Monday, November 14, 2011

Supersize? How about Downsize


Stryker is going to focus on quality by laying off ............................1,000 people
Stryker is going to innovate by laying off........................................1,000 people
 Stryker is going to control cost by laying off...................................1,000 people 
Stryker is going to drive growth by laying off...................................1,000 people

As consolidation becomes the noun du jour, it is interesting to read many of our your reactions especially as companies continue to use the upcoming 2.3% medical device tax as their rationale for laying off more employees, or moving manufacturing overseas.  A point in fact is the announcement by the Almighty Stryker that they will "downsize" their workforce by 5% "as part of Stryker's ongoing focus on quality, innovation, and cost, and position the company to provide strong consistent growth in a changing environment."

If you analyze the anatomy of MacMillan's quote, it reflects a perverse corporate mentality that has been prevalent for years, whereas publicly traded companies rationalize their decision to downsize its workforce to preserve growth for its shareholders. Has there ever been a CEO who had the chutzpah to tell its shareholders that they will have to tighten their belts for the sake of innovation? Now that would be out of the box, Stevie. Have you ever heard a CEO at one of these giant companies announce that they were taking a pay cut, or foregoing their stock options or bonus, because their company really isn't providing quality, innovation, or even growing the business at double digits, let alone being profitable after years in the marketplace? Let's be honest many of these companies take advantage of modified accounting rules as much as they attempt to increase revenue by buying marketshare or even occasionally launching a not so innovative, but new product.  It never has anything to do with their lack of vision, it always comes down to some external force or the current boogeyman that is causing lack of growth.  C'mon Stevie Wonder where is all that innovation coming from at Stryker? If the acquisition of Orthovita is innovation, I guess Stryker is really innovating.  Stryker is no different than a company like Covidien, in that it is a "bean counter" driven company.  Their foray into the recon medical device market was driven by their acquisition of HA technology, their jump into trauma was a by product of their acquisition of Osteo, and they acquired DIMSO to enter spine. Where is the innovation Stryker?  So, here is how Stryker is going to bring quality, innovation and cost to its shareholders, by downsizing the workforce by 5%.

TSB is sure that Stevie Wonder goes to bed at night tossing and turning that he has to let 1,000 people go, but at the end of the day, its all about the shareholder, isn't it?  We are sure that when the time comes to hand out those pink slips, he will send them a message on behalf of all of those at Stryker telling them how valuable their contributions have been and that Stryker will be providing outplacement service to help them find employment in an economy that is built around downsizing to begin with, but isn't that the same propaganda that has been Stryker's modus operandi for all these years?  TSB could hear Stevie Wonder in the background,

I just called to say I love you, I just called to say how much I care, I just called to say I love you, and I mean it from the bottom of my heart.


124 comments:

  1. I know 5 people that have been notified by Stryker already that their last day is 12/31/2011. They are in sales.

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  2. Where is Stryker trimming the fat?

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  3. The exodus has begun at Synthes...
    Big Kosta set sail for K2M.
    Apparently, many more to follow.

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  4. Kosta? Who's that?

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  5. We at synthes, AO, are well positioned moving forward. We will be calling the shots as this merger moves forward. Kosta is collateral damage!

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  6. He's the rep in NYC. He's a big dog to say the least.

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  7. 5:24pm thanks for the info. How much $ did he take with him to K2? 5:23pm are you drinking the company Kool-Aide?

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  8. 5:24, you're wrong. He was an AVP in the southeast.

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  9. 3:45... They are trimming the fat within their corporate offices and in sales. A bunch of people at the Ortho office got fired last week (around 100). It's interesting how no one in upper management (VP and higher) was let go and there are A LOT of VP's in their NJ corporate structure. Just some of the middle management and individual contributors with less inflated salaries were let go. Seems like a good way to cut the fat, right? Apparently, no one beneath the upper management level even knew who was getting canned. So, directors and managers did not even have the opportunity to provide their input on who should be let go, which is why some pretty smart and valuable people are out of a job. Hopefully, these people will find jobs where they can actually innovate and launch something organically...

    This whole blame it on the med device tax sounds like what airline companies have been doing the past few years. Cut free food, up ticket prices, charging for baggage, no pillows or blankets, no more movies, all because of rising gas prices. Yeah right...

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  10. Kosta is a solid guy with relationships and experience. Not sure this is a good move for him. Maybe he saw writing on the wall that territories will be cut, ie... compensation. K2 must have given him a nice package.

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  11. Why don't you folks address the future of healthcare in our country with OOOOBAMA and the fact that innovation is quickly moving to Ontario. Every corporation has a responsibility to it's shareholders as is evidenced by Stryker.Don't blame them for our country's failed policies. Our country was not built by the underachievers or the parasites but it is currently run by them and everyone should be very afraid.

