Thursday, January 26, 2012

AB 378 - Lawyers in Love

Effective January 1, 2012 the California State Law prohibits physician self-referral  in the context of workers' compensation cases.  Physicians will no longer be able to own an interest in a company that supplies prescription drugs and medical devices/implants.  This law effectively reverses the existing California law and outlaws Physician Owned Companies (POC's) in the workers' comp space.  The primary focus of the law was to address the perceived abuses related to compounded drugs (steroids or human growth hormones) and medical foods the primary objective was to place checks and balances on physician self-referral when it comes to medical implants.  Many of you know that there is a growing trend across the country where workers' comp attorneys, physicians and distributors are collaborating to take advantage of workers' comp patients.

Section 139.3 (a) of the California Labor Code as amended by AB378 states the following;

Not withstanding any other law, to the extent that those services are paid pursuant to [the workers' compensation program], it is unlawful for a physician to refer a patient for pharmacy goods, whether for treatment or medical legal purposes, if the physician or his or her immediate family has a financial interest with the person or in the entity that receives the referral.

The statute also provides that no claim for payment shall be presented by an entity to any individual, third party payor, or other entity for any goods or services furnished pursuant to a referral prohibited under Section 139.9.  Violation of section 139.3(a) shall be a misdemeanor, and that the appropriate licensing board shall review the facts and circumstances of any conviction pursuant to the statute and take appropriate disciplinary action if the licensee has committed unprofessional conduct.  In addition, violations of this section may be subject to civil penalties of up to $5,000 for each offense, which may be enforced by the California Attorney General, the Insurance Commissioner or District Attorney.

It will be of interest to gauge the response from the many POC's and POD's that have infiltrated the California market from the East Bay all the way to Orange County.  All medical devices will contain an FDA required Rx only or similar label.  This prohibition applies to POC's that are supplying spinal impants and orthopedic devices.  Could other states be watching the outcome?  TSB wants to know has this been a long time coming?  With prohibition being enforced by the Attorney General for the State of California, the market is 2/3's of the way from completely banning POC's and POD's.  No matter what the outcome, TSB is sure that there will be some legal challenge to this law as it continues to evolve to eliminating POC's and POD's.  You know what JB would sing:

God sends his spaceship to America the beautiful
They land at six o'clock, and there we are the dutiful
Eating from TV Trays watching Happy Days
Waiting for WWIII while Jesus slaves
To the mating calls of Lawyers in Love







148 comments:

  1. He's back - the MM is BACK!!!

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    1. He is back! And he's got his law degree!

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    2. definately NOT back....he always gives credit to the artists he references....No mention of Jackson Browne anywhere that I can read!

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    3. It says "you know what JB would sing" - sounds like a reference. He/she may be back!

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    4. I stand corrected!! but I am still not convinced. Where are the left leaning jabs at corporate greed and dirty capitalism??

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    5. Oh, he's back.... PODland will be open soon... As vacationland for Lawyers in Love

      JB is a big-time Democrat - plenty of left leaning jabs - go to the school of rock 5:43....

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    6. And the river opens for the righteous, someday..... SOON

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  2. Does this mean the end of POD's?

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  3. I am starting to keep tabs on all the surgeons that are consultants, teachers etc for Nuvasive and the list is really loooooooooonnnnnnnngggggggg. Have they always been pay for play or is this something new? I know all the purple pissers will chime in and say it's not true but I know it is. I always respected NuVasive and thought they were one of the few clean companies.

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    1. Clean as polished platinumJanuary 27, 2012 at 12:16 AM

      It's probably the grab-bag of recycled ex-MSD management they've hired trying to re-create what they had in Memphis in the 1990's. If you find a Cheetah limo heading to the local "gentlemen's club" with visiting surgeons aboard, they will have fully made the transition!!!!

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    2. "purple pissers" just made me piss MY pants!!!

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    3. I hear there's a "service" to "clean" that for you at your hotel room after your long day at their lab!

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    4. Any change yet with the distributors in AL,GA,SC,FL? I hear they are on the way out. Will NuVasive look for other distributors or go direct? PODs are gaining market share.

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  4. About frickin time! Any thoughts on Medtronic Nuvasive lawsuit news? BTW Lanx but No Thanks!

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    1. What's the matter, worried about Lanx?...better jump on board while you can.

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    2. There was a rimor flying around at this last NASS that Lanx was going to file to bankruptcy. Antone heard anything about this???

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    3. LANX medical I use to work for this company and have to say the products they promote are inferior and less then desirable. Many of the surgeon "investors" were fed up using 2nd rate hardware. Yes I jumped on Lanx bandwagon and quickly quit drinking the Kool Aide and got out of
      Compton.

