Saturday, January 21, 2012

MONEY BALL

On behalf of those that contribute to TSB and our many readers we would like to apologize for the delay in posting. Our objective was to reenergize our batteries for the 2012 campaign.  As for blogspot, we would like to ensure you that some of the changes that were initiated were not of our own doing.  Ever wonder why computer geeks do the things they do without ever notifying you? With that said, we send our condolences to those that have had trouble posting. Collectively, we have decided to initiate a website that will cover more than just spine.  What do you think?  We believe that with our tenure in general orthopedics, recon, trauma, biologics and spine this would be a more entertaining venue. Who knows maybe we can write another article on how stem cells can grow a real mustache.

Every now and then, one has to step back and put the fun back in spine.  Like the Energizer Rabbit, it keeps going, and going, and going, and quite frankly sometimes it just doesn't know when to stop. Even when it's at a standstill, it's still turning. What precipitated this blog was the screening of Money Ball, that team TSB attended. Team building, you've got to love it. If you ever get an opportunity to meet Billy Beane or hear him speak, he is truly thought provoking let alone entertaining, you know like having W come to your NSM, LOL. Or better yet, you could have some CEO get up on the podium and regurgitate some anecdotal leadership principles from some iBook, or, what some public relations firm wrote for them.  So, it got us thinking, and there's a scary thought,  why has this industry, let alone other industries evolved into such an us against them environment?  Is it the competition? Yes fellow bloggers,  there is mucho testosterone running around. Is it envy?  Is it a lack of corporate loyalty? Hmmm?  Is it a lack of understanding what it takes to build a business? Maybe you have all become the Street's prostitua.  Is it unrealistic expectations? Short-term thinking.. Are we self-immolating right before our own very eyes? Not only are you beating yourselves up, you are getting beaten up by your CEO's, hospitals, surgeons, rapetrax, vendor-rape, and the list goes on.  We have become so selfish and self-centered that Machiavelli and Sun Tzu would be proud of our behavior? They would love this atmosphere. How has this behavior affected our leadership? Too many people think these people are oracles and give way too much credit to the Lukianov's, Paul's, Orsingers, etc.  Maybe things have come much too easy for all of us?  Years ago, and yes young un's there is something to learn by living life, there was a fundamental understanding of how to build a business.  As previously stated, organic is a thing of the past whether we like it or not.  Is it because a lack of talent?  You be the judge.  How out of touch are some people? How many engineers actually spend time in the operating room Mr. CEO? All right, enough with the bitching. Let's just say there were rules by which we all understood we had to play by.  Even the CEO of the team and the Manager overseeing the team that he fielded understood each and every players ROLE.  But the one aspect that TSB truly sees lacking in our industry, is a fundamental disconnect between the rules and the respect that we had for one another.  Just read your comments.  What is it about the industry and the people that run it that make it so insane?

Let's look at corporate loyalty.  Recently over dinner, TSB had a conversation with a CEO about whether the so-called "negative employee attitude" was the product of inherent corporate deficiencies, or an individual personality trait?.  I am sure 99% of you can guess what his answer was?  Voila!  It's always the employee.  Have you ever met a CEO or senior manager whom was honest enough to admit that he had an ugly baby? HOUSTON WE HAVE A PROBLEM.  So I asked, what are the company's responsibility to it's employees?  Is it just providing the individual a job and benefits?  What happens in a relationship when one person perceives that they do not do anything wrong, or they do not listen, or do not communicate effectively?  If corporations are truly people (Mitt's Witt, or is it Nit Wit) why is it that corporations suck at understanding the human element in business? If corporations are truly people, then why do they suck at managing people? So, TSB proceeded to pose questions that many of our readers experience on a daily basis in spine.  Here's a sample of our discussion;

How responsive are you to the market, your customers, and your sales peoples needs?  A timely execution and focus results in success. Untimely execution results in well.....your untimely execution, or a staggering company. Can you name a few? Ever work for a CEO who insisted that there was nothing wrong with the product?  You know the old expression, "while Rome burned Nero fiddled." You can't make Beef Wellington out of BS.

Have you set realistic goals and objectives?   There is a difference. Goals are about effort, while objectives are about attainment.  How many of you work for management teams that have delusional expectations, and then hold you accountable for their ineptitude?  What would be the point of providing you with a objective that is UNATTAINABLE, and then hold you responsible for it?  

Do you listen with an open mind?  Years ago people didn't have books written on management, leadership, strategy, tactics and execution, yet somehow they managed to succeed.  Could it be that common sense no longer exists? Did it die?  Today, confusion reigns.  How did yesteryear's companies flourish without Drucker, Covey, Kotter, Menkes, or Maxwell?  Unfortunately, too many people read these books and then begin to believe that the company, or their employees are their laboratory, spewing out anecdotal quotes thinking that this will motivate when the problem lies within the corporation.  Leadership goes beyond academic intelligence, and contrary to what is written in books sometimes one has to look beyond the individuals magnetism or charism.  Do you want style or do you want substance? 

Do you provide your employees with what they need to be successful? If a carpenter does not have the right tools, how can one build a house on a foundation?  This goes back to the adage that one cannot make Beef Wellington out of BS.

Do you make promises that you cannot keep?  Haven't we all heard this before?  The companies that respond win, the companies that BS their customers LOSE.  Just look at who are the contenders and who are the pretenders.

Have you ever participated in an anonymous 360?  This is TSB's favorite considering how fragile and insecure most of the CEO's and senior managers are in this industry.

So how does this tie into MONEYBALL.  The companies that have succeeded in many respects are like Billy Beane.  Individuals who are or were willing to step off the ledge, take a chance, learn from their mistakes while at the same time keep life in perspective, yet understand that there is a human element to any venture. They realized what it takes to build a great product, go against the grain, and that doesn't mean stealing other people's IP.  But let's give credit where credit is due, behind every Billy Beane there is a Paul Podesta and without Paul's genius, Billy and the 2002 Oakland Athletics would have never accomplish what they did.  The most memorable moment in the movie comes when one of Beane's scouts confronts him, telling him that he was in over his head, that he doesn't understand that "this is the way its been done in baseball for years (sound familiar)." This is exactly what this blog has been about, this continues to do it the same way because for some ungodly reason, are you listening you brilliant investors and BOD's, you think you have a formula and it works regardless of the situation or environment, but its just not that simple.