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  12. so stryker is trimming the fat by doing away with jobs that arent revenue producing and by cutting the jobs that have no reason to exist anyway. thats a bad strategy?

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  13. Stop with the OOOOBAMA non sense, if only life was so simple, but then simple people have simple minds. 25 years of deregulation encouraged by both parties, by drinking the kool aid sooner or later you arrive at the cross roads of life. Our country was built by a generation that dwarfs the Lukianovs, MacMillans, Kuypers, Dvoraks, and Viscogliosi's. These people come from the me first generation, unrealistic expectations, schemers rather than dreamers, impersonators rather than innovators that worry more about the value of their personal portfolios. who carried a bag, who understands the business, number crunchers? Ontario, yeah try maybe China or Malaysia

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  14. Face reality as it is, not as it was or the way you want it to be.
    -Jack Welch

    I'm not a genius but would assume that it would be difficult to run a business today with the same amount of staff when margins (at least in Spine) have dropped by 50% in the last 5 years.

    This isn't a Stryker problem, they may be proactive in their decision to make cuts now but others will be forced to make some tough decisions very soon (Private or Public). We will all be forced to do more with less. This doesn't mean the strong won't survive, they always do.

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  15. Isn't Neutron Jack the guy that said that if you need a job you should go work for someone for three months for free? Yeah, I'd like to see Welch the old prick do anything for free, lol. What do you mean by strong those who kiss someone's ass the best, or have burn marks on their lips? Give me a break man up young man man up

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  16. Stryker and Depuy: Proactive
    Nuvasive and Medtronic: Reactive

    I would always rather work for the first. With a market cap of $635 million, Nuvasive reps should be more concerned with who they are going to be working for than our 5% global layoff.

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  17. I am going to defend the VeePee of xspine! He has built numerous sales forces from the ground up! He is honest and has extremely high values and morals unlike the rest of you. Why is everyone in this industry so jelous of him and the well oiled machine they are running. I talked to him and tend to agree relationships with PODS are not wrong and are key to continued growth.

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  18. 7:07

    Medtronic layed off in the spring = more "proactive" than Stryker if
    timelines are your qualifier.

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  19. 6:07 are you smoking crack? Kosta is anything but a good guy. His departure is welcomed by most...except Percy, Delong, and O'Toole. He was the worst part of Synthes Spine...a true dick who lacked ethics.

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  20. Kosta and his son Nick are said to be joining a Distributorship within K2M based in Tampa / St. Pete / Clearwater.. The Co-Principle had his former partner cut out of the Disributorship based on conduct detrimental to the company. This made way for the Kobakof's to move to K2M. I would say Nick has @ 2 - 2.5 million if that as the times have changed for Synthes.

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  21. is that Joe talking about himself again?

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  22. I must admit that 7:40 must be a publicist for X-spine. A well oiled machine? A machine is powered by an engine, x-spine may be powered by a battery pack. PODS are okay? How does that comment pop up out of nowhere? You sound stupid

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  23. Kosta's a good guy, his son Nick is a good guy, good luck to both. Player haters suck. Kosta knows more about spine than most entire distributorships, get over it. Sort of surprrised that he didn't get along with the guidos from DePuy NY.

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  24. Kosta's only move was to get out. He would have never made the cut with JnJ. This isn't hating it's just fact. He was a liability and knew he was in trouble. K2M clearly doesn't drug test. Good to see Daddy is still looking out for little Nicki.

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  25. I have to agree with 7:40 about X-Spine being a well oiled machine. I looked up synonyms for "machine" and found the word "tool". I then looked up the Urban definition of "tool" which is: "One who lacks the mental capacity to know he is being used. A fool. A cretin. Characterized by low intelligence and/or self-steem. i.e.That tool dosen't even know she's just using him.". Based on this, I agree that X-Spine is a "well oiled machine".

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  26. The Latin word for "tool" is Kenothis Hortiss aka Ken Horton.

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  27. Let's be honest with ourselves here. Big companies don't innovate, they acquire. As the industry growth rates are slowing (or shrinking), pricing is squeezed, and decision making shifts to hospital admin, there's a lot of slack and inefficiency in the system. Everyone will have to adjust to the new reality, surgeons, hospitals, reps, and companies.
    Everyone will be "tightening the belt," just some will do so by design and others will have it done for them.
    You can think of it as overcapacity, but SYK, MDT, J&N, Synthes, etc. all have plenty of unproductive people and spend that will get tossed overboard. There will be collateral damage with some good people displaced with the not so good.
    Whether is the pending device tax or simply good business, a lot fewer people will be employed in our industry next year and fewer the year after that. I'm not personally convinced this is entirely bad outside of those individuals and their families affected.
    Good business create good jobs for good people. Sloppy businesses create or hold too many jobs, and our industry has been the poster child for this effect as it's been too easy for too long.
    Understand the coming changes and get in front of them for your own benefit.
    Good luck to all...

