Saturday, December 24, 2011

Merry Christmas to All

As the Silly Season is upon us, TSB would like to wish all our readers, including the Cheetah Nation, a peaceful and joyous holiday season.  Liberate yourselves from the insanity that you subject oneself to for at least a few days,  it will be therapeutic.  Hug your kids, love your significant others, and keep things in perspective.  Closing those PO's this week will only get you inches closer to $1 Billion, or your bonus.  Contrary to a minority opinion,  those that contribute to our blog love this industry, we even like Nuvasive, but when you're news, you're news.  If you learn anything this coming year, keep "Da Noise" that exists in this crazy industry to a minimum.  Some would call it balance.  Some should actually try it, it works. Whatever you believe, TSB knows that our blog provides a heuristic venue to explore and investigate the many recesses that exist in this crazy industry.

So in the spirit of the holiday season, and yes my judaic friends that does include hanukkah, last year you whined about us not giving you a shout out.  Have a healthy and happy 2012 (shhh! don't tell anyone that we're devout capitalists), and while we're at it, can someone remind the POTUS that the shamash is always the first candle lit, an amateur Jew at heart looking for votes.  Until then, Merry Christmas to one all, Ho! Ho! Ho! Santa's got to go, he's got to deliver toys for all his spine girls and boys.

Team TSB

Come Dasher, Come Dancer, Come Prancer, Come Vixen, Come Comet, Come Cupid, Donner and Blitzen, lastly Rudy we're on our way.

55 comments:

  1. TSB 10 Q 4 D blog, hope U N your loved 1's have a gr8 holly day. Go Buckeyes

    John Boehner, aka R2D2

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  2. Speaking of Buckeyes, Dr. Karas at Ohio State and all his ex fellowship classmates are using Dr. Karas's older brother Naso (the garbage man) Karas to be their distributor. He is paying them a cut to schedule cases with him. I guess the garbage man is using his brother and his relationships to cash in. I guess slinging spine beats the heck out of slinging trash.

    Go Hawkeyes!

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  3. Merry F'ing Christmas all you bastids!!

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  4. Happy Holidays to all,, I look forward to taking all of your business via my POD in the New Year!! Whiners & complainers will all be receiving a set of steak knives tomorrow. Those who wish to compete w/ me, just want you to know I have a better screw, plate & interbody than you,, mine IS THE BEST. Mine will also always be the least expensive.

    Regards,
    That guy

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  5. As a concerned group in government, we appreciate your blog for the very public exposure of the caustic nature to your business. This TSB has done well to serve a venue to the sentiments of a changing slice of healthcare. We take note of the varied opinions and information. Happy Holidays to all and a Happy New Year. May you be a strong source of benevolence to all you touch. To you 2:10 and those like you, may the times be kind in your spirit as well. For me and mine and those that we serve, we will do the right things; honored to fight the fight.

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  6. Cocoa's for cobblers

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  7. What does TSB desire for Christmas?

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  8. 2:58

    You dont work for the government....

    1. Im not that lucky
    2. No one smart enough to know what the word caustic or benevolence mean would take a gov't job.
    And C... No gov't employee cares enough to monitor something like this on christmas eve.

    Also, if your trying to correct corruption, I'd start with prosecuting the S-O cases.

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  9. MM,
    Thanks for this blog.
    Happy holiday and the best to you and your family.

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  10. Only losers comment on Christmas eve.

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  11. Merry Christmas to you too. It is an auspicious day for all the Christians around the globe and time to celebrate the holidays with gifts from family and friends. Thanks.
    Keep posting.

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  12. MM,

    Thank you for a great year of helpful insight into our greedy little world. Keep holding their feet to the fire!

    Congrats to the effeminate one on your demotion, er I mean promotion to Ely Lilly.

    Go Tebow getting the Broncos into the first round this year and being the highest paid fullback in the league next year.

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  13. Many happy returns!!!!!

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  14. giggity, giggity! Anyone seen Stewie!

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  15. And a Merry Christmas, Happy Holidays and Happy New Year to all...

    I am doing a little research project and wanted to ask those on the front line that know...what are the top three TLIF implants (in terms of volume) in the U.S. today?