What the movie also teaches us is that the art of arbitraging is unique in that one profits from the simultaneous sale and purchase of an asset in order to profit from a difference in cost. Timing is everything. Maybe the spine market can learn something from its inefficiencies.  Ever work for a company that pissed money into the wind?  TSB is sure that many of you have.  Considering that pricing has deviated substantially from what was once considered the norm, how do we ensure that pricing along with our livelihoods does not continue to erode and you do not perish? Fluctuation in pricing in the spine market has resulted in decreasing profits across the board.  Why would someone want to underwrite another IPO when we don't even know what will happen with healthcare in this country?  In addition, this has placed a tremendous strain on start-up and early growth stage companies.  Who will survive and who will perish? If INFUSE has been battered and bruised, do those stem cell aficionados believe that there isn't a plan percolating for them?  

But the gift of giving will continue as you walk the aisles of CNS, AANS and NASS take a look around and ask yourself, what's new?  Where are we going?  Are we making things better? Are the patients really benefitting from all these procedures?  Are the outcomes getting any better? Hey what happened to the total disc market?  Or, has it all come down to the almighty dollar?  Who knows, maybe the Chinese will teach us that they can copy our implants and technology and sell them at a cheaper price around the world and even in the U.S.. Don't believe it, ask the Koreans. Unfortunately for many of you, it comes down to who is running the company, do they have the cash to make things happen, have they surrounded themselves with their friends because of their insecurities, and then you'll know where your organization is going.  So as we springboard ourselves into another year of fun and games, TSB wants to know will you make a difference, or will it be business as usual.  To paraphrase a line in the movie, "many are called, but few are chosen."





171 comments:

  1. Did they go public? ...yet?

    ReplyDelete
    Replies
    1. 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

      Delete
  2. "TSB wants to know will you make a difference?" Someone's trying to make a difference in Fort Wayne, IN:

    Tommy Mitchell (Orthodirect USA) and his lackey Shawn Hoover (and maybe Tony Sell?) are hard at work in Fort Wayne. Let me get this straight, two reps who can't sell any products are the first to sell out the industry and become "facilitators" for Tommy's "revolution". They would teach the hospital staff how to do cases without reps (who from the hospital is going to miss dinner to hump sets around town?) and Tommy puts the hospitals in touch with implant companies willing to sell direct to hospitals at basement pricing because no sales reps are involved anymore. Hoover is not well-respected in the industry and Tony's contract with Integra Spine was not renewed due to lack of sales. (One case every two months is not enough to cut it.) Is Tony really involved with Orthodirect? Anyone know? Who else is involved. Does this group have traction? (see 10-4-11 spineblogger post on Tommy Mitchell and his rep-removing "revolution") as well as a youtube video http://www.youtube.com/watch?v=8V4SGXsHoLQ where Tommy explains how he makes reps more "relevant" by "removing them from the equation". If this goes through, there will be no reps allowed in Fort Wayne's largest hospital. This seems to be a classic example of the few guys that can't cut it in the business ruining the business for the many reps that actually are succeeding.

    ReplyDelete
    Replies
    1. Sounds a lot like the dumb ass rep who started rep trax

      Delete
  3. Well, he is actually quite innovative... and he moved first in the markets direction. He will be rich... we will be losers. But, I'm not sour about it... I got skills, too.
    If not here, somewhere.

    Pricing will eliminate commodity reps.

    Better be niche, brother.

    ReplyDelete
  4. Is this Tom Mitchell with Spine Source your talking about and Tony Sell in Charlotte?

    ReplyDelete
  5. Tommy Mitchell with Orthodirect USA in Fort Wayne, IN. Tony and Shawn are in Fort Wayne too.

    ReplyDelete
  6. The days of reps in the OR for every case are numbered. It's a nice luxury for the surgeon and hospital, but we are moving to a bare bones system. The future will be about contract, price and product in that order. Adopt or die. Anyone who thinks there will be reps in every ACDF 3 years from now is a fool.

    ReplyDelete
  7. I liked it better whem the TSB just made one statement.

    ReplyDelete
  8. No kidding. He's the self-proclaimed Spine Blogger and he wants to start talking about general orthopedics? BO-RING. I think he's losing his mojo. C'mon, SB, get out of your funk, bro!

    ReplyDelete
  9. 11:14 TSB is the only spineblogger

    ReplyDelete
  10. I agree that reps' days in the OR are numbered. But that doesn't mean I have to be happy about a couple reps that failed in this business, dropping their pants and attempting to change the game for everyone else.

    ReplyDelete
  11. I wouldn't let Shawn Hoover train my cat.

    ReplyDelete
  12. Their model is flawed. Why would any company agree to work with them when they could go to the hospital directly and offer the same program? If by some slim chance they do succeed the big boys will walk in and undercut their pricing anyway or the GPOs will get into the game.
    Following this model COGS will be king and we will have Chinese implants. I don't know about you but any country willing to poison dog food and baby formula will not be making anything being implanted into my body.

    ReplyDelete
  13. That's what they do. They go directly to the hospital and say "We'll introduce you to some companies willing to sell to you direct, with no reps involved, at rock bottom prices. We'll also provide facilitators (turn-coat reps) to train your hospital staff to operate without reps. Just pay us for our training/consulting services."

    ReplyDelete
  14. I don't think they make anything (or maybe they do?) on the metal. The implant companies agree to work with them because they (orthodirect usa) hook the low-overhead implant companies up with the hospitals. Big solid implant companies have refused this model. MDT won't do it.

    ReplyDelete
    Replies
    1. Ummmm, large implant companies dont need that kind of "help"!

      Delete
  15. How are implant companies able to sell so low? I understand if you eliminate the sales force you save at least 30%, but are they able to copy patents (thereby eliminating engineers and other staff) and just pay some manufacturing company to crank out screws for them? Them sell them direct to hospitals at prices that legitimate companies (with engineers and patent attorneys and salespeople) can't match?

    ReplyDelete
  16. TSB, what's your take? I know you posted on this specific guy back in Oct. You didn't seem too fond of him then. Is his business model working anywhere? Is this stuff he's posting on youtube taking hold anywhere?

    ReplyDelete
    Replies
    1. well considering he has only 400 views, I say, not.

      Delete
  17. You should include robotics in the new website.

    ReplyDelete
  18. Paring back distribution in a market where prices are declining is common business strategy. Spine Cos. have to find cheaper ways to distribute their products or charge for value added services like case coverage. Whether it is sterile individual implants or an OrthoDirect model, I think it's a direction the industry is heading. We could all end up being Ethicon reps or worse.

    ReplyDelete
  19. Just talked to a guy in MI and he heard the Depuy distributor is going direct. Any one know if that is true? And how is that many now? In my state they are still an agency but I'm curious if it's going nation wide. Are the reps staying? I have to imagine with the Synthes integration territories will merge and or be cut. Looking forward to that disruption.

    ReplyDelete
    Replies
    1. Its nationwide. Not renewing many of the Depuy distributor contracts. Some reps are staying, some leaving.

