Ghosted in the O.R.: When Your Surgeon Goes Silent
One day you're in the OR every week… the next, you’re not. No calls. No texts. Just silence. What happened?
Lisa and Cindy tackle one of the most painful realities in medical device sales: when a physician suddenly stops using your product. Instead of panicking, they break down the mindset and strategy high performers use to respond under pressure.
From pausing emotional reactions to having uncomfortable conversations and rebuilding trust, this episode reveals the three critical steps that separate struggling reps from resilient leaders in medical device sales.
Episode Chapter Markers
02:06 That Gut Punch Feeling
04:32 Step One Pause Spiral
07:28 Step Two Find Facts
08:05 Comfort Uncomfortable Secret
09:00 Real Story Winning Back
12:06 Practice the Conversation
13:44 Talk Direct In Person
14:42 Step Three Rebuild Reset Pivot
18:49 Stay Visible Strategically
21:18 Three Steps Wrap Up
Must-Hear Insights and Key Moments
The OR Gut Punch When You Lose the Case - Lisa and Cindy discuss the emotional shock reps feel when they discover a surgeon has switched to a competitor and why that moment can feel like a personal rejection.
Step One: Pause the Spiral - Before jumping to conclusions, top reps learn to stop the emotional spiral and separate assumptions from actual facts.
Step Two: Seek the Truth - The only way to understand what happened is by having a direct, honest conversation with the surgeon even if it’s uncomfortable.
The TGOG Secret: Get Comfortable Being Uncomfortable - One of the most powerful skills in sales is learning to lean into difficult conversations instead of avoiding them.
Why Avoiding the Surgeon Makes Things Worse - Ignoring the issue or hoping it resolves itself can damage the relationship and close the door on future opportunities.
Rebuild, Reset, or Pivot - Lisa and Cindy break down the three possible paths after losing an account and how to decide which one is right.
Stay Visible Without Being Desperate - Smart reps maintain presence in the account without overwhelming the physician or appearing reactive.
Fail Forward and Refocus - Sometimes you won’t win the account back and that’s okay. The best reps use setbacks to sharpen their strategy and grow stronger.
Words of Wisdom: Standout Quotes from This Episode
“The first thing you have to do is stop the spiral of desperation and assumptions.” - Anneliese Rhodes
“You cannot take it personally even though that’s the hardest thing in the world not to do.” - Anneliese Rhodes
“You have to learn how to be comfortable in the uncomfortable.” - Anneliese Rhodes
“Avoiding the conversation never helps the relationship, it only makes it worse.” - Anneliese Rhodes
“Sometimes you rebuild, sometimes you reset, and sometimes you pivot.” - Anneliese Rhodes
“What happens when a physician stops using your device? Every rep will face that moment.” - Cynthia Ficara
“High performers don’t panic, they seek the truth.” - Cynthia Ficara
“If you avoid the conversation, the situation will only get worse.” - Cynthia Ficara
“Not everything that happens in an account has anything to do with you.” - Cynthia Ficara
“When a surgeon stops using your product, the real question becomes: how will you respond under pressure?” - Cynthia Ficara
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We'd Love to Hear Your Stories!
Ever walked into the OR expecting a case and realized you weren’t called in? That moment can feel like a gut punch. We want to hear your story. DM us or tag us and share a time a surgeon stopped using your product and how you handled it. Did you lean into the tough conversation, rebuild the relationship, or pivot? Your story might be exactly what another woman in sales needs to hear.
Blog Transcript:
Note: We use AI transcription so there may be some inaccuracies
Anneliese Rhodes: Welcome everyone to another episode of Secrets and Medical Device Sales, brought to you by the Girls of Grit. You got Annalisa and Cynthia here today talking about another hot topic for you guys that, oh my gosh, that's right. Someone wrote into us, Cindy, and asked us this is, I just remembered that like this is such a great topic because we were literally asked this, and so here we are.
We're answering it today for you guys.
The OR Moment Every Rep Dreads
Cynthia Ficara: And you know, this is one of the things where, um, every person will have this happen to them in one way or another. Mm-hmm. And this person wrote in and said, what happens when your physician stops using your device? Now of course we refer to a lot in the, or a surgeon using a device, but what happens when your physician.
