Tuesday, December 20, 2011

The Culture Club

As the year winds down, the "2011 Year in Review" has brought to light many of the problems that continue to exist in the spine.  What we have learned over the last few years is that our recidivistic nature supersedes our ability to execute. TSB loves to quote Einstein's definition of insanity for the obvious reasons. Management in spine companies are fused in a time warp.  They have forgotten where they came from and how they got there, regardless of what you believe, money and power can have a way of obfuscating reality. Dilution or is it delusion occurs. The eventual outcome is that many of these leaders forget what it took to get out of the box, or never understood what out of the box really meant. Considering that out of the box means moving in diverging directions which could potentially result in novel or innovative ideas, the fact remains that when you become the Street's bitch, you eventually lose the eye of the tiger or sometimes the eye of the cheetah. Shareholder value, that becomes your focus, don't believe TSB, just sit in on a Stryker or NuVasive call. Just look at Steve Jobs, love him or envy him, he was a visionary, an outlier, albeit in a completely different industry.  It was always about the product.  Yet, whatever the inevitable, some of us will leave the industry in a wooden box, while some will leave in a gilded box. The difference is that a gilded box influences others to believe that you were successful, because money is still perceived as a sign of success and power, sometimes even anointing one to sainthood.  Regardless, what the Street has predicted for our industry, many continue to live in the past.  What worked at Medtronic, J&J, Zimmer, Synthes, or Stryker in the roaring eighties and nineties has outlived its usefulness. The battlefield terrain has changed. The rules of engagement have change and the question remains do the generals have the ability to adapt and survive? Getting your testi's handed to you can be a humbling experience, just look at Nuvasive's recent demise in the stock market. How long does Alex and his minions plan on riding XLiF and neuro-monitoring? As one of our commentators suggested, the stock for this company is a highly manipulated stock. Isn't that a barometer of the lack of confidence that investors have in a company that once touted their innovation and responsiveness as cheetah like? How quickly Lukianov forgets, but then again, isn't some of this about smoke and mirrors? One can only ride the propaganda machine that your public relations company spits out on your behalf so long and then, it's game time. Yes, there are isolated exceptions, whereby some companies are showing growth. But in the larger picture, they are small companies generating growth by shear will, while some do it by buying business a la POD's and POC's. But, as far as the big boys go, or those that want to grow up, let TSB quote one of our favorite philosopher's Paulie "Walnuts" Gualtieri, "fuggedaboutit." Organic development is something the food industry has learned to capitalize on, the spine industry has lost focus and direction with how it arrived at this fork in the road, vis-a-vis INNOVATION and CAPITALIZATION, and we have no one to blame except ourselves. Where are the emerging technologies? The readers are correct when they poke fun at and criticize the industry leaders. Many can thumb their smug noses, but time eventually catches up with you, just take a visit to the graveyard of spine. Stability, not volatility and movement have reigned over the years, and then for some reason a school of thought emerged that if you are not growing by leaps and bounds, a sudden change in direction will solve your growth problems. It would be interesting to identify when this mercenary attitude become prevalent.  Just look at some of the companies within the industry, they are a revolving door. Are the expectations unrealistic?  You be the judge.

Consolidation is not a thing of the past, it is the future.  No fellow readers the days of start-ups will not disappear.  But, it has become difficult to launch anything unless it is truly an emerging technology.  Many smaller companies are finding this out the hard way.  Access to capital as in the pre-2008 bubble burst is long gone, and with that, so are the excessive valuations. Not only are many of you attempting to figure out how to survive in the battlefield, you are also dealing with leaders that still want to fight in a conventional war.  In today's market place, the sales representative or manager that has the ability to preserve and sustain your customer loyalty and revenue is much more valuable, than the gunslinger that rides into town and promises you the world, for the obvious reasons. There are no magic bullets. In addition, they are a hired hand, until the next deal comes along regardless whether its a distributor or surgeon. The tenured sales rep or manager at your company knows what the challenges are that must be addressed in order to maintain your business, the question is does anyone on your executive management team listen and have the cojones to execute, or, does it fall on deaf ears?  Is your company listening and being responsive to your battlefield needs?  Do you have the ability to be pro-active rather than reactive?  But then this has been our point all along.  Are you better off than you were two years ago?  Maybe that's why we all laugh at the industry. How do you sell when you have no samples, no marketing collaterals, no bone models, an inadequate training program not just on the clinical issues, but on the environmental issues that you are challenged with on a day-to-day basis?  Think how absurd it is when company executives claim that they don't want to be like the company that they previously worked for, yet surround themselves with the same people that they worked with at that other company?  Create a new culture?  Highly unlikely.  More like an attempt to catch lightening in a bottle by copying that culture because you think you can do it better, and then one day you wake up and you realize that you are no different than the company that you claim you did not want to be like.  You've become the 4,000 pound Gorilla that has an inability to innovate because everything becomes an exercise in accounting, you need to have meetings because everyone needs to cover their ass or wants to be heard, so all that execution that you once told the market you were capable of doing better and faster has come down to a grinding halt.  The result is that you start losing customers.  You know the people that will only tolerate your BS to a point and then shut you down by moving to another company or product.  Surgeons are customers, and an unhappy customer means you're in trouble.  So as Jethro Tull once sang,

Happy and I'm smiling walk a mile to drink you water
You know I'd love to love you and above you there's no other
We'll go walking out while others shout of war's disaster
Oh, we won't give in let's go living in the past

Once I use to join in every boy and girl was my friend
Now there's revolution, but they don't know what their fighting
Let us close our eyes outside our lives go on much faster
Oh, we won't give in let's go living in the past

TSB wants to know what you think.