      Delete
  20. TSB - you're right. It is time for a change around this blog. The change most needed is not a switch to general orthopedics (big, boring and much less contentious/exciting). The change most needed is to begin every topic with the most important question that has been glaringly absent from the world of spine surgery for too many years - begin EVERY conversation with the question "what is best for patients?" If the leadership in this industry put this question first, our corner of the med tech world would never have become such an embarrassment. Patients, not surgeons, are our customers. Surgeons are our valued partners in bringing better lives to the patients we serve. We value our surgical colleagues, of course, especially to the extent that they help us in our mission to bring better lives to patients.

    For example, when discussing sales optimization - Imagine how refreshing it would be to inspire a debate on the best path to insanely successful sales models for products that enable maximal patient benefit?

    When exploring emerging technologies - ask first not what will make me the most MONEY, but rather, what will make the biggest difference in improving the lives of the patients we serve? Getting our products approved, paid for, and sold needs to ALWAYS follow doing the right thing for patients and our clinical partners in the OR, the spine surgeons.

    We do need new sales models because we won't be able to successfully serve patients and build thriving businesses without them. The hatred, back-stabbing, bitter and venomous banter on this blog is deeply counter-productive in a world where the old rotted walls are crumbling and and the emergence of a new world order is both required and inevitable. We can go down with the old, broken, disease ridden ship or take a leadership role in the building of a healthier, stronger new one.

    Creative destruction rarely comes from the old guard, but it's not unheard of, so step up your game, TSB ; ) As TSB well knows, the inevitable creative destruction must be embraced, even facilitated, with a clear focus on building an industry we can all be proud of.

    The world of Spine is small enough, and TSB has enough of a following that this blog may well be able to be a part of that destruction and solution. Cautionary words for TSB (or a future TOB) -- you may have much less of a voice, a diluted voice, if you try to be a big fish in the much bigger ocean of Orthopedics. Good luck, either way.

    ReplyDelete
    Replies
    1. I agree. TSB, you're having to consider opening this up to orthopedics because the value of the discussion that happens in this blog has damaged its relevancy. Adding orthopedics will make you even less relevant within spine (for which this blog is named). Your posts set the tone and it should be directed at a higher level of analysis and objective criticism of devices, approaches, business models and policy.

      Delete
  21. Just what reps need, a third party, one of your own, assaulting your right to "earn a living." Isn't it a joke when these turds tout to the hospitals that "you can take back your operating room." They will educate the O.R., LMAO. It's quite evident that these dick heads haven't been in an operating room lately. Reps have never owned the operating, it belongs to the surgeon and the hospital. As for reps vanishing after 25 years, let's just say "it ain't happening" no matter what the oracles of the industry.

    Remember, you can unite and fight, or you can lay down.

    ReplyDelete
    Replies
    1. the anti-Karl MarxJanuary 23, 2012 at 1:07 PM

      Honestly MSM, cut the entitlement mentality already. Whatever we think of those guys, they have the right to pursue the business, just like the rest of us. None of us have a special entitlement to be given these sales jobs. Maybe their idea will work, maybe not...time will tell.

      The more you "unite and fight", the quicker reps will get booted from OR's...I mean, what are you going to do...form the spinal reps union and all go on strike?

      How about instead, we all just work really hard at taking care of our customers so that they come to the decision that the cost savings aren't worth losing our services over?

      Delete
    2. Free Enterprisers LMAOL Reps will never get booted out of the OR, if they do, the lawsuits will follow. Ever watch a surgeon use a complex MIS system? As for your anti Marx, you really don't know TSB, a capitalist but with some scruples unlike some of the slime that circles the drain of spine, anything to make a buck even if it means scamming. Are you job makers or job takers, you need to read some history to understand how this country was built so the anti-karl Marx's of the world would have an opportunity. RIP AKM

      Delete
    3. Karl Marx = Evil BastardJanuary 25, 2012 at 8:28 AM

      Haha. That could be a Chavez or Obama campaign speech. Leave it to the little dictator inside every socialist to anoint themselves as the differentiator of what sort of business model is or isn't honest. Always the excuse is that the company currently eating your lunch is "crooked", or "dick heads", "slimy" or "unscrupulous". Followed inevitably by a call for a new law or regulation to re-establish the status quo in your favor. Usually the truth is that the person eating your lunch innovated in some way (whether by technology, distribution model, new channels to market, etc.) or just plain out-worked and out-hustled your, or both, and you got caught with your little Marxi pants around your ankles

      In this case, here you are, claiming that your "right to earn a living" (thanks for making that one up, btw. Can I assume you are just paraphrasing the rights to life, liberty, and the pursuit of happiness?) should somehow trump the right of other people (in your terms "these dick heads") to do the same?

      Can you please expound: on what basis does your desire to pursue an income as a spinal implant sales person trump their desire to pursue an income acting as cost consultants to hospitals?

      Delete
    4. Is that Joe Ryan, Marty Altshuler, or Carrot Top pontificating about free markets

      Delete
    5. 7:35...who cares...note lack of response from the socialist.

      Delete
  22. Is it true that Jerry Summers is the new CEO at Amedica? Wow!

    ReplyDelete
    Replies
    1. Jerry, please stop posting comments about yourself on this blog. Nobody knows who you are.

      Delete
  23. MA DePuy spine distributor is out too!

    ReplyDelete
    Replies
    1. is this true?

      Delete
    2. It's true. Not sure of the details. Anyone know if the reps are sticking around?

      Delete
  24. Will ken K in Ohio keep his Depuy distributorship?

    ReplyDelete
    Replies
    1. Ken K great guy
      Hope his run isn't over

      Delete
    2. Ken is an awesome guy but he's gone too.

      Delete
    3. Ken K is one step above Chip R. Still in the mud.

      Delete
    4. Is Chip R gone too? wow

      Delete
  25. How much longer can the DePuy hoods in FL keep their distribution with such pathetic results? Maybe they can get one of their 'footsoldiers' to kneecap Hansjorge Weiss?

    ReplyDelete
    Replies
    1. That's a big distributor because of New York. They will be around a while I'm guessing.

      I left Depuy two months ago, they are causing tremendous disruption. The VP of sales is forcing this through with no regard or consideration.

      Synthes reps will be going to 8% and a territory cut/integration as well. Reps that can't sell will stay, others will open their eyes. It's sad what they could've done to take guys direct and keep them whole, but they are squeezing the sales force. But hey, if you sign, there's an iPad in it for ya. I'm no tracking software either...

      Delete
  26. 3rd party is fantastic as it deomnstrates raw capitalism! tsb, we beat up each other's co's, meanwhile we are the only representation of the free market in our industry. and now obamacare?!? our beloved industry is based on a false premis which forces us to compete yet insurance co's. and the govt hold the real power. force insurance co's. to compete across state lines and unleash the free market forces to save our industry and uncle sam and our country.

