Wednesday, April 20, 2011

Spine Uprising

Paranoia is in bloom
The PR transmission will resume
They'll try to push drugs that keep us all dumbed down
And hope that we will never see the truth around, So come on!
Another promise, another scene
Another packaged lie to keep us in greed,
And all the green belts wrapped around our minds,
And endless red tape to keep the truth confined, so come on

                                                                         -MUSE-

So come on fellow bloggers, the federalis spent the other day touring the office of Dr. Sanjoy Sundaresan at the Texoma Spine Center. By the sounds of it, Dr. S may have some unexpected legal issues with the Federal Government.  Leaving with boxes of evidence, potentially a little more than the practice of medicine was going on at the TSC.

A little pain, a little dream
A potent elixir another scheme
A frequent visit to my dealer
Pharma grade from my healer


"They give me injections  because my lower lumbar is tore,"  Obviously one of Texas finest,.  Ironically, people don't even know what they are being injected with.  Shocking no less.  If it makes you feel good, go for it.  Nothing what a l'il ol morphine will do for you.  So as Dr. Sundaresan makes the news, he now joins Dr. Makker as a one hit wonder, and the hits keep coming.

88 comments:

  1. Gotta give the writer of the article credit for capturing the grammer of the locals in their quotations. BTW, R.I.P. Anulex!

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  2. Id bet a hunny, MSM was drinking when he posted this.
    Nice

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  3. What does Anulex have to do with the story? What does that mean?

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  4. I used ta do a little but a little wouldn't do
    So the little got more and more
    I just keep tryin' ta get a little better
    Said the little better than before
    I used ta do a little but a little wouldn't do
    So the little got more and more
    I just keep tryin' ta get a little better
    Said the little better than before

    Nature Boy

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  5. why is everyone quitting globus ?

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  6. Great Muse pick, MSM! I wonder how many times that tune was blasted at various NSM's this year?

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  7. FBI agents and other federal investigators spent several hours today conducting a search warrant at a Wichita Falls doctor's office.
    It happened at Texoma Spine Center, at 1511 10th Street.
    Katie Crosbie was there today and joins us with the latest.
    Doug, the FBI tells us the search warrant and the affidavit are both sealed ... so they aren't able to release much information.
    Wichita Falls Attorney Steve Briley says he's representing at least one Medicare patient in a lawsuit against Dr. Sanjoy Sundaresan.
    He says Dr. Sundaresan prescribed powerful pain medication but would only prescribe the pain medication if the patient came in at least once a month for back injections.
    Briley says he presumes once patients were hooked on the pain meds, Dr. Sundaresan billed the injections to the government.

    It's not everyday that FBI agents raid your doctor's office.

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  8. Anulex laid off staff due to a warning letter from the FDA after marketing incorrectly, while they should have been an IDE. Again with Globus?

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  9. Everyone is quitting Globus because they're NEVER going to go public & people are finally realizing it.

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  10. Does anybody know if there is a comparable technology to MSD's O-Arm currently on the market? In exchange for a free O-Arm, one of the largest hospitals in my area has agreed to give Medtronic a 90% share of all hardware biz. What's even more outrageous is that the hospital is not requiring MSD to discount at all. Screws are $1,250 and TLIF cages are $4,900. WTF?

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    Replies
    1. Depuy/Synthes has a Brainlab Aero. It's new, open platform. Engineers for O-arm designed it. It is currently available and FDA approved

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  11. There is a company based out of Burbank, CA that has an imaging system comparable to--or perhaps even better than--Medtronic's O-Arm. The company is called Imaging3 and the imaging system is called DViS (www.imaging3.com)

    The company is currently working with the FDA to gain approval. Soon Medtronic's coercive way of securing business will be a thing of the past. That is, at least when it comes to imaging!

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  12. James Vishal Makker, Sanjoy Sundaresan, David Paul. Hmmmm. Who's next?

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  13. Dots, not feathers

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  14. I'm going out on a limb and saying list for MSD screws is more than $1250.

