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It’s Not a Sales Problem. Why Healthcare Companies Keep Solving the Wrong Thing
- Michael Colling-Tuck
- 12 hours ago
- 6 min read
When 80% access drops to 24%, the problem isn’t sales. It’s demand.
The Meeting That Changed How I See This Industry
A meeting with a medical device company last year. They’d just missed their forecast by 40%.
The leadership team’s response was predictable. Hire more reps. Invest in training. Implement a new CRM. The sales director was convinced the problem was execution.
Then I asked a different question.
“What’s the real cost of each rep?”
A fully loaded field sales rep in the UK costs between £100,000 and £165,000 per year. That’s salary, bonus, car, travel, training, management overhead. Everything.
Divide that by planned calls, around 1,400 per year, and you get £60–£120 per call. But that assumes every call happens. No failed attempts. No no-shows. No wasted travel.
In reality, the true cost per meaningful meeting is somewhere between £100 and £300.
Then I asked:
“How many of those meetings actually happen?”
The room went quiet.
(Rooms often go quiet at that point.)
The Shift Nobody Talks About
In 2008, 80% of healthcare professionals would accept a visit from a sales rep. By 2023, that figure had dropped to 24%.
This isn’t a trend. It’s a collapse.
And yet most healthcare companies are still running the same commercial model they used when access was abundant. More reps. More calls. More persistence.
The maths simply doesn’t work anymore.
When your channel to market depends on face-to-face access and face-to-face access has declined by 70%, you don’t have a sales problem. You have a demand problem disguised as a sales problem.
The Most Common Wrong Answer
When numbers are down, the instinct is to fix sales. It feels logical. Sales isn’t hitting target, so sales must be broken.
Hire more reps. They’ll cover more ground.
Invest in training. They’ll be more effective.
Change territories. They’ll have better opportunities.
Implement new CRM. They’ll be more accountable.
None of this is unreasonable. All of it is expensive. And usually none of it works, because the diagnosis is wrong.
The reason your sales team can’t get meetings isn’t that they’re bad at sales. It’s that the people they’re trying to meet have stopped saying yes to meetings.
(This is the bit that’s hard to accept. The problem isn’t your people. The problem is your model.)
Adding more reps to a model that doesn’t work doesn’t make it work. It just makes it expensive.
How to Tell the Difference
Here’s a simple diagnostic.
Sign one: Your reps struggle to book meetings. Not because they’re not trying. Because the answer is usually no, or no response at all.
Sign two: Your pipeline is thin at the top. You have opportunities, but not enough new ones entering. The funnel narrows before it should.
Sign three: New hires don’t change the numbers. You brought in experienced people. Good people. And after six months, they’re struggling just like everyone else.
If any of these sound familiar, you probably don’t have a sales problem. You have a demand problem.
Your sales team is capable. They just don’t have enough warm opportunities to work with. They’re spending their energy creating demand instead of capturing it.
And that’s not their job. That’s marketing’s job.
What a Demand Problem Actually Looks Like
When you have a demand problem, your best salespeople are working twice as hard for half the results.
Not because they’ve forgotten how to sell, but because the market conditions have changed.
Think about what happens in a company with a demand problem.
Reps spend 80% of their time trying to get meetings. Cold calls. Email sequences. LinkedIn messages.
Drop-ins that go nowhere. All the activity looks right. The numbers look right. But the outcomes aren’t there.
Marketing produces content. Blog posts, white papers, videos. All of it well-intentioned. None of it generating inbound interest. Nobody’s raising their hand.
Sales and marketing blame each other. Sales says the leads are rubbish. Marketing says sales doesn’t follow up properly. Both are wrong. The problem is earlier in the chain.
The pipeline looks busy but nothing moves. Deals stall. “Following up” becomes the most common status. Win rates are low because you’re pursuing people who were never interested.
All of this is symptoms. The disease is that nobody knows you exist before your rep tries to get a meeting.
What Actually Works
The companies that solve this don’t just fix marketing or fix sales. They build systems that create demand before the sales conversation happens.