Stops or a customer stops using your product. And I tell you, this can be painful.
Anneliese Rhodes: It's like a gut punch. I think you said that. Like literally I know the feeling so well, you're walking down the OR and you look at the board and you see the cases that you're normally in and you're like. Wait, I wasn't called for that case.
Wait, who's in there with that? Who's in there with that doc and then, or you see the backpacks with the names of the company in there. You're like,
Cynthia Ficara: oh, that's the worst.
Anneliese Rhodes: Literally wanna take their backpack and burn it.
Cynthia Ficara: The competitors lined up. You're like, why are they there? Why are they there?
Anneliese Rhodes: Yes. Products in the hallway.
You're like, Ugh. So I am so glad we're talking about this today because it is such a good. Hot topic that literally everybody faces. I mean,
Cynthia Ficara: oh yes,
Anneliese Rhodes: I've faced it so many times and it sucks. So I'm so glad that we're talking about this today, Sydnee, because I will tell you, I have learned over the years how to deal with this a little bit better.
It doesn't mean that I don't get upset 'cause I still get upset. I still have to tell myself, Lisa, chill out. You have to understand this is a free country. They can use somebody else if they want to, but then also figure out how you're gonna manage it.
Cynthia Ficara: And, you know, and I think that's what's really good because we wanted to take this episode to do exactly what you said.
Like a lot of times people can react in a way that's not going to help you. So let's just walk through a little bit of that. Okay. If this is the first time it's happening, which may have been our reader, or I mean our listener, um, or maybe, um, this just happened to you and, and it catches you by surprise.
Okay? So. What some people may do is think, oh, there's something happened to the product. Oh, something's wrong. Okay, maybe, maybe not, but then. We as humans let our ego get involved. Yeah. And without asking, without doing anything, your mind might jump to conclusions like, oh no, it's, it's a problem they have, or I did something wrong.
But all that you're doing at the very beginning is assuming things. So when this happens, 'cause it will happen, the immediate reaction's gonna be a lot of assumptions. What's going on, what's going on, what's going on? And yeah. Is the answer, Lisa, to just sit there and pawn over it? Yeah. Or do we get to the bottom of it?
Anneliese Rhodes: That's such a, you know, first of all, like how easy is it for your brain to just run away with like, oh yeah. Crazy assumptions, right? Like, I mean, what you're talking about is all normal human behavior. I'm raising my hand here because I do that all the time. Your brain like can create these imaginary scenarios where you're like, oh, it must have been this, it must have been that.
I must have said this. Then you start like questioning yourself. You question the doctor, you question the product when like you just have to try and slow down and actually that's our. Step one, so we'll just roll right into it. Yeah. You need to stop the spiral of like desperation and like terribleness of, oh my gosh.
It's because of the product. It's because of me. It's because of my clinical, it's because of my doctor. It's usually. Not personal. I mean, correct. If you did something wrong with the physician in an OR, or you pissed him or her off, you're gonna know about that, by the way. So that's not an imaginary thing.
Like you legit did that. But if, if you didn't do something and it just one day happened, the first thing you need to remind yourself is that you cannot take it personally. And Cindy, I swear this is like such a good reminder for me because I take things so personally all the time. I mean, how, how often do I call you?
And I'm like. Oh my gosh. I don't know what's wrong with me. I can't get this daughter to call me back. I've texted him, I've called him. He won't respond to me. Like, you have to stop taking it personally, you know, and I, I mean, I, I can preach it all day long, right? But it's of course so much easier to talk about it than it is to implement it.
So letting you guys all out there know it's okay. We're all human. We all take things personally when we don't need to.
Cynthia Ficara: And, and you know, it's really important because you can panic, right?
Anneliese Rhodes: Yeah.
Cynthia Ficara: And you know, you're giving yourself to, you're just making the situation much worse. I'll tell you something that can really make the situation worse is avoiding the surgeon altogether.
So if suddenly you notice that there is a. Decrease in your case, or wait a minute, when was the last time the surgeon called or hold on a minute. These numbers have stalled or they're slipping. What's going on? Um, just walking away hoping it's gonna get better is never the right solution. So when we would, like you just said, step one, we're just gonna.
What did you say? Stop the spiral. Pause the spiral. You said something. Pause the sp. Yeah, stop the
Anneliese Rhodes: spiral of desperation.