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    4. Hey 6:20, why don't you ask Dr. Cappuccino how inferior Lanx's lateral system is? He's in Vegas this weekend with about 30 other surgeons checking it out

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    5. 6:58 if you are implying that Dr. Cappuccino's involvement in the Lanx lateral system is any indication of the product being sound, is ridiculous. Dr. Cappuccino is a whale consultant for Lanx, who switched from NuVasive for no other reason than money. His opinion and/or use of their product is solely based on his wallet. I would hope that any Sales Representative or Surgeon, for that matter, would see straight through his intentions.

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    6. 10:13...spoken like a true Nuvasive Rep., thanks for the response. I'm sure you thought differently of Dr. C. when he was on board with you. BTW, where did your stock close at last week?

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    7. 4:37 touting a well paid spine consultant as a gauge of a products effectiveness is hilarious. You may as well ask Tiger Woods if he likes Nike Golf Clubs or perhaps you want to have George Foreman endorse your new grill? Also, commenting on NuVa stock is ironic coming from the perspective of a Lanx Sales Representative. This is not just an issue with Dr. Cappuccino, as it is with these types of consultants in general. This is similar to selling your devices with those "white papers" that are so prevalent. If you were to focus more on the devices differences, as opposed to your new consultant, you may have success.

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  5. http://www.businessweek.com/news/2012-01-26/medtronic-patent-trial-victory-over-nuvasive-remains-intact.html

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  6. All the docs involved with PODs should be tracked and subsequently fined when this is all outlawed. Or lose their damn medical license.

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    1. And raped in prison by Bubba.

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  7. Wonder what Bag of Donuts on the east coast for Alphatec! TIMBER!

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  8. It's still not illegal to use pod products? What are they going to get? A fine? It's only workers comp and only ca. It's a start but don't get too excited

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  9. You reps are still grasping at straws. This law does nothing, doesn't apply and we in the POD world (in and out of CA) will still be working on our business today, tomorrow and beyond. Take that on with your weak TSB words and his tune-ful connections. We'll be out making a difference.

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    1. It is sad that you are so bad at business that you do not realize that the big companies will swat you away like fly when you get too annoying. Do you think you can beat J&J in a pricing war? All you are doing is accelerating prices into the toilet. You are what's wrong with our country. You don't want to work but want to be rich so you take the easy road with a business plan a monkey could execute. I promise you it won't end well.......it never does when things come to easy.

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    2. AND YOU SAID JNJ WOULD SWAT THIS FLY IN A PRICING WAR.......ANY IDEAS SMART GUY?


      First Online Spine Device Company Eisertech Launches Cervical Cage Featured
      Written by Laura Miller | January 26, 2012

      Eisertech, a San Diego-based online spine device company, launched its first product — the Eisertech Cervical Cage, according to a company news release.
      Eisertech sells implants directly to hospitals and surgery centers for a lower price than many competing implants. The company's cervical cage is priced at $495 per cage. This means a hospital or surgery center performing only one procedure with that device per week could save more than $20,000 per year, according to the release.

      The company was founded by CEO Lukas Eisermann, in 2010. His business model is selling commodity implants directly to the customer and eliminating sales commission, which can be up to 40 percent of the implant's cost.

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    3. You are an idiot!!!!! Do you think this company has a lower COGS than J&J? If they are pushed they will do the exact same thing but bundle every other product in the J&J bag.....and you can sub any legacy company. The problem is your mind only thinks inside your tiny little box. You need to read business case studies from past industries. This is nothing new and happens all the time in other industries. You are the anal wart of the spine industry and will be removed eventually.

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    4. Actually 8:15am, I'm not in your industry. We just keep tabs on business case studies as you say and look for the value to invest in. I would say you may be the anal wart being removed. The likes of eisertech, JNJ, and ALL that can position their own COGS will lance you, their internal staff, the DEAD WOOD. We value plays in the market like this and put our money to work to make things better for the macro economy.

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    5. 10:26 thinks that it's good for our economy for prices of goods to rise after their market introduction. Glad TV's, computers, cell phones, appliances, et al bucked that trend. Imagine if your computers got 6% more expensive each year (without adding any new features). We'd all be working on $25,000 IBM 386's, cable TV would run about $8,000 per month, and everybody would wear the same underwear 8x since laundry would cost you about $100 per load.

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    6. Maybe I live in a bubble, but that shit will not fly around here. Not because I think I'm great or anything like that. I don't have any customers that will put up with it. A simple 5 minute conversation with my cage users and they would be screaming bloody murder over some POS being pulled out of the pyxis when it's fusion time. Any rep in this industry, regargless of their employer, should be able to shut this type of stuff down. Take what's yours, gentlemen. Be proactive. Have those conversations.