Here’s what that looks like.
Visibility. When a healthcare professional in your target market searches for a problem you solve, do they find you? Not your product name. The problem. Are you showing up where they’re already looking?
Content that earns attention. Not brochures. Not product information. Content that actually helps them do their job better. Content they’d choose to consume even if you weren’t trying to sell them anything.
Digital presence that qualifies. When someone lands on your website or LinkedIn, do they immediately understand whether you can help them? Or do they have to wade through generic corporate messaging to find out?
Warm handoffs. When a rep reaches out, is it cold or warm? Has the prospect already consumed something from you? Do they already have a sense of who you are and what you do?
The goal isn’t to replace sales. The goal is to give sales conversations that start warmer, with people who already know they might need you.
A Case Study in Getting This Right
A medical device company came to us with the pattern I’ve described. Flat numbers. Sales team working hard but not hitting target. Leadership considering hiring more reps.
We looked at their data. The top two performers were exceeding target. Everyone else was struggling. Gap of 3:1.
The instinct was training.
“Figure out what the top performers do and teach everyone else.”
We asked different questions.
What did the top performers have that others didn’t? It turned out to be systems. One had built her own approach to following up after demos. The other tracked every stakeholder at each hospital in a personal spreadsheet. Surgeons, procurement leads, theatre managers, finance.
Neither thought of these as “systems.” They were just “how I work.”
But here’s the thing: these top performers were still only reaching a fraction of the market. They were more efficient at capturing demand. But they couldn’t create demand any better than anyone else.
So we shifted the conversation. Instead of training everyone to be like the top performers, what if we created demand that the whole team could capture?
Within six months, inbound enquiries had increased by 40%. Not because the sales team got better at cold calling. Because prospects were finding them first.
The sales team still mattered. They still closed the deals. But they were starting conversations warmer. Prospects already knew who the company was and roughly what they offered.
That’s the shift. From creating demand one rep at a time, to creating demand at scale and letting sales capture it.
The Framework
This is what the book is built around. A diagnostic framework for understanding where you actually are and what to do about it.
First question: Is your problem awareness (they don’t know you exist), positioning (they know you but don’t see you as relevant), or conversion (they’re interested but not buying)? Each requires different interventions.
Second question: Where are you losing people in the journey? At first contact? After the demo? In procurement? The answer tells you where to focus.
Third question: What would have to be true for inbound enquiries to increase by 50%? Work backwards from that. Usually the answer isn’t “better sales.” It’s “more visibility” or “better content” or “clearer positioning.”
The book walks through each of these in detail with specific diagnostics and practical guidance.
Why This Matters
25 years in healthcare commercial. The pattern keeps repeating.
I’ve spent 25 years in healthcare commercial roles. Started as a rep carrying the bag. Ended up running an agency that helps companies figure this out.
And the pattern I keep seeing is the same. Good companies with good products solving the wrong problem.
When commercial execution fails, when the sales team can’t get meetings, when messaging doesn’t land, when deals stall for reasons nobody quite understands, patients miss out.
Products that could help people stay on shelves. Innovations that could change outcomes never get adopted.
That’s not a sales problem. That’s a recognition problem. A demand problem. A systems problem.
The companies that figure this out get their products to patients faster.
That’s the real point.
DOWNLOAD: The Demand Diagnostic
A simple framework to help you determine whether you have a sales problem or a demand problem. Eight questions. Takes five minutes. Might save you six months of solving the wrong thing.
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About Michael Colling-Tuck
Michael is the founder of Agency Bristol, a demand generation consultancy focused on healthcare and lifesciences. After 47 product launches in medical devices, diagnostics, and digital health, he now helps companies build the systems that drive commercial success.
References
1. ZS Associates. (2021). AccessMonitor Report: Physician Access Trends.
2. McKinsey and Company. (2024). Ready for launch: Reshaping pharma’s strategy in the next normal.
3. Deloitte. (2023). Healthcare Commercial Excellence Report.