Cynthia Ficara: I love that. That was awesome. So now let's think about this. We talked about the panic and how you feel.
Anneliese Rhodes: Yeah.
Cynthia Ficara: And people avoid, and all these things that go through your head. So as high performers that we speak to out there, what are some things we can do instead?
Anneliese Rhodes: That's a good point. Okay, so, well, you kind of said this already, but like, let's be real. Let's look at the last time you actually worked with a surgeon. Maybe it, maybe it was six months ago. Um, which by the way, shame on you if you haven't talked to them in six months. I mean, everybody gets busy. I, I get it.
I get busy too, and I'm the first to admit when I've let a, a couple of physicians down, like. I have not followed up with them, but like maybe you just did a case like two weeks ago. So think about the last case. You know, what, what happened in the case? Was there something bad that happened? Or maybe it went great, y'all were high fiving on your way out.
Well, now you immediately know clarity wise that it wasn't you and it wasn't the product. So then the next thing is. So what else has changed, right? Is there a practice changing? Did a partner leave? Is administration coming in and saying something? Is there something clinically that's happening? I mean, there are so many things that could be going on and it helps you pause the spiral and kind of just think of things logically, I think.
Cynthia Ficara: I, I love that. And you're right. So really just separate the emotions you feel from the true facts. Yeah.
Get Comfortable Being Uncomfortable
So step two. Mm-hmm. We're gonna be fact finding. Okay. Step two is about seeking the truth Now, not like it's, it's seeking the truth. Meaning like, huh, this one's hard. I say seeking the truth because. A, it's, it's having adult conversations, right?
It's, it's where people get uncomfortable and people wanna avoid that, which Lisa brings to our secret secret.
Anneliese Rhodes: I remembered. That's
Cynthia Ficara: right. Actually, I'm gonna let you reveal our secret this time.
Anneliese Rhodes: Okay. That's right. 'cause I legit can totally reveal it and then sometimes I forget about it altogether. Um, so this is a perfect opportunity.
This is our secret, you guys, and this is something that is way easier said than done. But if you can, if you can do this, if you can truly. Manage to accomplish this. In these types of situations, you will think clearer. You will handle the situation better, and your outcome will probably be better. So this is our secret.
It is learn how to be comfortable in the uncomfortableness, right? Like you gotta learn how to be comfy in the uncomfortable. And that sounds, I mean, I know we. That cannot be the first time anybody's ever heard that. I know that. You know, we've talked about this multiple times. People talk about it in books and movies and quotes, and it's true.
Sometimes the hardest lessons are, are learned in the hardest moments. But if you can reframe your mind a little bit to number one, you did what we just told you, which is write down the situation, and now you're gonna fact find, if you can be comfortable in this situation, you might actually uncover something even more.
And so I'm thinking about, I mean, I have multiple stories, Cindy, but like I
Cynthia Ficara: know you do
Anneliese Rhodes: not, not that long ago. There was a physician, I don't know. I mean, I say not that long ago, I feel like everything molds together. But like a couple years ago there was a physician that, I mean, I was running and gunning.
I was doing all the cases. I had like 80% of the business. It was awesome. And I kind of slowly realized a little bit of a bleed, kind of what we were talking about in our last episode. Right. Um, and I'm like, Hmm, it's kind of weird. And then I started noticing competitors coming in more and I'm like. What did I do wrong?
And immediately I'm just like blaming myself. And I finally sat down with him and he's not an easy person to talk to. He's very confrontational. You know, he's, he is just not an easy physician, which a lot of physicians are like that. That's fine. And I sat down with him and I was super honest with him.
And I was also a little bit like on the, on the, um, offensive, right, not defensive side of it. And I was like, Dr. Smith, you know, you and I haven't done a case in a while. Um, help me understand what's going on. And, you know, and I did, I, I did put it back a little bit on myself. I was like, you know, is it me, is it, you know, whatever.
And he basically was like, no, it's X, y, Z. And he told me the reasons why and I immediately looked at him and said, thank you for being so candid. Thank you for being open and honest with me. And you know what? That actually led to an even better conversation and he and I started working again because he is like, but you know what?
