals that the buyer. The potential buyer is giving to to us, and this element of the signal is something that elvio gramignano: most of our existing marketing elvio gramignano: teams are somehow neglecting. If you want. Sales and marketing efforts are often built in silos website, don't connect with social media, and so miss the opportunity to capture signals. Linkedin is generally used primarily as an advertising tool. Most of the companies now are using Linkedin, but they use they use as a elvio gramignano: advertising board, and they don't appreciate the difference, the huge difference between personal branding and corporate presence. We approach the events in the old way with a passive mindset. That means that all right. I'm displaying what I have, and if you want, you can come to me. That is definitely not. The way

elvio gramignano: is not the way that we should be using in 2025, when information is widely available and nobody would come to you to understand what's new. elvio gramignano: Youtube is generally treated as a dumping ground for videos rather than a dynamic engagement platform. So what we're doing at community, we are trying to create a feel rouge across all the activities. elvio gramignano: ensuring that one supports the other, and and they are all strengthening the the sales process. So what we're doing is what we teach is to leverage techniques and technologies elvio gramignano: to seamlessly guide our audience towards

elvio gramignano: high impact moments such as product demos or client site visits using proven formats that we know. We are sure that deliver results. elvio gramignano: Our Congress participation and medical education programs are no longer standalone events. They are all designed to be part of an overall digital campaign that then ends with the event. elvio gramignano: The process works. It's been tested, and what we have seen is generate results is backed by 5 years of hands-on research is trusted by more than 20 medical device companies, and it's built exclusively for the Mactech industry. And it's based on 4 processes. The 1st one is to create an ecosystem of resources.

elvio gramignano: article, clinical data, videos, medical events, head talk, videos, whatever that clearly drive the interest of the prospect and transform the prospect into a lead. You need to have a combination of open elvio gramignano: and gated content to be able to identify the signals. elvio gramignano: There is. The website must be visible, not beautiful. I don't like beautiful websites. I prefer visible websites. And you need to understand that everyone is searching. Google has millions and millions of search in the healthcare every day.

elvio gramignano: And and you need to find ways to get into this through the Google advertisement and through new ways of advertising. That is the retargeting ads. elvio gramignano: an ad that will be seen only by the people that is interested and will not bother who is not interested. Today. An appropriate use of Linkedin, understanding that there is a huge difference between the personal and the corporate profile. What you can do with the personal profile, the messaging at the right time to avoid, to again bother the people within the network elvio gramignano: and leading to your resources on Youtube, on the website, or on spotify or in any other area. And the last one is the smart use of digital and in-person events. In this way you can. As I said, you can create a continuum between the events

elvio gramignano: to make sure that once you organize an event, and you spend like 30, 40, 50, 60, and over $1,000, or pounds or euro, you really have leads at your booth. elvio gramignano: The overall objective elvio gramignano: of marketing is to create sales is to create interesting relationship. And this is what the marketing activities should aim to and clearly not focus on on branding elvio gramignano: now. I think I remain within the 30 min. That was my objective. I would stop here.

elvio gramignano: and I have many other slides, but I don't think might be useful at this stage. elvio gramignano: I don't know if you guys have any question, or. elvio gramignano: as I said, criticism or anything that can help me. I would really appreciate your your comment and feedback.

So there have been a few comments, and I had the same comment, which is the impact of large language models, chat, Gpt, etc. On search. And and I mean, I've struggled with that question myself. It's like, Okay, we've spent all this time optimizing for search engines. And now search engines are. I'm going, or I go around them. You know. I don't ask questions of search engines anymore. I ask them directly of the large language models, because I get much better results than I get with the search engines, and I'm wondering what you have to. Comments, thoughts.