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  15. 4:55 - right you are on screw price. Prob closer to 1600.00 at list. Still, MSD is trying this smoke and mirrors wherever they have no business, or are shrinking. If you are currently kicking some MSD butt, better grow eyes in the back of your head. The O-Arm dog and pony show is coming to town!

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  16. 4:55 and 5:04

    As a courtesy to our readers, would you elaborate with more details.

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  17. will imaging give my account a free system? because they are not going to buy one.

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  18. Stryker has a C-Arm that can also give you 3D imaging. Does a spin just like the O-Arm, but when not used for 3D can also be used as a standard fluoroscopy machine.

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  19. "Giving" an O-Arm in exchange for hardware business is simply a way for the hospital to shift the cost to operating budgets versus capital budgets which seem to be vanishing. It amazes me that Medtronic has taken this long for the divisions to work together to leverage the breadth of their product line. You could do the same thing with a fee per use or a lease and pay for it out of operating budget.

    My guess is that the docs wanted O-Arm more than they wanted 10:49's hardware. How long is the agreement? Eventually they will have paid it off at $1200/screw and the docs will be able to use what they want. And $1200 is not list, probably more than $1600 this year for standard legacy poly screws.

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  20. Ex Evil Empire Employee (EEEE)April 21, 2011 at 5:31 AM

    The Slow Arm is a major focus this year for MSD. They believe they have a 2 year jump with this technology and are trying to leverage no charge placement of the device with a committed contract (90% metal) for 2-3 years. This is an attempt to combat their loosing battle with the INFUSE rebate and 90% contracts where they are suffering for obvious reasons. Their success rate is low and in theory if the account is not hitting the their quarterly number then the device would be removed. Can anyone see that happening?

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  21. Can anyone out there get there hands on any of the POD agreements with doctors? If you can, please contact the authors of the WSJ article and forward to them. You can do this anonymously but they are going to need proof of the financial set up to expose these entities.

    Does anyone have a surgeon that has rejected an offer to join a POD that still has the agreement?

    Dr. Steinmann, you have been the most open surgeon proponent for POD's and claim that you are transparent. Why don't you offer the agreement you have for review? If it's above board, that would be a lot more convincing than the study you presented trying to prove that abuse wasn't occurring (which is irrelevant to the legality of the POD entity). Come on, doc.... show your cards and put this to rest if you dare. I know, I know, you can't because the model is so ingenious in skirting the law that the owners made you sign a non-disclosure agreement because they don't want it revealed and copied. Thats very noble of you. In that case, just let us know how much you invested and how much you have earned per year. If the risk and return seem reasonable, then we won't have any reason to doubt you.

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  22. nuva is coming out with an x arm. it's purple and comes with reps that don't understand neuromonitoring.

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  23. 6:44 Ha! Now at least they can do something in the OR other than place electrodes...shot....shot...shot.

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  24. 6:44AM, I work for Nuva but gotta hand it to you, that was funny.
    The O-Arm is actually genius on Medtronic's part. It is essentially a lease that will pay for itself through incremental revenue on metal.

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  25. O-Arm is not for everyone. It is a huge machine with limited uses until they get the vascular application up and running. Change in technique since you must operate around or through it. MIS k-wires in the way, etc. The amount of radiation it throws off is also a real concern. Better have a thyroid shield and a led barrier.

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  26. What happens when a hospital runs 3 spine rooms? Do the 2 surgeons not using the O-arm have to use MSD implants?

    MSD tried this at a large hospital in my territory and the hospital did not bite. They then came back with a 50% reduction in implants and the surgeons didn't bite. I heard their next offer is 50% off implants, an O-arm, Midas, 2 pacemakers, a pain pump and the rep is going to change the oil in the OR staffs cars(synthetic oil). I will let you know if they get the conversion.

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  27. I want to applaud the focus here. Only one knucklehead asking about Globus. Please refer to previous posts with any questions you may have.

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  28. 8:33 do you have some kind of inside information on Globus?