I've got a couple patients coming up that I know I can use your products on. Come back, remind me of these patients in a couple weeks. We'll get the cases on the board and we'll schedule 'em. And he did, but it was like I had to be. Uncomfortable in a situation and I openly looked at him and thanked him for his candidness, even though I didn't wanna hear it, and it was uncomfortable to hear when I did that.
Cindy, I think it rocked him back and was like. Wow, we're having a big boy, big girl conversation here. We're gonna talk about real life things. She's not gonna skirt away from it, and I'm not gonna skirt away from it. And it all came out in a better situation. Did I get all the business back? No, I didn't.
But I got some of it back. And, you know, the, the other goal, or the other option is not to get any of it back, to piss them off, to make them defensive. And then all you've done is really. Really hurt the relationship. So I, I don't know. I, I think being open and honest and being uncomfortable in those situations and then you can get to the facts, really helps you in these situations.
Cynthia Ficara: Well, something I picked up from your story, and I love that you shared that story because it was so real. There was genuine tone in your voice. So the reason I bring that up, so as sales reps, we have many uncomfortable conversations. I mean, let's face it, right? Yeah. Now, tell me this. If a physician were to pick up on your uncomfortableness.
Does it seem genuine? Does it seem real? Does it seem like there's something you're hiding? Because this conversation, this was maybe, I don't know, last year I had this situation when I was with somebody who was so uncomfortable talking to a doctor. It made me uncomfortable. But here's what I took away from that.
I think the doctor doubted the conversation. So why do I bring that up? I bring that up because this is so important to have this adult conversation. By not having it, it is gonna get worse. Yeah. So what do we do? We're high performers. What have Lisa and I talked about so much in this podcast? This is where you gotta lean in and get some help.
Either you call your, your friend on the road, like Lisa could call to me and say. Walk me through this conversation. Let me practice. How do I sound? Because the more you say it out loud, the more you realize, hey, this conversation isn't what my mind's making it out to be.
Anneliese Rhodes: Yeah.
Cynthia Ficara: I just really need to understand what the facts are.
This is seeking the truth part. And when you're genuine and just say, Hey, I noticed. I noticed we, you know, I haven't been here a little while. Can you tell me, are anything changing? It might be something completely out of your control, new payers for your insurance. It could be. Oh, um, somebody's. The new doctor's, uh, wife or husband's on maternity or maternity leave, or they're building a whole new wing and they had to shut down a room.
I mean, there are so many things that have nothing to do with us, but hesitating and having a conversation when you're uncomfortable doesn't help. It's important to have it, but you need to practice and be calm and present it in a way of truly just help me understand.
Anneliese Rhodes: Well, yeah, and I think when you're open and you're honest, you're creating that little bit of trust, right?
And in the truth, that's actually where you're opening it up to other options like I did with this surgeon versus him just shutting me down and being like. I don't wanna talk about it. Or he could have just been like, yeah, your, your product sucks and I don't wanna use your, I mean, I don't know, but like, the point is, if you avoid it, like you mentioned the beginning, just avoiding the surgeon altogether.
Well that does nobody any good. 'cause you're giving that surgeon an out, they're not gonna come to you. I mean, you're kidding yourself. If the surgeon is ever gonna come to you and be like, Hey Cindy, uh, I stopped using your product. Do you wanna come get it? You know, like, no.
Cynthia Ficara: On that note, I have to expand here.
There are many people on the or and you know how sometimes when we can't get to a surgeon, we may call the secretary or call somebody else if you're trying to get an appointment. Yep. Please listen, everyone, this is not the situation to talk to anybody else but the surgeon directly because anybody else might assume like you.
Anneliese Rhodes: Yeah.
Cynthia Ficara: And, and that's not gonna give you your answer, so you're wasting your time. You might make it worse, so please know you're gonna be uncomfortable or maybe not if you really have a good relationship with them. Hey, just pick up the phone. No. Go in person and, uh, have that direct conversation.
Anneliese Rhodes: Definitely need to do it in person. I mean, you know, even if you have to wait to make the lunch date or the office, uh, meeting or whatever it is that you need to do, definitely do it in person because this is a truthful conversation. It's uncomfortable. You're probably putting them a little ill at ease as well.
So like. Let's, let's just not make it any more ities. And if you text or phone call, they can easily slide outta something. This is something personally that you wanna handle.