    ReplyDelete
  27. Hearing some bad things coming for Alphatec. PODs starting to crumble and the rats are scrambling! Could this be the end? How long can they last at under $2 a share? Dirk..Dirk...Dirk can you hear us inside your organization trying to tell you the end is near and your management is grossly over their heads?

    ReplyDelete
  28. Replies
    1. Why do you invoke a coach of a simpleton game on this blog? He was an overpaid but good phys ed teacher, that's all.

      Delete
    2. JoPa is a loser in the game of life. Read the WP interview, a Brown graduate? Worked with a pedophile for 30 years and didn't know what was going on, was his head in the sand or up his ass, say it in't so Joe RIP

      Delete
  29. ATEC too bad. They just passed law in California that Surgeons can't use PoD products for workers comp. How many PODs does ATEC have in Cali? The problem they had in my state is that the Regional VP lies so much. You know the "sassy one".

    Even if they fail financially,
    Wouldn't there be value in the patents and inventory they hold?

    ReplyDelete
    Replies
    1. So you are contending that if ATEC loses its POD-based workers comp business in California, they will fail financially? Doesn't sound realistic to me. I doubt that business accounts for more than 1 or 2 percent of ATEC's total sales. And even though Hartson Hogan law firm interprets the law to apply to spinal implants, keep in mind that they work for the anti-physician ownership lobby, and their interpretations and opinions are neither legally binding or neutral. They've been "interpreting" all the laws to make physician ownership illegal for years. So far, OIG, DOJ, Senate Finance Committee and state legislatures don't agree with them.

      Delete
    2. Alphatec's VP of sale, Al Bundy, will claim POD sales are a very low percentage of sales. The problem is what he uses as a defenition of a POD. Being an OEM manufacturer for a POD is still supplying a POD. You cannot burry you head in the sand. Every sleaze bag in my territory carries Alphatec, and the good surgeons know it.

      Delete
    3. Isn't Hogan the law firm representing Blackstone in the whistleblower lawsuit?

      Delete
    4. 4:19

      I agree. It isnt that they have poor products but their management are complete sales whores. They have no long term business strategy except grab every dollar they can. Long term that doesnt work. I would expect them to have a serious management turnover in 2012.

      p.s. Im not in your business. Just an observer with financial interest.

      Delete
  30. ATEC's products are not bad at all. Are they really so bad from a management perspective that they cant find reasonable distributors to represent them nationally? Why didn't they realize that POD's are not only a short term fix but a long term liability with regards to image? I wish I was privy to an explanation of their decision making process.

    ReplyDelete
  31. I understand that the times are changing and that reps' days in the OR may be numbered, but when a few guys who failed in this game take action that directly destroys multiple successful reps' jobs, I think I have a right to be upset at those failed guys at orthodirect on a personal level. It's one thing for a hospital to attempt to cut a direct deal with a company (which not all companies will do), but when it's the failed reps (insert Shawn Hoover and Tony Sell) that are trying to broker a deal that directly destroys others' careers in the exact career that they failed, I believe that makes them turds. Thankfully I won't be affected but I have enough insight into this specific deal to know what's going on. I feel bad for those goods reps whose jobs Shawn and Tony are actively trying to "remove from the equation".

    ReplyDelete
  32. 11:25am
    Don't know the situation you speak of with Shawn and Tony. Let me understand. They bring value to your hospitals and turn some business. Isn't that what we all try to do? Adapt or get out of the kitchen. Sounds like they beat you or your friends to the business. They may be turds. Sales guys in general have earned that reputation (like it or not). At the end of the day, they have earned the bacon. Now what will happen like TSB says....unite & fight or lay down!

    ReplyDelete
  33. WHAT VALUE? YOU ARE OBVIOUSLY JOKING? IF NOT YOU HAVE NO IDEA WHAT YOU ARE TALKING ABOUT? EXPLAIN VALUE? YOU ARE EITHER ONE OF THESE GNOMES POSTING ON THIS BLOG OR ARE DELUSIONAL. COME ON BIG BOY WHERE'S THE VALUE? ALL YOU ARE DOING IS CONTINUING TO DRIVE DOWN THE PRICE OF IMPLANTS LIKE THEY HAVEN'T BEEN BEATEN DOWN TO THE POINT WHERE NO ONE WILL MAKE A LIVING. ARE YOU A JOB MAKER OR JOB TAKER? THESE PEOPLE BEHAVE NO DIFFERENTLY THAN THE BANKERS THAT SOLD BS MORTGAGES AND POCKETED THE PROFITS. LMAO FOOLS. OUR GOAL SHOULD BE TO OUT EVERY COMPANY THAT UTILIZES PODS AND THESE IMBECILES THAT DO NOTHING MORE THAT THREATEN EVERYONE'S EXISTENCE. THESE PEOPLE ARE EVERYTHING THAT IS WRONG WITH OUR COUNTRY. JOB TAKERS NOT JOB MAKERS.

    ReplyDelete
  34. They don't turn ANY business. They want to train hospitals to operate without reps. Not sure if any have taken them up on it, yet. I know a few so far who have told them no. They haven't beaten anyone to any business. That's the point! They're trying to make all the business non-existent. They haven't earned any bacon. They're both unable to turn any sales numbers. TSB says they're turds and dick heads.

    ReplyDelete
  35. Spot on TSB!!! Wake up 1:42.

    ReplyDelete
  36. I heard that Obama spoke at the Nuvasive NSM this year.

    ReplyDelete
  37. Cheetah Nation

    IIIIIIIIIII I'm so in love with you, whatever you want to do is alright with me
    Cause you make my back feel so brand new, and I want to spend my life with Alex too

    Love
    The POTUS

    ReplyDelete
    Replies
    1. So...who else caught that little eye flutter? It sure looked like a live attempt at man2man flirtation. Anyone?

      Delete
  38. 1:22 us that true?

    ReplyDelete
  39. 4:21, sorry. Is that true about Obama?

    ReplyDelete
    Replies
    1. Hell no it's not true. Nuva did the smart thing and instead of spending $ on a speaker they gave the sales force iPads loaded w information.

      Delete
    2. Loaded with information that none of them will use. Then again welcome to the 21st century, albeit a year or two late. I've had mine going since they came out

      Delete
    3. you want a cookie 5:02? so have most of us.

