Is It Time to Rethink the Role of Spine Sales Professionals in the US?

In the shifting landscape of the spine industry, it seems timely to question the traditional roles of Regional Sales Managers (RSMs) and Area Sales Directors (ASDs). With changes in hospital approval processes, evolving compensation expectations, and the rise of ambitious Territory Managers, there may be a need to reimagine the future of spine sales.

Distributor and Surgeon Networks: Less Leverage?

Traditionally, success in spine sales was all about whom you knew, with distributor and surgeon networks providing the fast lane to hospital contracts. However as hospital approvals become increasingly stringent, the influence of these networks is not what it used to be. Today, if a distributor or surgeon can’t get you on a contract, is it a dead end for the sales progress? The once unshakeable value of these relationships is now up for debate—what happens if a well-connected RSM or ASD can’t leverage their network to drive results?

Salaries vs. Results: Are Companies Getting Value?

With RSM and ASD salaries averaging around $150,000 base and on-target earnings rising to $275,000–$300,000, these roles represent a hefty investment. To justify these costs, companies need results, but if it takes 12 months (or more) to get on hospital contracts, what are these companies truly paying for? As these positions become more expensive, hiring companies may begin questioning the value of traditional sales hierarchies and considering alternatives.

Enter the Hungry Territory Manager

The emergence of younger Territory Managers who, several of my clients have started to look for, have spent a few years cutting their teeth at companies like Nuvasive or Globus, now present a compelling alternative. These professionals might lack the expansive network or seasoned experience of an RSM or ASD, but they bring a proactive, "door-knocking" or "hunter" mentality. Often ready to grind out new business by building relationships from scratch, Territory Managers represent a more cost-effective and driven generation. Are these ambitious individuals the new face of the spine sales force?

A Financially Savvier Alternative?

Territory Managers also bring a substantial cost advantage, with salaries closer to $100,000, plus commission. As investment continues to be difficult to come across, companies may view these cheaper, eager salespeople as an appealing investment, particularly if they’re trained to develop new business rather than relying on well-trodden networks. Could they be the answer to budget constraints while still driving growth?

A Reimagined Role for RSMs and ASDs?

While we may be witnessing a shift in emphasis, RSMs and ASDs are far from obsolete. Their experience and depth of knowledge continue to hold immense value. However, perhaps the industry should consider reshaping these roles. Instead of relying on them for sales traction alone, companies might integrate them into strategic advisory or mentoring roles, nurturing the younger Territory Managers. Additionally, it may be time to revisit compensation structures. If networks no longer guarantee a quick entry to contracts, should we be adjusting expectations—and perhaps salaries—accordingly?

Conclusion

As the spine industry continues to evolve, so too must its sales strategies and structures. Embracing a balanced team that leverages the expertise of seasoned RSMs and ASDs, while empowering cost-effective, ambitious Territory Managers, might just be the path forward. More performance-based salaries, a redefined role for experienced professionals, and a fresh influx of young talent could be the recalibration the industry needs.