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  10. Word on the street is that Chicago is next for the DePuy Spine Conversion to Direct - Maybe even this weekend - End of an Era

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    1. Boston fell, so one would suspect more. I heard Texas and Minneapolis were going direct as well.

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    2. Is there a buy out clause in the distributor contract for Kurt and Dave ?

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    3. Synthes model is coming for j and j.

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    4. Any word on what's happening to the VA distributor and his reps?

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    5. What's the word on the street concerning DePuy's NY & FL distributor? I've been interviewing with Spinal Dimensions and just wondering if it's worth continuing to pursue if they're losing there lines.

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    6. 3:01, now is the absolute worst time to get a job with JNJ bc of all the uncertainty. The Spinal Dimensions guys were jackasses when everything was certain, so now they will be savages.

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    7. Large Carolina distr going down too.

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    8. "Large Carolina distr going down too."
      Can you explain this? JnJ had a # of associate rep positions throughout NC online last month and I heard they canceled all of them. Curious as to why.

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    9. What is going on in the south with JNJ DS? They jsut changed 1099 to W2 not a good soulution for no business. Nobody can sell in Georgia!

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    10. Will the greedy DePy ortho distibutor in Columbus lose spine too? Power hungry bitch... All of her reps are terrified of her.

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    11. All Reps in Louisiana have gone direct! Synthes reps flying for other companies!

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  11. Any thoughts on laser surgery? Is it the future? Endoscopic? What could be the flaws of this procedure other then making a zero price surgery turn into a pricey one? I know its used to market and that seems to be the theme. Who are the player?

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    1. Lasers are for Star Wars geeks. Endoscopic is the future. Microinvasive, videos of the discectomy, less trauma than any MIS system. No brainer.

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    2. And for $40k you can have the VERY SAME surgery advertised in airline magazines.

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  12. Has anyone seen this? www.eisertech.com

    Cervical PEEK cages sold directly online with no representation, only $495 each! You can by even buy a "starter set" of four cages (all one size!) and an inserter for $3495. All credit cards accepted! Coming to a hospital or POD near you.

    Yes, folks, the End of Days has finally arrived.

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    1. Would you really buy this? There is no mention of any insurances, neither IP protection if there ever becomes a lawsuit nor is there any mention of the product liabilities insurance. There is no mention of who is behind this program or where manufacturing is from. It could be another crap Korean company that doesn't do the proper testing and is snookering the FDA because they do the testing in the homeland. They sell cheap inferior quality products and insure their products with a foreign policy. Good luck in collecting if there is a lawsuit. They pack up and leave. Watch the quality of Medtronic's product drop since they have moved their manufacturing to China. Much like the quality of Life Spine's products, especially instruments, made in China. CRAP! When some of these companies have failures it is always attributed to surgeon error so there is never a MDR made. PLEASE! Let's wise up Americans.

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    2. What a total joke. He even offers the cages "with representation" for $795. Who the hell is he going to get to represent this product in some random town? How is he going to handle traceability, postmarket, storage, insurance? I don't think this guy thought this through very well.

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    3. Actually $495 for a cheap cervical cage without representation is not a good deal. You can get comparable cages out of Korea for much less than that.

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    4. Actually, my ASC got their brochure in the mail last month. Says its all made in the USA. Big American flag on the literature. Cost reduction is by selling direct, not by importing cheap stuff.

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    5. How much the korea cage?

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    6. Eisertech has thought it out perfectly. Dont be naive! There is more to worry about too. Bang Surgical is going to end reps in the OR for product support with or without Eisertech. I just saw them do a case for total joint/knee and spine fixation. Reps in the OR are limited. . .

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  13. 7:39am
    Really?? What are you hoping we are now dumber after reading this? Need a better argument than this. Work on your spiel.

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  14. Not a good deal. I am sure they are buying them from China and marking them way. I don't want an implant from a country willing to poison baby milk.

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    1. Amen to that Brother>

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    2. Don't forget the lead paint on implants! No really, it's good for the patient!

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    3. Seriously, it's a piece of fucking plastic...how difficult is that for anyone to manufacture? Do you really think yours is tht much better?

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    4. It's a piece of plastic that goes inside your body!!!! Don't diminish what our industry is manufacturing. It is very easy to tell instruments that are made in China. Why do you think the cheap shit instruments coming out of Pakistan never caught on? Germany still dominates because surgeons can tell when you put a piece shit in their hands. Implants are the same way, I see it all the time. I agree with the price correction that has occurred but cutting corners when comes to patient safety is not acceptable.

