Tuesday, November 9, 2010

A Marriage Made in Heaven

On Monday, November 8th, 2010, Synthes USA (SUSA) announced that it had acquired Anspach Incorporated, a West Palm Beach, Florida based company known for its high speed pneumatic and electric powered tools for neuro, orthopaedic, spinal and ear, nose and throat surgery.  Having visited Anspach on numerous occasions, Synthes acquired much more than state-of-the art powered tools.  Anspach corporate headquarters now provides Synthes a satellite office where cadaver labs can be offered for the Southeast, Southwest and Mid-Atlantic Regions.  But this is really only a small benefit of this acquisition.  Today, Synthes now offers one of the most comprehensive power tool portfolios with a power tool division with close to $200 million dollars in sales.

Looks like the Almighty Stryker better start looking over its shoulder, there's a new sheriff in town and his name ain't Reggie Hammond.  Is this the new Syntes (love that lisp)?  In addition, they have bought some nice shoulder instruments, considering that they have been attempting to get into the shoulder market over the last few years.  This organization has done a wonderful job of assimilating itself into the American culture of buying, rather than developing their own products, especially when it is cheaper to gobble up a leading company rather than develop it organically.   But what does it say about R&D at Syntes?  You know that new generation of engineers, love sitting in front of a computer rather than being in surgery.  Will they become the next T-Rex in the industry, gobbling up anything that's worth their cash.  You be the judge.  TSB wants to know what our readers think.

Get in On, Bang the Gong, Get it On!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

67 comments:

  1. Great move. I heard that Synthes had 300 to spend on new products over the next 12 months. Looks like this took most or all of that.

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  2. Excellent move but we'll see how they take advantage of it. They are a slow organization.

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  3. I love your song references....you are a renaissance man indeed!

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  4. Already heard that the Synthes reps won't see this in their bags. Keeping the current distributorship model. If, that is true, Stryker has a little less to worry about. And, what does this mean to T-Rex cousin Midas Rex? Get in on Bang a gong hit a bong!

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  5. TSB:

    Well you're dirty and sweet, clad in black, don't look back and I love you
    Your dirty and sweet oh yeah, Get it on, bang a gong get it on!

    Wyss will never give this line to his Syntes reps, because just like spine, they will never let the trauma reps make mucho dinero.

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  6. Anspach reps, in many instances, gain tremendous access to spine surgeons as a result of selling this line. Considering that a majority of current Anspach distributors carry Depuy or some other spinal hardware company, is it realistic to think Synthes will continue with this sales model long term?

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  7. I remember fondly the trip down to West Palm for the Anspach dissection courses. The evening out afterwards was an experience to remember. Many arrived as boys but left as men. Good times.

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  8. I keep hearing the Almighty Stryker is looking to make a spine purchase, maybe by year end. Globus or Nuvasive, probably Globus

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  9. Not to fan the rumor fire but the Globus private jet was spotted at Kalamazoo's regional airport. Either they were meeting with big brass at Stryker or more likely transporting a doc to another meeting back at their corporate headquarters. They can discuss how to improve patient care and develop the highest level of products and services.

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  10. Speaking of distribution, a ton of DePuy distributors carry this line. What becomes of them?

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  11. Okay. So this was a nice move on power. Now there biologics profile is being leap frogged by many and needs some attention. Chronos is a dog, DBX 3rd or 4th place in the market, and Norian is soon to be bon voyage. Your move West Chester.

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  12. TSB couldn't have said it any better myself....Syntes has hung its hat on DBX so long that you those unused boxes on hospitals shelves are beginning to look like they were covered in volcanic ash.

    I guess tricky Ricky Gennett has milked that relationship with MTF so long he reminds TSB of Panama Red, he'll steal your woman and then he'll rob your head....on his white horse mescalito he comes breezin' through town, I'll bet your woman's up in bed with ol' Panama Red.

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  13. Now thats funny MC

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  14. Nice one Greg ;)

    Expect Synthes to ultimately discontinue the relationship with the distributors, at least domestically, as we like to employ the large sales force. Mgmt here is incredibly slow and integration will take a while. It's high time this company made a decent acquisition. Forget Biologics as Wyss doesn't feel comfortable with the science and PD is a mess.

