Wednesday, May 4, 2011

It's a Sin to Tell A Lie

Just be sure, it's true, when you say I love you
It's a sin to tell a lie, millions of hearts have been broken
Just because these words were spoken,
I love you, yes I do, I love you, If you break my heart I'll die
So be sure that it's true, when you say I love you, it's a sin to tell a lie.

On Wednesday, May 3rd, 2011, it was reported by the New Jersey State Board of Medical Examiners that Thomas J. Errico, M.D., Richard A. Balderston, M.D., and Jeffrey A. Goldstein, M.D., three prominent orthopaedic spine surgeons in the metropolitan New York, New Jersey area were fined for failing to disclose to their respective research institutions the financial interest that they held in the ProDisc spinal disc device.  As Gomer Pyle use to say, Surprise, Surprise, Surprise!

Errico and Goldstein were fined and all three blind mice must now complete an ethics course, LOL!  Errico agreed to pay $60,000 in civil penalties (pocket change), and $17,500 to reimbuse investigative cost (gas money for the boat), while Goldstein agreed to pay $30,000 in civil penalties and $10,000 in cost.

Attorney General Paula Dow admonished see no evil, hear no evil, and speak no evil by stating that, "undisclosed confiicts of interest on the part of these three doctors undercuts public trust in the medical profession."  But here's an interesting question for our readers, based on the fact that these fine surgeons had a financial stake in the the outcome for this product, how much of their findings were influenced by money?  Another question that needs to be asked is, what would provoke Errico to have to obfuscate his involvement in the study?  Is it  his use of the Rudy Giuliani defense, "to the best of my recollection, I cannot remember being involved in a study for the ProDisc," or, did he use the Jeff Wang defense, "I forgot to report it."  Was he hiding something?  Either way, for someone as successful and intelligent as Errico, based on his humble background, his role as President of SAS, his success as a surgeon, and his war chest of IP, did he actually believe that he was beyond reproach?  Money does breed a certain arrogance, but you know what Joe South once sang;

Oh the games people play now, every night and every day now
Never meaning what they say now, never saying what they mean
And they wile away the hours, in their ivory towers,
T'ill they're covered up with flowers, in the back of a black limousine

Oh we make one another cry, break a heart and then we say good bye,
Cross our hearts and we hope to die, that the other was to blame

Yes fellow bloggers, it is another chapter in the great spine saga, and the hits just keep on comin'!


91 comments:

  1. Now all we need is for some of them to get in trouble for PODs and improper coding. But the fines were silly and small, and hardly an impediment to others.

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  2. I know the government thinks that surgeons having their name in print for being naughty is as heavy a punishment as any fine. Please ... I bet I personally know 50 surgeons who would happily pay the fine so long as the gravy train is not affected. Memories are short Mr. Government. Companies get fines in the $100s of millions. They get government monitors for multiple years. They get products pulled (often for good reason, but more often because of some reporting error). It leaves a lasting impression and changes behavior.

    Mr. Government, how about let's do something that will earnestly change behavior. $60,000 is chump change. Start at a mil, that will get attention. Pull there time card for 6 months to a year. If there were any Medicare patients in the mix, or work in a facility that takes Medicare patients, lets bane them for a period of time.

    Yes, harsh words, but to to get the attention of the masses of surgeons (and it's not just spine, so don't feel singled out) either on the take or collecting shady money, the masses need to know they can get caught and the punishment is more than a slap on the hand.

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  3. I had a sales call the other day with a surgeon I occasionally do business with. I am trying to get him to try a new product that is one that I truly know will benefit him and his patients. He agrees that it is a good product and I say, "great" we can we start?? his response.....(drum roll please) "What's in it for me?" Other than the obvious answer of "what part of it is the best thing for your patients did you not understand?"

    I was speechless! Now add to that my sales associate is a rather attractive girl that was covering for me recently who informs me that this same surgeon came up behind her and grabbed her by the waist and thrust his pelvis into her!

    Now she says she will no longer EVER go into his O.R. and rightly so.

    Sorry TSB, I really tried to take your advice and go out there and sell something.

