Building the IDN team that matches the contracts you have, not the one you wish you had.
Four signals that tell you it's time to stop leaning on the sales team and hire dedicated IDN leadership.
Complex systems need dedicated navigation
Crosses territory lines within your organization
Not just territories, but regional boundaries
Collectively across the system
Trigger: First GPO contract. ~$20M company, around 12 reps.
One person managing the GPO contract, distribution, government, maybe even handling some IDN work. Regional directors might pick up strategic conversations where they can.
"That's very common still today. I still see that a lot where it's like, look, overhead. You can't afford to have a bunch of bodies, so you run as lean as possible."
This works when you're small. But the moment your IDN opportunities span multiple regions, you physically can't cover them with one person running around the country.
Trigger: 2-3 GPO/RPC contracts. IDNs requiring C-suite business conversations the sales team can't have.
Here's where companies make the biggest mistake: they hire one person and hand them 40 accounts.
"When I first started, I had 40 IDNs on the East Coast and maybe two GPOs. 40 IDNs is impossible. The effectiveness is minimal."
The right model: 5 to 10 accounts. That's it.
"Those five to 10 accounts you pick are going to more than pay for your IDN director in that region."
Trigger: 5-6 contracts (GPO + regional/RPC). Opportunities spanning both coasts.
Two IDN directors, splitting the country. Each has their own anchor IDNs and surrounding targets.
"Have them split the country and use that same model. What are the right accounts for them to go to? But you have that oversight of someone who's really living and breathing selling the company first."
Same 5-10 account load per director. Same anchor-plus-warm-targets approach. The model scales horizontally, not by piling more accounts onto one person.
Trigger: Established portfolio across multiple GPOs. Proven IDN success. National coverage needed.
One GPO person managing all three major GPOs. Three IDN directors: East, Middle, West.
"One person could navigate the three GPOs, whether you've got a contract at all of them or not. But having three IDN directors really helps split the country up well."
Each director owns their anchors plus opportunistic accounts. When something emerges ("Hey, UC Davis is really going well"), the IDN director steps in to own the business conversation.
"Remember, the rep is not the business manager. They're not that. So you say, 'Hey, we're going to bring in our regional strategic director and let them own that conversation at the top level.'"
Dan's interview question that reveals everything about a candidate.
"I have to sell the company first. I have to sell the business model first. I have to sell what the value is in our company before I can start anywhere else. The person that says, 'I want to sell the products and the features and benefits and get them sold on our technology,' that's great, but that is not the world we live in in strategic accounts."
Give them a scenario. Tell them they're presenting to a value analysis board. Let them navigate 20-30 minutes. You'll know in the first 10 minutes if they can have a conversation at that level.
There are reps who want to move into IDN selling and would probably be good at it. Great HR strategy to build within. Just make sure they understand: this is selling the company first.
The structure only works if everyone is speaking the same language.
Contract strategy and national pricing
System-level business conversations
Field execution and relationships
Unified message and pricing
A rep promises tier 4 pricing to a physician. Meanwhile, the IDN director is negotiating tier 2 with the C-suite. Now you have two competing commitments in the same health system. The disconnect kills deals and damages credibility.
The growth model from solo operator to full national coverage.
Don't force an IDN director to waste time on dead-end accounts.
"If there's one or two that are just complete dead ends, pause those, find another one and put it into the mix. Rotate them in and out. It's okay. You can change baselines mid-year. Why have an IDN director working on something that you know is a dead end?"
MedBridge Advisors helps MedTech companies design and implement IDN team structures that drive contract penetration.