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  16. In the eyes of a nuvasive rep? Or true reality?

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  17. true reality, please!

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  18. That is a silly question.
    It is clearly going to be the top 3 "Legacy" companies.
    A better question would be: what are the top trending types of designs for TLIF/DLIF.
    etc.
    Or materials...

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  19. it's not what are the top 3 companies, it's what are the top 3 TLIF implants, by brand/product name?

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  20. How about this question instead?

    WHAT'S THE ASP IN YOUR MARKET FOR TLIF CAGE? PLIF CAGE? ACDF CAGE?

    POD'S AND LOW-FLIER COMPANIES ARE DRIVING PRICES, DOWN,DOWN, DOWN. MY MARKET PRICES:

    TLIF...$1900
    PLIF...$1100
    ACDF...$700

    OUCH!

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  21. How about what a POD actually pays for above implants.

    TLIF-$900
    PLIF-$900
    ALIF-$900 (not stand alone)
    ACDF-$500

    Know these prices, have specific implants targeted in these price ranges and take the margins out for these busch league businessmen. Sure, still have your premier products i.e. MIS, coated screws etc. , but the answer will be to have some drop bottom dollar pricing to offer hospitals on certain products to keep this virus to a minimum.

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  22. WOW, this is so pathetic. You're talking about what the best TLIF cage is? Sad.

    What's next,, Who has the best cervical plate?

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  23. 6:07 Holy Mother of God! I thought my pricing sucked.

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  24. Stewie, Quagmire here, heard you were looking for me. Are you with Brian? Giggity, Giggity!

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  25. Prices suck! What is next? What does 2012 hold? Seems like the big earners are going to be the emerging tech reps. Bash the SI Bone, Baxano etc guys but in a world of falling metal prices they at least are selling unique products. So instead of just bashing let's talk about the unique fringe products coming in 2012/2013. They might be the only reps making the big bucks.

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  26. SI Bone has some competition now. I hear Globus is launching thier knockoff. When are they going public?

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  27. Take a look at these prices........Sports Medicine reps are making more than those prices!

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  28. That's interesting...a question was asked about the top 3 TLIF implants in the U.S. by volume and no one can answer. Some of you are going to bash the question as looking back, old news and we need to look forward. But it's the bread and butter of today's business and no one knows the answer...amszing.

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  29. Anyone hear that the S--t hit the fan at Spine 360?

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  30. The shit has been hitting the fan since Spine 360 was formed. Something new going on?

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  31. Globus just got SI Fixation product with an old facet screw...same old problems with loosening and FDA approval for fixation, not fusion. We are not getting paid enough to sell it. Globus copies old ideas...doesn't invent new ones.

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  32. @840am

    1 word: "Amen".

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  33. You are better off with a big bag full of

    A. Commodity Metal to compete on Price
    B. Unique products for premier pricing
    C. Luck

    Have all of these and you will be fine!

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  34. Heard today that 3 pod physicians were questioned today in CA by the feds. All partner names, names of surgeons shaddy consulting deals were gained, and all suppliers were ratted out in first 10 minutes.

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  35. Let's hope they throw many of these dirty physicians & sales people in jail. Thay nneed to send a clear message!

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  36. 5:31 who were the surgeons questioned and what products are they using? Greed is going to destroy medicine.

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  37. Surgeon in NV killed a patient doing a Globus lateral lumbar procedure. The surgeon should not be doing cases if he's not able to competently perform the procedure, and the rep should be thrown out of the industry for not having the ability to guide the surgeon! Where were you Timko?

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  38. new HCA prices:

    $2700 TLIF
    $1350 PLIF
    $2750 ALIF not stand alone
    $1100 ACDF peek
    $700 Screw

    No Sign the contract, no do the case

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  39. I don't use Globus' LLIF retractor because it is unsafe. The two anterior blades do not just splay up and down; they also splay slightly anterior. My concern is that--unless splay is done under live fluoro to safe-guard against "over-splay"--there is a potential for vascular injury in the lumbar spine. This is especially true at L4-L5, and even more so if vessels have lateralized due to scoliotic curve/rotation.

