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Al Merritt founded MD International in 1987. A former salesman for a medical equipment company, Merritt saw
an opportunity to act as an export intermediary for medical equipment manufacturers in the United States. He
chose to focus on Latin America and the Caribbean, a region that he already had experience in. Also, trade barriers
were starting to fall throughout the region as Latin governments embraced a more liberal economic ideology,
creating an opening for entrepreneurs such as Merritt. Local governments were also expanding their spending on
health care, creating an opportunity that Merritt was poised to exploit.
Merritt located his company in south Florida to be close to his market. Since then, the company has grown to
become the largest intermediary exporting medical devices to the region. Today the company sells the products
of more than 30 medical manufacturers to some 600 regional distributors. While many medical equipment
manufacturers don't sell directly to the region because of the sizable marketing costs, MD can afford to because it
goes into those markets with a broad portfolio of products.
The company's success is in part due to its deep-rooted knowledge and understanding of the Latin American
market. MD works very closely with teams of doctors, biomedical engineers, microbiologists, and marketing
managers across Latin America to understand their needs and what the company can do for them. The sale of
products to customers is typically only the beginning of a relationship. MD International also provides training to
medical personnel in the use of devices and extensive after-sale service and support.
Along the way to becoming a successful exporter, MD International has leaned heavily upon export assistance
programs established by the U.S. government. For example, in the early 2000s a shipment to Venezuela was held
up by the Venezuelan customs seeking proof that the medical devices were not intended for military use. Within
two days, staff at the U.S. Export Assistance Center in Miami arranged for the U.S. embassy in Venezuela to have
a letter written and delivered to the customs officials, assuring them that the products had no military applications,
and the shipment was released. Merritt has also worked extensively with the ExportImport Bank to gain financing
for its exports (the company needs to finance the inventory that it exports).
Despite these advantages, it has not all been easy going for MD International. Latin American economies have
often been highly cyclical, and MD International has ridden those cycles with them. In 2001, for example, after
several years of solid growth, an economic crisis in both Argentina and Brazil, coupled with a slowdown in
Mexico, resulted in losses for the year and forced Merritt to lay off one-third of his staff and cut the pay of others,
which included a 50 percent pay cut for himself. Things started to improve in 2002, and the weak dollar in the
mid-2000s also helped to boost export sales. However, the global financial crisis of 2008 ushered in another tough
period; although prior experience suggests that MD International can not only survive such downturns, but also
come out stronger as weaker competitors fall by the wayside.
Case Discussion Questions
1. How does an intermediary such as MD International create value for the manufacturers that use it to
sell medical equipment in foreign markets? Why do they want to use MD International rather than
export directly themselves?
2. Why did MD International focus on Latin America? What are the benefits of this regional approach?
What are the potential drawbacks?
3. What would it take for MD International to start exporting to other regions such as Asia or Europe?
Given this, would you advise Al Merritt to continue his regional focus going forward or to add other
4. How important has government assistance been to MD International? Do you think helping firms such
as MD International represents good use of government resources?