110 comments:

  1. Wow
    That was truly an amazing summation of our industry.
    You are a smart MoFo.
    Great post !

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  2. I was BORN AGAIN after leaving the corporate d--k sucking contest and became a distributor. Let those visionary companies rise and fall, I don't care. I'll provide what my docs want (without regard to what's allowed into my lame bag by some corporate nitwits). I can have simple instruments manufactured without some jackass attorney telling me I can't. The list goes on and on, get out of the grind guys, and be your own man!

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  3. You and others continue to bashNuvasive, a recurring theme, but they continue to post revenue growth in the low teens. I get it that the Street giveth and taketh, but Nuvasive appears to be doing what every other 10-15 year old company has done ... ride a flagship, landscape changing technology and grow off those spoils. From the looks at their booth at NASS, they have a complete diverse bag.

    They are by no means perfect, but they are a lot better off than most companies in this space.

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  4. This is hilarious. Culture and innovation? New ideas? Uhhh look in the mirror and realize this blog is nothing more than Nuvasive, V Brothers, POD, and a little Medtronic hate speech.

    What are you doing to get better?

    (cue all of the "I'm taking all of Nuvasive's business posts.)

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  5. Great, now go wipe your ass with the NuVa stock grants.

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  6. http://www.startribune.com/lifestyle/wellness/135899413.html

    Tim Healy and Terry McCord are Dr. Polly's puppets

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  7. “Just look at Steve Jobs, love him or envy him, he was a visionary, an outlier, albeit in a completely different industry.”

    TBS, it’s obvious you didn’t read Jobs biography. You forgot he was an asshole and a whining bitch that was gifted. Not many people are like him nor would like to work for someone like him.

    Once again, you have made the 2011 TSB blog a memorable one!

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  8. SI Bone baby!! Tough but rewarding. I don't know how long the ride will last, but no worries I will just move to the next startup looking for new tech reps.

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  9. One can always count on TSB for inane chatter about what is wrong with the spine world. Doctors are corrupt and capitalism is evil. If businesses make too much money they are greedy; if they make to little they are managed by fools. Innovate and solve problems without failures or changes in price. Salesmen are under appreciated, and executives over paid. The list goes on. If I were not afraid of your answers, I would suggest you provide some productive suggestions to the world.

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  10. Inane chatter what's the matter 11.55 per share sounds like a great company considering the cheetah's were hovering around the 40's a year and a half ago.

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  11. AZ TSB SEZ: Da Truff Hertz, or was that Mike Tyson

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  12. TSB, You say surgeons are our customers ....are you sure you dont mean our competitors. How can business function when this is the case?

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  13. For all of those who still believe & buy into the culture of NUVA, depsite a stock price hovering in the $11-12 range,, My words of advice to you are simply: "Don't drink the kool-aid".

    Happy Holidays,
    Rev. Jim Jones

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  14. NuVasive exhibits most of the qualities referenced in this post. I am quite amazed at the lack of "cheetah" speed and innovation within the company. It seems as if we get more emails pushing the recruitment of ancillary programs (Better Way Back/SOLAS) than emails regarding surgeon follow-up. It's a sad state of affairs when your management spends most of its time tracking patient ambassadors, as opposed to following up on surgeon objectives. I believe NuVasive would do well to flush the middle managers and shake up the executive level ASAP. How many of these people actually operate withing their "Cheetah" atmosphere? We sure do get cheetah speed when they want PO's closed! I wonder what Alex would think if he actually saw how many sales representatives complain at the lack of responsiveness from the middle managers and the marketing/engineers at NuVasive? EZ2DOBIZ- just words...

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  15. Can I get a "When's Globus going public?" Hahahahahaha!

    Wonder if their employees got a one year subscription to the Jelly of the Month Club?

    Merry Christmas.

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  16. 4:43 - You now the difference between Jelly and Jam, right?

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  17. So, which of the following companies hit a brick wall in 2012 and have their caboose flash by their engine car?
    1) Alphatec
    2) TransOne
    3) Nuvasive
    4) ???
    Put your projections out here for us to ponder and wage upon.

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  18. Alphatec will be toast when the next WSJ article comes out. Maybe the NSM can get a coaching job at Penn. He is steering the turd around the toilet bowl.