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    5. I am a spine surgeon. A piece of plastic PEEK is a piece of plastic PEEK. Period.

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    6. Again, it's fucking plastic with no moving parts. Use your fucking head.
      Ok, so mabe one of the tantalum markers is off a few nano meters or whatever ...so what. Or maybe the lordosis is 8.3 degrees instead of 8, big shit....

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    7. OK, I will make some out of industrial PEEK in China and you write a script and implant them in your patients.

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    8. You are an idiot and have absolutely no concept of how the free market is evolving. Where do you think Steve Jobs and Apple decided to assemble their line of unbelievably superior electronic blockbusters? That's right, China, you freak. Just read the inscription on the back of your iPhone, Einstein. THAT'S why AAPL has a current market cap of $417B.

      Go ahead and bury your tiny little head in the sand and continue to blame the surgeons for implanting inferior products while the Asian spine companies blast past us like they did with electronics and automobiles. You'll see...

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    9. 7:29
      Out of all the companies you pick apple as your example? Apple does manufacture over seas but owns most of the capital equipment used to manufacture their products. They control every step of their manufacturing like you control your collection of German piss porn. Their capital expenditure annually is mind-blowing.
      Apple is a terrible argument as they have taken commodity products and increased prices. Their products are the most expensive in every category and continue to rise. Manufacturing in China is NOT why Apple has a $417B market cap, if that were true why isn't Dell, Lenovo, Nokia or Motorola as successful selling the same products? They INNOVATE, something we are forgetting to do. Apple makes 7x more on each computer than other companies that manufacturer in china.......can you tell me why genius? It is simple, they delight their customers.
      Cost cutting was the way to increase profits in the past 20 years. Moving manufacturing did raise margins but didn't increase loyalty. Companies that focus more on producing products customers love and less on the margins will win the war.
      You have to open up you mind and THINK. Making the cheapest copy of others products has never been sustainable and never will be.

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    10. 7:29 you got owned!

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    11. Then delight your customers, you dumba$$. The problem with close-minded losers like you is that you fail to recognize that your customers are the patients, surgeons, and hospitals. Don't EVER forget that.

      The cheapest copy of poly-ether-ether-ketone (a.k.a., plastic)? Are you f'in kidding me?!? First of all, the unethical practice of grossly overinflating the price of a simple piece of plastic because of its 'medical implant' designation, is a practice that will go by the wayside in today's day and age. Secondly, whether this piece of plastic is made in the US or Asia doesn't change the fact that it's still a piece of plastic. Show me how you intend to innovate a piece of plastic better than the Asians. That's what I thought, Sherlock.

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    12. 5:35 You still got owned. Your points lack any intellect and you came back with nothing. I have to keep remembering that intellect is not learned it is genetic. My guess is that your family genetics closely match the giant steamy shit I just took.......and flushed down the toilet.

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    13. So talking about taking a shit is your best response? Really? With idiots like you making sophomoric statements like that, it's no wonder that our once respected industry and country are going down the drain.

      And by the way, intellect happens to be both genetic and learned, you dumbass. I have over 15 years of education and training, make seven figures, and shit on guys like you all day and night. So just keep your ugly pie hole shut and go back to stocking our shelves, little guy, since that is what we pay you for, isn't it?

      Now that's a good boy.

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    14. Correct me if I'm wrong, but if you have 15 years of education that means you dropped out of college your junior year. Do you prefer your odd sexual fetish of shitting on men during the day or in the evening?

      I make 8 figures and shit in toilets all day and night so beat that! I would love to stock your shelves with my superior plastic products, let me know where and how much you want.

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    15. 8 figures stocking shelves? LMAO. Must be hard kissing ass all day, then anonymously dreaming of being the man you never became. Must be hard trying to wash all of that shit off your face every night. Well get used to it, boy.

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    16. Huh? I was making fun of you and you are to dumb to see it. No one that makes 7 figures tells people about it......unless you are a redneck that one the lottery. Back in the 80's I purchased a shitload of gold bars. Sometimes I throw on an eye patch and sing a pirates life for me while I fire my blunderbust into the air Arrrrrrggggggg!

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    17. Won the lottery........anyway.....I am pretty sure you are low level Deutschbag pretending to be a big wig. Or maybe you are just a complete asshole.

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    18. Great... really great. This is pathetic. Back to the point that actually started this... ahem... "discussion".