    And to those self righteous a**holes that keep getting on here and whining about how our customers get on here and read this, get over yourselves already! We are only calling out the crappy ones like this guy. Those few left out there that have any ethics and/or morals know who they are and should not be offended.

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  4. Next!

    http://ryortho.com/companyNews.php?news=859_Study-No-Overutilization-for-POD

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  5. I think it goes without saying, especially on some of these high-profile devices, that the surgeons are usually "in favor" of the device in question. What investigator for pro-Disc, Charite' or Mavercik did not have a vested interest in its success? I think the best way to get accurate data is to prohibit surgeons from having any ownership in such a device, at least until the results are in. Or perhaps not getting paid, at least over and above, what the research costs a surgeon in terms of office staff, statisticians etc... Simple disclosures have proven ineffective are are easily circumvented. Pie-in-the-sky? Perhaps.

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  6. Please note, the issue is, they did not disclose to their research institutions. That's a "full disclosure requirement - especially if that institution receives federal funds for research. This is a bit more of an "oops, I'm sorry I forgot" situation. The world knows this. They put their research institution in pretty serious jeopardy, again, especially if that institution treats Medicare and Medicade patients. Hospitals can not survive without Medicare.

    To 12:37, interesting info (the POD investigates it's own POD), but how does it relate to this post?

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  7. Who gives a shit what RY Ortho posts, Robin Young and his band of merry boys and girls including mommy do nothing more than spew more propaganda into the market feeding the beasst

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  8. The surg ed courses were done at their hospital which took months of organizing. How is it the hospital didnt know when they book a reservation for their facilities as well as get a fee for the use? Sounds like hospital covering their ass while throwing surgeons under the bus.

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  9. "inadvertent clerical errors on my watch." Always deflect the blame on some poor clerk. How about for once someone just admitting that they f#&k#d up. The non admission of wrong doing is always a favorite. Incredible that we send someone to jail for ten years when they rob a gas station for $50. As TSB likes to say, and the beat goes on.

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  10. Sounds like Jeff Wang forgetting to check off a box, you got to love these guys

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  11. Do any of you actually like your careers?

    For Crying Out Loud!

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  12. 3:47 Here's the bottom line. When this industry was infiltrated by Wall Street and PE capital there was a shift in the dynamics in how business was done. Pump and dump became everyone's mantra. Some people still believe that they can develop their business model around a concept that rarely exists. The attrition rate is phenomenal with people bouncing around from company to company, because no one has any patience to build a foundation, immediate gratification is the norm. If you can't deliver results in 3-6 months, you're gone. Many in management positions have either never sold in this industry, don't have the skill sets to run a company, or have never accepted the fact that the sales cycle has changed. The market is saturated with too many products, too many companies, and too many sales people. We are willing to undercut and undermine one another for the sake of getting the business. The new generation of surgeons have been schooled extremely well in the art of the deal by their mentors. Everyone wants a deal. But the interesting aspect of your observation is not whether we actually like our careers, but whether the people that we deal with actually like theirs. Your observation should not be limited to the people that comment on this site, the problem is that there is an epidemic of hopelessness in this country. You know the nurses, the doctors, the hospital administrators, the purchasing agents. No one really cares anymore and therein lies the problem. Maybe it's a sense of hopelessness, maybe its people's frustrations that they are working extremely hard and not progressing, maybe its the end of the American dream. The truth is a harsh reality unfortunately those on top rarely admit that something is amiss with the industry. But you know what they say, while Nero fiddled, Rome burned.

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  13. I totally agree, if we can weather the storm this industry will work itself out. Joints went through this sort of thing 20 ago. Just not to the severity of what spine is doing now. Just hold on!

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  14. Goldstein???!!! I bet Salami and the White Shadow are furious.

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  15. 5:33 Great reference!! What about Coolidge, Thorpe & Go-Go Gomez?

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  16. "The point is ladies and gentlemen that greed, for lack of a better word, is good."

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  17. greed is exactly what is killing this country

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  18. MM great point of view and you are 100% correct in your analysis of the current market!!