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  19. Rusty you sound a bit rusty, LMAO

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  20. Olympus update

    http://graphics.thomsonreuters.com/11/11/7733/7733_FLW.swf

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  21. Does anyone think NUVA will be bought? I mean why buy them when the stock is tanking and reps are leaving. If I compete against them and the rep leaves I am going to go hard after that business. They will be in the single digits in 2012 so you can buy them up for around 6 bucks a share if you like. PS....all of this makes life very difficult for GLOBUS.

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  22. Follow the smoking gun

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  23. What's the ATEC wsj article and when will it be here?

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  24. 5:06 what NuVasive reps are leaving? The rate of attrition is no more or less than other companies. There is no en masse departure. I promise you. I like your 2012 business plan though..."wait for all the reps who are better than me to leave, so my mediocrity can fill the void." Good Luck with that.

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  25. 12-39 Tyson,,,"everybody's got a plan,,,till de get hit..."

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  26. Globus grew at over 17% last quarter.

    Mmmmmmm the Jelly is goooooood!

    Merry Xmas ;)

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  27. 6:30 - you sound well informed if you have not heard about NUVA reps leaving.

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  28. Globus reps and managers have left in droves over the last year. Lanx raided them all over the country.

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  29. Lance "hot pants" DeNardin made a deal with the devil and he's gunning for competitive reps all over the country. Unfortunately their just a paper tiger. The financial backing is running on "e".

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  30. While I agree with TSB about a lot of the issues, particularly the part about companies paying more attention to the dollar vs. innovation, I think it is also important to point out, the ability to innovate, and get it paid for is difficult right now. 3rd party payers are so resistant to new technology, taking a minimum $15MM risk, with a high potential for a non-coverage decision, and the cost of fighting that should it happen, is a daunting situation for most. Trans1 comes to mind.

    That being said, management has not done the things important to payers to justify their existance. The part being left out in the innovation process is outcomes. Most managers have not put it into project plans. As we have seen, even CMS is getting involved. It's difficult to not be empathetic to those in Florida who get to go through a review for their Medicare patients. If companies can make that leap, include 3rd party pay systems into the customer mix, it's the belief of a number of industry leaders that it would help.

    All companies must charge what the market will bare, but to this point, it has not included 3rd party payers in the process (to see what they are willing to pay). It's doubtfull there will ever be a time that all circle and sing a common song, but companies better find ways to work with vs. treat them as an enemy.

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  31. this industry has taken a complete 180 since I started back in 2000. Gone are the days of big market companies controlling the market through innovation and old school selling. As time has gone on, it's been nothing but rogue distributors carrying 15 different lines, dropping their pants on pricing and sticking it to the rest of us in the meantime. It's no skin of their back when they are getting 30% on a 500 pedicle screw...its still more than my 8.5%

    Consulting companies, shady business practices, health care overhauls...you name it. It's a perfect storm for the hospitals to drive us out, just like the cage rage was the perfect storm for us to cash in. The pendulum has swung.

    In an industry that will barely grow this year, many have realized their respective companies are tightening the belt, reducing the investments for R and D, and chalking it up to 'thats the way the market is going'. While I've had a very good year, I cannot say i am as excited as I once was about our line of work. Consolidation will happen, it has to. These rogue distributorships will dissapear, and we'll be pharma reps dropping off trays making 75k a year

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  32. 9:39- You nailed it. Been in Spine for 10+. The industry I used to be so proud to be a part of.........poof! Gone! What remains is a Cesspool.... 75k? Think that's being kinda optimistic!

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  33. We may be moving toward the European model where distributors cover a huge geography and reps do not attend most of the cases. Reps could still make good money but their geography would be huge. This will drive all of the small players out as inventory will need to be parked at every hospital. The company with the best implants and lowest COGS will win. I hope price reductions don't drive us to this but at this rate it looks like a real possibility.

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  34. So much whining going on here.
    There is an adjustment taking place but the panic is from those who KNOW they have been enjoying the spoils for too long and don't have the goods to back it up.
    Good reps will still be in demand and will be paid accordingly. Maybe not the top dollars seen in the recent past but a better living than most. Top 5% and up! So what I am mostly hearing is the death throws of the average rep who knows his days are numbered.
    Darwinism is alive in well in the spine market.

    Chill out an evolve!

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  35. You got it 1233, bring value or you will go away, one way or another.

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  36. This will likely get my ass in a crack, but it is difficult at best to compare device to pharma. Have lots of friends in the drug biz (legal drugs for those who might question). They do pretty darn well - well over $100K for most. They work 8-5 most days, no weekends, no call, little inventory to schlep around, don't stand around getting beat up by Drs., staff and others, and don't have to handle or be exposed to bio contaminents like blood, puss, etc. They seem to have to put up with a similar amount of company BS. They have to know their drug and all is provided by the company, have a pretty long and unlimited number of customers. In general, it appears like a pretty easy way to make a living compared to what the professional spine dude or dudett is required to do, and certainly a lot less ass kissing, POD issues, hospital contracts,etc. Most everything is provided by the company vs. the personal considerable investment in training and education. Having made multiple attempts to work with drug reps, they just don't get the urgency or intensitive we deal with and most wash out. Most of us could do that job with our eyes closed, and if it gets so we can't make $150K, it's not a bad fall back.