elvio gramignano: It's it's elvio gramignano: it's 1 of the questions, you know, it's it's probably one of the questions with a capital QI think people can. elvio gramignano: Clearly a lot of people are now searching. I am searching myself on Chat Gtp. And I search much less on Google, although I think there is a different type of search. So if I'm searching technologies or procedures, I tend to continue to use Google, that gives better answers. elvio gramignano: But overall, it doesn't change much, because at the end of the day Chat Gtp is the result of what is in the web. You need to be present in the web, and you need to be present in the web in a certain way. What I think this new trend will change

elvio gramignano: is that will probably change the efficacy of the Google Ads advertising. Yes, that's something that will be changed. elvio gramignano: And and that's the reason why. elvio gramignano: like, we are trying to deal with campaigns that are going on Google, on Meta, on Linkedin, on most of the of the of the tools. elvio gramignano: And I'll keep it brief, because I see the reason there are some other questions. But what I want to say is that this word is evolving every 6 months. elvio gramignano: I started in 2021. I was writing posts in a certain way. Then Chat Gdp arrived, and we all started to write posts with Chat Gtp. Because it was much better, and it was giving you a certain tone and flexibility that was increasing the reach.

elvio gramignano: Then we noticed that the reach of the post written by Chat Gdp was decreasing because they were all formatted in the same way. So we started to change. Things are changing very rapidly, and this the search through Chat Gdp, is one of the elements. But it's not changing the value of what we're doing.

Next Arlen has a question, comment, something.

Thanks for thanks for your presentation. I'm an ent surgeon. And I have a couple of questions. One. My influence on the buying decision has deteriorated significantly over the years. Because of what you mentioned the buying group, whether it's B to C or b 2 b has significantly changed. so my question to you is as someone that used to do. I'm doing other things now, but I did it for a while a long time as someone in a specialty like otolaryngology, orthopedics, ophthalmology, urology that does a lot of ambulatory surgery stuff

and runs independent practices as dwindling as they may be. how are you altering the marketing strategy from B to B to B to C. In other words, directly to me.

elvio gramignano: Let me understand if I got your the, the essence of your question. elvio gramignano: You're asking me how manufacturers can talk.

To you more directly is correct. Because I'm I'm I'm the decision maker in the b 2 b in the B to C scenario. In other words, I'm the person who runs the practice who orders the stuff for an ambulatory surgery center that has a 90% equity stake by doctors. I'm the decision maker versus the buying group at a hospital where I am not the decision maker. At best I'm an influencer. So how do you? How are you differentiating the conversion strategy in those 2 scenarios?

elvio gramignano: Let's say, 1st of all, most of our clients are talking directly to surgeons, and so we it might sound a little bit bizarre. But let's say elvio gramignano: the methodology does not change much in the sense that I am doing. We are doing exactly the same process to the surgeons, the same information sharing to the surgeons that we're doing to an executive of a medical device business in a b 2 b environment. elvio gramignano: If you want what changes is the type of information. What changes is the time when this information is consumed? Surgeons tend to be more active in the weekends and much less active during the week. But overall I don't think it changes it.

elvio gramignano: You will. elvio gramignano: What I'm trying to say here is that elvio gramignano: I need. I need to. I need to have the evidence I need to understand through the signals in in different ways. I need to understand that you are interested in my solution. elvio gramignano: And then it is exactly the standard process of when the sales was made in a face to face. By the way, I don't think that in our industry we will ever be able to change the set. The reason human element that is part of it. You will still need a demo. You will probably still need to. Do a business.

elvio gramignano: It's just what is happening in this period and how I deliver the information to you that changes with digitalization of the process. elvio gramignano: Is that answering your question.

Yeah, I'm I mean you. You answered the question. I I would challenge you to change how you're thinking about that. We can talk about that offline. But I I just don't think the model is the same. 1st of all, 80% of doctors in the United States are employed. There's all kinds of pressure and constraints on costs and access and everything else. I think the value proposition is questionable. I think commoditization of stuff. I mean, you know. I don't know how many, just to use a simple, stupid example. I don't know how many tympanostomy tubes there are in otolaryngology, probably 50 or 60, and it's, you know, old wine in a new bottle.