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  19. Greed and lack of compassion, it's so true. Most of us typically see only what's going on in the OR. You want to see lack of compassion, go up and talk to a few patients on the floors. Don't know how many times I have heard, "we're just a herd of cattle up here." Watched a surgeon dealing with a patient in the ER about a week ago. Dr. could have cared less about the patient's issues or if they get better. But didn't waiste any time doing the bill to get paid. Did it right in front of the patient.

    Patients have become a revenue source; just keep them running through the factory. Surgeons are considered a revenue source, just make sure they keep buying, pay'em if you have to. Companies only see dollar signs. Anyone see the Zimmer pres's comments about the bizz at big blue? Didn't see a word about technology. It was all about maintaining stock price.

    Here's something interesting. Even with the drop in ASP, reduction in insurance approvals, costs per surgery are still higher by almost double compared to five years ago, and by the way, with all the supposed evolutionary improvements, it hasn't changed outcomes 1%.

    So, if you expect to make more in the next few years, get used to not. If you expect anyone to feel sorry for you, doubt that will happen either. Nobody owes anyone anything. Go do the best you can and I bet you will earn a living.

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  20. I want to live,
    I want to give
    I've been a miner
    for a heart of gold.
    It's these expressions
    I never give
    That keep me searching
    for a heart of gold
    And I'm getting old.
    Keeps me searching
    for a heart of gold
    And I'm getting old.........

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  21. Speaking of telling lies,, How about Nuvasive's Q1 earnings report today? They doubled their profits as they "changed the way they account for loaner instrument sets??"

    Give me a friggin' break,,, Pulled another rabbit ouf their hat of tricks today.

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  22. 12:37
    Irrelevant to this post but a complete hack "study" with no data, only conclusions. Nice job Dr. Steinmann. If that jackass would only open himself to a public dialog I would eat his lunch over his stance on POD's. Has ANYONE found an opinion from a credible source that PODs are anything other than "suspect", "concerning", "present serious legal risks", "likely to be found illegal", etc? Anyone? If so please post the link.

    Dr. S, are you out there? I have some questions for you.

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  23. 12:37 I know the WSJ has a lot of ammo now so Dr. Steinmann's model will soon be brought to light.

    Back to the subject: I am sure these stiff penalties will deter surgeons from this type of behavior in the future. Our government is a complete joke.

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  24. ALPHARETTA, Ga. -- Amendia Inc., led by chairman Timothy E. Taylor, has launched a $5 million offering of mixed securities, so far raising $450,000 from five investors, according to an SEC filing.

    Executives named in the filing include president and CEO Jeffrey A. Smith; COO Tim B. Lusby; CFO Chris Butler; CTO Jeffrey S. Radcliffe; and vice president of U.S. Sales Tracy S. Anderson.

    Directors named include Taylor; Thomas H. Greene from Alpharetta-based Clarity Benefit Consulting, LLC; William Michael Ogie; John W. Walden; and neurosurgeon Randolph Bishop.

    Here is POD on steroids. Surgeon is part owner. They develop, manufacture AND distribute for their surgeon investors.

    Looks like these slick guys one upped the PODS!! Oh and the surgeon/owner/investor/medical advisor also implants what they manufacture in his patients.

    Sorry Dr. Steinmann. Looks like your POD is leaving some manufacturing money on the table.

    Opinions?

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  25. I think it is perfectly fine for surgeons to be involved in business outside of medicine including distributorships. But they cross the line when they implant a product where they will profit from it.

    University hospitals in my area have strict regulations that if a surgeon develops a product they cannot use that product. They can profit from the sale of that product but not as a result of their own patients.

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  26. Problem arose when Wall Street and PE invaded the industry? Give me a break from that populist drivel. Many of the big problems in this industry came when people that ran distributorships or sales management started thinking they can run their own companies. There is a big difference in the skill set required to run a sales organization and an entire company. When sales people run companies it leads to stupid decisions like developing a third or fourth pedicle screw system b/c your two "buddies" from middle of nowhere, U.S.A are worth $3M in business don't like any of your current rod reducers.

    I may be picking on the sales people, but there are many others that are just as dumb. It has been too easy to make a buck in this industry for the last 10 years and the riff raff has infiltrated the marketplace. I welcome the hard times ahead b/c those with out vision will be washed away.