    Not saying there are not professional drug sales folks, it's just a different mentality most of us would get totally bored with.

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  37. 3:09 agree, for most there's is a better gig....only nuva reps brag about growth....and every year it's significantly less then the year before. No talks about there real problems with the shady remote monitoring, lack of strong profitability which is huge! There the most likely to collapse with pricing falling like a rock...tie in a little fraud w/ remote monitoring where they're screwing insurance and Medicare having docs "monitor" cases they haven't monitored in their entire careers so they can create another income stream really shows how fragile there business is. I know, use to work for them and they try and get there reps to push "income" in the hundreds of thousands and even millions of dollars surgeons can make with there remote monitoring scam...it's very blunt.."doc you can make 300k..or your 7 man group can make 4 million in extra revenue! Let us show you how...by the way, after we set this system up and your making tons of money, will you give our hardware an honest try? Even with this shady "GROWTH" nuva's profitability is on life support. I hate that pricing is falling but at least it will really put the squeeze on companies like Nuva... Oh yeah and they owe Medtronic over 100mill....anyone want to buy a purple terd...I mean 3 legged cheetah.

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  38. This comment has been removed by a blog administrator.

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  39. 8:36pm
    Where did you come from? Ridgemont High. You sound like a NUVA disciple!

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  40. TSB,

    Your post demonstrates the shallowness of your understanding of Nuvasive, its management staff and its product line. Nuvasive filled its bag, occiput to sacrum, faster and better than any company in the history of spine. Their retractor was the best mini-tlif gadget before XLIF was even released and the new MAS-TLIF system is the most elegant product they've come up with to date, XLIF included. Precept is as good as any perc screw system with possibly the best reduction system of any perc system. They pioneered insert and rotate technology for interbody, first obliquely lordotic TLIF. ILIF has been a huge success. Armada is as good as any system and close to being small stature. Literally could go on and on.

    To suggest they are milking XLIF and NV and are a onetrickpony is a joke and ignorant. But what are you going to do? Haters hate. Ask Tebow.

    To be sure, the cultural slogans are easy to mock but by who? Reps that didn't cut it at Nuva? All the shorts who are posting their drivel just to hit a put price? All the has-beens or never-wases?

    The stock is this low because of speculation regarding the MSD suit. Period, end of story. Strong Buy.

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  41. You keep telling yourself that their not a one trick pony, keep drinking the kool-aid and believing that there is divine intervention, I guess Tom Brady proved you can only call on God so many times, and then you're on your own. Have a great holiday, the stock will be up by 40% by the end of January.

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  42. 8:13
    Are you appearing at the Comedy Connection soon or do you have a standing appointment kneeling at Alex's feet?
    You have been bamboozled and spew your spoon fed drivel as if they are facts.
    Your comments show your lack of spine history as well.

    This is called an opinion:"Nuvasive filled its bag, occiput to sacrum, faster and better than any company in the history of spine." not a fact.

    Measuring against yourself and not the market is quintessential kool-aid drinking: "the new MAS-TLIF system is the most elegant product they've come up with to date"

    Really? "Precept is as good as any perc screw system with possibly the best reduction system of any perc system" So you're just like everyone else.

    I remember Hourglass: "They pioneered insert and rotate technology for interbody"

    "Literally could go on and on" but you have the kneeling appointment you have to make?

    I am glad to hear you are proud of the company you work for. That is great and honorable but naive. I wish you well in your maturation and in your future job search.

    Kool-Aid is for kids.

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  43. 8:13

    As life ages you like a fine wine, you will learn that the company that you work for really doesn't give a rats ass about you, its all about what have you done for me lately, don't believe it, as TSB says, visit the spine graveyard there's a plot waiting for you, just like everyone else that wore the color purple.

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  44. TSB - after the Tom Brady/Tebow reference, nuff said. You're that guy eh. Should have known anyway as it fits perfectly with what this blog reakes of in every way. Just stick to writing your boring entries that 70% of us just skim thru so we can get to the star of the show - the comments section (without your comments)

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  45. 8:13

    Everything you mentioned is in the past.

    The stock is low because Nuvasive does not have much of a story for the future. This time next year it will be in the single digits.

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  46. Hey Tim, I didn't know you read TSB. Shazam.

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  47. I recommend anyone that has any sort of positive feelings toward NUVA to stop posting on here. Not worth the time or the effort. NUVA has made some business moves that they believe will result in long term growth so let's see how it shakes out for them. Either all these guys that post mostly crap will be right or the few hopeful ones will be able to laugh at everyone on here in a few years. Happy Holidays.

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  48. Pioneered "insert and rotate" IBD? Maybe they pioneered the use of the term but the concept has been around since the early nineties.