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  15. Great move for Synthes, but they will ultimately have to stop selling through distributors here in the USA. Too many of them are already competing with Synthes on the trauma and spine front (Zimmer, DePuy, etc.)
    I can only see the Stryker Instrument reps crapping in their pants. There will be twice as much turnover with those guys than there already is. (Which is a lot)

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  16. 2:50PM.....Yes, only years ago when know it all Wyss stated "we don't need any f'in BMP to sell a plate" and off went rhBMP-2 to Medtronic. Where would Synthes be now if they had BMP-2 for spine, trauma and CMF? Whoops

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  17. Wyss hasn;t changed one iota since I sold for Synthes in the 80's, obstinate old fool. If he could get his nose out of his girl friend's ass he'd see the forest thru the trees. A real visionary with myopia.

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  18. It's "see the forrest for the trees"
    You'd think an old guy like you would know that.
    Yet you do know about tossing salad, so I'll give you some credit!

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  19. Wyss suffers from severe cronyism, only listening to his BFF Robie and such henchmen as Rick Gennet. The Europeans are also always right in his mind. I bet the real reason the AO is distancing itself from Synthes further and further is they're sick of how wealthy that organization has made Herr W.

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  20. in today's market, should one apply to jobs at small companies with prospect of acquisition or stick to applying at the larger 'buyer' companies? Do employees at places such as Anspach get liquidated or assimilated?

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  21. 10:57 pm... If you're worried about job security, it depends on whether you're replaceable or not regardless of the size of the organization. In any M&A, there is typically some duplication, particularly in the back office (accounting, HR, finance, etc.) and any non-essentials tend to be quickly eliminated in the acquired org.

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  22. "..the AO is distancing itself from Synthes.."

    Are you crazy?

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  23. The AO has been distancing itself from Synthes? If anything, Wyss has attempted to distance Synthes from the AO. When he acquired Mathys and Straumann his goal was to leverage his control/ownership to re-negotiate the SMS licensing agreements with the AO. Wyss has always believed that he was paying too much. But if you ever have been to Davos, one would understand that someone needs to subsidize the party and the labor camp. Surgeon loyalty made Synthes in the USA....Hill Hastings (Indiana) the impetus for Synthes making the first Hand/Wrist Fusion Set, Fred Behrens (Minnesota) the impetus for the Large External Fixator, Thomas Schuler (Virginia), they stole his ideas for the Spiral Blade Intramedullary Nail, LeTournel (France) pelvic system. Educating attendings and residents, the greatest marketing tool for a company that doesn't even have a formal marketing department. This once great company no longer has that aura of invincibility because those on top have gotten old and soft, counting their benjamins rather than keeping the eye of the tiger. Look at their recent acquisitions, Pro Disc (will they ever recoup $375 million?), NSpine (DS dead off the coast of SD), at least Anspach is a revenue generator.

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  24. 4 Depuy distributors who carried Anspach have already been cut. The timeline for complete transition is not known. They're obviously going to be direct and it seems they want to be quick about it. Stryker/Medtronic has a chance to possibly make some moves on strong Anspach accounts during this apparent aggressive move by Synthes to assume total control so quickly. Just an outsiders perspective.

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  25. What is the upside of a Globus acquisition by Stryker? Globus doesn't really have any game changers and they have too many duplicate devices. So they pick up some variations on the ACDF & Pedicle Screw theme and a lateral cage. Do you think they're just buying some top line revenue to pull the old growth head fake? Do any of us expect that revenue to stick around with the acquiring company?

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  26. Why would you buy Globus? Unless there is a game changer in the IP portfolio, I don't see this happening, but, Stryker has done this in the past. I am sure their financial analysts would/will model how much of this revenue they would be able to keep..... Remember, once a new owner comes in the rules of engagement are modified. But I must concur, what is it that Globus has, outside of a % of marketshare that would/will make someone buy them? Let's be honest, everyone thinks that their baby is beautiful, yet, beauty is in the eye of the beholder. Why would you want another pedicle screw, three more cervical plates etc... I believe that Stryker is much smarter than that. They are definitely looking, but the question really is, in what market, and at what other technologies. It's a buyers market.