    (Just for humor's sake)

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  29. 8:11, yes its not for everyone, but have you seen it used. most everyone leaves the room when in use. The doc goes and takes a piss and when he gets back all the o arm work is done.

    it as its limited uses. those include applications used in the lumbar spine, lateral spine, brain, and dlif.

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  30. MSD rep here. O-arm program will not work everywhere but when it does its nice. Surgeons want this technology and the other players in the market do not have the same technology or capabilities.
    I have not heard of this 90% deal but have heard of hospitals having to shift a certain amount of business for a predetermined amount of time 2-3 years in order to pay for it. If the docs want it they have no issues switching to MSD to get it. And as far as paying a premium for implants, thats not accurate either.... the program we ran here was based on a low priced national contract, no upcharging.

    @8:11 obviously ate paintchips as a child, one of the main selling points of the O-arm is less exposure to radiation. You do your scan at the beginning of the case with everyone out of the room except leaded tech and then you load everything into NAV if thats what a doc wants to use. It also has robotic positioning so while you are working it is out of the way, and with the push of a button it will come back in to a preset spot and shoot if you want to use it that way. Also being used for pelvic fractures and upper cervical/thoracic which the other machines cannot do well at all.

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  31. it is a requirement to eat paintchips if you are to work for nuvasive. purple paint chips.

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  32. I love how the NUVA reps have all been informed by corporate that placement of the neuromonitoring leads is "grounds for immediate dismissal", but when it comes down to it, the sales rep is placing the leads and corporate knows it. Ever notice how the blinds go down over the window when the pt is rolled into the room? It's not for pt privacy, it is for NUVA secrecy! To all of my fellow reps out there, get your cell phones out and start collecting pics of this illegal activity. Sales reps are not allowed to touch patients at all, just ask Joint Commission
    First: show it to risk mgmt at your hospitals
    Second: send them to NUVA headquarters
    Third: send to WSJ
    Fourth: Find out which of their fellow surgeons are illegally having their partners do the reads and billing for them
    Fifth: Initiate a huge whistleblower suit to expose this fraud

    At the very least it would be fun to see the NUVA reps getting scared!!

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  33. 12:42,, Purple paint chips that taste like a SH!% sandwich??

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  34. MSD rep here....roger roger! Arrogant and smug as always.

    You're not from CT by chance?

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  35. 12:58: I'm a competitor to NUVA & couldn't agree more. In fact, I was in the O.R. when a picture was taken of one of their distributors placing leads on a patient. The guy was white as a ghost knowing he was caught in the act. This was certainly not the 1st time I've seen their people placing leads.

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  36. Then bury them 12:58!
    If all it takes to bury this company is to make them follow the rules, then do it! Why would hospitals and surgeons allow this practice? I don't know one of my hospitals that would tolerate it.
    Somehow I think NUVA will still be around.

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  37. I know of a Kyphon rep that puts gloves on and mixes the cement at some of his cases. Very shady.

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  38. 12:58 here, I have and it is quite alot of fun to see the looks on the faces of the hospital admin when they find out. Not only that, then they start looking into how much they are paying for the leads!!! usually $1200-$1500 and compare that to an IOM company charging them $600-$800 for a machine, a tech, and the leads. That does not even include the value placed on deflecting the liability from the surgeon and the hospital.

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  39. Kyphon has reps?

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  40. What's up with the NuVa hating all the time? The rep in my territory does a pretty good job. He sees patients in clinic with me on a regular basis, and really does a good job explaining the various programs NuVa offers to patients before and after surgery ("The Better Way Back"?). In fact, one might argue that NuVa reps have the hardest rep-jobs in spine because they are responsible for running (not interpreting!) the neuromonitoring IN ADDITION TO assisting with the hardware. Most reps are just responsible for the hardware.

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  41. 2:40 Nice job of promoting yourself as a Nuvasive rep and telling us that your job "is one of the hardest" in spine,, PLEEEEEEEEEASE.

    I'm not sure anyone cares that you think your job is challening because you sell Neurovision (Sorry, can you even call it that these days,,??)