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  49. 9:43

    Please do not post on here then. Is this not what blogs are for? If you have something you would like to contribute or have the ability to argue a counter point then offer it up instead of taking your ball and going home.
    If you spend time reading the entire blog you can filter through the BS, The delusional, The spot on and the truly helpful insights. Your passive wait and see attitude is the hallmark of the uninformed and disengaged.
    Try contributing something of value next time instead of giving up.
    Not everyone gets a trophy you know.

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  50. Medtronic Inc. (NYSE:MDT) is under the spotlight at the IRS for profit-shifting practices that effectively cut its corporate tax rate in half.

    The IRS targeted Medtronic in a $958 million lawsuit in U.S. Tax Court over the way the company shifted income to offshore units, according to Bloomberg.

    Medtronic paid income taxes at a rate of 16.8% in 2011, less than half of the standard federal rate of 35% for corporate income, by attributing much of its profits to a foreign facility.

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  51. How much more corrupt can this business get?

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  52. 10:43 - Let your imagination run wild. We haven't even begun to see the F'd up scams people will use to milk this cash cow.

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  53. Well said, 10:43. Makes me laugh when I see all the Medtronic reps pointing at the PODs as doing dirty business. The perfect example of the pot calling the kettle black.

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  54. 8:13, don't step to deep in the water. NUVA did not invent or even remotely develop insert and rotate interbody technology. That goes to Dr. Madhavan Pishardi, Brownsville, TX. Which, by the way, was seen as a pitch to promote a license agreement while the NUVA boys worked for MSD. Check it out. He has very specific IP around it - and as often happens, has not litegated it since the cost to the Dr. could bankrupt him. Also, XLIF is certainly not a new idea. Do you really think it was invented by Louis? They made it a pretty package, made it safer (not, I didn't say safe), but it's certainly not new or revolutionary.

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  55. 12:23 - I dont believe NUVA ever claimed to invent lateral surgery itself, that has a long history. What they did do is create the instrumentation and implants add the nerve monitoring and package it in to a procedure thats accessible to the surgical population. Like most "inventions" XLIF is an evolution of existing knowledge and concepts, its certainly a lot more inventive than a number of patents i have read over the years which are nothing more than writing down the obvious.

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  56. What's fun on this board is that the only people who ever actual try & defend Nuvasive are those that still work there. Why is that? Well, it's either because they're new (there less than 1 yr.), it's their 1st gig in spine, or they're just too stupid to know better. The bottom line is that Alex is no different then any other evangelist who has a certain minion of individuals completely brain washed via preaching "culture", etc.

    The culture in that company is nothing more than a masquerade for all of the ineptitude which exists there. Most of the product managers are kids barely out of college,, hell, most of them surf in the morning before making their way into the office. What is the name of the VP of Sales?

    At the end of the day & last time I checked, growing market share wasn't the only thing that mattered in business. Those NUVA folks who constantly try & defend themselves by saying "look at our growth" obviously understand little about the business world. Did Enron once proudly boast robust growth? In fact, here is a quote from Enron in 1999:

    October 01, 1999

    When Andrew S. Fastow, the 37-year-old CFO of Enron Corp., boasts that "our story is one of a kind," he's not kidding. In just 14 years, Enron has grown from a heavily regulated domestic natural-gas pipeline business to a fully integrated global energy company with thriving activities in natural gas, electricity, infrastructure development, marketing and trading, energy financing, and risk management. And much of that growth has been fueled by unique financing techniques pioneered by Fastow.

    Sound a little familar? "Nuvasive will be a $1 Billion start up,, blah, blah, blah,,,"

    Newsflash: Upside growth potential, solid product pipelines, sound management teams, robust earnings, etc are what matter to The Street; Nuvasive is clearly lacking in many of these areas as evidenced by a stock price that now sits below the level of where it IPOed nearly 7 years ago.

    Cheetah Nation, here's your wake up call, you too are now classified as endangered species as with each passing day, you are simply 1 day closer to your extinction.

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  57. What they do claim is that it is the holy grail for spine surgery appropriate for every level save 5/1 regardless of the pathology...oh and btw their monitoring is a frkn joke-ridiculously expensive and an obvious liability. Surprised I have not heard more litigation stories on neurovision. I mean an unlicensed, uneducated, unqualified biz grad putting leads on patients undergoing major surgery?!? The height of lunacy..

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  58. Was Pisharodi before or after Steffee's "insert and rotate" ramps:

    http://cms.spineandspine.com/news_img/30/2011-5/18/201151822159405.pdf

    Either way, well before Nuva was a glimmer in anyone's eye.

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  59. 2:24, it was after, but they are not the same either. Dr. P's refers primarily to trial & implant insert and rotate vs. instruments. Steffee's patent is a tools and technique methods type and (as I remember and could be wrong)long ago expired.

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  60. NuVa common stock is up by about a buck-fitty in the past 2 days. Next week it will be pushing $15.

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  61. I love it...keep it coming. Why don't all the new Lanx people from NUVA standup and take a bow. You are off the the next 2-3 and out stint in your career and acting like you have some great relationships you can bring the to table. You were made to look like a star at NUVA because they signed up one of your docs to a deal. GO BLOW!