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  27. Besides...If Stryker did purchase the Glow-Bus you could kiss a large percentage of their sales goodbye. Better than half of them are waiting to cash out so they can jump ship! That's why they went there in the first place.

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  28. Globus has a very nice perc screw system ... Stryker's Mantis is not very nice. Globus's XPand would be a great addition to Stryker's Tumor/Trauma portfolio for their large academic accounts. Globus has 2 stand alone interbody devices, to my knowledge Stryker does not.

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  29. What is up with Stryker's R&D team? 8:31 points out that SYK doesn't have a stand-alone cage. Something like this should take less than a year to develop and get FDA approved. How can a $500MM+ organization not be able to spit these things out on a regular basis?

    Does anyone have insight into their product development process? What prevents them from coming out with new devices?

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  30. SYNTHES is going to have a dedicated power tool division, intergrating current products into Anspach and basing it out of Florida. The current CEO will be the President of the new division. Good bye distributors and good bye Stryker.

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  31. Engineers sitting in front of computers is how new products get to market faster. Having educated sales people who are technically inclined and know how to communicate user needs to corporate marketing and R&D is what is and has been lacking for a long time now. Today's sales people are all about relationships. None of them know the technical aspects of their products or how to really sell. What does it matter anyway when reimbursements are getting lower and the quality of the product doesn't matter anymore - to either the surgeon or the government. It means cheap products, no innovation, cookie cutter uneducated sales, and to the larger size victor go the spoils. This is what corps and their lobbyists want all in the name of lowering health care costs.

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  32. "Good bye distributors and good bye Stryker" Just a tad brash, ya think? A solid competitor, yes. Good bye, I think not.

    As for the Globus - Stryker comments, let us revisit some of the biologic comments in play. Neither of these companies has anything to write home about on this front. Globus now without a DBM is left with a basic me too synthetic and Stryker has squat as well which is even more deplorable considering there size. OP-none has been a total flop since introduction, their DBM initiatives basically non-existent and synthetics consisted of carrying Apatech for some time. What gives?

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  33. Stryker needs to make a play for NovaBone, at least they would have a synthetic comparable if not better than Apatech's depending on whomever's propaganda one chooses to believe.

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  34. OP-1 = OP None. Ever wonder how companies survive in spite of themselves? Their initial foray into spine was with the ACQUISITION of DIMSO, they acquired the SR90 and screwed up all the relationships that SDI had with its distributors, they bought a cylindrical cage hoping to fill it with OP-1, they screwed the pooch on that one, they acquired Spine Core's TDA portfolio only to have problems with adjacent vertebral fractures, now they are in litigation with Errico. This division reminds TSB of the song Science Fiction/Double Feature from the Rocky Horror show.

    Denny Stripe was ill the day stood still but he was told where we stand
    And Mike Manelli was there in silver underwear, Ned Lipes was the invisible man, Then something went wrong for Tim Scannell and Steve MacMillan They got caught in a celluloid jam Then at deadly pace it came from outer space and this is how the message ran;

    Science Fiction - Double Feature John Brown will build a creature.

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  35. Novabone is crap. Stryker now has rights to a synthetic by etex. Equivabone and Carrigen. It has level 1 prospective, randomized, etc. data published in the JBJS to support it. Only synthetic on the market that sets hard. I don't sell it but have seen it in a couple cases and it handles nicely.

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  36. Stryker will figure out how to f up that product, that's what they specialize in, at least lately LOLLLLLLLLLLLLLLLL Ha, Ha, Ha, Ha, Ha, Everyone wants to get into the act

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  37. Does Novabone have any clinical data? Please don't cite "clinical case studies", which are all too often spun to make a case for a license/acquisition. Seems like too many synthetic bone grafts have bupkus where real clinical studies are concerned. So besides the flamboyant product language, how does their putty feel from the surgeon's perspective?