Cynthia Ficara: Oh, good point. Good point.
Anneliese Rhodes: Alright, that's good number. Uh, so step three. So step two is basically, you know, like going in, being uncomfortable and the uncomfortableness, right?
Stay Visible, Not Desperate and Rebuilding Trust
Having that adult conversation, being open and honest. And number three is really. You know where you need to rebuild, right? You need to, you need to figure out what you're gonna do. Are you going to rebuild? Are you gonna reset the whole thing or do you pivot? I mean, in some cases, Cindy, there's situations where.
You may have to pivot on this surgeon or just specifically this device. So let's talk about that. You know, the rebuilding is kind of what I was doing, you know, is it salvageable? Is the relationship salvageable? In my situation, it wasn't that the relationship was hurting at all, it was just that he found a solution in another company and I needed to.
Figure out a way that I can still work with him and still give him what he wanted in the other company. So I rebuilt that relationship in a truthful and honest way, looking for other avenues that he could use my proctor, uh, my pro, my product.
Cynthia Ficara: Well, you know, and I think that that also brings important conversation because as products develop, there's going to be competitors that maybe solve one other solution.
Yeah. But then again, what does your product. Solve for maybe a different patient. And there there's I, you know, in this crazy medical device world, I can honestly say there really is space for a lot of us in many ways. I think there are some products that kind of, you know, can be replaceable, but you're the salesperson, be creative, build the story around.
Why they need you for a certain reason. Is it a niche? Is there, is there a great, um, you know, scenario where this works best in X type of anatomy? Yeah. Pull out data again. I mean, it, it, it's, it is a lot of rebuilding, but it's going back to everything that, you know, sales 1 0 1.
Anneliese Rhodes: Yeah. Um, and you
Cynthia Ficara: build confidence that way, you know?
Anneliese Rhodes: So if you're not able to rebuild the relationship or rebuild the usage of your product right away, maybe what you do instead is you reset a little bit. And what we mean by that is you take some time to step back, like, okay, you just had this really hard conversation with this surgeon. He doesn't need you in his face in the next like.
Day. Like, Hey, okay, when are we gonna do another case? When are we gonna like, no, chill out strategically, like step back a little bit. Give him or her space to figure out after that conversation all the dust settles, like where they wanna implement you again. And there's nothing wrong with giving it a little quote unquote pause.
You know, you're not. You're staying visible, but you're not desperate, right? You're not pushing them because that's, truthfully, that'll probably push them right back over the edge and they might not ever come back. So you gotta be smart with this. You gotta be super strategic with this. If you're gonna reset and rebuild you, give it a little bit of time.
Let the news sink in, let the conversation sink in your candid conversation with your surgeon. Let them feel empowered to want to give you that case again. Or cases again, versus you just push them onto the defense and they're like, oh God, I gotta work with this person again. And then you're in their face the very next day.
I guarantee you, they're just gonna avoid you again.
High Performers Refocus and Come Back Stronger
Cynthia Ficara: Oh yes. Well, and I think giving an example of being visible is, is probably helpful here. And what does that look like? Exactly what you said not to do is be in their face. But being visible is, think about this, like what else? What other products do you have?
You know, how do you leverage some value you have elsewhere? So you're still visible in the account, right? Maybe you have another product arm that you can extend and they know you and they trust you, you know, and then just kind of see how things come, but maybe. If it was one offset, but you're, you're still top of their mind, but okay, so maybe you don't have another arm.
Being visible is making sure if, if you did a routine round, maybe every month or something, if you scale it back, some just don't disappear because if you disappear. It would give them the assumption that you trying to rebuild or, or, or your side of the story may not be true if you just totally walk away from it.
Yeah. If you believe in what you said and you wanna rebuild you just slowly, carefully, and respectfully, respectfully, use their time by not beating their face.
Anneliese Rhodes: Yeah, no, I agree.
Cynthia Ficara: And then time heals all wounds. I will say after, sometimes it's years, sorry, but that's true. Sometimes if it's something big, it could take years.
But, you know, just let that, let it settle. Let all these conditions kind of mature into a different scenario and you'll, you'll get another chance. Those good reps and high performers come back and get it again.