    Anyway, the bottom line is that reps SHOULD NOT be responsible for neuromonitoring in any way, shape or form. The majority selling that product know little about the field of neurophysiology except for what's been "fed" to them as the company line. Case in point,, How many reps ACTIVELY promote & sell the MEP capabilities of JJB or M5? Not many,,

    Why?? Because they either don't understand it, are intimidated by it or docs simply don't trust it. After all, now you're going to have a Nuavsive rep trying to instruct someone how to place corkscrew leads in a patient's scalp?? You have to be kidding,,,

    The company has certainly had it's fair share of injuries, complications & lawsuits as it relates to that product line. They've simply done a very good job of keeping them very, very quiet and out of the public domain.

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  42. please keep your boring comments to a short, pithy, pungent, minimum. Nuva reps don't usually read surgical techniques, why the hell would they care about your pathetic rant about their own company?

    red light, green light, go

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  43. I know several offices that do their own reads and bill using NUVA. The rep sits in the corner checking FaceBook on their laptop while the machine makes digital fart noises.

    Here is a conversation I had with a NUVA rep:
    NUVA rep "Hey I have to go, if the machine starts making noise hit this mute button."
    ME "Isn't something wrong if the machine is making noise? Shouldn't I say something to the surgeon?"
    NUVA rep: "Never mind I will just mute it now. See you later doc."
    ME: "HAHAHAHAHAHAHAHA"

    If the surgeons and NUVA were truly concerned with patient care they would have a board certified IOM tech in the room and a live neurologist doing the readings.

    I heard when a NUVA hires a new rep the RM dips his nuts in purple paint and gives the new hire a bandit mask. They are like a $500 Million fraternity. Can anyone confirm this rumor? I have an interview next week and am scared to death!

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  44. Imaging3 guy (Dean Janes)

    doesn't look like that Dominion machine is very well equipped to be used in the OR. Maybe in a clinic...no where near the capability of the O-Arm.

    Boom roasted

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  45. Love the haters. It's called incomprehensible demoralization. They can't understand why they are getting their tails kicked....so they hate.

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  46. 3:12 PM...
    What about Yellow???
    It is more like Red, Yellow, Yellow, Yellow, Red...... What does that tell the doc?

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  47. 3:12
    Those colors tell the doc to expect their attorney to be contacted by the patient's counsel sometime within about 6 months after surgery reporting thigh pain, leg/ hip flexor weakness and/or a "dead" foot.

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  48. ever notice how the NUVA reps on here blogging never really respond to the facts about the illegal shit they do mentioned previously? why is it so hard for them to understand that the reason they get the majority of their business is because they have concocted a scheme to get the surgeons paid?
    Go ahead and laugh now and brag about your business prowess cause its not gonna last much longer.....G-men will be on your ass soon enough!

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  49. I've been a NUVA rep for 2 years and the stuff being written on this wall is ridiculous. First of all we have better training then anybody. Period. We know what those noises are, they can only mean one of three things:

    1) Lunch is done in the microwave
    2) My Phil Collins powermix on my iPhone is starting the 3rd cycle
    3) the patient lost use of his/her legs

    Also, it IS like a fraternity and you are all are just jealous that you cannot attain the professional camaraderie we have achieved. And by the way, the bandit mask joke is classless and distasteful. New reps ACTUALLY get a glass-bottom boat...

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  50. The heat are gunna win

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  51. In the final analysis, It's still red, light, green light. My college fraternity was more difficult o get in to. Time to stop patting yourself on the back for the "work" your machine does.

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  52. I want answers, i want answers now, what is going on with reps, doctors, pod's, it sounds like the begining of the end. It almost sounds like the recession in spine is about to happen like 2008 when the banks screwed all of us, seriously is the goverment going to step in to see what all of you are up to or what.anytime the average income is $250,000.00 and everybody is complaning, something is wrong!

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  53. 8:07 First of all, the average rep does not make 250k. Secondly, where do you see people on this blog complaining about money? Thirdly, what does the government have to do with this blog, us venting or our income. You must be some kind of socialist.