      Delete
  40. Hey Guys
    I'm an ORT mostly ortho and spine and Ortho Direct talking to my management. Woopee maybe I can be the ORDT! AND HOW MUCH MORE IS MY HOSPITAL WILLING TO PAY ME? What do my RN and AORN members have to say about this? What about hospitals that don't use ORT's? Will an RN take less money for more responsibility. I can see some value OD wants to bring to table. But what about those cases going late into the night (burst fx's) or where we have to rotate a less experienced ORT into a big case lineup? There are truly times we, ok fuck that, there are times I need a rep and appreciate the help especially when some new gadet comes along. How can ORT's and REPS stand together to tell Ortho Direct - SHOVE IT UP YOUR ASS!
    Also, bullshit I'm not going to train fellow techs. What I see is a potential of compromised patient. PERIOD

    ReplyDelete
  41. Isn't Alex one of the smartest guys in the room? LOL . The jig is up

    ReplyDelete
  42. Did MSM sell TSB to someone else?

    ALL CAPS? thats not MSM's style.

    ReplyDelete
  43. I agree. A few things have made me question if someone else was posting under his name.

    ReplyDelete
    Replies
    1. Maybe an occasional interloper posting in there. Might be his hired help. His rants still otherwise stink of idiotic lefty politics, coupled with an unhealthy dose of misunderstanding economics.

      Seems like the same knuckledragging retard that's been leading us idiots that read this blog...

      Delete
    2. Dear Adam or should I address you as Mr. Wealth of Nations, it"s TSB here, you know that anti-capitalist capitalist. Having woken up in 2012 the world must be moving at lightening speed from when you penned your magnum opus in 1776. We all wonder how you would have responded to the carnage on Wall Street since the agricultural revolution was a different animal. Since you are a proponent of free market economies you should have been around a few years ago and witnessed what unfettered free markets can really do when they are unregulated. There was this financial instrument initiated by Wall Street called collateralized debt obligations CDO's, by the way that's a modern day acronym, that were packaged and sold to investors, the catch was that those selling the CDO's were also betting on them to fail by buying insurance on those same CDO's using a financial instrument called a credit default swap or CDS. These CDO's were a by product of a major housing boom whereby the government, a bipartisan collaboration promulgated a housing boom. You know a chicken in every pot......oops I shouldn't use that analogy I may confuse you. The long and the short was the economy crashed and burned. Now I know you are not fond of big government or maybe any government at all, but the Federal Reserve had to step in and stabilize the economy because all those free marketeers decided to have a free for all. Unfortunately, the burden of paying back this lifeline was placed on the back of the people.

      I happened to read your book when I was a young laddie, that's Scottish for young man, and found it rather confusing. Oh I forgot you areas Scottish. Well anyway, I did like your theory on division of labor and laws of supply and demand. But I must admit, the world is a different place and what happened in 1776 may not necessarily hold true today. Anyway, I still love the fact that you have awoken from a deep sleep and read TSB. PS: don't insult our readers nor should you ever put yourself down, arrogance and hubris will always come back to bite you in the ass.

      MM

      Delete
    3. You Can't Handle The Truth.January 25, 2012 at 8:54 AM

      Unfettered free markets, or failure to enforce existing laws?

      Look at the bigger picture. Start from the fundamentals of the asset class. Behind every CDO composed of garbage debt was a mortgage that someone agreed to pay. There was a massive amount of mortgage debt issued to people based on "stated" rather than "verified" income. Anyone that "stated" an income they didn't have was guilty of fraud. While unfortunate, it is true whether or not they understood the implications of things like balloon payments or adjustable interest rates.

      There should be mass jailing of these "homeowners" that defrauded their banks to obtain funds to purchase houses they could never afford.

      You may feel sympathetic to these people, since we all hold "home" so near and dear to the heart - but consider, what if instead of mass fraud to obtain home loans, there had been mass fraud to obtain luxury cars and yachts? Would you be equally sympathetic to the poor car owner that had his Porsche repossessed and now drives a used Honda, or the captain that lost is 42 foot ocean cruiser and now goes lake fishing in his hand-built rowboat?

      Unfortunately, the only investigations seem to be happening against the banks.

      Doubtless, the banks were collaborators in the fraud. Though is it said more appropriately: those employees of the banks that chose to put their short-term bonus payments ahead of their fiduciary duties to their employers; and knowingly participated in fraudulent transactions?

      Instead, the buffoon patrol in Washington decides that the victimized party (the banking corporation) is the criminal for "preying" on or laying off those (the mortgagees and loan officers) that perpetrated crimes against it.

      Then along come people like you, MSM, who don't stop to think about the headlines they read and happily send along messages that the criminals are the victims and vice versa, either oblivious to what you have done, or doing so intentionally to line your pockets or pad your ego.

      Delete
    4. MSM, Thanks for reading my book. Please come back for the remedial course and I'll get you a signed copy.

      Before the course....READ IT AGAIN. This time, please take notes and try to understand it.

      Delete
  44. Who took MSM!?!? We want him back!

    ReplyDelete
  45. Don't pay any attention to the man behind the (msm) curtain!

    ReplyDelete
  46. I agree, some of these posts don't sound like MSM. I don't know the guys involved, and maybe they're tools and the service they are offering is a sham. But if someone wants to sell a service to to hospitals that claims to reduce their costs by eliminating reps from their ORs, they're entitled. There's no law that says inventory management, moving products to the OR, and checking that the product is complete and ready to go has to be done by the company selling the product. (Which is much of what many reps in the OR do.) If the hospital decides they can do it themselves (as they were all doing 20 years ago) and save money, then they're entitled to pursue that path. If you're a free market advocate you have to be in favor of someone offering them help to do it. A lot of the banter I hear sounds like union workers protesting and arguing to protect their high-paying service monopoly against changes to the way their business is being done. As TSB says, just add value every day, compete as best as you can, offer your customer a fair price for your service, and they won't have any reason to change.

    ReplyDelete
  47. I agree with what you said, 9:34. My issue is on a personal level with the reps who failed in this business now trying to cut out those reps who succeeded. My points are that 1) these guys are turds, 2) money will be saved, 3) patient care will decline a bit and 4) some hospital employee making a meager salary won't go the extra mile to make sure all the implants/instruments needed for a complex scoli are available the way a rep would lose sleep stressing over every detail of an upcoming complex surgery, and 5) these guys are turds. Oh yeah, I already said that.

    ReplyDelete
    Replies
    1. What...you afraid to compete with a couple of turds? If they're the crooked simpletons you reps make them out to be, they won't be in business long enough for it to matter.

      Think about the business plan for a minute: teach hospitals to function without reps? Are you kidding me? There are only a few product areas where reps are as prevalent as spine. The hospitals know how to operate without reps...think trauma, oral, cardio, neurology, IR, gowns, gloves, suture...etc etc..they choose not to in some areas like spine. If they decide going direct is a better deal, they will...they don't need some reps to teach them how. As if the nurses can't open a set after a case and write down which sizes were used.

      It doesn't take a genius -if it did - I'd bet that most of the nurses have better educations than most of the reps. I think they can handle it. Hahaha.