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  28. As we can all agree there isnt a sole in this industry who likes to discuss layoffs. The idea of of them can be described in thousands of words, and upper managment of companies can give a million excuses as to why they are happening.

    The reailty of it is Steve MacMillian is an excelent buisness man(anyone who argues that is just ignorannt). TSB im sure your right, he probably is having sleepless nights wondering how he is going to lay off 1,000 people providing for a family. All that tells me is that you know he has a heart and obviously doesnt want to do this.

    "Stevie Wonder" as you call him is doing nothing different then anyone else would do. he needs to show results or show profitablity or those 1,000 people will stay and he will let go.

    Your comment about it being all about that stock holders is correct! it is all about the stock holders! as it is with anyother public company! They are his Bosses, and just like your boss and mine they want results.

    Does Obama care have to do with this and this whole device tax, yeah you bet your ass it does. Is that the only reason? absolutly not, but is a big factor. this money needs to come from somewhere. If you can function just as well with a thousand less employees why not? operating a little leaner if fine then.

    Lastlty your looking for innovation. Are you serious? come on TSB i been foolowing your blog for years now. The Innovation days are over. you know that as well as i do. The next great thing we may see is stem cells, and that is a ways away. There isnt going to be anymore revolutionary procedures anymore. The "XLIF" was the end of that era.

    My opinion is nobody wants to lay people off, nobody wants to downsize a company, but in this market where it is so volital its either sink or swim. dont mean to sound cold cause i do feel for the families that will go through lay offs, but truth hurts i guess?

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  29. There was one company at NASS that had innovation and it was an imaging company!!!! Not even a hardware company! It was a portable ct scanner...forget the name.

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  30. 7:09

    BodyTom by NeuroLogica - are you pimping for them????

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  31. 6:52 you state that it is only a simple mind that blames OOOOOBAMACARE and that the real culprit lies with the deregulation of these evil banks and Wall Street Types?
    Do tell us more about your sophisticated and uber-informed theories as to why OOOOBAMACARE has little to do with the demise of our healthcare industry.
    I am guessing that you do not believe that this medical device tax has much to do with the future of Healthcare?
    Let's say you are CEO of a public Company and YOU are trying to plan for your Fortune 500 companies' growth. Do you say to the shareholders, "we better hunker down cause there's great uncertainty ahead with med device tax and increasing costs related to providing employee benefits?"
    My bet is "no", you are the CEO calling up O'BAMA saying, "PLEASE Mr. President, give us an exemption from your Healthcare!!!"
    Deregulation my ass....you are the simplton

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  32. Every time I saw Kosta, I was sure that someone put a mob hit on me.

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  33. 7:09

    Thats it I think....and no. I'm an out of work Stryker Babe.

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  34. It's ironic to me that leaders of these spine companies, such as Stryker and Medtronic, are so 'spineless'. To let 1000 employees go in order to counter the finacial impact of a mere 2.3% device tax, and because you dont have the balls to tell your wealthy shareholders that your employees and their families are more important, is utterly shameful. So what if the shareholders revolted and fired him! What would he leave with? $50 million in total compensation? Think he could survive on that? The sad part is the board and shareholders would vote in another crony/asshole as CEO that would make the "tough decision" to downsize the workforce. Then they'd carry him around on their shoulders and praise him like a hero. The TSB asked an important question: when was the last time you heard of a CEO and his cronies at the top voluntarily taking a pay cut or foregoing stock options and bonuses for the sake of saving or mitigating job cuts at the bottom. NEVER. You know why. It's called GREED my friends, GREED. And it is as pervasive in our industry as it's ever been because the pie is shrinking. Just once in my life time I would like to hear of a CEO like Stephen MacMillan of Stryker, $3 million a year in compensation, stand up and say "we're going to cut it at the top this time, not at the bottom. Fat chance.

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  35. As Gordon Gecko said, "Greed is good."

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  36. First of all 11:04, Gordon Gecko was a character in a movie. Make believe. Fairy tale. Entertainment. We are talking about real people here at Stryker. Heads of households with mortgages to pay and kids to feed. This is not humorous to them. Stryker is a 5 billion dollar company. 5 BILLION DOLLARS!! The leaders of this company are laying off 1000 people because they are afraid of their shareholders! These greedy-ass leaders are afraid of their greedy-ass shareholders because they all value the almighty dollar moreso than their employees. Greed is not good! It ruins lives. Good, decent productive people will lose their jobs because Stryker cant figure out any other way to make up 2.3%! Now I would hope that if Steve MacMillan is so smart that he is worth $3 million a year in compensation, he could figure out a more creative and humane way to solve this crisis. Cut the lights off, turn the thermostat down, negotiate better credit terms, cut EVERYONES salary 5%, (including yours Steve!), streamline manufacturing, negotiate better contracts, etc, etc. But no, he took the usual and customary (and easy) way out and fired 1000 people, then went Christmas shopping with his wife or gassed the company jet up for his Thanksgiving vacation in Aspen. Shameful.

