Active listening requires that you are completely focused on your customer.

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3. Active Listening

In the last two blogs, I highlighted How to Create Enthusiasm and Open-ended Probing.  In other words, believe in what you are doing and be genuinely enthusiastic about it.  Then, ask your prospect questions that require a thoughtful response beyond yes or no.

The highest level of respect you can give a person and certainly your sales prospect is to LISTEN TO THEM.  Do this listening “actively.”  This means you’re not thinking about what you need to say as they are speaking.  It means you listen to what they have to say.

Active listening requires that you are completely focused on your customer. It requires that you fully concentrate, understand, respond and then remember what is being said. No distractions (including the silent ones in your own head), no interruptions, no text “phone-looking”, no pre-occupation of your thoughts; just 100 percent unadulterated LISTENING!  The responses of the customer will direct you to the objective you seek.

You may have been pre-occupied with the assumption that a surgeon is only interested in using static cages.  We hear this all the time.  After probing you realize that L-Varlock Expandable Cage is in play because of the surgeon’s interest in segmental lordosis and sagittal angle.

The question is “did you listen actively enough to know when to orient and adjust?”

Here is a good series of examples of probing and active listening:
Hand shake, eye contact and smile: “Hello Dr. Smith, I am Joe Green with SpineMed.  It’s truly a pleasure to finally meet you and thanks for the time.  How much time to you have right now?”

“Great, do you mind if we sit down so I can ask you a few questions? Great!  Thank you.”

Dr. Smith, (ask your open-ended probes, listen and think on your feet)?

“I see. So, if I understand correctly, you use static cages, but you want to an atraumatic technique to preserve endplates.  You also want to help restore segmental lordosis, so you oversize the cage.  Did I hear that correctly?”

“Okay good.  May I ask why these things are important to you?”

“Okay.  Now I understand what you are looking to do.  Based on that, let me present to you the L-Varlock Expandable Lumbar Cage.”

NOTE:  You did not pull out the product until you learned what the surgeon wanted through probing and listening.  You did not feature dump.  You are helping the surgeon solve a problem.  This is professional selling.

“You see Dr. Smith, the L-Varlock Expandable cage is implanted at a zero-degree angle and can be adjusted to any custom increment you want, up to 24 degrees.  How do you think that could help in your objective of achieving segmental lordosis?”

Also, it gains up to 7 mm of height.  So, the anterior portion of the 8 mm cage is 15 mm if you fully expand it.  How might that help you on the case with the “fish mouth” L5-S1 disc space?

Give the surgeon time to digest and metabolize the information by saying nothing.  Silence is golden.  Use it.   Is it time to close?  In this situation, yes.  As for the case.  Get the book out and book it.  Get the scheduler on the phone to book it.  Follow through.

If the surgeon is not convinced, keep probing and keep listening.  Once, in front of an entire group of veteran spine reps I was challenged by a surgeon who thought using expandable cages was in his terms “worthless.”  He threw every objection at me.  I made it fun.  I kept asking him open ended questions.  Finally, I found a hole and I went into it.  The hole was this: he disliked using the cage he was using because the roughened titanium surface was traumatizing endplate.  He was seeing some subsidence and did not like it.  So, I went to the atraumatic technique that L-Varlock Expandable Cage offers.  It can be implanted with very little impaction then elegantly expanded to the custom angle and height he wanted.  He agreed and we booked a case.  Lesson learned: just because you get an objection doesn’t mean no!  Keep probing and LISTEN.  That active listening will bail out and lead you to prosperity and succeed.

History of the Ten Techniques of Surgical Selling

Leon C. Hirsch is credited with the original Ten Techniques of Surgical Selling during the 1980’s.  The Company he founded was U.S. Surgical Corporation (a/k/a AutoSuture).   I worked at AutoSuture from 1989 through 1994 as a sales rep, or Certified Stapling Technician.   This company and its products forever changed and shaped how surgeons sutured.  Instead of a needle and “thread,” AutoSuture introduced surgical staplers that would apply staples one-by-one, or in automated rows through the use of disposable cartridges.

So how does this relate to the spinal implant sales professional or selling an expandable cage like L-Varlock®?  In every way possible.  Spinal implant sales professionals need to know their products better than anyone in the world, know their customers’ needs, know their roles in helping surgeons, hospitals and the O.R. staff solve problems, and most importantly: ALWAYS have the best interests of the patient in mind.  The patient is always the ultimate end user of a medical device.   Although these attributes of professional medical device selling have not been completely lost, they are not as prevalent as they once were.

At SpineSource, we have no choice but to try to resurrect the art of salesmanship.  The reason is because the L-Varlock Expandable Cage has unique features that result in benefits.  These features and benefits are intuitive:

  1. Easy design.
  2. Easy to use and implant.
  3. Up to 24° of angle
  4. Up to 7 mm of expansion.
  5. Large amount of bone graft in an open framework design that can be packed prior to an after implantation.

If these differences are not correctly presented, they will never be assigned a value in the mind of the customer.  But selling differences does not start with any selling at all.  It starts with creating enthusiasm.


Tom Mitchell
SpineSource, Inc.

SpineSource, Inc. was founded in 2004 and is based in the St. Louis suburb of Chesterfield, Missouri, USA.  SpineSource has a consistent history of introducing disruptive innovation within the medical device industry: primarily expandable cages used for intervertebral spinal fusions and vertebral body replacement.  These expandable cages have benefited surgeons, hospitals and most importantly, patients with spinal disorders because they provide an atraumatic surgical technique, as well optimal sizing and positioning.  Please visit for more infor