      I don't know the guys you think are turds - I think the business plan is not worth losing sleep over.

      Delete
    2. This is the most well put post, on the subject, that I have seen yet !!

      Delete
  48. Little known fact: OR's in South Korea have been operating without reps in the room for decades. Ask a Korean nurse. The circulator scrubs quite often, also.

    ReplyDelete
  49. Does anyone know the name of the Globus rep in San Jose, CA? I think he is Indian. The guy is the biggest douche bag on the planet. He comes up to me (I never met him before) and starts getting in my face asking what I'm doing at a certain hospital in San Jose. Keep in mind, I'm a young female that doesn't sell spine or compete with him in anyway. I told him I was working with a doctor at that hospital at which point he tells me he has teamed up with one of my competitors and that if I don't work with him, he will make sure I don't get any other cases. Keep in mind I've never met this guy before in my life. I'm good friends with the materials manager at this hospital and he told me that this Globus rep came at him with all these questions about what type of pricing I was giving the hospital as well as who else I was working with. The materials manager told the Globus guy it was none of his business and to not put his nose where it doesn't belong. I then find out that this guy has been kicked out of several hospitals, permanently. I think one of them was UCSF, but I think he was working with a different company. Anyway, I hope he somehow comes across this post and realizes that he will not last long in this industry if he pulls what he tried to pull on me with someone that has some pull in the spine industry...

    ReplyDelete
    Replies
    1. Although this will sound sexist, if he pulls that on most guys he'll be laid out in the parking lot

      Delete
    2. I know the Globus rep well. He's a great guy. He has rock solid relationships many spine surgeons in the area. I'm sure if you asked around the feed back will be positive.

      Delete
    3. The rep in Austin is the same way. Very aggressive.

      Delete
    4. That San Jose globus rep has a ton of baggage.

      Delete
    5. 2:34 posted from a Globus computer. If it looks like a douche, and sounds like a douche, it must he must be a......

      Delete
    6. Wow, this is hilarious! I used to work with this Globus rep at Medtronic spine when he was an associate. The guy had gotten promoted to a spine specialist role, but was quickly fired by Medtronic after he verbally assaulted several members of the SPD staff at UCSF. He also tried to pick fights with a few competitive spine reps in the hospital when they converted a few cases away from him. The guy is off his rocker and I was shocked to find out that a spine company hired him after that whole debacle. I bet they had no idea who they were getting. @2:34, I carry a few lines that compete with this guy and I can tell you right now, the docs are not his biggest fan. One doc told me if this rep approached him again he would "punch him in his face"...no joke. From what I hear in the community about this guy, he is a lawsuit waiting to happen.

      Delete
  50. BTW, did he tell you when they are going public?

    ReplyDelete
  51. Sounds like your typical awesome Globus rep, whose business scruples are learned from the top down. In fact, I'd even let him baby sit my kids!
    Sincerely,
    Jerry Sandusky

    ReplyDelete
  52. The guy who started RepTrax was an ex-medical rep. I think he made a bit of $ on his (unfortunate for us) scam

    ReplyDelete
  53. Globus' national sales meeting was in Cancun this weekend. I was really hoping some Cartel thugs would have crashed the party, taken a few souvenirs. A cleansing of the scum of our industry.

    ReplyDelete
  54. TSB,
    Are you ok?
    Have you been taken captive?
    Or did someone from Pharmacafe steal your iPad?
    Im worried

    ReplyDelete
  55. How many NSMs are going on over the next few weeks? Stryker had theirs last week in Vegas, Nuvasive had their Cheetah Ball and everyone's door prize was an IPad (w/ a GPS tracking device to monitor every move of each "Cheetah in the Wild").

    Who's next and are there any great, funny, interesting stories out there? You know, the type like last year when a young rep was hammered at NUVA's meeting and basically went off on Keith Valentine? Yeah, those kinds of stories,, No need to use names, just share the fun w/ all!!

    ReplyDelete
  56. Congratulations to Spinal USA's newest member of the board of directors, Dr. W. Brent Faircloth of Mobile, AL. Only a $77,713 min. investment!

    ReplyDelete
  57. Can you share the story about the young rep going off on Keith Valentine last year? I haven't heard that one.

    ReplyDelete
  58. I don't think JnJ is having a full blown NSM. I wonder why, haha! They fired everyone and signed them up as direct with shittier pay. "C'mon out and let's all get together and have party at corporate!". Riiight!

    But hey, they are giving out iPads (tracking software included at no charge), can't pass that up!

    1984

    ReplyDelete
  59. Orthofix canceled there nsm. Surprise.

    ReplyDelete
    Replies
    1. For spine, ortho, or both? I was just told the ortho division is doing very well.

      Delete
    2. I believe that it was only the Spine meeting postponed for OFIX. I know the STIM meeting is on for sure. Not sure why all are down on OFIX. We had our greatest year to date as a distributor and will build on it in 2012.

      Only the cheetahs would spend the cash for a NSM when the product launches are not there yet.
      Please enlighten me to why OFIX should get everyone excited about new products that they can't run with yet.

      Delete
    3. the problem with no new products, is the old ones suck. have you ever heard of a company that is fda 510k approved for an inter-body take over a year to launch?

      Delete
    4. Uh yes Alphatec GLIF...2 years and counting its been FDA approved and not here yet.

      Delete
  60. The direct model will only gain traction until a patient dies on the table because no one is in the room to answer out-of-the-box questions that arise in difficult cases. There is a POD in my area that uses the ortho-direct model, but of there own creation and things were going well for them until they had a few cases go very poorly due to intra-op complications that no one was there to speak to a solution. They are now seeing huge declines in the volume of business even with surgeons pushing for them. There may be many overpaid and under experienced reps out there, but you will never replace strong clinical acumen. Not when patient outcomes are at stake, too many ambulance chasing lawyers out there!!!

    ReplyDelete
    Replies
    1. Sales reps as liability shields? Yikes. Scary.

      Delete
  61. 7:12

    Any surgeon who needs a rep to provide a solution in a difficult case needs to stop operating immediately. Yes, we all know these hacks are out there- but it's truly a sad day for the profession when a surgeon doesn't know how to troubleshoot the system he is implanting. In some ways PODs and direct models are a backlash by the surgeon community against this sort of unprofessional dependency in its own ranks.

    ReplyDelete
  62. 7:12
    You are clueless

    ReplyDelete
    Replies
    1. I agree. 7:12 is clueless, or a doc, or a clueless doc.

      Delete
    2. completely clueless.

      Delete
    3. or perhaps just not a sales person and is telling you the truth?

      Delete
    4. I stayed at a Holiday Inn Express last night.January 25, 2012 at 9:46 AM

      7:12 is right.

      are you f-ing me? the rep steps in and saves the patient's life? really? REALLY?

