Friday, September 24, 2010

Friday Morning Roundup

On Friday, September 10th, TSB posted a blog entitled, "Blue Velvets of the Spine Industry."  Since that date, there has been much activity in the spine industry.  Applied Spine (AST) employed an agent (Gerbsman Partners) to sell the company, US Spine was acquired by Amedica, and it is painfully obvious that Disc Motion is on life support.   As the 25th Annual North American Spine Society trade show approaches, it will be interesting to witness what other acquisitions or announcements await us.  Word on the Street is that the potential of another acquisition is imminent, if the provisions of the deal can be hammered out prior to NASS.  Based on what TSB has heard, the deal will probably hinge on a stock/cash transaction, backloaded so if there is a future IPO the sellers will benefit from a public offering.

On a much lighter note, let's not spend so much time critiquing one another's grammar in the comments section.  Rather than having intelligent dialogue on a topic that needs some serious attention, the clinical efficacy of SiN, we are being distracted by each others pettiness.  Considering many of you are college educated, TSB would hope that y'all learned the three "R's," reading, riting, and rithmetic.

So in closing, Friday morning's question is posed to our fellow bloggers by one of our readers;  Are surgeon/distributor/company relationships on the decline?  Does loyalty even exist anymore?


  1. Being in the game now for almost 3 years with one of the "Big Three", I can tell you it's all about location, location, location. Oh yeah...and mix in some luck. Sales skills are bullshit in this environment. It all comes back to the amount of grease needed to lube the doc/hospital and the old reliable driver they were trained on and pull out of the bag everytime they operate.

    I understand my spine sales experience is limited. Just my observations after bashing my skull against the ground each day trying to make some real money in this industry. Maybe it's time to jump ship to Danek or Nuva?

  2. I've wonderedo if the hospital is now having more say on the purchasing decision. A local conglomerate hospital in the southeast has consolidated all their supply chain/purchasing department into one location. Has the good been commoditized, and the hosptial has taken over the pricing and the purchasing?

  3. Having been in this industry for quite a while, on the general question, yes the relationships have really changed, and I guess "loyalty" is gone as expectations from the surgeons' standpoint have increased. Back in the day, a surgeon viewed their industry rep in the same way John Q Public might view their local shopkeeper. You could change whom you purchased your products from, but if they were providing you with good product and good service, why would you? As the power and financial influence of the industry has increased, so has the surgeon's view of the industry as a potential business partner, someone with whom to collaborate and potentially profit either financially or professionally from. And business partnerships are always more fickle, as there's typically more at stake. Unfortunately, IMHO, the view that modern surgeons have of the industry as partners and business opportunities rather than simply vendors has tarnished the nobility of the surgeons' profession and their role as leader in the healthcare event. It's clearly muddied the waters when it comes to the decision making process about product usage, which hasn't been good for our industry as a whole.

    And for 7:09, yes many goods have been commoditized and purchasing does hold the authority now more than ever. A shame that surgeons lost control of that part of their decision making authority, but arguably it was due to their own ignorance and disregard for cost and value in the choices they used to be able to make.

  4. 9:37 is absolutely correct. While surgeons remained focused on their own income and forgot that hospitals actually paid for their product choices, the hospital took away their power to choose what was affecting constantly increasing costs. The behavior of a few greedy surgeons who sold their souls to make big consulting incomes hurt the majority of surgeons who actually cared about their patients and their hospitals. The reputation of the industry was tarnished and the pitiful surgical outcomes of spinal fusion patients has created a level of mistrust that keeps 9 of every 10 patients who need surgery seeking alternative therapies or living with their pain. In general the spine surgery industry has a bad reputation with hospital administrators, payers and the public at large. Greed kills and the good surgeons suffer from the bad behavior of their peers. Outcomes rule to the payers and we live in a world of comparative effectiveness based on scientific not anecdotal evidence.

  5. Does loyalty even exist anymore? I've been with the same spine company for 12+ years. There has never been any loyalty in this business. Not from the surgeons, from the device companies or from the reps. Every last one of us is loyal to our next paycheck...and that's about it.

    When a surgeon switches 100% of his business, literally overnight, to his own surgeon owned company---and forgets to tell you---that is not loyalty.

    When a rep leaves a device company because a competitive company guarantees him a better paycheck for a year or two---that is not loyalty

    When the same company fires a rep for performance after a bad year, and the company didn't launch any new products and his top surgeon left his territory (and wasn't replaced)---that is not loyalty.

    What I find hysterical is how the same company won't give a loyal employee two weeks notice that they are going to be fired. Yet, the company expects an employee who isn't loyal, to give them two weeks notice that they are leaving to work for a competitor? What am I missing here? Oh yeah, loyalty. Maybe common sense too? I'll stop making fun of my own company...

    In 12+ years, what's new and exciting?

    Construct pricing

    Also, when did device recruiters become "executive recruiters". What makes them "executive"

    What's old?

    An executive recruiter called to ask me to jump ship to help Synthes sell a new and exciting pedicle screw? If you think pedicle screws are new/exciting, then I might start becoming loyal? And this would mean you'd have to remove the "executive" tag from your business card.

    Are surgeon/distributor/company relationships on the decline?

    Only unless the paychecks stop arriving.

  6. I say, "here, here" to 8:12 AM. Loyalty is in the toilet. I was around when Jim Lent was trying to take DePuy public and you better believe there was no loyalty to the 25 year distributors that had built that company. They were terminated like bugs on a bug zapper. We will not see a turnaround because the surgeons can't help themselves.