So I just think the whole model I applaud. You're trying to change the approach. My concern is, you're not changing it enough. You have to make the old model obsolete. You can't just change it. That's my point.

elvio gramignano: No, it's it's a it's a very interesting challenge. elvio gramignano: I you know. elvio gramignano: I told you I'm 60, and I'm hearing these comments since I started 35 years ago, and this hasn't happened. So I cannot imagine this will happen in the next 20 years. What I'm saying is that okay? Can we at least make a further step forwards. elvio gramignano: and and try to improve a little bit to me is a journey, but if we don't make the 1st step. It will be difficult elvio gramignano: now, sorry, just just to add one little element clearly, clearly.

elvio gramignano: I don't think that digitalization or all this set of information is useful when you're going into the fully commoditized. elvio gramignano: So I think that probably this element starts to become relevant when you have a new robot or your new surgical procedure, or some level of marginal differentiation that make the information useful, because when the products are all exactly the same. elvio gramignano: probably the only real differentiating element is the price, and

elvio gramignano: and in this case marketing does not exist.

My final comment is that I you know, if you don't think things are going to change in 20 years. I I significantly disagree with that. And I think that the wild card is artificial intelligence. And we can say that, yeah, yeah, yeah. Yeah. But I I think that anything that can be measured can be automated with artificial intelligence, and the Med Tech marketing industry is not taking advantage of that opportunity.

Hmm.

elvio gramignano: I love this comment. I hope that you're right. You know it's clear there are some elements that are. There are boosters of the overall situation, like everybody, is saying the same, but the pandemic has clearly elvio gramignano: improved and and sped, increased the speed. The acceleration of certain changes. elvio gramignano: I hope that artificial intelligence will make a further improvement. You know I'm with you. As I told you, I founded this company because I strongly believe that this is a necessary change. I hope I will be able to see it.

I think a number of things to your comment, Arlen. And you know it's interesting because I also work in marketing, and I've watched the medtech industry, resist change, resist change, resist change, resist change like you wouldn't believe for many decades, and the reason behind that is the C-suite wants to see a 4 to 10 x. Return on investment on anything that they purchase. The middle managers are risk, averse, and want to send their children to Swarthmore, and the end users are absolutely resistant to change. I think that the resistance to change is probably going to get run over by AI. I think that probably what we're going to see is a lot of winner. Take all behavior

in the marketplace, and we're going to see a lot of the people who are laggards, and who are resistant to changing. Get get sort of wiped out like a tidal wave. And or tsunami. Take your pick. What you're saying, and yet at the same time. you know, every few years there's a giant buzzword in the community, and and this is going to take over. And this is going to revolutionize everything, and for as much as companies. Marketers in particular like to use the word revolutionize. I have never seen a revolution in the marketing world. And so I've seen I've seen changes. You know, when I started we were doing direct mail and telemarketing. The Internet did not exist.

However. There, there are certain things where you're like. you know. It's the more things change, the more they stay the same and so yes. but the fundamental point that he made about buyers buy when they're ready to buy, not when you're ready to sell to them, etc. You know, there are things that are that are going to remain constant. That's my personal opinion. I don't know what anybody else thinks of that I'd love to hear from Paul d'souza, for example, or any anyone else that has that has comments on this.

You have to promote Paul.

Oh, well.

Yeah, yeah.

Carry opinions, thoughts.

You all know, change is bad. It's gonna take them what? 20 years to change right, Jose.

I just thought about this tip.

Typical phase model with the change management where you 1st have to shock.

Period, and then resistance, and then goes to emotional acceptance like this little curve. You know.

Agree. It's all grief.

Yeah.

I've changed it.

Hurry suffers grief.

Okay.

Literally on my about me pages the stages of regulatory grief on my website.

Yeah, it's it's just 5 phases of recovery. Right? First.st

Oh, Michelle.

And I did it for Dennis.

Sorry. It's work.

Taken how many years to be recovering. Dentist! It's years.

Since since Sean kind of put me on the spot. There, you know. Listen, the fundamentals of sales are are the fundamentals, and you know. Like you, said Sean. You know the fundamentals don't change right. The more we change, the more we stay the same. But AI is definitely changing the cadence of communication and and the opportunity. And it's just this is the way it's it's it's everywhere where today if companies don't embrace it, what's gonna happen is like, remember, it was okay to send a letter 1st was okay to send a pigeon. And then if it showed up, you got the communication right that we send letters, and then we move the faxes. And now it's instant that just happens. And

AI is allowing us to to do you exactly what you said? Allow the customer to engage with us.

Let's do this.

When the customer wants to engage.

It's okay.