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  38. Alphatec and Orthovita both have stock prices severely in the tank. What about Stryker buying VITA? Solid science in human studies. Their sales force is largely direct with little metal experience for easy convert to Stryker distribution.

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  39. You were careful not mentioning ATEC as a buyout. Too many "deals" by http://en.wikipedia.org/wiki/Tweedledum_and_Tweedledee.

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  40. Solid science in human studies, really? what about the bone stims they use as well?

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  41. 3:28. Not sure what your point was but most bone stims studies are double blinded, randomized, prospective studies that have shown statistically significant results in increasing fusion rates. Signals replicate the same electrical signals produced by compression on bone (wolfs law)

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  42. I think what 3:53 means is that the Vitoss studies also included the use of bone stimulators.

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  43. I know this is off topic but what do you all think about Integra Spine.

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  44. The Great and late Peggy Lee once sang:

    Is that all there is, Is that all there is, if that's all there is my friend so let's keep dancing, let's break out the booze and have a party.....

    Would that sum up Integra Spine? Does this company have anything innovative? Another me too product portfolio acquired from Randy 'Take the Money and Run" Theken. Nothing innovative. mediocre management, lot of uncertainty from sales, the eDisc nary a baboon it didn't like to torture.... Why do you ask?

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  45. MM, Looking to pick up a line and get into the game. Just not sure which I should go after. Looking for recommendations.

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  46. Depending on where you sell and the demographics of your customer base, you should be looking at a company that has a comprehensive product portfolio from Occiput to Sacrum, if you want to be in hardware. The next question you must ask is whether they have a competitive biologic. Hospitals are more than ever looking to streamline their vendors and you will never compete in a "one-stop" shopping environment if you don't have the portfolio to compete with the big boyz. Some other questions to answer, do I need a salary? Remember, if you want to become an independent distributor you will need capital to subsidize yourself. It will take time to ramp up even if you have the relationships. At best whenever I made change I was able to convert an estimated 12-30% of my existing business unless I had something unique and emerging. In this economic environment think big, like legacy company. MSD, Stryker, Synthes, DePuy, NuVasive, Globus, K2M. These companies will be demanding but if you're young and hungry you can do it. I can only lead you to water, I never make anyone drink the Kool Aid. That's your freedom to choose. Drop me a line on my spineblogger e-mail address and I will attempt to network you with some of my industry contacts. PS: But you need to let us know what you want.

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  47. Musco Man - alot of discussion on biologics. How about a post on synthetics, particularly? Interesting part of the field right now.

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  48. What's Randy Theken up to these days?

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  49. Nov. 10 at 1:42, please provide bibliographic reference for prospective Etex study.

    Yep, didn't think so...

    How about this: "The Evolving Role of Bone-Graft Substitutes," AAOS Orthopaedic Device Forum 77'th Annual meeting. The panel reviewed all available bone grafts and ranked them in a table according to the available evidence. Everyone can say what they want about their favorite product, but there are only 4 products on the US market with Level I studies: InFuse, OP-1, Vitoss, and Grafton. As always, it's up to critical readers to decide what these studies mean.

    That leaves a lot of synthetic bone grafts, DBM's, stem cell "products", and other stuff on the sidelines with their animal studies and consultant white papers.

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  50. Probably flying his twin engine into the Akron office and then driving over to pray at the shrine that he built for himself to pray to false gods.

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  51. Nov. 11 at 10:41, please advise...

    http://www.ejbjs.org/cgi/content/full/90/10/2057/DC1

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  52. 1:15

    Please post on The Tibialplateaublogger

    Thanks...

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  53. Anon 10:41. that JBJS paper from 2008 only refers to an old, and no longer made CaP product called "Alpha". DePuy ran with it for a year or so then dropped it.