    If you don't like what you're reading GO AWAY! I suggest Spain.

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  54. 8:07 again, the mere fact that your complaning, or wondering why this why that, whats going on with them, can you beleive they did this is all related to greed which is why all of you joined the company's who have been taking advantage of all of us for so long, not 1 of you care about the patient in the end, hom many boats can you own, and maybe you should move to spain and see what its like when greed plays no factor and its to late for the goverment to help because of people like you

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  55. 8:07/8:33pm,

    Let me be clear and to the point; you are ignorant and uninformed.

    As for the rest of you, I sure hope that you take the things said on this blog with a grain of salt. 90% of the things said (negative or positive) are either not true or only true for certain geographies.

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  56. I think we should start a blog about how dumb 8:07/8:33 is. The 8:33 comment is the worlds longest sentence.

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  57. OK, so the guy ranting on-and-on about NuVasive and its neuromonitoring crimes against humanity obviously works for an IOM company, and obviously feels threatened by the fact that with an automated system like NVJJB or NVM5, a CNIM is no longer needed or required. In other words, this guy is worried that his cushy little job where he sits in the corner of a room all day playing Angry Birds is in jeopardy of being ELIMINATED!

    The truth is, neither the ACS nor the AORN explicitly state in their position statements that properly credentialed and trained reps under the supervision (or at the discretion) of a surgeon cannot place surface electrodes for the purposes of neuromonitoring. In fact, they actually state the opposite. It's the needle electrodes that reps are not aloud to place, and I don't think very many of you cry-babies out there can say that you have ever seen a NuVa rep place needle electrodes. I know that about ten of you are going to say that you see the NuVa rep in your territory place needle electrodes all the time, but like most of the comments made on this blog, you will be lying.

    As for the price of Neurovision vs. standard IOM, Neurovision wins that battle with ease. NuVa only charges for one EMG disposable kit on a posterior screw fixation case regardless of the time spent in surgery. The average price for this kit is about $1000, but can be as low as $500 depending on each hospital's contract. NuVa does not charge the hospital, the patient, or the patient's 3rd party payer for anything else. Let me restate that; NUVASIVE ONLY CHARGES FOR ONE EMG KIT AND NOTHING ELSE!!

    The IOM companies, on the other hand, charge for disposables, use of their machine, a tech fee, a professional fee, and a mysterious hourly fee just because they can. In total, a 2-3 hour posterior screw fixation case can cost between $3000 and $4000. Longer cases can cost much much more.

    The bottom line is that NuVasive cannot be beat on price for neuromonitoring because we do not try to make any money off of it. We leverage the NVJJB/NVM5 technology in order to separate our posterior hardware from the competition. A screw is not just a screw if it comes with dirt-cheap monitoring now is it?

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  58. 5:09 is hilarious.....well done sir, well done indeed...

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  59. Since when is patient care the responsibility of the sales rep??? I always thought it was the hospital and surgeon. Ohhhh thats right - they are only concerned with making money as well. When was the last time you witnessed some joker purchasing agent factor in patient care. Lumbar Spine degeneration = annuity. The gift that keeps on giving. Get over yourselves.

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  60. Kool-Aide drinking monkeys all of you! Never had to manage a payroll in your life and most never had to truly earn business.

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  61. There was a good thread going on about MSD's use of the O arm to lock down hardware.

    Any other thoughts about this program - ways to mitigate it and so forth? Seems like a pretty poor compromise for the hospital and docs long run. Once in place, has anyone figured a way to work around that arrangement?

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  62. 9:05 - in the end it's a unique technology that, at the moment, no one can compete with. You better hope that it is not unique enough to your docs that they are willing to switch.

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  63. MSD is in trouble. A major loss of market share, declining ASP, layoff's...again. The O-arm is not going to fix anything. The program was designed to convert large competitive hospitals by flipping $2 to $3 million over to our metal. However it generally just pisses off my current loyal customers since they have to pay for the device b/c they were loyal!

