Marketing drivers of medical device selection: the mediating role of surgeon training in suburban Tier II Indian health-care markets

Purpose This study aims to examine the marketing drivers influencing medical device selection among surgeons in suburban Tier II Indian cities, with an explicit focus on the mediating role of surgeon training. The research addresses a major gap in existing research where multiple marketing and product-related drivers have not been jointly analysed, nor has the mediating role of surgeon training been explored in resource-constrained suburban Tier II Indian markets. Design/methodology/approach A cross-sectional structured survey of 394 surgeons across 40 suburban Tier II Indian cities was conducted. Using partial least squares structural equation modeling, the effects of device safety, performance, innovation, vendor reliability, peer influence and cost consideration on device selection were assessed. Surgeon training was assessed as a mediator. Reliability, validity, mediation and structural effects were assessed using a bootstrapped sample of 5,000 iterations. Findings All predictors significantly influenced device selection (β = 0.1117–0.358, p 0.01). Surgeon training partially mediated the relationships between device safety, performance, innovation and peer influence, strengthening the impact of marketing-related and peer-driven influences on adoption. The model demonstrated strong predictive power (R² = 0.71) and acceptable fit (SRMR = 0.045). Research limitations/implications The cross-sectional design limits causal inference. Specialty-specific behaviors were not analyzed. Future research should investigate longitudinal adoption patterns and comparative analysis between urban Tier I and suburban Tier II cities. Practical implications Medical device marketers targeting suburban Tier II Indian cities should prioritize surgeon training initiatives as a strategic lever to increase medical device selection. Building strong vendor relationships, emphasizing safety and performance and leveraging peer endorsements can enhance device selection. Social implications Policymakers can institutionalize and facilitate accredited surgeon training programs, introduce evidence-based procurement policies, introduce vendor reliability ratings and leverage key opinion leaders in government panels to aid device adoption. Originality/value This is one of the first empirical studies to integrate marketing, technical and social drivers into a unified model of medical device selection in a developing-country context. It advances theoretical understanding by identifying surgeon training as a critical cognitive mechanism linking marketing and clinical attributes to adoption behavior. The findings offer actionable insights for medical device marketers and policymakers operating in low-resource markets.