      The cost of manufacture of cages is so little in comparison with the sales price that it really doesn't matter much where you make it. It's absolutely feasible for a small company with low overhead to offer a line of US-made PEEK cages and still well undercut the price of larger players. And now that hospitals have become price sensitive, here they come. Sure they'll have to take out or reduce some of the services that are paid for by the higher prices (e.g. representation, meetings, educational programs, clinical research funding, other "marketing" expenses, legal fees, etc., etc.), but the price sensitive hospital or ASC doesn't care that much about them and is happy to see the savings.

      The small percentage of savings achieved by manufacturing or procuring from overseas only makes a difference if you sell a ton of them, and thus is only really interesting for larger players to pursue. We're a long way from the place of manufacture being the difference in pricing being competitive here in the US.

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    19. What has happen to American craftsmanship? outsourcing american jobs to China is unAmerican! Shame on you sir!

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  15. Beside the POD issues, this is what companies are now doing to get business and cut out the reps:

    Eisertech announced the launch today of its online service, selling the Eisertech Cervical Cage directly to hospitals and surgery centers at www.eisertech.com . Eisertech is offering the PEEK cervical spacers for $495 apiece, with discounts for volume purchases. A complete implant and instrument set, which includes 32 implants, is priced at $14,995. The website also includes pricing for implants that are supported by on-site sales reps. Individual cervical spacers are priced at $795. Eisertech was started in 2010 by Lukas Eisermann. Eisermann has more than 16 years of engineering experience in spine and previously worked for Acromed, Theken Surgical, Medtronic and most recently NuVasive as Senior Director of Advanced Technology Development. The Eisertech website notes that a cervical plate, PLIF/TLIF cage and pedicle screw system are coming soon.

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  16. "if the physician or his or her immediate family has a financial interest with the person or in the entity that receives the referral". I'm not that bright on these things, so can someone explain to me what technically determines "financial interest"? Would a surgeon who owns mutual funds that invest in J&J or Stryker have a conflict? What about a doc who owns 100 shares of Zimmer? Technically these guys have financial interests as well, albeit not to the extent that a surgeon owning 30% of a small spine start up.

    Where and who draws the line?

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    1. they would qualify as an Exemption as the Interest is obtained through a Publicly traded co.

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    2. ... and there are percentage of ownership limits that establish the amount as being so small that the individual's influence doesn't affect stock performance.

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  17. I would say if it is a fund of some sort you're ok. If you are a clinical consultant or receive comp for your services by working with a company, then that would be a conflict.

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  18. The richest one percent of this country owns half our country's wealth, five trillion dollars. One third of that comes from hard work, two thirds comes from inheritance, interest on interest accumulating to widows and idiot sons and what I do, sell PEEK implants. It's bullshit. You got ninety percent of the American public out there with little or no net worth. I create nothing. I own. We make the rules, pal. The news, war, peace, famine, upheaval, the price per pedicle screw. We pick that rabbit out of the hat while everybody sits out there wondering how the hell we did it. Now you're not naive enough to think we're living in a democracy, are you buddy? It's the free market. And you're a part of it. You've got that killer instinct. Stick around pal, I've still got a lot to teach you

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  19. Some of you stupid overpaid sales reps think your surgeons have a god complex? I have an M.D. from Harvard, I am board certified in neurosurgery and trauma surgery, I have been awarded citations from seven different medical boards in the USA, and I am never, ever sick at sea. So I ask you; when someone goes into that chapel and they fall on their knees and they pray to God that their wife doesn't become paralyzed or that their daughter doesn't bleed to death or that their mother doesn't suffer acute neural trama from postoperative shock, who do you think they're praying to? Now, go ahead and read your Bible, and you go to your church, and, with any luck, you might win the annual raffle, but if you're looking for God, he was in operating room number two, and he doesn't like to be second guessed. You ask me if I have a God complex. Let me tell you something: I am God.

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    1. Well it is good to know that God also follows TSB.

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    2. ok alec baldwin

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    3. God reads TSB, oh my Gawd

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    4. Lets be clear you became a surgeon hoping you would get wild hardcore sex. You left you wife that supported you when you were in class/fellowship, dumped her when you got in the OR and the first RN hit on you. She left you because she realized that you were into worshipping yourself extremely boring in the bedroom and you had bad credit. Now you are sixty at the end of your career, are in a pod, are remarried to I am guessing married to your 9th Nurse OR a sales rep that is essentially a vagina for Hire. Not to mentio you are suffering failed vision from pulling your pud in Med School and the addiction to a combination of drugs mainly Viagra/Propecia/Grecian Formula/HGH

      I have a citation airplane, I have wildhardcore sex every day and have since I was thirteen, pay the rep that you are in love with, and have good credit.