      Delete
  63. Depuy in Colorado going direct? Will I have to stop promoting my other spine line products to my surgeons working on studies? This will hurt many reps main source of income.

    ReplyDelete
  64. Anyone know what's happening w/ the large DePuy Dist. in the Philadelphia area?

    ReplyDelete
    Replies
    1. How can Depuy/JNJ buy out the Distributors non compete contracts? Seems really wrong to me. Would prob be a crap shoot whether or not it is even enforceable....

      Delete
    2. Happened to us. Philly is safe, for now...

      Delete
  65. 7:12

    You must be very new to this industry. The rep is the most expendable body in the OR. Next you'll say your peek is better than everyone else's peek.

    ReplyDelete
  66. Guys, I have news for you. Having a rep in every single spine case didn't start until about 10 years ago when companies started carving up territories. And ankle biters started appearing.
    It was common place that I would have have two or three cases going on around town, but obviously could only be in one.

    ReplyDelete
  67. Ten years ago, it was only simple stuff with a couple of trays that techs could manage. ACDFs with no options, and simple pedicle screw trays.
    Now, there are so many trays, and assembly of complex MIS instruments CORRECTLY are beyond most techs I work with, even those regularly used to seeing it.
    Plus, the troubleshooting being done now, will not be done nearly as well sans reps, and many cases will not end as well.
    Recall total joints were done without reps too, when everything was simple with zero options.
    Now there are wedges, modularity, customization, and mind numbing options.
    And spine has way more complexity, with more dire consequences.

    ReplyDelete
    Replies
    1. 1:13 has been OWNED

      Delete
    2. And the results, when there were 'zero' options, were as good or better than today, at least for hips and knees (JBJS, December 2011). So, all these options serve but one purpose, to allow industry and surgeons to milk more money out of the system.

      Delete
    3. Fuck, I forgot this blog now encompasses total joints. That's gonna suck.
      Anyway, I'm 1:13. There is a bit of truth to hat, but to be honest, the cervical trays and pedicle screw trays today arent much "harder" than they ere ten years ago if anything, they are laid out much better. It also took a tech who knew the trays inside and out.

      Delete
    4. 1:13...let's reminisce...ahh...I remember the days when reps didn't have to be in EVERY case just to defend the business against 20 competitive reps piping in your customers' ears.

      Remember when you could make sales calls, instead of just servicing your existing accounts?

      Sing along...."those were the good old days...the years go by, but the memory stays...those were..."

      Delete
    5. The reason reps started going to every case was because they were and are helpful to the surgeon and the team. Reps would make life easy for the circulating nurse and the cleanup crew, by doing the parts of their job that pertained to the implants. Hey, if it doesn't cost anything, why not give your business to the rep who's always there helping out. So it was a way to gain and protect business, and thus became the norm. The fact that the job of a $90k circulating nurse was being replaced with a $150k rep didn't matter to the hospital, as they billed the added cost built into the implants to the insurance company anyway. Heck, they even made more money from the extra markup. Nowadays though, cheaper is better, and when they do come out of the same budget suddenly having the $90k nurse go back to doing the job makes a lot of sense. Believe me, they can do their job as well or better than we do, and they will again. We'll go back to the days where we're only there when we really need to be, and that's a good thing.

      Delete
  68. When I got into this business 10 years, I routinely left customers alone to do cases. Scolis, acdfs, you name it...I just didnt have the support when growing a new territory. Fast forward to today... 30+ spine companies, cover reps for your cover reps, and underhanding anyway to get an angle, and now people look at you like you have 3 heads if you tell them you wont be at the case. We have no one to blame but ourselves. We have created this monster. The ownus is on the reps to train hospital staff to be able to complete a case without you there. Until then, they'll be calling you at 715am wondering where you are every case. Make yourself valuable and you will be kept around

    ReplyDelete
  69. Does anybody know what Alphatec and similar players pay in commissions?

    ReplyDelete
    Replies
    1. ATEC 28%-37%
      SYN 12.5% & changing + benefits
      DePuy 18%-25% & changing + benefits
      MDT 6-15% depends on what products sold, inventory, etc. + benefits
      NUVA 15-30% depends on contract negotiations (wild and woolly) + benefits
      SYK 15-25% depends direct vs distrib vs negotiated deal + benefits
      Globus 15-30% depends direct vs distrib vs negotiated deal + benefits
      All others 30%-75% depends on your negotiations

      Delete
    2. No way. 18-25 Depuy? Not a chance

      Delete
    3. 2:57

      I am not the OP and i can verify that it is that way in my area as well. reaps made top of 18% on Viper 3d and dist gets 25%

      Delete
    4. I would like to know who is paying 75% commissions that has a legit product. I was told Globus is a flat 22% for all new distributors, I doubt you see too many Stryker distributors not on enhanced commissions at that 25% rate, MDT 15%, maybe for the few distributors remaining and I call BS on Depuy. I know of a very successful distributor that left when they cut his commissions to 19% five years ago. I would say most companies and most deals lean towards the low side although I am sure there is an outlier or two towards the high side.

      Also, in regards to ATEC are your referring to distributor commissions or POD commissions?

      Delete
    5. Unfortunately your ATEC numbers are overinflated.

      Delete
    6. All your numbers are wrong.

      Delete
    7. 7:51am......our business is small world....everybody knows. These numbers represent range relative to base and growth as well as those folks that negotiate better. Here are the base numbers...

      ATEC 28%
      SYN 12.5% + benefits
      DePuy 17.75%
      MDT 6-10% + benefits
      NUVA 20 % + benefits
      SYK 15% DIRECT -25% DISTRIBUTOR + benefits
      Globus 15% DIRECT - 25% DISTRIBUTOR + benefits
      All others 30%-50%

      Delete
  70. does anyone know of good retractor systems for mis surgery. i need a better option than the one i currently carry. any suggestions will be appreciated.

    ReplyDelete
    Replies
    1. What kind of MIS Surgery? Micro-Disc, lateral, TLIF

      Delete
  71. Does anyone think that if you eliminate the reps in the OR then surgeons are more likely to choose the best implants for their patients rather than choosing the relationship with that rep...ie they talk to them, ingratiate them, they are women(excluding those with other financial secondary gain issues/relationships)? Might they choose the system that is most user friendly and reliable? Maybe the best device/company wins? Might there be a shift in the balance of power in the bigger spine companies if this were the case?

    ReplyDelete
    Replies
    1. The answer is no. If the rep is taken out of the process so will the surgeons choice. A middle aged hospital administrator with an RN or a Non-Surgical MD will be making the decision. Price will be king because on paper that administrator will look better. It's funny that you ever consider that this is about the patient. It's not! That's nit my fought or any reps fought. There are payees and providers. If you don't get it you never will.