    One of the reps in my territory jumped a Dr. in the parking lot and scared him silly. Needless to say the Dr. was making fun of the rep later that day in the OR.

    Realize that this is about your name in the business (your geography)....not just the company you work for. You may be digging your own grave.

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  62. $15 ? Is that some NUVA rep or manager wishing for a Merry Christmas

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  63. Docs were using insert and rotate allograft for years. Nuvasive commercialized it.

    Hibbs invented interspinous process fusion. Kyphon bought St. Francis for north of a half a billion and were left with their pud in their hand. Nuva identified a reimbursable and efficacious procedure...ILIF.

    EMG was around for years. Nuvasive put the info at the surgeon's fingertips and away from the neuro tech playing Suduko.

    XLIF a joke. Then why the arms race?

    The only company that has really endeavored to bring procedural change to the market in the last 10 years has been....drum roll... Nuvasive.

    I didn't drink the Kool Aid. I funneled it and proud of it.

    Tebow Fan

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  64. Another wannabe Tebow Fan, don't tell me you genuflect before speaking to your surgeons, heyTouchdown Jesus this is a blog for pagans.

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  65. My bet is 3:44 is a poser. Just trying to have fun at everyone's expense. No one is that stupid.

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  66. 3:32 You just proved what an incredible idiot you are,, The reason so many former NUVA reps are now at Lanx IS ACTUALLY BECAUSE OF THEIR SURGEON RELATIONSHIPS.

    They're the ones that serviced the key doc(s) and now that those docs are at Lanx, guess who they want to be in the O.R. with them?

    Sounds like pretty solid relationships to me,,

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  67. Without NUVA this blog would die. TSB can't go two posts without slamming NUVA. Frankly, it's worn out but without it all of TSB's eyeballs would leave because so many just enjoy bashing them for no other reason than their own company can't emulate their success. Bumps in the road? Sure but who hasn't had serious issues the last 5 years?

    . Too bad because there is so much going on in Spine, especially the numerous Synthes, MDT and Depuy defections, Biomet's continued slide, and Stryker's indifference.

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  68. 4:21,
    On the money. Moreover, whilst Nuva bashing keeps on, the Draconian CMS pre-payment authorization is in effect. All TSB can do is rehash Nuva hate mail peppered with song lyrics(?). What a silly effort. TSB should recognize Nuva's commitment to furthering the art rather than mock it's culture.

    Tebow Fan
    John 3:44

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  69. Amazing that one NUVA dude spends so much time posting on here and bashing TSB trying to elicit a response.
    But then again what else does he have to do.

    Let's please move on TSB.

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  70. Insert, rotate, and leave behind carbon fiber PEKKEK implants totally were Art Steffee's invention. He called them Ramps. As with many other things he pioneered, he probably did not, or insufficiently, patent them. Few surgeons have been taken more advantage of by colleagues and industry characters alike than he.

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  71. 4:57 - The reason everybody breaks your balls here is because you all keep trying to pass off your cult as a culture. Perhaps you should have Tom Cruise as your spokesman...

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  72. If Globus gained 17% last qtr, that should be about 68% Annualized Growth.
    Whew! You guys are the fricking Google of Spine. Oh I forgot, you have no
    IOM and a B+ product line with questionable growth tactics... I'm guessing that took your 30k stock options from $1M value to $1.68M.

    I don't believe it. K2M will surpass Globus in market share by 2013. Don't get me wrong, you guys are very aggressive and have done quite well, but I just don't think you have sustainability in this tricky market.

    TB

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  73. 6:56
    What makes you say K2 will surpass Globus in market share? What makes them so different other than you being employed there?

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  74. "The people will read again."

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  75. 6:56, if you went to college you should get your tuition back... Your math is on par with the average SAT scores of an inner city high school.

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  76. 6:56 , I have worked at Globus and there line is the best in the business... period.. The good ol boy network and sub par reps at the company is a different story all together. It's a line worthy of Navy Seals and unfortunately they give to puppy dogs..protected by their managers...To bad they are not publicly traded so they could be driven by share holder value and maximizing their territories, instead of retarded little girls and their managers getting business on shear amazing products and making fat checks without hard work creativity and PASSION. Enough to get by should be the rep motto...DAVID PAUL is a mad scientist with huge NUTS...the stupid liberal IP that is awarded in our industry is sad and restricts innovation which Globus is the best at...Oh well, and the management sucks..To bad DP is too busy developing. The right management and reps would make this company unbeatable.

    Globus just has too many weak reps, some strong ones for sure but a lot of weak...still the line is sick! 6:56 you are on crack......NUVA SUCKS, merry Christmas.

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  77. For all you kool-aid drinking X pharma Nuva reps! Your stock is at historic LOWS and you're still at 66 times earnings!! At .19 cents a share ya damn morons! Your f ed... No other way to put it. Not getting any easier from here. If that's your best effort at profitability in spines Golden Age!!! What do you think you'll do as our industry continues it's race for the graveyard. No way your around in 5-7 years. .19 cents???? Are you kidding me? And I wonder how much phony accounting it took just to get that number!