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  64. What's a glass bottom boat?

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  65. The funniest thing is hearing all the Medtronic, Depuy, Synthes and Stryker reps bemoaning pods. Didn't you all and don't you all buy doctors with sham consultancy and royalty agreements? Now a model comes out that is even dirtier with more illegal benefits and everyone is crying. Nobody here sees throwing in an O-arm or a O-face as an inducement? What about bundling? Face it the system is broke beyond repair and it might not be this year or next but doctors, reps and administrators are in for a correction. The government cannot afford to keep us all in our nice houses and cars, which means those of us in sales are going to have to sell a lot more or something else. I for one am ok about it the doctors and hospital administrators have it much worse if you really think about it. What are they going to do? Right now they are going to do what the sales reps are doing and make it where they can.

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  66. Of course they'll make it where they can. But, once their names are dragged through the mud or they wind up in the pokey, they will regret their shortsighted business model, as well as the fact that the pool boy is now the one banging their wives.

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  67. @11:12, go to urbandictionary.com to find out. If you're remotely morally respectable, you don't want to know.

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  68. Going back to the billing scenarios for the O-arm, the insurance payer mix will play a role in how successful the strategy is with hospitals. I'm not a reimbursement expert, but I believe there are still some instances where the payment the hospital receives from the insurer depends on the costs of the case, implants among them. So for cases where they send an itemized bill to the insurer and are paid back for the cost of the screw, they don't care how much it costs, and getting an O-arm for free is exactly that. However, if the facility performs mostly cases where the payment they receive from the insurer isn't related to the costs they incur (i.e. they are paid a global fee for the case regardless of their expenditures), paying a higher price for implants will come out of their pocket. Most places will have a mix of reimbursement patterns (depending on patient insurance type, geography, insurers, etc.) and their percentage of each type will determine how good the "deal" really is for them.

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  69. How did an O-arm MSD conversation turn in to NUVA bashing??? It sounds like the fat girl talking about the HOT girl!!! Haters! Ive been in spine for 10+ years and with NuVa for only 2. We are by far the best trained sales force and have the most innovative products! We might not be growing as fast as we used to, but we are still growing and MSD, Stryker, Synthes, and Depuy is not! Thanks for thinking of us HATERS!

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  70. 2:25 Can you confirm that your RM gave you a purple bandit mask with his nuts?

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  71. Are you kidding me 2:52pm?! Do you honestly believe that any self respecting NuVasive rep would let his/her RM give him/her the "dirty-purple"? That's crazy talk! I would never take such treatment from anybody but my AVP!!

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  72. 2:25 I am here to help as it appears you have some purple paint in your eyes.

    Discussing matters using "fat girl" and "HOT girl" shows your immaturity. Proving my point is your use of the term "Haters". I find it hard to believe you have been in spine for any length of time.

    "we are by far best trained sales force and have the most innovative products" indicates to me that you are naive and easily swayed.

    Your awkward sentence "MSD, Stryker, Synthes and Depuy is not" is indicative of your limited education.

    You have successfully proved to all of us that you do in fact work for NUVA.

    I am betting that you are either female and or an effeminate male. Either way I am sure you wear the bandit mask regularly.

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  73. @2:25 This turned into NUVA bashing because everything does and because Purple is an easy color to target. Get used to it, it will continue on as long as you & every other person in that organization continues to carry the level of arrogance that you do.

    Who cares how fast you've grown or who you've passed in the process? You're still behind MSD, DePuy & Synthes and will continue to remain there for the forseeable future.

    So you're bigger than Stryker spine, Zimmer, or any of the other crappy companies out there? Who really cares as long as you remain firmly behind the true leaders of the industry,, which you will since your growth has slowed tremendously.

    As for your comment that "you are the best trained sales force"; that is certainly questionable. While the training programs may be solid, the average tenure of your sales group remains at 3 yrs or less which makes many of your reps some of the least knowledgeable in the industry.