So I'm designing these sales, narratives, and engagements. I've actually removed the word marketing, and I've removed the word sales from our operational lexicon.

If it was updated.

Because it's really what are you driving engagement? And if the engagement is seductive enough, engaging enough, informative enough, that prospect will convert and say, we'll opt in. So you're looking for engagement and conversion, engagement and conversion. and the more you engage with value, the more the customer will opt in for a deeper engagement with you, and now you have you sell once your service forever. You do a conversion. You're dropping your cost, and AI is allowing you to do that engagement at a much lower cost. right? And how you leverage AI is where the the magic's at like I was just on a call with labyrinth. We're designing models and sales, pitches and decks, and allowing the customer to put their hand up and say, that's interesting.

And now my cost of sale dropped. So anyway, my 2 cents.

I would also add that I think there's a significant gap in an understanding and execution of sales operations. This is all about data driven decision making.

Yup!

And again, whatever you can measure can be automated.

Yep.

That. And that is, I think, something that will significantly and is changing sales operations. So you know how many people you can fill the funnel, get rid of the people that aren't interested, march them through the process, and convert is something that used to take a very long time and a lot of effort. And now does it take as much time? Oh, and, by the way, as many people, let's do it. So what you're saying is, sales, operations. contracting and firing people that used to do this stuff by hand, but now gets automated.

Totally.

And then the the rubber meets the road. When it comes to. Okay, I'm ready to buy. So all the stuff before that gets automated. and whether it's design thinking and getting into the head of the customer or understanding their wants and needs. It's all the buzzwords. But you know all the stuff upfront can be automated until it's time for a human to talk to a human.

And to your point. Arlen. Right? It's this idea of being findable. because whatever you send, whatever call you leave, whichever golf, you know in the old days we take, you know I'm the old sales guy, right? I take people golfing and this and that doctors and take them out to lunch and then. But now, when there's a need by an administrator, by a doctor, by a surgeon for something, they will go search for it with AI. You can be findable, you have to be findable. create content that is findable, and then create a intelligent engagement model online that converts right? The opt in close. Just remember that findable and opt in close. Those are the 2 things I'm always looking for. Are you findable at the time of need?

So you gotta have a lot of data points out there so that the the algorithms catch you and present you. you've got to embed with all the right linguistics. And they used to call in the old days, SEO, it's different now. It's not SEO. But are you findable at scale and hyper targeted to your audience? And then when they have an interest, this is where most companies fail. They don't have an online version because nobody wants to talk to a sales guy. However good looking, we are right. Nobody wants to talk to us. That's why all this, they said. Don't let Paul go out alone. I always have a subject matter expert.

but a lot of that. Now, people, they want to manage it themselves. They want to check. They want to see the reviews. They want to see this. They want to see proof points. They don't want to talk to people. And this is where companies fail. And I'm actually yes, I got an opportunity to somebody well established Services company. No, they don't have a sales process. The CEO is closing. All deals with relationships that's not scalable. Allow your your prospects to engage and convert at their at will for them when it makes sense to their business that drops everybody's cost. That's going to arlen your point of sales Ops.

elvio gramignano: Both ask you one question.

Yes.

elvio gramignano: Yeah, because I I love your concept of eliminating the word sales and and.

Marketing, yeah.

elvio gramignano: And marketing, and and talking about conversion and engagement is excellent. If you have any article about this, I would love to to read it. elvio gramignano: and.

I wish I wish I put it in my book when I wrote the book.

elvio gramignano: Oh, great! I will buy the book. I will buy the book. Excellent! elvio gramignano: No, but you know. But here you're talking about AI. elvio gramignano: But to me. The problem is that elvio gramignano: 80% of the mid-sized companies still don't have a Crm. elvio gramignano: so you don't have the AI because you don't have the foundation from the AI. You don't have the data. And how do you build all? So? Yes, I agree with you. By the way, I still think that we should go playing tennis or golf with the surgeons. It's a human interaction, and that's absolutely not. But this is in addition to all the information that you were saying.

elvio gramignano: The point here is is, how do I get these sets of information.

My biggest. I'm doing it right now. By the way, I'm doing it with our group here with the foundry the best way to go is find those points of connection where you can engage. So leverage leverage leverage leverage right? Find networks find of people organizations and find these get very creative on how you engage with groups of people that could potentially be your clients. And this is where art comes in right. This is where the design of an offer is critical.