      Charles

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    5. Dr. Harvard,

      YOU ARE A COMPLETE ASSHOLE!!! Such vanity is disgusting.

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    6. How do people not realize that God speech is from a movie....

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  20. Mr. "Harvard" surgeon I think in all fairness, I should explain to you exactly what it is that I do. For instance tomorrow morning I'll get up nice and early, take a ride to your hospital and walk in and see you for our scheduled case. if you don't use my instruments and implants, I'll... crack your head wide-open in front of everybody in the hospital. And just about the time that I'm coming out of jail, hopefully, you'll be coming out of your coma. And guess what? I'll split your head open again. 'Cause I'm f ing' stupid. I don't give a damn about jail. That's my business. That's what I do.

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    Replies
    1. As Larry the Cable would say, "That there is funny! I don't care who you are."

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    2. I really need to spend more time watching old movies... or reading this blog. Not sure, but entertaining as hell either way! Keep 'em coming o ye who are more creative (and versed in movie-speak) than I.

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  21. Big companies will be cutting commissions more in months ahead...market beware from an insider that knows....definitely works in favor of smaller companies with decent products and commissions with stable foundation. What companies are out there that would be worth looking at with more than just a cervical plate and interbody?

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  22. The smaller companies will not have a chance. Hospitals are stream lining vendors. They want a company that can supply EVERYTHing from cervical to sacrum. GET out of spine while you can. The glory day's are over. Yes, there will alway's be a need for spinal implants, but it is not what it used to be.

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    1. You are so right. But at a cost to your commisions. The Super Ortho companies have spent large sums of money on being able to supply EVERYTHING; the value of the sales rep gaining business is diminished. Depuy-Synthes doesn't need an overpaid rep making 350K to gain access to a hospital. They have already secured that with the acquisition. Materials Management and JNJ Corporate have a relationship. Surgeons and reps are down, down, down the food chain. Happy Selling

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  23. Your name is "you're wanting", and you can't play the man's game, you can't close them, and then tell your wife your troubles. 'Cause only one thing counts in this world: get them to sign on the line which is dotted. You hear me you maggots?

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  24. Lots of trash talk today. Back to the subject. Florida is starting to go POD with Penile USA. Many of those 'loyal Medtronic surgeons' were the first to jump onboard. Nobody's safe, so just keep fighting and eventually you may eke out a living, assuming Obamacare doesn't ass-rape us all first.

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  25. Those of you who don't know Lucas Eiserman are stupid and uninformed. He was one of the lead engineers and Medtronic and Nuvasive. He is considered one of the brightest and best brains in the industry. He makes the implants and instruments just like he did for the big companies and has done it many times times before. The implants are not Korean they are American just like yours if not better. The are 510 k cleared by your FDA and ready for sale just like yours. But you are not needed to restock or sell because he has a leaner buisness model. This man has developed a lot of the things you sell and are so proud of. Believe me, those who lead your big companies know Lucas and respect him. He is very honest and has a great idea. All of you who deride him just show your ignorance.

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

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  26. Lucas started at AcroMed, then took his knowledge he gained there to help Randy Theken set up his rip-off business. For those of you who are too young, Theken started as a biomechnanics lab testing for AcroMed, Danek and some others. Once he had seen and tested all their products he made his own with just enough of a change to circumvent patents. Smart? Yes. Ethical? hmmmmm

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  27. Interesting thread...as a surgeon I find it interesting to read the varied array of comments. Her's the bottom line; the reps ARE valuable on many fronts, from helping the nurses and techs on the back table as well as with room set up, being sure back-up instruments etc., are available,making sure things are re-stocked, and so forth. It is NOT as simple as it might seem to have the right thing available, and if you think I'm going to put my professional reputation on the line by taking a patient into the OR without proper back-up you are crazy. I wouldn't trust ANY F*(%!%$ hospital to provide an implant no matter what the price. They can't even get you a standard crew that knows what opertation you are going to do, nor can they pull the same set of instruments from 1 case to the next. I don't care how some engineer made his reputation or implants, but without a good rep in my room I won't use that implant even if it were free...

    ReplyDelete
    Replies
    1. A lot of hospitals would be lost without a GOOD sales rep, in some cases they have been there longer than the OR employees and surgeons.

      Delete
    2. 1:44pm
      I'm calling BS on you being a surgeon. Just read what you wrote. Pathetic that a rep must imitate a surgeon to build yourself up. Most administrators, as I, would be embarrassed if you spoke as a member of our surgeon staff (employee or not).

      Delete
    3. 4:37
      No offense but surgeons complain all the time about hospital staff and administration. They are just like all other people. Don't be so sensitive, I am sure you are good at what you do.