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  27. 8:02 - c'mon man some sales people are very good at running companies. I am a salesman and I have been running a very successful company for over 20 years, often more organized and focused than many majors and mid-sized cos.

    What has allowed us to succeed is and an ability to make nimble decisions, differentiation, and skill sets to sell concepts over commodities. Having the pressure of producing is the best motivator and brings out our competitive drive. No VC cash to burn-up. Eat what you kill...

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  28. There's a long history of surgeon ownership in manufacturing and R&D aspects of business. Some of the great innovators in spine were owners or shareholders in companies that made their products. As 6:44 points out, as long as their objective isn't to enrich themselves by profiting from their use on their own patients, it's clearly above board.

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  29. To 12:11's point, Dr. Art Steffee owned AcroMed and Dr. Dubosset was an owner in Sofamor, S.A., along with the Cotrel family (engineers & doctors). Some of the early doctors (i.e. Chet Sutterlin, Richie Ashland, etc.) associated with TSRH were significant shareholders in Danek Group prior to the IPO. Dr. Kuslich was a significant shareholder in Spine-Tech and although Dr. Ray had been bought out by the time of Surgical Dynamics acquisition by US Surgical, he also was a significant shareholder. Let's not forget Kyphon (Dr. Mark Reilley, among others), St. Francis (Dr. Jim Zucherman), SpineCore (Dr. Tom Errico) and many more.

    The distinction with these companies and technologies versus today's market is that all of these products were major technological break-throughs AT THE TIME. Many of these products required clinical studies and often opened new therapeutic options for surgeons and their patients. Most of today's activities are hardly an incremental improvement over dozens of similar systems out there.

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  30. 6:23/6:24 - This same surgeon also appears to be an owner in his Surgery Center as well according to a simple google search.

    It is apparent from the posts that the lines have not become just blurred they have all but disappeared.

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  31. 12:35 Nice post. Additionally, how about Luiz Pimenta & his role at Nuvasive? While he isn't a U.S. surgeon, his involvement there is equally as significant as those referenced in your post.

    How about Cervitech (prior to being acquired) and the 3 man team of Pimenta, Cappuccino & McAfee? The bottom line is that anytime a surgeon has a strong vested interest in a product (IP, royalty, etc.), they typically become the best "saleman" for the technology & the company as they stand to benefit greatly from it at the end of the day.

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  32. 8:02 in response to 10:25:

    You make a very good point. I should not have lumped ALL sales people into the same mold (and I should have included SOME surgeons and various other knuckleheads). I'm referring to those that contribute absolutely nothing to the market other than another pedicle screw/cervical plate/PEEK cage. Think Spinal USA, Eminent Spine, Spine 360, Spinesmith, Atlas, Choice, Allez, Vertebron, Captiva, etc.

    If you are a rep carrying any combination of the companies listed above, please stop coming on Spine Blogger and whining about the decline of the spine industry. If you haven't already ruined your reputation with your local surgeons, go out and pick up some innovative lines and you might start getting some new business. There are plenty of small companies out there with cool technology that can get you in the door. Here's a tip though, if they are paying 45%+ commission, they DO NOT have innovative technology. Those are the companies that have dummy sales people running the show and they will either be out of business soon, or cut you out for one of your sleazy colleagues that claims to have an extra surgeon or two in his pocket.

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  33. UNITED SPINE
    Rumors on the street, distributed by reps without their distributor principal knowing( as a secondary line)

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  34. How come nobody here knows the basic ADVAMED rules about getting paid for using implants? ALL companies keep on file a list of the hospitals that a physician who helps develop an implant has priviliges at. Each quarter all sales of that implant are totaled up and then the amount of sales to all hospitals that that doctor has priviliges at are subtracted from the total and off of THAT number, royalties are calculated. So not only does the doctor not get paid for implants he puts in, he doesn't get paid for ANYTHING that ANY doctor puts in at those facilities. It can't be any more fair than that...

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  35. 3:42 Love it! These guys are a joke. Please let consolidation ruin these scumballs! They are what is wrong with this industry. Hang in there, it will be over soon. We can go back to being consultants and eat what we kill. Bye Bye cockroaches. Get out of jail free card is in your future. you did forget a few, but your point was made.