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  78. 8:49PM
    You must be on crack! Please educate us all as to what exactly Globus has ever innovated.
    Their (please notice I used the correct their and not "there" like you did) entire product line of PEEK spacer that were first introduced in 2004 were exact copies of the Synthes blue prints that DP and his minion admitted in court document to stealing. Their cervical TDA will never see the light of day since Synthes whipped MDT's ass by getting a permanent injunction due to patent infringement. Their insert and revolve IBD came after Synthes released Opal. Their zero profile cervical and lumbar devices both followed Synthes and MDT who released their products more than 2 years in advance. Their dynamic rod is nothing but the combination of a Dynesis and N-Hance splicing. I know you are just waiting to hold up the expandable PEEK corpectomy cage as a true innovation. The expansion mechanism and implant design look no different than a number of other expandable cages on the market - they simply used PEEK instead of Titanium. M.A.R.S. is just another of a long line of MIS retractor systems on the market. Don't even hold up Revere - nothing special about that pedicle screw. Nope, a quarter turn locking cam with a locking set screw has been used since 1999 by a small company called Surgical Dynamics which was later purchased by Stryker.
    So in the future when you want to brag about your theiving company, maybe you should consider the factual ineptitude of you statements.
    Globus = XeroxSpine

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  79. Bashing NUVA has become too easy but the reps have earned it over the last few years with the mindless lemming like behavior. The reps at NUVA now suffer from the same issue as the corporation does. Time has passed you by. NUVA should have sold years ago at a premium. The company is now a skeleton of what it used to be with no competitive advantage and no long term vision. The same applies to the reps. There value in this industry has dropped off the map. No one needs your relationships anymore. You add no other value to a company as your only sweet spot is covering an xlif case. Oops, so can every globus, msd, depuy, K2, Lanx, and Alphatech rep. You should have moved on two years ago but your blind faith in Alex, Pat and Keith has destroyed your personal value in this industry. 90% of the reps at nuva can't spell deformity, do not know what TLIF stands for, or have never seen a trauma case. Keep hanging on to the your dream as you watch the management team leave for greener pastures just as Alex, Keith and Pat exercise options at your expense. For your benefit... Your options are worthless unless your strike price (read your statement) is higher then the market price.

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  80. Dec 22 at 4:21 I really enjoy readiing the articles The Spine Blogger writes. The anonymous comments are the ones that drone on about things (usually NUVA bashing) and other things totally unrelated to the article that has been written. For example, look at the article written about the Blackstone issue, NEIN X NIEN = NEIN,117 comments, 13 comments relating to the topic. I was interested in hearing what people think regarding the illegal activity, it seem the only things people want to comment on is NUVA

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  81. 10:03 innovate can mean many things, some look at it as revolutionary paradigm shift/product and concepts...as rep I look at it as putting the best products available in a reps hands. There products are over tested and never let the rep down! The instrumentation is best in class and wows docs. Have you ever sold Revere? I'm sure your buttress thread is amazing... Addition is a system that can attach to any pedicle screw system in the world? Transition Dynamicr is like Zimmer?? W/o the kinks and failures??? You clearly have not seen it...Revolve perk system that has Rod to Rod articulation that wows Docs, and will never let you down in the OR. A custom dept that can make you any instrument in the world? In 1 day! They took the concept of the nuva retractor and made it 3 times better years ago....their interbodies are the best on the mkt-period! I clearly talked about the weaknesses of the company...but when your on that island-----as a rep----f pageantry and history of being one of the first system of which the stuff sucks...I want the best products and custom's with stream lined instruments that make Docs cream there pants. Who care if somebody (ex zero p made a product first- Globus zero profile makes that thing look like dog shit). You a story to tell about how you have 1 or 2 "ideas" you bought from a doc or work for a copy that can take any idea whether preexisting or not! And make it better!!!!!!!! Keep your fraternity, And I'll keep the boat, lake house and an early retirement. That's it, it about putting the best stuff in the reps hands and Globus does it the best.

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  82. So 5:25, why has Globus stalled and not gobbling up huge market share? You must have put as much emphasis on studying vocabulary as you did grammar. innovation is not the same as reverse engineering. If it were, China would be the most innovating country in the world
    You should really go back to Pheonix and finish up your pathetic degree. Your writing is a grammatical nightmare. Keep posting though. It truly exposes the caliber of reps Globus hires.

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  83. Stewie here, anyone seen Quagmire? Giggity, Giggity!

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  84. Gobus Products Rule !!!!

    Hands down the best products ( across all approac/treatment options ) in the Galaxy.

    Paul has Huge Balls.
    I was with Blue Boys for 15 yrs. left the cesspool on TOP.

    Now killing it with Globus.
    Watch Out !

    I may come to Your Town.
    Take your relationships and $ volume.

    Your wife will leave you.
    Your kids will refer to you as 'Punk ass Bitch'.


    Merry XMass !!