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  37. The best way to deal with the tax is to press politicians to repeal it, not fire employees. Scott Brown (R-MA) is fighting this tax in Washington and we should pressure others to do so as well. Where is our lobby? Advamed where are you...?

    2.3% of gross profit. You pay regardless of company performance, so the tax is actually significantly higher than 2.3%

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  38. Scott Brown isn't he the guy that posed for some girlie magazine, let's face facts if we enacted a new tax code for a 7% flat tax, you all would complain it should have been 6%, its human nature. If corporations are complaining about taxes, open your books and let's see what you paid in taxes over the last three years, just as a reminder GE is a prime example of what a major corporation does or doesn't pay. As for publicly traded companies, it always comes down to the shareholders, who cares if there is collateral damage, as long as a Stryker can show their 20% growth or whatever is acceptable is all that matters. As for blaming Obama does;'t that reflect our short term, let's blame the next guy mentality? Numbskull it didn't happen over the last three years, its a by product of 25 plus years of abuse by BOTH PARTIES our government is corrupt whether you like it or not, the banks are corrupt, the politicians are corrupt, the lobbyist are corrupt and we all believe its acceptable to behave that way. So in the end, who gives a rats ass about 1,000 people, I'm sure Steve MacMillan and the BOD will be toasting one another at the Stryker xmas party acknowledging that they really are the smartest guys in the room, at least they think they are.

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  39. Layoffs are less about greed than it is about something often overlooked in the rhetoric-laden discussion of healthcare: property rights. A share of stock is a piece of individual property...just like your house, your car, your cell phone, or the undies keeping your stuff warm in the cold winter. The shareholders have every right to demand that their property is managed in a fiscally responsible way. They bought the stock hoping it would appreciate in value, and are right to demand that the managers of the company execute their duties in a manner consistent with this expectation.

    A job on the other hand, is a contractual relationship. One person performs X services in exchange for Y compensation. More often than not, the relationship is defined as "employment at will", meaning either party can end the relationship at any time. There is no right force this contractual relationship on an unwilling partner. E.g. there is no right to a job.

    That's not to say isn't distasteful to cut employment only at the bottom of a company (and likely inefficient compared to cutting a few VP's), but it's how it is.

    I wouldn't be at all surprised if cutting 5% of the staff towards to bottom of the pyramid works out to about 2.3% of revenues. Don't forget that there is also downward pressure being applied to pricing by the legislation in question. More cuts are likely in the future. SYK reported $2.031B revenues in Q3 2011. 2.3% of that would be $46.7M in taxes. Earnings in Q3 were reported to be $327M. Therefore, without cutting some expenses, "mere 2.3%" excise tax would actually have worked out to 14% of Q3 earnings.

    What do you think will happen if pricing pressure knocks that $2.031B down 5% or 10%? Who is going to pay the salaries for all those workers?

    Think on that as you pack up your tents and tarps to go "occupy" some city park near you. Where you should be heading is to the White House lawn to protest the partisan idiocy masquerading as "universal healthcare".

    If you're still inclined to make demands on private businesses via camping in a city park...may I suggest you instead head to Venezuela? El Presidente there is sympathetic to your cause and has created wonderful model of an economy organized around government seizure of businesses that didn't employ enough people, provide the right salaries, or paid their owners too much. I'm sure you will be welcomed with open arms...but make sure to learn Spanish, since they won't have much patience for you if you expect to navigate their country for your whole life without learning the local language.

    XOXO

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  40. 11:53am - Where is Advamed you ask? They are FOR Obamacare & requiring the individual mandate for purchasing insurance. It's a simply ploy to get in good with the politicians while expanding their customer base. It's on their website. Check it out.

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  41. 11:53 is 100% correct, the device companies will be paying pre-tax. It makes no difference if they make a profit of show a loss. This will freeze innovation in the U.S. and lead to much larger layoffs.

    11:31 Every CEO can take a huge pay cut and nothing will change. Playing Robin Hood doesn't solve the fundamental issues with our economy........it's a tiny temporary bandaid. I am fine with a person running a $5 billion dollar company making 3 million per year. If they do not perform they will be fired so fast their head will spin We can have Bozo the clown take over for free and there will be a lot more than 1000 people out of a job. Your anger should be focused on our bloated government spending.

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  42. Sounds like a bunch of gringos worrying that they are becoming a minority. Whom do you think cuts your lawns, grooms your greens, washes dishes at your favorite bistro, we pay taxes dude, we work hard, we are the American dream, not some pendejo whose daddy got him into Harvard and paved the way only to find out junior is a total f@&k up

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  43. How funny when someone claims it's the big bad government, and who makes up the government pres t'elle? Democrats and Republicans both thieves and scoundrels. Austerity has worked in Greece, in Ireland , in Spain, let's cut back even more so that everyone's stock can go back to those hyper inflated numbers of te past, mmmmmm does that ring a bell

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  44. Nov 14, 2011 9:04PM

    Tim Miller, is that you?