      Delete
    4. 1:44, you're a rep. Please spare us the bs. Hospitals supply implants all the time to all types of surgeries.

      Delete
  28. True doesn't sound like a surgeon but his message rings true. For the forseeable future those that provide a tangible service (case going well) will still be valued. Naysayers will proclaim that the value of the person in the room that takes responsibility for all the items needed in the room or on standby to ensure positive outcomes is no longer needed are short sided. A tenured rep not only insures that his items are there but also supports hospital staff by making sure all the needed items from the hospital are either in the room or available. Sounds insignificant but after 20 years of doing this I can tell you that someone that knows what they are doing can really change the flow of a case by anticipating what may come around the corner in a case. The good ones know what I am referring to the others may not. Keep your head down, do the right things day in and day out and you will survive as you are a valuable part of the equation regardless what the others say.

    ReplyDelete
    Replies
    1. You Hit The Bullesye.
      Thank you

      Delete
  29. The role of the spine rep will ‘survive’ as a service rep just as reps are required in joint and trauma cases. However the days of premium salaries above the norm in the med device arena for spine will continue to become a thing of the past.

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  30. There are good reps and bad reps. Unfortunately most of the younger reps under 35 don't have a clue about the art of selling, and bring no value to the scenario.

    ReplyDelete
    Replies
    1. With all due respect, I always get a kick out of the legacy reps talking about the "young guns who don't know about the art of selling." What art is that, exactly? Taking a doc out on the annual fishing trip? Paying for a few rounds of golf back in the day before it was heavily scrutinized? Please.

      I wouldn't have made it very far in the industry without the coaching, experience and insight of several veteran reps when I came on board. No question about it. But even talking with those guys, they'd agree that only takes you so far in our current state of things.

      I would guess 90% of the transactions I see happening in spine have little to do with actual "selling." It's simple leveraging long-term relationships (which started with selling), or worse.

      Agree there's a lot of younger, entitled, hot shot reps who's mere presence is enough to make you want to leave the industry. But the fact that many of these types of reps have been successful year after year only proves the point that "knowing the art of selling" is no longer a prerequisite for success.

      Delete
    2. IMO, spine implant reps don't "sell". Most buy the business and kiss ass. Just fill the tray up boy.

      Delete
  31. What really cracks me up are those reps that "think" they have these uber secure and solid relationships with "their" surgeon(s). Then one day out of the blue....surgeon is using/sampling a competitors product....uh-ho WTF. Now confident rep is not so confident, goes in to speak with solid surgeon and finds out the unfortunate truth. The reps story and product line has grown tiresome, and he suddenly has lost out on 25% of his income. Now he is pissed and challenges the surgeon thus pissing him/her off and forever burns the bridge with that surgeon. Seen it over and over again. Surgeons should evaluate differnt/new products and it is not always easy to explain to reps that their time has come, but business is business, and it is not always personal

    ReplyDelete
    Replies
    1. I have seen this mostly with Medtronic and Depuy reps who think they are entitled to a surgeons business. They think if a surgeon did a Medtronic or Depuy based Fellowship that the surgeon should be exclusive. They plan their long term income ( car payments, home mortgage, ) based on their "Depuy" or "Medtronic" doc loyally supporting them for the next 20 years.

      Delete
  32. DePuy based fellowship? LMAO !! I work for DePuy and I have yet to get a DePuy trained customer move into my territory. FYI DePuy is afraid of their own shadow. And, since at JNJ, attorneys outnumber reps by 20 to 1, there are almost no fellowships given out. If there are, they go to the same 5 surgeons every year. Don't want to go around giving the "Wrong Impression", I guess. Therefore, I find it hard to believe that you get only DePuy or Danek fellows moving to your town. Suggest placing the blame for your failure elsewhere.

    PS: TSB - not a big fan of the new format.

    ReplyDelete
    Replies
    1. 20 to 1, wow. How many lawyers is that?

      Delete
    2. JNJ spends over $350million annually for LEGAL. How many Lawyers do you need to spend that?

      Delete
    3. Market cap is $180 billion. $350M in legal is probably way under the actual number. That might just be the cost of the in-house counsel, not outside firms.

      Delete
  33. Is It true nuva reps are tracked via GPS (iPod)? How embarrassing is that.....

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  34. zimmer making strides

    ReplyDelete
    Replies
    1. Mediocrity...

      Delete
    2. Heard there were some shake ups in upper management over the last couple of weeks. My local rep approached me about making a move as he is worried about his job security.

      Delete
    3. Another crap quarter ... That makes 12 quarters in a row with negative sales growth?

