How do you reach more customers without hiring a bigger sales team?

DermaSensor had 300,000 doctors to reach and money for a small team. Cody Simmons borrowed the sales reps of bigger companies and fixed his sales process first.

Borrow other people's reach, and get your sales process ready before you push. Cody Simmons, co-founder and CEO of DermaSensor, had about 300,000 primary care doctors to reach, by his count, and a launch budget that couldn't pay for a big sales force. Most of his sales came from digital marketing, and his next step was partners whose reps already visit those offices. When a supplier failure left him with nothing to ship after the FDA authorized the device in January 2024, he used the gap to lock in the sales process first.

Most owners I talk to assume growth means hiring. More customers, more reps, more staff. Cody's math didn't allow it, and I think his answer fits any founder-led business trying to grow without adding headcount.

Why couldn't DermaSensor hire its way to more customers?

Because the numbers didn't work. By Cody's count there are about 300,000 primary care physicians at 140,000 locations in the US. He said the company has raised over $40 million in total, but the round meant for commercial launch was a bit over $10 million.

You can't hire 200 sales reps with that, right?

Cody Simmons

Where did the sales come from instead?

So far, Cody said, most of their sales come from leads generated by digital marketing, with their own reps doing outreach by email and LinkedIn on top. The next step is partners who already have reps in doctors' offices. He described four:

• One of the largest distributors in the country, whose reps call on tens of thousands of primary care locations.
• A contract sales force with more than 100 reps, many of them focused on primary care.
• A reseller that has sold to the VA for over 40 years.
• A large health network, which he couldn't name yet, that employs tens of thousands of primary care doctors.

That's the pattern I'd point any owner to. If your buyers are spread across thousands of small offices, find the people who already visit those offices every week and give them a reason to carry your product.

The same thinking works on the work behind the sale. Before you hire someone to chase every lead, ask whether an agent can do the first round of follow-up and hand a person the conversations that are ready. I wrote about where that works and where it annoys people in a post on AI sales follow-up.

What does DermaSensor sell, and who buys it?

It helps a family doctor decide whether a suspicious spot needs a dermatologist. The FDA authorized it through the De Novo pathway as a prescription device for evaluating skin lesions suggestive of melanoma, basal cell carcinoma or squamous cell carcinoma in patients 40 and older, used by physicians who are not dermatologists. The FDA is specific that it is not a screening tool, should be used only on lesions a doctor already finds suspicious, and should not be the sole basis for a diagnosis.

The result is either Monitor or Investigate Further. An Investigate Further result also shows a score from 1 to 10. In the pivotal DERM-SUCCESS study, run at 22 sites with 1,005 patients and 1,579 lesions, higher scores went with a higher chance of cancer. About 6% of lesions that scored a 1 were malignant, compared with about 61% of lesions that scored a 10. The FDA notes those percentages depend on how common cancer was in that study, so they show the direction of the scale more than the odds for any one patient.

Cody told a story about that scale in the episode. The second patient ever scanned after authorization was an older man with a spot on his upper body he'd had for a couple of years. His doctor, a family physician in Pennsylvania who was the first in the country to get the device, thought it looked like melanoma. The patient argued. He didn't want to deal with it. The doctor scanned it and it came back a 10. That was enough to get the man to go. The doctor called a local dermatologist, who saw him within a week, and the biopsy confirmed melanoma.

I understood that patient more than I wanted to. Years ago I had a mole I avoided because I was afraid of the answer. My primary care doctor told me it looked fine but I should get it checked. It was taken off and it wasn't cancer. I go every year now.

Why get the sales process ready before you push for growth?

Because the first customers find every gap in it. Cody learned this by accident. His design and small-batch manufacturing partner lost key engineers after COVID and went bankrupt. He said that firm still owes DermaSensor hundreds of thousands of dollars. The company moved to a bigger manufacturer, which wasn't ready in time. So the FDA said yes and there was nothing in the warehouse, and his sales team was frustrated.

Looking back, Cody calls it a blessing in disguise. The gap let the team lock in the sales process and customer training materials before the first device reached a doctor. His advice to founders was a question.

Just because you can hit go from a regulatory standpoint, do you actually want to?

Cody Simmons

When does the pressure to show growth start?

The day you can sell. Cody said the moment you hit go, investors start counting how sales are going. He admitted he was frustrated at the time and wanted clearance in 2023, because missing that felt embarrassing. Now he's glad it slipped. With clearance in 2024 and the first sale in the middle of that year, the story he tells investors lines up with where the numbers are. A 2023 date would have put extra expectation on sales and partnerships that the company wasn't set up to meet yet.

I think that applies well outside medicine. Every launch date you announce starts a clock someone else is holding. Pick the date you can back up.

What should an owner do before trying to grow without hiring?

Find the people who already reach your customers and give them a reason to carry what you sell. Then make sure the process behind the sale works before you turn up the volume. Cody had a device the FDA had just authorized and nothing to ship, and he used the wait to build the sales process and the training. If you're about to add partners or agents so you can grow without new hires, ask whether your process and your promises are ready for the day you say go.

This post shares Cody's experience from our conversation and isn't medical advice. The study figures above come from the FDA's decision summary for the device. If you have a mole or spot you're unsure about, see a qualified clinician.

Cut from Building the First FDA-Cleared Skin Cancer Scanner for Family Doctors.