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  45. 1:38 - what's up with the racism. Give peace a chance and be grateful that you have an opportunity in this fine country founded by "gringos." Afterall, you could be living in the third world shit-hole that your friends and relatives live in amigo.

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  46. I am a "gringo" and I cut my own lawn and prune my own trees. I am pretty sure that's not the American Dream. Also, I don't know anyone that went to Harvard or who's father got them into any school. Loose the chip. You are speaking about a very small minority of people that are from wealthy families....I think you would call them the 1%. That means 99% of us are in the same boat.

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  47. Loose the chip! Then loose the hounds!!!!

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  48. 1:19 landing the uppercut.
    Facts is facts friends. They are different than opinions.

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  49. 7:48 NOV 14- What did the K2 co-principal do that was so detrimental? I heard he was a solid guy.

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  50. What spine company hires mesicans?!...WTF

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  51. Just curious, from those of you railing against efficient management of public companies in challenging times: Where are you investing your retirement money, shares of Greenpeace?

    Seems like you'd have suggested typewriter companies have found a way to keep all of their employees in place after the PC/Word shift. Their leadership was just being GREEDY too?!?

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  52. Buggy Whip Spine Inc. I demand perpetual employment!

    Suck it up cry babies. The gravy train is over. Find a new industry if you don't like this one and stop tilting at windmills thinking the gas you are spewing is going to accomplish anything. Too many people comfort themselves with the thought that if they aren't doing well they are at least effectively showing the world that they aren't happy about it. All that does is make you and the people you spend time with (e.g. your friends and families) miserable.

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  53. Prediction, Alphawreck's new VP Regulatory/Clinical Affairs/Quality/ect. will be gone under three years. Ever work their?

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  54. Firing 1000 people before the holidays is cold. I agree the gravy train is over, and the money being poured into sales expenses for 100 redundant screws, cages and plates makes no sense. Crashing ASPs won't allow it. If there were 6,000 spine reps making $150,000 each, there will be 3000 making $100,000 each. I'm sure some of you will parse me on the math, but you get the point. It is absolutely going to happen. But Stryker should do this after the holidays.

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  55. 8:23 - No one ever makes a 3-year anniversary at AlphaWreck.

    Signed,
    3-year anniversary watch salesman currently hungry and broke in SoCal.

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  56. my guess is that the sandbaggers posting on this blog during work are the ones getting laid off. if you were making appointments instead of bitching on this forum maybe you'd be part of the lucky group being retained

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  57. Nov-15 6:00 AM "The Innovation days are over. you know that as well as i do. The next great thing we may see is stem cells, and that is a ways away. There isnt going to be anymore revolutionary procedures anymore."

    This statement reminds me of the legendary story from 1899, when the head of the U.S. Patent Office supposedly sent his resignation to President McKinley urging the closing of the office because "everything that could be invented has been invented."

    6:00, I hope more people feel like you do, as the true innovators that have vision and guts, continue to change the marketplace.

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  58. Stryker is laying off 1000 people?...so what? The big cos are too fat, way too inefficient and these adjustments are simply needed. Those affected will get a soft-landing and anybody with value and determination will be just fine. I predict that in 5 years, the vast majority of the so-called "casualties" will say that it is the best thing that ever happened to them.

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  59. 11:23- agree wholeheartedly! it is the liberal mindset to say, Oh no, those poor people are all out on the street now!" This is mainly because they think these laid off people could not have had the foresight to save up for this possibility. Therefore we become reliant on government to pay our mortgage for the foreseeable future. Life sucks sometimes...the conservative mindset believes just what you said in your prediction.

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  60. Five percent of the work force after decades of never trimming any fat is very conservative. Jack Welch cut 10% every year, which admittedly is a bit much. Important is you select the individuals that do not contribute, either because they lack the skills or attitude, or because the needs of the company have changed. And you don't spare the higher ranks. We will see more of this in the coming years.

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  61. Everyone on here talks a fairly tough game until something happens to them. God forbid you lose your job, lose any healthcare coverage, and have a child or wife with pre-existing conditions that make it impossible to cover their healthcare costs without going bankrupt. What then?

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  62. Plenty of charities exist to take care of the aforementioned, rare exception (St. Jude's, etc.)

    Our GOVERNMENT should not be a charity! Socialist policies and "take care of everyone" government is not what made this country great. Socialism and universal healthcare all look good on paper. If Jesus was here, he'd be a socialist. But none of us are Jesus! We have selfish motives...to provide for ourselves, our families, etc.

    To quote Thomas Jefferson, we cannot "waste the labors of the people under the pretense of taking care of them."