      Delete
    4. Wait, they just launched a anterior cervical plate...with a window. Those guys are innovators.

      Delete
  35. Did I miss it? ... checking, checking... No, it's not here! 120+ and counting and no Globus going public comment! You (guys) are slacking!

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  36. Globus is going public this year.... That was so 27 seconds ago. Sorry, the Slowskys are my IT guys !

    ReplyDelete
  37. Quagmire here again, anyone seen Stewie? Giggity, Giggity! Peter just landed at Globus!

    ReplyDelete
  38. Looking at picking up Orthofix Spine. My question is with the commission of Trinity. I was told that points on Trinity are 20% of 70% of the price. The first 30% goes to MTF, is this standard?

    ReplyDelete
  39. Ofix loils to be improving their lineup. Im with Depuy and looking to make a change. They are on my list. Not sure it's the best place for me or not. The commissions on trinity sound suspect. A percent of a percent deal never works out right. Get a flat %, the mark up on biologics is huge and they'll pay 30% from selling price.

    ReplyDelete
  40. Check the products and instrumentation out for ofix before signing up......that's all I'm saying.

    ReplyDelete
  41. Serenity Now! After reading all of the emails about Eisertech, I called. What I found out...
    * Guy who started company is legit.
    * Products are FDA approved, made in US...documents to prove it.
    * He sells commodity products & not unique ones that need a rep
    * Focusing on surgery centers - simple surgeries, less red tape...
    * Selling products - 3 different ways
    1. Direct - $495 ("self-service" gas station; wholesale)
    2. Rep - $795 ("full-service" gas station; rep makes $300).
    3. Referral - $495 (Hybrid? Rep sells product, but does not service account...no specific details, but would work a deal to pay a % of sales over X years).

    Last option sounds interesting...go to competitive accounts...pick up some new $...but I need to know % and years first...

    ReplyDelete
    Replies
    1. I work for a large global spine company and can sell my implants cheaper than that if I do not have to cover the cases. If they get traction I will undercut and put the instruments in on consignment. This is a shitty business plan as they offer nothing unique, every company under the sun can offer the exact same program........good luck!

      Delete
    2. Your commissions per case will rock. 8% of the $400 per cage you'll have to offer to get the customer to switch back. $32 per level. 50 cases per year...hmmm...$1600 total commissions in exchange for having to convince the corporate a-holes that the account is worth putting consignments at.

      YES!!!!! I'LL DO THIS TOO! WE'RE GOING TO BE RICH TOGETHER MY BROTHER! YOU'RE A GENIUS!!!

      WOOHOOO PORSCHE DEALERSHIP, HERE I COME!!!!!!!

      Delete
  42. For all of you who think you can get rid of spine reps in the OR please sound off if this happens to you frequently. The "trained" scrub is all ready and prepped for the case. Then right when It is time to do hardware, lunch time! You get the floater who has never done a spine case and is flailing. The only reason the case goes well is because a spine rep is in the room.

    ReplyDelete
  43. What would be conaequences if a sales rep for a korean company u&i had more orders than could be met and took some u&i ped screws to local machine shop for duplication and then used those counterfit screws in cases along with some creative computer billing ...would this be something which a bag may not want a cat out of?

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  44. 2:13, that is sooo true! I hate that. Besides, how often does a doc get chippy when it takes 4 seconds to get him the instrument. If there was no rep it could take 10x as long in some cases. The demise of the rep has been greatly exaggerated

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    ReplyDelete
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  48. Stryker strikes again only it's worse this time! Their latest batch of victims, the Cervicore victims, were injured even more grievously than the hip implant victims and there was even more criminality involved. CerviCore is an artificial disk implant meant for implantation into the cervical spine. Not only is it a metal shedding Frankenstein design like the Stryker hip implants, the Cervicore disk never received FDA approval for use in patients. It gets worse, the Cervicore disk never even received FDA approval to be used in clinical trials or IDE (Investigational Device Exemption). The Cervicore disk is such a piece of shit that it could not even get and IDE from the FDA but that didn't stop Stryker's doctors from implanting them in the spine of patients.

    Currently the is a class action lawsuit being filed against Stryker Medical.

    file:///C:/Users/Chris/Downloads/File%20Stamped%20Copy%20of%20Complaint.pdf

    On Friday April 11, 2014 the law firm of Zoll, Kranz & Borgess, LLC filed a lawsuit behalf of a group of fourteen plaintiffs against Howmedica Osteonics Corp. (which does business as Stryker Spine) alleging Howmedica’s trial device called called CerviCore injured them.

    Stryker Howmedica Facing CerviCore Class Action Law Suit and Possible Jail Time

    ReplyDelete