      Delete
    2. "That's nit my fought..? " What is that, Scottish? I know it isn't autocorrect.

      Delete
    3. That's nit my fought too!!! Funny post, but my Scottish friend is forrect in his affertions!

      Delete
    4. Scottish??? Is that really the best you can offer? I'm on the road. Staying in a hotel tonight and typing on an iPhone. You need to realize that the spelling does not matter. It's the substance. Think about it.

      In the end " They will pay CASH"!

      The answer to your next question is : The people whose surgeons still get to pick the implants.

      Delete
    5. Spell correct sucks

      Delete
    6. Ahhh c'mon!!! That Scottish comment was funny! No one's making fun of your content, just your spelling. Besides, it's nit my fought!

      Delete
    7. Sounds like nit-picking to me. As Fat Bastard would say, "ah farted."

      Delete
    8. Not a chance. Some preferences aside, in the surgeon's eyes they are capable of operating well with just about any system for all of the bread and butter procedures. Deciding factor between the three or four systems that they know fit the bill used to be exclusively the rep, now it's the rep and hospital preference (i.e. price).

      Delete
  72. Next time your in a case ask the surgeon if health care is all about what's vest for the patient. They will laugh. It's very sad.

    ReplyDelete
  73. Yeah, I'll be sure to ask that question to a surgeon in my next case.

    ReplyDelete
  74. Just wait and ask him after he signs his evaluation for for your company...any earlier would be in bad taste.

    ReplyDelete
  75. anybody know how much the hospital makes off of an $800 screw after their mark up?? I know that this dollar amount will vary based upon the patients' insurance carrier, but lets say it is a Medicare patient (since 60-70% are these days). The DRG as far as I know, will pay a certain dollar amount for the diagnosis, but does the reimbursement to the hospital even break it down into reimbursement per screw, or is it just a fat check for the surgical procedure?

    ReplyDelete
    Replies
    1. I don't believe the hardware cost (or whether or not any instrumentation is used, for that matter) has any impact on what the hospital gets paid on Medicare cases; mainly, the DRG payment is pegged to diagnosis, procedure, and co-morbidities. So, they will get paid a fixed amount for a lam with posterior fusion, much less for a laminectomy, much more if a one stage 360 is done. They may get a bump up if the patient has emphysema, post-op atelectasis or anemia, or cardiac disease that requires some treatment. The amount is pegged also to geography, and there may be some determination based on the type of hospital (high level trauma facilities may get more per case since they theoretically have a higher indigent/non-insured caseload, so they are compensated by a slightly higher per case rate). At least that's what they tell me.

      Delete
    2. Spinal fusion except cervical without MCC is DRG 460 = $20,969. For Medicare the reimbursement is the same whether it is a one, two or three level fusion. Hospitals generally want to keep the total implant cost (including metal, bone and interbodies) below 30% of this cost or $6,290 otherwise they start to lose money.

      Delete
  76. Does anyone know why NuVasive's stock trading was suspended today? Potential takeover?

    ReplyDelete
    Replies
    1. MDT injunction request was denied.

      Delete
    2. No surprise there. MDT seriously grasping at straws. They are scared of Nuva plain and simple

      Delete
  77. Did you notice the million shares that traded 4-minutes BEFORE the news broke????

    Did Martha Stewart re-surface???

    ReplyDelete
  78. Serious question here... what happened to MSM? This is definitely not him posting under his alias. Not sure I've ever seen a blog entry where he responded more than occasionally and there's four on this one already. He certainly never uses "LMAO" in his retorts.

    It's like when I was in college and Homer got a new voice - the Simpsons just weren't as good anymore.

    RIP MSM. You'll be missed. Don't tell me this spot is going to get all Corporate now! Or worse... RYO.

    ReplyDelete
  79. TSB here rumors of my death are greatly exaggerated, you know Arnold use to say, "listen to mr now or here me lader". I"ll be back. RYO LMAO. does that seal it?

    ReplyDelete
    Replies
    1. Not buying it. Too many typos and lack of attention to detail. TSB, either you've farmed out the work or you're getting sloppy. Neither of which bodes well for the site. At least have some standards to keep up appearances if it's the former, and a shame if it's the latter.

      Delete
    2. No way that's MSM! Typo's are not his style.

      Delete
  80. "listen to mr now or here me lader" perhaps you mean Listen to Me now or Hear me later

    LMAO....Stryker Rules

    ReplyDelete
  81. The bloodletting has begun at JNJ, huge distributors fired, lots of opportunity for everyone else! Synthes guys better make a break for it before the Death Star arrives.

    ReplyDelete
    Replies
    1. JNJ has become the biggest ortho company, has also become the worst place for a rep to earn a living. As for the Synthes reps, most of the good ones have moved on already, the ones left behind have nowhere to go or no one wants them.

      Delete
    2. Who else got axed?

      Delete
  82. Stryker rules? Is that a joke? Rules at no innovation and being boring! World class in that category. JnJ collapse will mean opportunity for Globus, Nuvasive and K2M. Sorry Medtronic, your weak ass reps have no shot, even with a larger name badge...No wonder they only pay you guys 7%...bunch of farmers and pu€€|e€

    ReplyDelete
  83. Stryker rules at fumbling and bumbling: no launch date met, no corporate support, no risk-taking, no fun

    ReplyDelete
  84. True Dat regarding stryker..... only bad news is that the one's that continue to do well each year do so by either their relationships or good salesmanship as there are no "cool" new products to get a surgeons attention. Imagine if there were???

    ReplyDelete
  85. i just read this blog and all discussion. are we still on the topic or we have somewhere else. :)

    ReplyDelete
  86. What is Depuy offering the distributor reps they want to keep?

    ReplyDelete
  87. i heard alphatec is providing private labeled spine systems in Indy and already cut out the rep and the docs are on board. They told their dist. rep that if they sell the private labeled product he gets no commissions.

    Times are changing, is Ortho direct's model the "best"? Maybe not, but the system we live in is changing, will continue to change and will never be what it is today a year from now. Look for creative business solutions to come and then the market will decide.

    Follow the money, us reps have no control over this and to think we can unite and fight this is crazy. We just have to deliver VALUE every day to prove we are a needed asset in the process. The process is what will determine our VALUE. It's changing and not just in Ortho.

    ReplyDelete
  88. I have lived on Boracay apartmentsfor 15 years and loved the place so much i built cohiba. These are the Biggest and Best value for money apartments on the island period ! Every apartment has stunning sea views and 30m2 to 40m2 balconies with which to enjoy it. We are overlooking the windsurfing / kitesurfing bay where the season goes from November to april. Its either a great sport to participate, or great to just sit on your huge terrace and watch. Apartments in Boracay

    ReplyDelete