Monday, February 13, 2012

NJ Spine Society Emergency Meeting

Dr. Mitchell Reiter, President of the NJ State Spine Society has called for an emergency meeting to be held on February 15th, 2012 at the Sheraton Tara Hotel located on 199 Smith Road in Parsippany, NJ. If there ever was a Call To Arms, this is a meeting to collect input and coalesce NJ Spine Surgeons to address a direct attack on spine procedure reimbursement.

If there ever was a call for unity, this is the meeting.  A message to all NJ spine surgeons, if ever you were going to talk the talk, its time to walk the walk. Action will speak louder than words. Forces in the State are threatening the current out-of-network providers with legislation that if effected will hinder your ability to practice medicine and earn an fair wage for your efforts.

The matter at heart is the PIP fee schedule, which is to be overhauled.  This schedule threatens caring for MVA victims financially untenable for NJ spine surgeons.  The patients freedom of choice is being threatened.  The current crisis is predicated on the ideas of some influential individuals in the State to change the manner in which out-of-network billing for spine surgery is performed.  The fundamental rights of patients' and surgeons' to have freedom of choice is being threatened. If spine surgeons in the state are not ready to unite, the likely outcome will affect the future of all Garden Staters.  So NJ Spine Surgeons do you have the cojones to unite and fight, or are you going to roll over?

Spine Surgeons of the Garden State Unite and Fight.

Who knows maybe the NJSSS will adopt Twisted Sisters famous song of years ago

"We're not going to take it, no we're not going to take it, we're not going to take it anymore!!!!!!!!!!

122 comments:

  1. Solution: Penile USA will save the day with PODs.

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    1. Dude, this is like your fifth "penile" comment in the past two threads; one included the word "sucky" in the same sentence as penile. If you have an issue with coming out, a different site may be better suited to your needs.

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    2. When is PENILE USA going public?

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    3. BTW, 2:52 was my 1st Penile USA posting. Get over yourself 11:06, just trying to have some fun in the Obama Era before I put a gun in my mouth.

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    4. Now that is funny, and sadly true...Obama purposefully wrecking our economy, planning his 2012 victory now, and secretly plotting no future elections is a reason to put a gun in your mouth. That's right, you heard it here first, he will try to become a dictator of America if he gets re elected this year. Protect your families boys, buy guns before they take away the right to bear arms...

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  2. Call Hoch, he has the answers!

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  3. 2:52
    Stop with the inflammatory remarks. Lanx will save the day by paying surgeons for their business.

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  4. What exactly are they uniting and fighting against? Is the out of network fee schedule just being lowered too much, or what is the deal here?

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  5. this means NJ surgeons wont be reimbursed 800% to Medicare on 1 level acdfs in surgery centers. Only 500%... I really feel bad for them

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  6. This effects all of us: Reps, Md's, anybody who makes their living in the peripheral economy set up around spine surgery. TSB - how about some more details? Whats' on the line here?

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  7. This is like a post only for insiders in NJ. TSB, give some details that we can comprehend and rally against. How are we supposed to ask if Globus will go public in a clever way when we don't even know what youre talking about?

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  8. It basically means that as a surgeon you cannot just charge what you think your skillset is worth. If you want to operate on patients you have 2 choices
    1) operate on a patient that is "in network" meaning you have agreed to a pre set fee guideline the insurance companies have offered up, or
    2) operate on an "out of network" patient and simply hope that they pay something reasonable for your services. It is really amazing that as a surgeon the ins. companies get away with not having to tell you what you will be paid until after the job is complete....basically the reason that all providers of healthcare must mark up their services 1000% so that they may get somewhere close to a reasonable reimbursement.

    It is all a big game

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  9. Any doctors that accept medicare patients are agreeing to be paid at the published medicare rate for fees and services. If and when Obamacare ever gets going (provided it is not deemed unconstitutional), there won't be enough money or incentive to pay the physicians let alone any of the sales reps.

    What student in their right mind would want to put in the incredible efforts required to become a doctor when the reimbursements for their hard work is going to be just barely over that of a unionized plumber?

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    1. Easy. It will look like the British model. About 50 native citizen surgeons that have all the full certifications from a US medical school, and about 5,000 foreign MD's that get a lesser certification to actually perform most of the procedures at about 1/3 the pay of the fully-certified ones willing to put up with the system.