    In my world, it's a game of millimeters. Globus will say that my concerns are unfounded. I politely disagree.

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  40. I wouldn't be too concerned about being polite when it comes to patient safety, vs risk of death.

    Tell anyone very directly to change their retractors to make them patient safe, period.

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  41. 8:23
    With all due respect doctor.
    Splay?
    If your talking about angulation, that is directly controlled by the surgeon with the Globus retractor.
    If your talking flex or drift in the blades under pressure, then all retractors have the same problem. Your excuse is lame. If you don't want to use it then don't.
    I suggest you trial it in a lab before you announce that it is unsafe.
    Tragically the surgeon in Nevada found the aorta. I suppose it was an engineer's fault for making a retractor that actually gets a lateral cage into L4-5 past a high illiac with the least amount of retraction on the Psoas.
    By all means, give the Synthes, Stryker, and Alpha-contraption retractors a try. Let me know how those work for you. Those "seasoned" spine companies really got it perfect.
    Side note. When was the last time you heard your POD setting up a cadaver lab to better your skills at the lateral approach? Answer is never.
    How about rewarding manufacturers that actually support training and innovation by using our products while the rep gets 8% for their effort.
    Or you can continue to use the slime ball who is paying your referral doctors and gets 40%. Wake up.

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  42. Don't know where you work, but I would love HCA pricing.
    FYI, Kaiser is at $2300 for a one level Posterior Lumbar Fusion.
    No- not unilateral, that's four screws/caps and two rods.
    That is where we are heading boys. No matter what president we elect.
    Giggity Giggity, indeed! We are all getting screwed.
    Thanks Depuy. Thanks Medtronic.

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  43. 12:00 if you don't like the pricing, don't sell your wares at that hospital. Don't blame the big boys. It's the bottom feeders that got us where we are today. They're the ones who undercut the establishment to get their slice of the pie. Regardless, we are all looking at a substantial pay cut. Hospitals in Charlotte are proposing that we sell pedicle screws for $600.00 or don't bother showing your face. 1st people to agree: bottom feeder spine companies. You know who you are.

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  44. Good idea nerds discussing pricing on a public forum for all hospital purchasing people to see. You guys are such nerds.

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  45. last poster is exactly right, except he should have called you "idiots" not nerds.

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  46. So many coverage reps....so few sharks.

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  47. 11:39pm aka Mr Clean Never had a big "consultant" in his territory. Never leveraged his distributor to maintain that consultancy agreement with his Big manufacturer who supports training and innovation. His consultants never forced his hospital to allow his big manufacturer products find their way through Purchasing . He's a clean machine. Making the wife so proud. "Ethics" is tattoed on his hormonally enhanced biceps.

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  48. 11:39 "If you are talking flex or drift in the blades under pressure, then all retractors have the same problem."

    You are incorrect to say the least. All retractors are different. What type of material that is used in the retractor makes all that difference. The blades, base, and portion of the retractor that angulates - these are all frequently made from different materials for different reasons.

    I won't name names but next time any of you come across two competing retractors here is an interesting test. Grab the distal end of the blades as you input retraction and watch how much the blades splay compared to one another...major differences out there.

    8:27 - you rock.

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  49. @11:39pm

    All of you Globus reps are just alike. You come into my office like a bull in a China shop, and you think you know it all. You aggressively assert your opinions as if they are fact. Then you have the audacity to get visibly upset with me when I disagree. Wake up! You have B.A. in Liberal Studies. I have a little something called an M.D. I win!

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  50. Globus sales people are as bad as the ones at Nuvasive. So many youngsters who know so little, yet come out of training thinking that they have all the answers.

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  51. Xspine sales management is he best in the business totally awesome products, honest, strong moral values, only getting stronger with the POD Markets, and aquisitions in 1st quarter.

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  52. Say it ain't so Joe

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  53. It is going to be funny when xspines incredible leadership crushes all of the losers in this space.

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  54. Leadership Say it ain't so Joe. What will there next scam be when carrot top can't cut anymore deals, who will pay for the plastic surgery

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