No.

Right. This is deduction. It has a positive impact like you. You have to. You have to design an offer that that speaks to the the emotion of the people to the economics of their business interest. no longer features and all that. How I got a new Ferrari? No, when we talk about a business solution or a product. We have to talk about the economic metrics that make this thing valuable. or the professional reasons why somebody needs to look at this like I I got bounced with labyrinth. I got bounced by a geothermal company. They said, No, no, you guys don't know what we're talking about, and I was offering them a $45,000 solution.

My team said so. I fell on my sword. I said, I'm sorry we I don't think we we designed it properly. Let me come back to you. 2 weeks later I got back to them. I told the team guys take the gloves off. No swim lanes. How do you think we should help this company? Because they gave us a reference point? I went from a $45,000 solution to 5.4 million dollars. I said we did it wrong, but I think this is what my team said is the right way to do it. It's 6 people. It's 9 people 6 months. I don't put the number there, because I don't want to scare the fish. And he came back and said, That sounds right, and we got reengaged.

My point is nothing about our solution was attractive until I framed it in their world and their reality. This is what I'm asking you to do. What you, if you have an offer that a surgeon needs. you've got to figure out. When do they think about this? Which problem are you solving for them? And when do they think about the problem? I don't solve problems. I only solve funded problems. So the question is, when do they have a need that is funded? It's relevant timely. And you need to understand your customers so much that you can preempt. It's like dancing. You've got to know how to get in cadence with your customers and get in sync with their business cycle, their buying cycles. There are no sales cycles. There are only buying cycles. They are in control, and you've got to surrender to and understand. And this is where humility comes in, where you say, I know my customer

right, and that's how you find these people. It's not easy. Not but AI helps right. AI. You can find these lists. You can figure out where the conferences are. You can cross reference attendees. This. I mean, it's amazing what the marketing guys can do with AI.

I would say.

Bye, bye.

I I would offer 2 other tips. One is engage the ecosystem economy, not the individual buyer, and second. you. You don't ignore the changing buyer persona of this generation of physicians, they are totally different than me.

Yep.

They're expecting you to connect with them via social media. And if you don't do that, you're not meeting their needs.

Yep.

Very interesting. Thank you both for your comments. Does anybody else want to comment. Michelle? I was thinking of you while he was giving the presentation because I was thinking about claims, and I was thinking about the interaction of the regulatory in the process. So, Lvo, you know, on your slides, you showed, you know, alignment with regulatory at a certain point in the process. But you know a huge part of that, for the medical device sector is claims and the kind of claims that can be made sort of like through social media comments like that that count like where I mean, I see a lot of really questionable stuff on Instagram a lot of the time, and like what? That seems highly illegal to me. And

you know. So yeah, Michelle, do you have anything?

Yeah. So I think that it's important that regulatory and marketing kind of stay in lockstep, so that that marketing knows where their boundaries are at all times, and they go. They can go up to them because marketing usually wants to like shoot past them like. And so one thing that we did. My last industry job is we had, like a whole control claim set that the engineers and the marketing people were allowed to use in any configuration that they chose to. But then we had some things that are like. These things are too far. So it gave them some guide. Girls.

You have to. It has to go through, Doc. Control all of your labeling claims. The last few can't tell you how many UN letters the FDA sends out for claims, and there's a company I won't say, because it'll show up on all of your medias if I even say the word out loud, because but they'll get, and they'll get letters in the mail.

They'll get on.

So.

To be honest.

On all of your wherever because it like automatically pops up everywhere. I mean, it's awful. But you'll get. You'll get letters from the FDA and the agency, for on all of you know Amazon everywhere.

And you need to also think about. You need a procedure to review what people are posting on your social media and comments. Do they like qualify as complaints? Do they infer things that like unintended uses? You know.

Because guess what they look at, they just they have a well, I don't know if they're still employed, but there's a whole group at the agency that's specifically looking at social media. So.

Exactly all they do all day long is troll the Internet.

So if Isil has a hand raised, I'd like to give him a moment and then wind things down.