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  63. 1:59

    Your quoting someone who was not alive(1743-1826) when taxes were first adopted (1861). I'm pretty sure our forefathers would have up to date quotes had they still be alive.

    Paying taxes is charity to the government.

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  64. 2:19, you obviously don't drive a car, don't fly anywhere, let alone take a train. You also have no electricity or running water, or access to the internet (sic!). All those things are made possible by taxes. And how about Medicare/Medicaid causing your income to be higher than it would be if it was all paid for by private insurance?

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  65. Amish via Internet café  “Wir sollten uns nicht in Frage stellen, wo Gott legt einen Zeitraum.“

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  66. Dear 2:43
    Am I to believe that without a bloated, greedy, wasteful, leviathan gov't we wouldn't have airplanes or roads or clean water? Shut your pie hole u jackass! Uninformed knuckleheads like you is why OOOBAMA Care wil unemploy us all.

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  67. Easy, there Tiger, I think you've just been trolled.

    Aint no way a medicle device person could have written those words with a straight face.

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  68. Dear 4:16, your eloquence speaks volumes about the average intellectual capabilities of the Neanderthals that populate todays' spine companies and distributorships. It's high time this industry gets cleaned up and that the health care system is modeled after the more successful European examples. FYI, waiting times there are now noticeably shorter than here for virtually all specialties. And the European patients have no fear that they will be subjected to unnecessary tests and treatments for reasons of a legal CYA or direct financial gains. Go back to your cave, Cro Magnon. You should be unemployed.

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  69. Socialism no... but healthcare for all children until they're 18/21, yes... !
    Invest in the new generation. You can't help who you are born to... (less than perfect families)
    The People are smart to have our Government invest in the health and prosperity, the right and equal start to any child... especially those with pre-existing conditions.

    If you're some jerkoff that smokes for years eats at McDonalds then has heart trouble and develops "a pre-exisiting" condition... tuff shit.

    A child born with a congenital condition DOES not equate to the above. It's inhumane and shameful to think or have laws otherwise.

    JW

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  70. The 2.3% tax is half of a company's R&D budget. It will affect innovation and jobs. Several big players are moving some R&D functions to China in an effort to gain some efficiencies. No company wants to slow new product development, but they will have fewer resources to do it. I suspect a number of multinational co's will invest more in new market development than in new technology development. This is because newly imposed regulatory risks and capitated pricing lower the ROI for new technologies. New markets actually diversify revenue streams and reduce corporate risk. Our Corporate leaders are reacting to a changing business environment and doing what makes the most sense. I don't like it, but I don't see how they could do otherwise.

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  71. As soon as depuy synthes is integrated j and j will buy every good technology. They have the mandate to be number one and will keep the ball rolling. All the other top companies are doing nothing now and will fall far behind in 5 years

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  72. 3:11, the best way to reduce the costs of health care is to have every American light up from a young age: J. J. Barendregt, L. Bonneux, and P. J. van der Maas, “The health care costs of smoking.,” The New England journal of medicine, vol. 337, no. 15, pp. 1052–1057, Oct. 1997.

    Would be interesting to do similar research for obesity.

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  73. I have been approached to sell Ulrich implants in my distributorship. Has anyone here had experience dealing with them or their VP of sales?

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  74. Nov-16, 1:02PM: We can't be afraid of change that must happen in order for our companies to be more competitive and responsive to the marketplace, even when it impacts human beings, including ourselves. If the necessary change isn't initiated by the cos themselves, the alternative is more destructive and more permanent. My comment above on Nov-16, 11:23AM isn't "talking tough" without having experienced it myself, as I have been without a company after two different acquisitions over the years, the first with 3 young kids and a new house and the last time, with those 3 young kids in college and I had to pay my own family health insurance for years that time...both situations came with some stress, a requirement to "step it up" on my part and bring value somewhere else and in both circumstances, looking back, I wouldn't change a thing, as better opportunities and personal/professional growth was the result. For those concerned about being displaced, don't be afraid, embrace it, get back "onto your toes" and go after it...it's the American way.

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  75. I've had it with the Euro-trash who swallow (and then vomit to me) the lie that Socialized medicine is somehow better, faster, blah blah...

    I was there, here's the truth:
    -Patients die in filthy hallways
    -Simple procedures save lives but are denied because they're deemed too expensive by the God-like gov't drones
    -Human beings having to beg those drones to let them live, pretty please
    -Surgeons stopping work after their gov't runs out of money for the year

    If you think insurance companies suck, just wait until some bureaucrat has your life in his hands.

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  76. 1:54, where exactly were you? Bulgaria or Switzerland? As a European I do not recognize the cartoonish picture you paint. I have seen the overburdened ERs in the US, where people are forced to go for simple family medicine issues since they have no insurance. As a result, you wait half a day to get your broken wrist fixed. Spare me your sanctimonious Tea Party crap.