    Most can't cover a thoracic XLIF by themselves, nor do they understand how to sell effectively into the deformity market (outside of degen scoli of course,,). It's great that you have a talent like Ross Sylvia there rolling out products that the reps can't support,,

    Hell, several of the reps that I see still have to have a support person come in for tough XLIF cases or even for the newer MAS TLIF stuff.

    Take a seat because you remain in the rear view mirror to those in this industry that matter most.

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  74. 2:52 are you smoking crack? Give me a break. I will give credit where credit is due, and you all brought lateral to the market and have done well with it. But to say that anything else you have is innovative or unique is a joke. W/ the exception of xlif, there is not one product in your bag that is unique. Another bunch of "Me Too" wannabe products. And before you go touting your prowess, you might want to string together more than two profitable quarters in a row.

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  75. Interesting how this blog always degenerates into bashing either Globus or NuVasive. Arguably two of the fastest growing $200M+ revenue spine companies over the last 5 years.

    Granted both are well behind the "big 3" but these two are still taking share each quarter and have largely gotten to where they are organically.

    Setting aside for the moment whether the J&J - Synthes marriage takes place ... MSD, J&J, or Synthes reps would be loving life to have that NuVasive platform of products in their bags! J&J would love to have the speed of Globus's engineering and exec focus.

    After having met many execs from more Spine companies than I care to remember, it becomes clear that NuVasive and Globus execs really don't give a damn what you think. They are forging their own path and you can't deny that, so far, it's working. The evidence is based all throughout this blog.

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  76. 6:16
    Do you wear the purple mask while playing your rusty trombone?

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  77. Alphatec has a new distribution contract exclusively for PODs and a surgeon just gave me a copy. hmmmmmm I wonder who I should send it to? What a bunch of sleaze bags.

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  78. Post it hear come on!! That sales management is disgusting. Actually dont send it to all the right players. Get me a copy and ill get it on either Beck or ORielly.

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  79. 6:16 "organically"

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  80. GO SPINE FRONTIER!!!!!!!!!!!!!!!!!! time to throw a shout out! I EAT FACET SCREWS FOR BREAKFAST BEATCH

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  81. Ok TSB,, Time for a new post.

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  82. Who in the hell is spine frontier, sounds like another hack company, a doctor running the company? Really? That should turn out really well. Blahaha

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  83. 6:45

    Can you summarize the details of the contract for us?

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  84. I knew a NUVA rep, she used to boast about how she did coke with the docs. Two big thumbs up for that loser.

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  85. I work for Nuva. All of the Nuva hate is quite flattering to be honest. Like any company actually GROWING (and WINNING) there are going to be new faces. Just wait and you'll start to see the level of expertise by Nuva reps outshine the rest (perhaps even you). The training is damn good. I always enjoy when the Medtronic rep has to call in a specialist to cover a DLIF or Cortical screw case. That's gotta be reassuring to your surgeon...

    The perceived arrogance as some have called it is just a motivated sales force excited about selling good products and growing business. Sure we drink the kool-aid but that's cause the s-hit tastes good. Like it or not, NeuroVision is a great technology and a differentiator to all the other "me-too lateral" systems around.

    Nuvasive's executive leadership team - our CEO, COO and President all were execs with Medtronic when MSD was kicking everyone's ass and were the only show in town. They've been there before, have seen what works in this competitive market, and have also seen what doesn't work. Sure, TSB loves to bash the Bear for his Broadway interests and extravagant spending at Sales meetings. But those meetings keep the pulse and the culture of the company going, and they beat the pants off the MSD sales meetings, even the good ones back in the day.

    So please, keep hating. Keep yapping. I'll just keep growing.

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  86. Neurovision cheaper than a traditional IOM company?? Thats a joke!!!! Nuvasive maketing gimmic is that they tell the surgeon the the monitoring is no charge. However they forget to inform them about the$1000+ elctrode package, in addition to the clip and probe. I have never seen a charge for less that $2000 dollars. On top of that the reps who may gone to a 1 day seminar now think there experts

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