      The foreign docs are told they can be certified as full surgeons if they just re-do medical school, residency, and a fellowship. Having done all of that already in their home country, and realizing they don't want to spend their 40's going through what they did in their 20's, they resign themselves to always being a second-class doc on the totem pole.

      The foreign guys are still making 10x what they'd get in India, China, or Pakistan, and they tell themselves they're doing it so that their kids can be raised in the land of opportunity.

      Their kids then disappoint their parents and go on to careers in sales, engineering, politics...anything other than medicine, since they realize that they can make more money while spending less than half the time and money on a medical education.

      In the meantime, the progressive politicians keep getting re-elected by promising a gullible, uninformed voting public that they will "control" the cost of healthcare and "give access to everyone".

      Imagine how great our TV technology, cost, and access would be if we had just enacted "universal TV" in the 1950's. Fee schedules for RCA, Sony, et al based on the size of set. Purchasing subsidies to all the unemployed. Mandates to provide "HD access" to all satellite and cable providers. Excise taxes and profit caps on Hollywood studios and telecoms.

      Progressive nirvana.

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    2. Spinal Solutions ofTemecula has a list of docs that reads like Homeland Security's Can't Fly List.

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  10. Obama and the growing left movement don't want surgeons to get paid more than hard-working plumbers. They both provide a critical service to society, one is no better than the other in their eyes. Anything else is just elitism.

    "From each according to his taxable gifts, to each according to his welfare needs" - Barack Marx

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  11. It's interesting if this could lead to more surgeons uniting to fight insurance companies. However, as more become employees of the hospitals this is a pipe dream.

    Off topic, I'm still dying laughing at how a CEO of a major medical company can be so stupid and be forced to resign in such shame. A guy once told me "the fucking you get ain't worth the fucking you get"

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  12. They all say that but there is no shortage of replacements and the ALL "take the money they get 'till they can't".

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  13. What is it that MacMillan is alleged to have done? Can all of the dime-store attorneys that comment here confirm that the use of the word "alleged" allows us to skirt libel/slander laws?

    Also, isn't it going to be funny when it's confirmed that a device firm bought out MSM to get control of TSB so they can filter out the gossip/truth about their company?

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    1. Mac man allegedly had inappropriate sexual activity aboard the stryker jet with a flight attendant.

      Corporate jet+ mile high club= free time to handle the divorce.

      He gets over 60 mill in stock options. His soon to be ex wife was making half a mill a year at stryker as director of catering.

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    2. Does that imply there is appropriate sexual activity aboard the stryker jet? Did they not used an approved position, or what?

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    3. I heard that he was claiming "shrinkage" which occurs above 30,000 feet.

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  14. Did the BIG MAC get credit for his miles and did he RIDE the same flight back???

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  15. Topic Deviation:

    Someone forwarded a job posting to me that stated: "LEADING SPINE Client is getting in Kyphoplasty Space- (AND in 12-24 months going to launch a pain stimulator in this bag)."

    Anyone know who this would be?

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    Replies
    1. Globs is correct

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    2. They were messing with Endoscopic stuff too.

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  16. 221 got called about that too. Globus

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    Replies
    1. Obama is evil, please God let anyone but him win, even my dog

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    2. Wait until we have Santorum leading the way..... Within a month you'll be on your knees begging for Obama.

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

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    4. This blog is increasingly populated by the dregs of a dying industry. An interesting sociological phenomenon.

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  17. NJ docs: join the local pipe fitters union, give $ to Obama's campaign, and then you too can feed at the public trough and destroy our kids' futures by spending all the money. It's easy once you assimilate with the Borg.

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  18. I think John Wait is an idiot and needs to leave the world of spine

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  19. Did MacMillian really nail some chick on the corporate jet? Unbelievable. Hate Stryker like the leadership!

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  20. So is anyone doing business with Pediguard? I have carried the product for months and this James Coile Cat is a punk ass used car salesman. Note if James emails me again about sales I am dropping you product

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  21. LMAO off about Pediguard. Good product but hard to justify the cost. Thats James job isn't it;-)

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    1. I've watched it in action and it does work. But the word is the hospital got them down to a sub 1000 price point. Doesn't do SSEP or MEV either.

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    2. James is a telephone and email tough guy. When you meet him in person he reminds you of the kid in school that would eat his buggers.