Do it.

Do I need? Yeah, go ahead.

Yeah, yeah, I mean, I can just chime in on on that part of it of being a regular professional myself. because social media. I mean, you know, I remember in the beginning it was very much hands off. They were just given. We would just give some sort of a guideline and say, That's it, you know. Don't even go there. Don't even go on social media. My experience is that yes, you definitely need to keep on top of it, and maybe even, I mean, what could be? What could be worth seeing is regulatory professionals that specialize even more in it, and are definitely more in a lockstep with the marketing people so that they can, they can try and figure out what is actually

doable. And and how can you even configure those social media channels so that you can allow people to do more. So yeah, I hear what you're talking about, and I concur. It's the same here in Scandinavia we are dealing with the same, maybe even being a little a little more conservative when it comes to some of these things.

So we have 2 min left. I'd like to give those 2 min to Lvo to bring us home and thank him for joining us. I think he did an excellent job. This is an exciting topic, and.

elvio gramignano: No, I thank you, Sean, and I thank everyone for the comments. Really. 1st of all, I'm definitely going by immediately. Paul's book. I found his idea extremely extremely inspiring. And I want to thank everyone's comment elvio gramignano: with regards to the regulatory. You know, my wife works in regulatory. So I have these type of fights elvio gramignano: almost. Almost. elvio gramignano: But yeah, we're not trying to get out. We're trying to do our job.

Dances.

elvio gramignano: Think we need.

Totally dominoes.

Sometimes it's salsa, but.

Saw the nightclub in my young days, when I.

Correct.

elvio gramignano: You're Italian, you're supposed. elvio gramignano: But but I think digitalization as is helping marketing people to speak with salespeople. Or now I don't know if you want to continue to use sales and marketing based on Paul's comment. But let's say, as is helping sales and marketing people to start to talk together, I think, will also help the regulatory and the marketing to speak together and to find a common ground elvio gramignano: social media. I don't sorry. I don't remember the name of the of the guy from Scandinavia. That commented, yes, is elvio gramignano: social. Media is not going away, unfortunately or fortunately, I don't know. It's not going away, so we need to find a way to be able to communicate and to be able to communicate in an ethical way, 1st of all ethical and then compliance with the different global regulations.

It's like the dance floor. Baby. It's like you don't. You don't just force yourself on somebody to dance you. It's an invitation. You put your hand out.

elvio gramignano: And we need to dance exactly.

Step on each other's toes. It hurts exactly that.

Yeah, and technologies, and allowing you to do the band air allows you to really fine tune that literally. Trust me, let's have a conversation about the opt-in close right? That should be my next book, and that's exactly what I'm doing. It's amazing. And then those deals tick. So anyway, I can go on as you can tell.

Just because Scandinavians have big feet doesn't mean you can step on them.

elvio gramignano: No.

And I'm not.

No, you know.

I don't like to rock the road. We just, you know.

I think. Yeah. Mornings we should come up with something.

I would like to.

Spice for your book, Paul, you know. Yeah.

It is the summer.

Jerry, Britain.

It's a happy midsummer. It's a summer.

Good.

It's a little of everything, longest day of the year.

You know, Kerry, it should be. The title of your book is, I think, your program should be. Let's dance right AI FDA and sales.

Can't use the word sales. You said it.

Hey? Engagement? Yeah. But you gotta drink. Bring people in. So.

This is true, how not to say the word sales sean.

Just a reminder to everybody. I'm looking for you to submit article ideas. So please get get on with that Stefan Ruskinski is gonna be. I'm probably saying his name wrong. Clinical evaluation pathways for ce marking next week, and we will not be having a call on July the 4.th

Oh, come on!

No, we're not. And It was a grip decision. And oh. however, I'd like each one of you to bring a friend who needs to know about C clinical evaluation pathways for Ca marketing next week so that we can continue to grow this group. It's important that we grow this group so that we can reach a critical mass and really support one another to further all of our careers. And I think everybody can get on board with that. So I'm asking for your help, and we'll see you next week. Goodbye, everyone. Thank you. Okay, thank you. Goodbye.

elvio gramignano: Have a great weekend bye.

Bye, everyone have a great weekend. It was nice skiing here.