    Bonz

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  36. ADVAMED is irrelevant -- much like the AMA --

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  37. agreed with 3:45 - Advamed are guidelines for manufacturers. Stark and Anti-kickback statute are however relevant...

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  38. Does anyone think Globus will go public?

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  39. My distributor says Alphatec is about to make a big move. Any body know what's up?

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  40. Alpatec make a big move?? Yep,, well, their stock is up $.06 at the moment to $3.05.

    Can't wait to see what they can buy,, PLEASE.

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  41. My buddy told me that Alphatec is going to by Medtronic.

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  42. Stryker to buy OrthoVita?

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  43. Xspine is going to buy Alpharec and Bad Hair Club For Men advertisement "Stromer" is going to take over for Lubenever grown business and Bag of Donuts. Then Globus is going to be acquired by aMedicrap and will take over Synthes market share because the AO fellows won't be getting the money and perks that they are accustomed to.

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  44. I hate that all of the docs that get airtime here are the bad ones. I feel very fortunate to have a stable of honest docs and haven't been impacted by POD or consulting agreements in my territory (although it is all around us).

    This is just a shout out to all the good guys (docs and reps) who are in this business for the right reasons, to help patients and make an honest living.

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  45. Archimed is gearing up for an epic move in the wake of releasing their game-changing new product, the Error 404 - Not Found:

    http://archimedcorp.com/products/remedy-cervical-plate-system

    Brace yourselves, folks; this product is about to change our industry as we know it.

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  46. If PODs existed in the 1970's they'd still be implanting Harrington rods. POD's would kill innovation. Curious how it will go down when a plaintiff attorney is very eloquently describing how a surgeon gets paid using oversized graphic displays that illustrate the how the money flows. You don't even need to be Makker, just have an adjacent segment of a patient you did initially go south. Won't be pretty.

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  47. You reps are so anti doctor it makes me understand why surgeons want to get rid of you. Your envy reeks. Go back to school and get over yourselves.

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  48. Maybe I'm blind, but I have a great respect for all the surgeons I call on. My docs work crazy hours! Five years ago, I had zero penetration and share in my market. I work for a top five company and they told me it was not a sprint and work hard, have a plan and you would be fine. I'm still here. None of my docs are involved with my company. And, I didnt have prior relationships. But, I stay busy and have gained their respect. I don't get all their cases, but I'm able to provide for my family. I'm not sure what benefit you receive in bashing your surgeons. Without them, we have no career. Certainly, there are some bad apples cut there are as many bad reps. Stop the bitching and finger pointing and focus and formulate a plan. If you are worth your weight in salt as a rep, you will be successful for the marathon we run an a daily basis.

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  49. 7:59

    Although your post is noble and details the ins and outs of being a rep in the 1970's I fear you are in for a rude awakening sooner than later.
    I too came up the same way you did, zero agreements in place... only solid relationships and technical skills and great product. The value of these things is not nearly what it once was. Good luck though, do tell Eddie and Wally hello for me and give June Cleaver a pat on the ass for me when Ward isnt looking!

    Signed,
    Beating a dead horse......

    Oh and yes, you are blind.

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  50. NUVA NUVA!!! You guys are a bunch of wimps... You see what NUVA just posted! HA. Double digit growth and positive earnings. I have been eating your lunch and now your dinner. We will not be bought out, we will be the buyers. Lament J&J and Synthes. Here we come!

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  51. 3:53...."You reps are so anti doctor it makes me understand why surgeons want to get rid of you. Your envy reeks. Go back to school and get over yourselves."

    We most often despise in others what we hate in ourselves. Perhaps your ill will toward your rep is actually a reflection of your dissatisfaction with yourself and the mire you find your soul in.

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  52. I love that I transfered from Miami to South Dakota to bill list price. Happiness is pets.

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  53. 9:26

    Want to buy some land? or a Bridge?