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  77. 9:45AM - I would stay far from them They have a very limited portfolio. The VP, Erika, has NO spine experience. I heard she was kicked out of the only case she attempted to sit in on. The regionals are all bitter. The company does $12M. Shocking considering they really only have corpectomy implants. Their scews suck.....Hope this helps...

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  78. watch out for that back stabbing snake delong. he is gonna try to slither into kosta's avp spot. i know from experience.

    sincerely

    keith brewton

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  79. I sell Ulrich and have been very pleased w/ the Obelisc and small VBR. They are arguably the best expandable cages on the market. Tango pedicle screws are a bit fiddly but have their place in oncology surgeries. Ulrich can't be your only line, but it's a great one to have.

    DePuy Distributor Employee

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  80. With the Depuy reps going direct, will JnJ allow them to keep Ulrich?

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  81. Are you kidding me?

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  82. Ditto on Ulrich's Erika and their "CEO" Hans. Both are former buddies from some home health company. They thought they would give spine a try. Neither have ever been in an O.R. prior to Ulrich. Good luck with that.

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  83. Here's the skinny on how the French system is set up.

    http://www.medicalnewstoday.com/articles/9994.php

    It doesnt get into waiting times or access, other than to say that the government decides what services are covered and how much they will pay. Our government can't make those decisions because the political consequences are too high. The main thing to read is the control the government has over the hospitals and doctors and then to realize that, regardless of effectiveness, it would never be tolerated in a society like the US where the recipient class has more rights than the provider class.

    Also of interest is the cost. Some stats say that healthcare represents 10% GDP in France, but this articles states that 20% of gross income is deducted from paychecks to pay for their healthcare (which they call Social Security). They also have significant out of pocket expenses and it can be assumed that there is some confusion in getting reimbursed since portions are paid by government, some by private insurance. They also note that due to increasing costs, the government is considering lowering the amounts it will pay.

    Similar to ACA, if the government overspends or undercollects, they will simply reduce the budget and pay less out in benefits. Unlike ACA, the French system controls what will be covered, and to what degree.

    Make your own determination as to whether or not you would want this type of system, but politically, you cannot expect it to work in the US.

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  84. Speaking of Stryker, their VLIFT Expandable cage is in my opinion the best expandable cage on the market. The ulrich small VBR is a good option in cervical only because the VLIFT tends to be to large in the cervical with current sizes offered. Just my imput as I have sold both cages...

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  85. Ulrich corpectomy cage has now been passed up by newer offerings.

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  86. am going to defend the VeePee of xspine! He has built numerous sales forces from the ground up! He is honest and has extremely high values and morals unlike the rest of you. Why is everyone in this industry so jelous of him and the well oiled machine they are running. I talked to him and tend to agree relationships with PODS are not wrong and are key to continued growth.

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  87. 6:50... that's some funny stuff. Keep em coming.

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  88. 6:50

    I'm "jelous" of your grasp of the English language and grammatical skills.

    "Yooo Dok - wanna buy some spine stuff"

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  89. Joe is that you behind the curtain, built numerous sales forces from the ground up LMAO unlike the rest of us, keep us laughing, jelous is that the french spelling, speaking to yourself in the third person is a sign of multiple personalities. Keep em coming , you have a career in stand up

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  90. Nuvasive's new XCORE Mini is now available. A product extension from their current expandable corpectomy cage XCORE, with smaller diameters for upper thoracic/cervical 12mm or 14mm diameter core spanning anywhere from 17-74mm with customizable endcaps. Truly remarkable!

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    Replies
    1. Hey NuVasive rep, FDA has never approved a cervical corpectomy device for sale in the US, so your X-Core mini is being illegally marketed there and you're tip is sending the Feds after your tail.

      Delete
    2. http://www.qmed.com/news/fraud-allegations-surround-spinal-device-greenlit-fda

      Delete
  91. Attendez la crème

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  92. Could anybody confirm the new codes that FDA recently released on stand-alone devices. Apparently, all cervical and lumbar stand-alone manufacturers received a new device code notification in September that stand-alone devices w/ integrated fixation are interbody devices w/ integrated fixation.

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  93. Stryker can't afford 1,000 employees because they are suing everyone under the sun for the hip implant patent violations.

    Ridiculous! That company sucks the big one and I hope all their former employees a piss on them the rest of their careers.

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  94. Police probe gangster link to Olympus...
    http://www.reuters.com/article/2011/11/18/us-olympus-idUSTRE7AH03O20111118?feedType=RSS&feedName=topNews&rpc=71

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  95. Is there any connection between the gangster link and the questionable, exorbitant payments to the VBs in the OP-1 deal?...in anybody's opinion out there?

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  96. @8:53

    I guess you can't afford to spend any money on marketing due to all of your lawsuits so you've decided to promote your product on here? That's awful.