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  54. For you seasoned reps out there that claim to be relationship experts -- I'm curious - how do you approach a "conversion"? What is your process? How do you structure your conversation with the prospective physician? 1st meeting, 2nd and 3rd? Assume this physician has a 5+ year relationship with a rep and company. I'm not looking for people to tell me the surgeon needs to be bought. I'm looking for someone that is an expert in making a relationship in order to break a relationship. Assume also the products you sell are equal in utility and outcomes to what he already uses.

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  55. Well if your not looking to buy the physician then your not getting his business, period. You probably should start looking at other physicians in town, because you arent breaking a 5 + year relationship with selling on features and benefits of your spine products. But, im sure your regional manager is telling you to sell on features and benefits, good luck with that.

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  56. You may want to try a career in breaking up marriages. You will have better luck. TSB you respond to someone wanting to pick up a line and get into the game? Give a shout out to the Veterans. This guy just showed up to the party at the wrong time and the wrong address. Keep up the blogs they are a breath of fresh air. Cbar

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  57. Veterans of the Spine World, Unite what are you looking for, e-mail me and I will do my best to network you with the right people

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  58. Are hospitals buying capital equipment these days (i.e. isn't there a slight trend downward given the economy?). What about BM aspirate systems and enrichment devices, is anyone seeing acceptance of these products? I know the data isn't there (yet) but are there success stories out there with a marketing spin???

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  59. when you buy a company, ya sure, the ip matters to an extent, but your buying the customer base mostly and the relationships that come along with that.

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  60. @5:22 It seems you may be underappreciating that (as surveys have shown) the number one reason for most surgeons choosing the implants they do is the rep. Many reps are providing tremendous value to the surgeons and their teams in the OR on a daily basis. So the conversion process is pretty straightforward. Doc says to the OR team, "Bobby's always given us great service over the years, and he's got a new line that looks pretty good, so let's give it a try." Will paid consultants to the implant companies convert? No. But will many of the others who choose their implants based on the service they get. Yup. It's not what the reps do that converts the docs, it's who they are.

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  61. Sorry 5:22, 7:05 here, but I think I misread your post. I thought you were asking about the conversion when a rep jumps ship to a new line. I see now I was mistaken.

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  62. Large companies like Stryker, Medtronic, & Synthes buy their technology instead of developing it in house, so the innovative engineers go to the smaller companies where the magic happens.

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  63. Lately the well has been dry. When one discusses emerging technology, it must be innovative not only from in design but in changing clinical outcomes. Tell us what is coming out of companies like Atlas, Phygen, Sea Spine, Eden Spine, I-Spine (Facet Screws? At that price?), SI-Spine, Custom Spine, Choice Spine, X-Spine (Still waiting for the ISP device), Osteomed (One Trick Pony), Amedica/US Spine, Integra, that is making life any better for the patient? Common, where's the beef? Lots of me-too, you-too, all for the sake RDD2.

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  64. I disagree with 5:35 and applaud the challenge of 5:22. We have lost our skill set. Spine sales used to be the apex of the medical device arena, but now most reps rely either on their relationship or the company's relationship to sell products. Look at the way most reps go to work - in scrubs. How ridiculous is that. I have worked in spine for 22 years and have never left my house in pajamas because after covering a case I would make sales calls to grow business. Nobody does this anymore. People cover cases and go home. Covering a case is not a sale, that was yesterday's sale, most likely made by somebody else to boot!

    To sell you have to take time to probe what the surgeon want to accomplish. Then analyze the best method to fill a need
    . Nobody does this. Instead, reps ask surgeons "what do you think of this...?" When rejected, the rep turns to the other 15 identical products that he reps from 9 different companies until the surgeon suddenly sees the magic bullet. Lets face it...there is room for a lot of improvement in spine technology. Currently, our industry has been diluted with poor and lazy talent that look for easy ways to get business - consulting agreements & now PODS. Its shameful how much we have degenerated. Just say no man. Use your skill to beat your competition!

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  65. Depuy to buy Orthovita - heard it today directly from an Orthovita rep... What does everyone think...?

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  66. How to write a resume - Creating a resume is a skill which needs practice and better understanding about your determination. Be 100% sure that spending another couple of minutes to learn how to make a resume will bring a ...

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