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  54. 7:59

    Keep doing what you are doing. Many surgeons will never participate in a POD or a consulting agreement because it violates their personal code of ethics. Align yourself with those surgeons and become a valuable part of their team and you will survive. The reps who are willing to offer other types of "value" will naturally be aligned with the surgeons who respond to those propositions. They will never get any of your business and you will never get any of theirs. But you and your customers can sleep well and not have to look over your shoulder.

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  55. "Bought business is always for sale"

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  56. Yeah 3:53--the surgeons all want to get rid of their reps right up until the check comes...

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  57. Hey 3:42

    I sell something for all of those companies. I have no management oversight, no quotas, and very generous commissions. I am in it for the money and nothing else. Why are you? If you are not, then sell shoes

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  58. 7:54

    Thx for showing me I'm not the only dinosaur trying to work my antique style in 2011. I provide for my family, sell features and benefits, don't cross ethical lines and sleep very well at night. I'm one leopard that won't change his spots for short term gain. No name calling or finger pointing here.

    The Beaver

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  59. Archimed? You mean Synthes. Looked it up and found that domain name owned by Synthes.

    Looks like your flight has been cancelled.

    Domain Name: ARCHIMEDCORP.COM
    Registrant:
    Synthes USA HQ, Inc.
    1302 Wrights Lane East
    West Chester, PA 19380
    US

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  60. @9:26 You're an idiot. Nuvasive posted the numbers that they did because of a "change in accounting practice" for how they account for loaner sets. Really?? After 8 years in business they only realized NOW how to do this?

    Once again Alex went to his finance & accounting teams and asked "Ok, which rabbit can we pull out this time"? A few qtrs. ago it was a write off on the lease of their bldg, now this,, all a sham and all because the company IS NOT growing at the rate that Wall St. is being led to believe that it is,, they simply can't afford to miss the # AGAIN.

    Perhaps you should look up Kevin O'Boyle and give him a buzz,, Ask him why he decided to "leave" Nuvasive sitting on all of the stock that he was?? Hmmmmmm,,, think it had anything to do w/ the Bear asking,, no telling him how to deliver the numbers?

    Honestly, you look foolish continuing to boast about your company when all they're trying to do is put themselves in the best possible position to be acquired. Lukianov, Miles, Valentine, Rydin, et al have been to this rodeo before and undertsand that it takes to drive the stock price to a premium prior to being acquired.

    Keep believing everything that you're told. You'll be the first one in line behind everyone from Synthes looking for a job.

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  61. Alphatec is making a huge move. They are switching from 2 ply toilet paper to 1 ply toilet paper in all their bathrooms. The management believes that this will boost earnings to .00002 per share next quarter.

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  62. "Is this where you want to be when Jesus returns..." Joe Dirt

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  63. Alphatec to buy SI Bone

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  64. Alphatec is not buying SI Bone.

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  65. Alphatec is buying snakes and sparklers...

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  66. Met a young surgeon last week who will complete his spine fellowship next month and has excepted a position in our area. Has a high comfort level with the products we represent as well as our distributorship based upon experiences in residency and fellowship. The kicker- 'not sure what I will use in my practice. Depends on who offers me a consulting agreement.' WTF!

    While my sales rep was distraught, I saw an opportunity to pass on some advice I received years ago from one of my mentors, John "Bluto" Blutarsky- "my advice to you is to start drinking heavily" (I reminded him that Bluto was pre-med)

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  67. Actually it was Greg Marmalard who was Pre-Med. He was also Pre-Law. "Hey, it's gotta work better than the truth".

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  68. Correction, you're right. They were both Pre-Med.

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  69. Hey 1:30. "excepted"? Really? Or did he accept a position?

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  70. There is a Ortho spine fellow joining his daddy's practice and he already owns a share of his daddy's POD and is not even out yet! What a way to start your career.

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  71. omg. That shit's retarded.

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  72. How did this post start again? Right, the Errico research thing...

    Hospitals/Research Institutions actually don't necessarily know the product is being implanted/used for a research trial. It's incumbent on the PI, that's Principal Investigator...not Magnum, to disclose the study to the institution and, if applicable, have approval from an IRB. This is particularly tricky where a product may be FDA approved and commercially available for sale and use; but a company/surgeon are studying an off-label use.