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  97. What's the story with the FDA recall of the Jackson Spinal Table?

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  98. Nuvasive XCORE mini and New XCORE II are not out yet......But will be at end of the year...

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  99. Apparently the Jackson table recall was a "educational recall", whatever the hell that means. Apparently there have been one or more instances where the incorrect pin (there are two per side at both head and feet) was removed and instead of releasing the table, the patient hit the floor - again, unknown if a patient was on the table but sounds like it - or could fall....
    Sorry for the messy answer but the circulator in my room the other day mentioned it....
    Short answer is that, to my understanding, the tables don't have to actually be recalled, this is an "education" issue.

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  100. they issued a type 1 recall.

    For those who don't know...

    "Class I recalls are for dangerous or defective products that predictably could cause serious health problems or death. Examples of products that could fall into this category are a food found to contain botulinal toxin, food with undeclared allergens, a label mix-up on a life saving drug, or a defective artificial heart valve."

    There is nothing educational about this. The table is seriously injuring people in a predictable way.

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  101. This is one of the few times I've learned something useful on this blog. I'm looking to get a new OR table and I had not heard about this recall. This is actually useful as compared to the usual crap on this site!

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  102. 8:49 AM: there is gold in them thar hills, you just have to be patient and keep mining!

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  103. Hey doofus it's a blog not an academic institution get serious

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  104. Any manufactures looking for a surgeon to test/trial/design an MIS system. Surgeon interested

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  105. Nuvasive below 14.00. Haven't seen that level since 2005. Billion dollar baby seems far off.

    What are the latest implications on the AMA rejecting Trans1's bid to convert the T code to a Category 1 code. Its in the recent 8k filing. It looks like the market shaved half their value the day the AMA released its position. Market cap now $44M.

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  106. Mfg looking for MD to test/trial/design MIS?

    Contact me: Dumbass MIS Inc.

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  107. What's up with Spinefart? Is that a moth or a butterfly?

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  108. It's a butterfly with its legs sticking up in the air.

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  109. Taggart gone from Bacterin as of Friday. Anyone know what is going on in brokeback mountain land.
    People are dropping like flies.

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  110. You Joke about SpineArt but I was at Eurospine with my company and they have some very interesting products.....far more innovative than any US company at the moment.. Granted the FDA will ensure the devices never make it to the U.S, but they seem to have a very skilled engineering group. All the new technology is going to be coming out of European companies like SpineArt and small startups in Isreal. My company has nothing innovative in the works and seems to think hitting their wall street number by cutting employees is sustainable. Small more nimble ( non BS POD companies) are going to eat our lunch.

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  111. 12:29 - Like what? Baguera? I think it was the cappuccino and macchiato they were serving.

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  112. Spineart has nothing that stands out against US or outside US products. Trent N. is a piece of work; both Alphatec and lanx ran him out. Pockets not deep enough to bring their precious few to market. Can't play in big cases; lack of instruments/products. Think the butterfly thing is Trent in touch with his girly side.

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  113. Baguera is by far the best disc on the market. They have taken a big part of the market in Europe....probably top 3 and growing. Makes sense as the CEO of SpineArt designed the Prodisc. They are on the cutting edge as far as companies go and have become a big thorn in my companies side over the last few years. They have no market share in the U.S but they are bigger than you think. Everyone likes to bash but SpineArt is a company to watch. They developed a formula that seems to be working.

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  114. In France. Their french. Good luck waiting to sell Baguera when it gets approved.

    I have to admit that they have taken Spine Next marketing and have done a good job with it. Very stylish.

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  115. WSJ today, Synthes guys set to fry. Sad.

    http://online.wsj.com/article/SB10001424052970203699404577046204020672824.html?grcc=330d3b278936f5050e88871384211c4bZ3&mod=WSJ_hps_sections_business

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  116. SpineFart just fired their senior leadership in the US. Are they closing shop here and going back to the land of Surrender Monkeys?

    Do you know why they have trees on the side of the road in France? To shade the Germans as they invade their country! Goodnight ladies and gentlemen!

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  117. Spinefart ! Their main investors are from middle east.....for a company based in switzerland.......no comment

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  118. Betcha Alphawreck downsizes soon. Failed management, failed surgeon investors, failed PODs, failed stock that never got above its IPO and closed yesterday at $1.84... And the music goes on and on and on and on.

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  119. 10:24 PM
    You're full of crap. Fact check - it is Dr Marnay who designed the ProDisc. After implanting roughly a dozen ProDisc-L he then stopped implanting and followed the patients for 10 years. He was in control of the device, not the manufacturer.

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  120. Synthes filed a law suit against Kosta! This just doesn't get any better!

    Weee this will be fun to watch! Kosta the attorneys will get it all and you will get what you deserve!

    SYNTHES, INC. et al v. KOBAKOF
    Filed: December 1, 2011 as 2:2011cv07422

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