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  85. 5:25:

    That is as disjointed a post as I have read on this blog. Can you complete a thought without misspelled words and grammatically incorrect writing? Wow, you must have had your ADD levels at an all-time high this morning. Yikes.

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  86. 7:35, You are suuuuuuuuch a TOOL.

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  87. This comment has been removed by a blog administrator.

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  88. Guys Stop Bashing each other about the companies ....Because if you are a great rep doesnt matter what company you work ....

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  89. The last run of posts are the reason "anonymous" forums don't work. TSB, bite the bullet and go for a verified email address and registered identity. This could be a very useful forum instead of what you have... 20% useful and 80% high-testosterone sales reps seeing who can "out-blumpkin" the other.

    Signed

    Anonymous

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  90. Agreed. This is turning into the lowest common denominator.
    Embarassing to be in the industry.

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  91. One of the good guysDecember 23, 2011 at 11:06 AM

    Don't be embarrassed to be in the industry just be glad these tools are your competitors. You don't think Wall street is full of testosterone terds? What industry isn't filled with them? Software, advertizing, how about congress or even the douche bag surgeons?
    Get over it and keep winning. You know who you are and the tools will still be tools!

    ReplyDelete
  92. TSB here:

    As critical as we can be of one another, bringing family members into the discussion, using sophomoric language, or calling people out on their lifestyles NOT ALLOWED, NADA, NOPE, NYET, NJIGDY, If you can't have a reasonable debate you will be censored. Have a Merry Chrisrmas

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  93. After reading this blog, All I know is that there will be A LOT of spine reps & other members of the spine industry getting nothing but a lump of coal in their stocking this year.

    Regards,
    Santa Claus

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  94. 2:48

    Good thing we have all the money in the world...otherwise we would rely on handouts like most people.

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  95. I can hear the paid carolers from the hallways of Alphatec singing...
    "All I want for Christmas is my POD, my POD, my POD. Gee if I could only have some more PODs, then I could wish you Merry Christmas."

    Hopefully Grassley and the DOJ will pull all the PODs and Alphatec and the other rat companies creating these entities can all walk around "toothless".

    Merry Christmas to all and to PODs goodnight.
    J

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  96. 3:29...
    LMAO...sounds like some POD markets have taken a toll on what little biz you had. Hope you enjoy your Downer Holiday thoughts and wishes for the coming year. in fact, you may want to keep pouting and maybe somebody will feel sorry for you but don't count on it. Rock on POD Families!!! XOXOXO.

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  97. I'm considering looking at a job at Lanx, inside not in sales. Can anyone give me insight about the culture, spirit internally, future potential, etc?... Without the typical bashing seen on this blog?

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  98. If you're involved with a POD just shows you have no ability to sell. The surgeons involved with a POD only use the products because they are making money - NOT BECAUSE OF YOU. You have therefore placed yourself into a little valued position where the POD can insert whoever they choose to do your job. Which they will when their profits start to get squeezed with price reductions and they decide to replace you with a scrub tech making 75K.
    We all know who the surgeons are that gravitate towards the POD model. They're the same ones who always had their hands out for huge consulting fees or retainers. Once the DOJ rolled up that scam the rats and the docs moved onto PODs. The DOJ will eventually do the right thing and PODs will fade away. The rats however will find another corn bend to feed from.

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  99. In response to 5:04...from a current employees perspective, by & large lanx is a very good company to work for. Pay, benefits, & percs are very good, especially given the current economy, & the state of spine in general. There is for the most part a commitment to excellence,although as with any company you have to wonder why some people still have their jobs. Morale varies depending on with whom you speak. Future potential?...If the senior team is truly committed to the spoken game plan, chances are very good that the company will grow more than most in the field. i don't know what your current situation is, but it's one of the better places that I've worked at in my career.

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  100. I would totally work for globus if the points made sense. Their product offering is insane. But if you have the relationship then why take less than 30 points?

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  101. Why take less than 30 points ?
    For longevity my friend.
    Most of the companies offering 30 points will not be around in two years.
    And yes, Globus products are vast and will allow you to fight with the Best weaponry no matter what part of the map that you are on.

    Great rep + Globus products = POWER

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  102. 12:26....thank you!

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  103. Happy New Year to a lot of miserable Spine Reps. Change your attitude or change your company...am sick of listening to all of the negative bashing of an industry that I have been part of for 20 years. And guess what...I love my job.

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  104. Juvenile squabbling aside, TSB made very accurate initial points. MDT Spine for one has lost its way. With the change in leadership over the years (no laughing here!), we've stopped playing to win, we're playing to not lose. We think we're still a medical device company with med device margins of old to cover our sins. The new normal is an old school med device company with eroding margins, selling a 'manufactured' product having no clue what the COGS is at the plant level, let alone what the COGS could or should be.

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  105. 3:44

    Kyphon bought St. Francis for north of half a billion and "were left holding their puds in their hands..." That, and the north of 4 billion they were holding after Medtronic acquired them 6 months later.

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    ReplyDelete