If you want to be a six-figure (and beyond) performer in medical device sales, it starts where the revenue is created: in the OR. In this conversation, orthopedic surgeon Dr. Brian Blackwood (Boulder, CO) , early adopter of robotics, high-volume hip/knee specialist, practice owner, trainer, and multi-business operator breaks down exactly how reps help (or hurt) outcomes, workflows, and relationships.

Big truths most new reps miss

• Quota isn’t your first job being an OR asset. Anticipation, setup, and backup plans beat any pitch.
  
  
• Read the room before you speak. Time, tone, and surgeon mood matter. Earn the right to talk.
  
  
• Transparency > excuses. If a tray, size, or set is missing, say it early and bring solutions.
  
  
• The rep can tilt a day good or bad. Clean, complete, on-time, ready inventory prevents delays and risk.
  
  
• Surgeons carry all the legal & emotional weight. You don’t get sued they do. Respect the stress.
  
  
• Most surgeons need more help than you think. Median annual volume is ~26 knees / 19 hips; your pattern recognition is valuable if offered respectfully.
  
  

What makes a great rep (from a surgeon’s chair)

1. Prepared like a pro
   
   
   • Knows the case list, sequence, sizes, alternatives, and backups (“If you have one, you have none”).
     
     
   • Verifies SPD status and tray completeness before wheels in.
     
     
   • Arrives early, checks C-arm/robot needs, confirms count sheets and loaners.
     
     
2. Reads the OR dynamic
   
   
   • Learns names/roles of scrub, circulator, PA/first assist, anesthesia.
     
     
   • Senses the surgeon’s style: regimented vs adaptive—and tailors support.
     
     
3. Communicates like a teammate
   
   
   • Short, precise, timely. Flags issues upfront (“We’re missing X; options are A/B/C.”).
     
     
   • No selling in case. Service first; sales later.
     
     
4. Product & competitive mastery
   
   
   • Knows their system better than the surgeon, plus competitive differences and when to use what.
     
     
   • Offers subtle, specific guidance when invited (“Consider +2 mm augment here?”).
     
     
5. Integrity always
   
   
   • No sandbagging, no spinning, no hiding. You’ll be trusted—or you’ll be gone.
     
     

Behaviors that get you bounced

• Showing up late or clueless about the day’s cases.
  
  
• Chatty small talk during setup/closing or late in a heavy list.
  
  
• Surprises mid-case (“It never arrived…”) that could have been surfaced early.
  
  
• “Sneak selling” while the patient’s on the table.
  
  
• Excuses and blame instead of ownership + fix.
  
  

Why robotics/tech matter (and how to talk about it)

• Tech reveals patient-specific anatomy and reduces “manual guesswork.”
  
  
• Smart angle: “Here’s how this workflow reduces variability, saves time, or improves alignment in your setting,” not “Here’s our fancy metal.”
  
  

Remember the surgeon runs a business (or ten)

• Many surgeons juggle clinics, ASC ownership, payroll, insurance fights, authorizations, plus family life.
  
  
• Your value grows when you save time, prevent denials/delays, and simplify logistics—not just when you demo.
  
  

Rep playbook: do this next

Before the day

• Confirm case order, implants, sizes, loaners, backups, SPD clears.
  
  
• Pack redundancy for drops/contamination and odd sizes.
  
  
• Prep a 1-pager: instrument path, potential pitfalls, backup plans.
  
  

In the room

• Introduce yourself to the team; observe first.
  
  
• Offer concise support at key steps; keep chatter down.
  
  
• If anything’s off: flag immediately + present two fixes.
  
  

After

• Debrief with staff: what to add, remove, relabel, reorder.
  
  
• Same-day follow-up to surgeon/PA: what went well, what you’re improving, next steps.
  
  

30/60/90 for new reps (hips/knees example)

• 30: Shadow high-volume rooms, learn count sheets cold, map instruments → steps, meet SPD leads, build a backup matrix.
  
  
• 60: Run room setup with scrub tech, lead tray verification, anticipate sizes, document recurring pain points, pilot fixes.
  
  
• 90: Own logistics for a full list; deliver zero-surprise days; present a data-light ROI (turnover time saved, contamination saves, re-order accuracy).
  
  

Quick checklist

• Arrived 45–60 min early
  
  
• SPD cleared, trays complete, backups present
  
  
• Sizes verified vs templating/plan
  
  
• Robot/C-arm needs checked
  
  
• Team names/roles noted; surgeon tone read
  
  
• Issues surfaced before incision with A/B fixes
  
  
• Zero selling during case; send follow-up after
  
  

Lines you can steal

• “Quick heads-up before we start: set B is still en route. Options now are X or Y—your call.”
  
  
• “I noticed in the last case we reached for two extra sizes—added them to today’s pull, and I’ve got a sterile backup.”
  
  
• “I’ll step back unless you want input on alignment—happy to offer what I’ve seen elsewhere.”
  
  

Final Thoughts

Be the rep who makes safe, smooth, on-time surgery the default. Master your system, honor the room, communicate early, and bring backups for your backups. Do that consistently and you won’t just hit quota; you'll be the surgeon’s first call.

Want More Details?

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All the best,

Jacob McLaughlin