Anneliese Rhodes: Yep. And. Sometimes they don't. Right? I mean, sometimes they just don't. That's true, and I've had that happen to me before.
I have told the story before on one of our other episodes. There are times that your it ma it was a mistake of yours. And you know, yes, we're all human, but we are in medical devices and we can't afford to make really crucial mistakes. And you know, sometimes doctors don't come back. And you have to, if you've done everything you can and you have had the con candid con, uh, conversation, you were open, you were honest, they were open and honest with you, and yet they're still not gonna call you.
There's also something that you need to acknowledge, and that is, this is just not a situation that I need to be in anymore because it's gonna hurt you ultimately and your business. Sometimes we just have to pivot, and like you said, there's a chance that they call you again someday. Maybe we even work for a new company, or you have a new product and they're like, oh, well I'll try you for this.
That's fantastic. But you need to at some point recognize when you've hit that wall that. There's probably no more pushing at this point that we need to do something else. We need to refocus.
Cynthia Ficara: And on that note of refocusing, okay, so yes, you've had a customer that had a closed door, but as successful as you were in the next couple years, successful as you are now, as we are still in the working world, mean you're still out there in the field every week.
You are pushing for President's Club again. So you know, when you refocus your energy and you start growing on other accounts, it doesn't mean that that one that you lost means you're gonna lose everything.
Anneliese Rhodes: Yeah.
Cynthia Ficara: And it's just building again. But that's part of the refocus and the pivoting, and you've been able to do it.
Now you're gonna build new champions. And I'll tell you sometimes when this happens to you, you become even better when you present your product in a whole new way. It's like confidence. And momentum. 'cause you don't want whatever that issue was. And again, that issue may not have, like in that one scenario you mentioned that was a mistake.
But like we said at the very beginning, this may be something out of our control. Yeah. But you stay a little more focused on what you can control. And it is amazing when you relaunch this, your confidence builds because, all right, we've tripped a little bit. We fell a little bit, get back up again and wow, look at how much better because.
We, we talk about failing forward, right? Not every failure is a true loss. It's really not some open doors that you never would've expected.
Anneliese Rhodes: Yeah. Well, I'm really glad we talked about this today, Cindy. This is definitely a good. Hot topic, you know, issue that we all will face at some point. Maybe we're all facing it right now.
Everybody that's listening in and you know, my heart goes out to you guys. I totally know the feeling 'cause I have it a lot, you know, I've had it myself. So you're not alone. You are not alone. We are in this together. Whatever those, all those things were right? But like. We are, we're here for you. This is why we do what we do.
This is why we took the time today to answer this question from a listener who specifically asked us about this, because it is a hot topic and it is something that really concerns you, especially when you care about your business and about your company, and about your customers. So I'm really glad that we talked about this today.
And do we have a call to action, Cindy? 'cause I feel like.
Cynthia Ficara: Yeah, and I think, I think this is such an important topic. I just wanna real quick summarize the three steps.
Anneliese Rhodes: Yeah.
Cynthia Ficara: Number two, I think you used the word pause the spiral. I really like that. Let your emotions be aside. Then number two, really seek the truth.
This is where our secret comes in. Be. Get comfortable being uncomfortable, have the adult conversation directly with the source. And number three, this is, this is kind of your, um, decision point. It's your crossroads. Either you rebuild, you reset, and, and totally have a new trajectory. And I think that's really important because when a surgeon stops using your device.
Don't think, oh no, what did I do wrong? Start thinking, how will I respond to this under pressure? Because this is what's gonna define which way the path is. So trust your yourself and the call to action today would be
Anneliese Rhodes: our call to action today for all of you guys is. If you listen to this episode and you felt it deep down inside, you gotta know that you've got some colleagues out there that are also facing the same things. So do yourself and your colleagues and us a favor and forward this episode to them so that they can hear how to handle these really tough situations.
And you guys all need to remember, you gotta get comfortable in the uncomfortableness. Have a great day. Have a great week.
Cynthia Ficara: Bye everybody.
Anneliese Rhodes: Hey, declutter, this is our snippet. One day you're in the OR every single week, and the next you're not. No emails, no feedback, no text messages. No phone calls. Just silence.
Cynthia Ficara: And here's the truth. What you do in the next 30 days will either stall your career or elevate it.