    Moreover, manufacturers are increasingly payor or last resort for research studies, opting to eat the cost of the suppliers and pay only the PI... or sell the supplies at cost and instruct the institution to charge for a listed code (in this case, if it was listed at the time of the study, Cervical/Lumbar Arthroplasty)

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  73. How about the son of Dr. Jim Maxwell, Ortho surgeon that does spine. Maxwell used to be Zimmer's Dynesys Clinical Educator ( for a reported $400k). Spineology hired Robert to be the Phoenix Territory Manager. One guess who's the largest user of Spineology in Phoenix? If you guessed Robert, you are correct. The regional is a real tool.

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  74. alphatec has really good tools.

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  75. Anyone know anything about Innovasis?

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  76. Have a big cutter in my area that was a huge NUVA guy, then switched all of his business to Globus for a few months. Now he is back to NUVA exclusively and I see lots of ads in the local medical journals (and even on TV) touting his expertise in the XLIF procedure. Do my fellow bloggers think he was simply unimpressed with the Glow-Bus, or Nuvasive had a few incentives??? Curious minds want to know!

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  77. 6:56. Sounds like you a referring to a surgeon in Austin?

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  78. It was Otter, aka Eric Stratton that was pre-med/ pre-law. Jeez, get your Animal House right!!

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  79. 6:56 The big cutter obviously realized that Globus cant hold Nuva's jock. How can you compete against the best trained sales force in the industry, world-class/surgeon driven monitoring, & one the most innovative MIS techniques ever introduced. It's a bad day when NUVA gets a foothold in your territory. My guess is Nate Quarry and Bill Walton will be in your territory in the next 90 days. Good luck... you are going to need it.

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  80. Animal House was awesome!!!!

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  81. 6:56 - have seen a very, very similar scenario in my territory. The doc didn't leave Globus/return to NUVA because of instrumentation or the "best trained sales force in the UNINVERSE".

    I work for neither but it has been interesting to watch these two groups go toe to toe over a very large account.

    Where is your territory - state?

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  82. Globust tried their damnedest to "buy" the surgeon referenced in 6:56pm's post, but in the end, his loyalties remain with the company that has superior products.

    And if you're calling him a "big cutter" because he's the one of the busiest and most well-known surgeons in town, then you're right...he's a big cutter.

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  83. 7:39 - how is it that you know this without 6:56 telling us roughly where this supposedly took place? Sounds like you think you know the details but its all pretty irrelevant if there isn't any clue as two where this - supposedly - went down.

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  84. I know exactly who the bitter rep (6:56pm) was referring to, so shut your pie-hole, 8:10pm.

    -7:39am

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  85. Globus wouldn't pay him cash, and Nuvasive came back and bought one of his patents to keep his business. They will prob. ending up never bringing the patent to market, they just basically paid to keep the business.

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  86. 7:39 - Glad to hear you are so sure of yourself....everyone is deeply convinced that you know exactly who another poster is refering to, just 'cause you said so. My guess is that you are just full of shit.

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  87. 6:56 here-
    Not sure why anyone thought I was bitter about the surgeon switching (I do not work for either company) just thought it was interesting. And it is in fact in Austin, Texas!

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  88. I wouldnt trust a rep that doesnt know the difference between excepted and accepted.

    whats up with the comments here btw...they disappear and reappear..and verse vica

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  89. Dr Sajan Hedge Spine Surgeon India, Doctor Sajan Hedge India Info On Cost Spine Surgery Delhi Bangalore India, Spine Surgery Testimonials Hospitals Bangalore India, Spine Surgeon Mumbai India, Spine Surgery Center India, Spine Surgery Doctor India, Spine Surgery Clinic India.Here i suggest peoples to go INDIA for surgery, then you must search for Spine surgery India, Laser spine surgery India, Best spine surgeon India, Spine surgery best hospital India & spine surgery cost india

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  90. Usually the people who have gone through a spine surgery recently they are advised to start their treatments through some exercises.

    San Antonio Spine Center

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  91. Many of these POD's are started by your jackass collegues that partner with surgeons to make a quick buck and compete with you all directly.

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