WAVES Framework

Sales Strategy: The WAVES Framework

• W — Who and Where: Target and identify the right stakeholders and locations.

• A — Ask, Observe, UNDERSTAND Discovery: Perform deep-dive discovery to maximize every customer interaction.

• V — VALIDATE INTEREST: Use the information gathered to educate the customer.

• E — Establish Alignment & CLOSE: Move the conversation toward a solution and secure commitment.

• S — SUPPORT, Sell, and Expand: Ensure clinical success to drive further growth.

The 7-Step Meeting Structure

• Step 1: Set the Agenda

  • Establish a scheduled time.

  • Avoid "scrub sink" conversations.

• Step 2: Reciprocation

  • Ask: "Is there anything you would like to address today?"

• Step 3: Take Notes

  • Ask: "Doctor, do you mind if I take notes?"

  • Always use a physical notebook.

• Step 4: The Introduction

  • Establish value and credibility.

  • Script: "As you know, I'm Savannah. I've been in the medical device industry for five years, a career focused on working with doctors to improve efficiencies and achieve the best treatment outcomes for their patients."

• Step 5: Understand the Vision

  • Uncover their "Why."

  • Use high-level questions such as: "Can you tell me about your BPH treatment algorithm?"

• Step 6: Discovery Funnel

  • Level 1: Open-ended questions.

  • Level 2: Follow-up on impact/outcomes: "What is the impact to your practice when that happens?"

  • Level 3: Explore pain points across Clinical, Operational, and Economic domains. Hold the sell; just gather "nuggets" of information.

• Step 7: Summarizing and Response

  • The Summary: "Dr. Monroe, to summarize, you’re currently referring out larger glands because they slow you down intra-op, and you’re looking to drive incremental volume into your practice. Does that sound correct?"

  • The Response: "I have great news. You are the perfect candidate for Aquablation. It will not only solve the barriers hindering your growth, but it will also be the catalyst to differentiate your practice. Let me show you how…"

Core Discovery Pillars

• Clinical (Outcomes & Reputation)

  • What is important to you when treating BPH patients?

  • What type of volume are you seeing monthly?

  • How do you choose which patient gets a certain modality?

  • Why do you think so many patients are "waiting on the sidelines"?

  • Why do you think ejaculatory function is important to some patients and not others?

• Operational (Efficiency & Quality of Life)

  • What points in the procedure commonly cause delays or intra-op inefficiencies?

  • How do these delays affect the cases you have scheduled later in the day?

  • Talk to me about how you feel at the end of a 4-surgery case day.

  • What is the percentage of patients who forgo surgery when you offer it, and why?

  • What would it do for your practice if you could increase your patient acceptance rate?

• Economic (Growth & Revenue)

  • Tell me about your current reimbursement model (Physician fee, global period, payor mix).

  • What are you doing to drive new patients into your practice?

  • What tools do you use in clinic to educate patients on surgical therapy?

  • How do you track your case acceptance rate?

  • What is in the way of your practice growing from an incremental revenue standpoint?

Benign Prostatic Hyperplasia (BPH) Market & Pharmaceuticals

• The 3 Market Buckets

  • Watchful Waiters

  • Medical Management

  • Surgery

• Pharmaceutical Classifications & Details

  • Alpha Blockers (Flomax/Tamsulosin, Uroxatral, Hytrin):

  • Mechanism of Action: Relaxes smooth muscle.

  • Side Effects: Dizziness, fainting, ejaculatory dysfunction (EjD).

  • 5-ARIs (Proscar/Finasteride, Avodart):

  • Mechanism of Action: Shrinks the prostate by blocking hormone conversion.

  • Side Effects: Decreased libido, ejaculatory dysfunction (EjD), breast enlargement (gynecomastia).

  • Long-term Risks: Cardiac failure and Dementia.

• Pharmaceutical Efficacy & Market Reality

  • A total of $6.7 \times 10^6$ men suffer from pharmaceutical side effects.

  • Pharmaceutical medications only offer a $5\text{-point}$ IPSS reduction and a $2.5 \text{ mL}$ flow improvement.

Non-Resective Procedures (MISTs)

• Rezum

  • Uses $0.42 \text{ mL}$ of radiofrequency-heated sterile water vapor delivered in $9\text{-second}$ treatments.

  • Thermal energy denatures cell membranes and closes vasculature as well as alpha-adrenergic nerves.

  • Tissue is naturally absorbed by the body’s healing response.

• Urolift

  • A mechanical solution utilizing a $19\text{-gauge}$ needle to deploy $4\text{--}6$ nylon sutures fitted with metal tabs.

  • The outer capsule of the prostate acts as a firm anchor, allowing the device to lift and hold tissue out of the way.

  • Involves no cutting or heating.

• Optilume

  • A drug-coated balloon utilizing Paclitaxel.

  • Pre-dilation opens the channel; the drug-coated balloon prevents cell division and fibrotic scarring.

  • Paclitaxel has been utilized in chemotherapy since the 1990s and in coronary stents since 2004.

• iTind

  • A temporary nitinol device placed for a duration of $5\text{--}7 \text{ days}$.

  • Exerts continuous pressure at the 12, 5, and 7 o’clock positions, creating ischemia and necrosis to form three new channels.

Resective Procedures (Surgery)

• TURP (Transurethral Resection of the Prostate)

  • The surgeon uses a resectoscope with a wire loop to shave off tissue.

  • Widely effective but frequently compromises sexual function and continence.

• Enucleation (HoLEP)

  • Benign tissue is "peeled" away using laser energy.

  • Provides durable results for all prostate volumes.

  • Recognized as a gold standard for large glands since 2010.

• Greenlight

  • Utilizes a laser fiber to systematically vaporize enlarged tissue until the obstruction is removed.

• Robotic Prostatectomy (da Vinci)

  • Typically indicated for cancer.

  • Provides a 3D view to spare delicate nerves critical for urination and erections.

  • The bladder is reattached to the urine channel over a catheter, which remains in place during the healing process.