Curon Medical, a Silicon Valley medical device start-up, had developed and introduced a new device, Stretta, for a new medical procedure treating gastroesophageal reflux disease (GERD). Stretta used radiofrequency (RF) to deliver small wounds in the muscle of the lower esophagus just above the juncture to the stomach. As these small wounds heal, they create a thickening of the juncture and functional improvement.
The company had determined that the best initial targets were gastroenterologists (GIs), as the primary physicians treating patients with GERD. However, GIs primarily seek to “treat” patients, not permanently cure patients. A continuing range of newly introduced drugs to treat GERD, and periodic endoscopic procedures to visualize and confirm drug treatment’s efficacy, keeps GIs patient loads full.
Stretta, the new, invasive procedure, was intended as a cure, but there were no long-term studies on its efficacy. Also, many GIs work out of private endoscopy centers that they own and were not conducive to the new procedure. Sales were stagnant. Reimbursement from insurance companies for the procedure was also a challenge.
We contracted with Curon to provide a fractional Director of Sales. We suggested the Stretta procedure would be better promoted to general surgeons who were already seeking to cure patients, rather than simply treat them. Stretta provided a new minimally invasive option, and an alternative to a more complicated existing procedure. Hospitals and surgery centers were also a much better location for the procedure, considering the continued momentum towards more minimally invasive procedures that supports day surgery within hospitals.
We developed mechanisms and pathways to redirect sales and marketing efforts to general surgeons. Training centers were established, and physician trainers were engaged to educate their colleagues and the communities on the procedure. Marketing materials were prepared for training seminars for referring physicians and communities. We trained the clinical applications staff to work with general surgeons. We profiled and began hiring for the best sales individuals comfortable dealing with surgeons and operating rooms.
To improve insurance reimbursement, we built a community of individuals within surgeon practices and hospitals to share information on successful reimbursement strategies, keeping the company out of those conversations. The company began working on a long-term project for reimbursement coding and reimbursement.