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    3. eating buggers...damn that is funny...and really kind of accurate. He does send some weird emails

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    4. sounds like online bullying , you must have been the tough popular jocks in school. couldn't please the folks enough so you took it out on the playground bullying people like james

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    5. I’ll preface my post by writing that I do not work for SpineGuard. I know of many distributor agents that are successful selling PediGuard. As the one poster noted, it does work. If you can only sell on price and not value then do James and SpineGuard a favor and drop the product so they can get a competent distributor agent in your geography.

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    6. I would say James is the bully after reading some of his edicts and expectations. Yes it does work but $1,800 and even at $1,000 a very hard justification

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  22. What are your thoughts about Corentec, a South Korean company, entering the US spine market?

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    1. my initial thoughts were to google Corentec

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    2. After checking their website, my initial thoughts were: titanium PLIF cage? LOL

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    3. This is a joke of a company with an even worse sales vp who doesn't know shit about spine or totals. When asked in a case what the thread pitch was he didn't know what's a thread or pitch was and looked puzzled. My surgeon asked me never to bring this shitty system in again.

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  23. What's up with K2M? I hear they are in a hiring freeze now and backing away from their initial push to grow by acquiring talent? Seems like the Private equities guys may have seen lipstick on a pig?

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    1. This company is growing too fast, and to make matters worse, they are trying to grow with "me too" products. Sorry guys, you will only grow with reps that have loyal surgeons; those that are new hires, with no relationships are up crap creek. Plus, since K2M is new to spine, they lose out on being able to bundle price packages with joints/biologics/trauma etc. Sorry, they are a "flash in the pan", fiddly products and poor reps...good luck working for them if you just joined. Their middle mgt team is below average at best, they hire good reps with solid relationships, but forgot they have no real mgt experience. Have fun being micromanaged. The grass is not always greener kids...spine is dead, no matter how you look at it or what company you work for. Compete well

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    2. Not sure they qualify as "me too" products or as "new". New to you? However, I agree their management is a joke.

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    3. K2M definition of hiring talent for growth = Hiring Kobakof to lead Key Accounts... Does it surprise you that they are backing off from their original idea? Talent isnt old, or act adolescent. Get Real K2M... actually, keep on keepin on.

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    4. I don't like to wish ill of anyone, but I might make an exception for Kosta. Keep your distance lads.

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  24. The Cleveland Browns are in a freeze and have also been trying to acquire talent.

    Sincerely,
    Every Pig Wearing Lipstick at Last Call is HOT!!!

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  25. 8:59 you do not have a clue , not a clue
    and also. can you define "loyal surgeon" ? are you confusing your pet collie with your customers? Please post your thoughts on what a Loyal Surgeon is

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  26. I am hearing some great things about SI bone. What has the group heard or seen?

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  27. Dubious diagnosis + suspect product = company destined for failure.

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  28. I heard they have been adding many new direct reps and the sales have grown substantially.

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    Replies
    1. Nice way to ask a question and then answer it 5:15.

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    2. No kidding. I love it when an ankle biting company like SI (ShIt) Bone tries to drum up interest in their product with one anonymous post, and then re-post as another person singing its praises. The same doc that invented kyphoplasty invented SI bone, and look where kyphoplasty is now. The guy isn't even a spine surgeon!

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  29. TEXAS: Perennial ankle-biter LANX hired several big-hitters away from Nuvasive, DePuy & Medtronic, offering these tenured reps distributorships. Assuming that A) these cowboys can flip their docs, and B) LANX even has a bag (jury still out) then they actually may have a pulse in TX.

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    1. I find it difficult to believe even the most desperate rep would believe that ridiculous "promise" from the wizards of lanx

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    2. I had the same thought but have been pleasently suprised. They've done a lot to fill out the bag and they're no longer a one trick pony.

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    3. Thanks Lance. I was hoping to have the opinion of someone other than the VP.

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  30. You guys are just running your mouths...and don't know crap about K2... Freaking losers, who cares about management! Please, I crush morons like you, the products are great, I don't need someone on a sells call to take your business. What the hell does middle management do? Pay for the steak dinner? Wow! Thank goodness, keep talking crap about K2 and we'll keep punching you weak legacy companies in the mouth and take more of your business. Grow some stones and say this stuff to your competition instead of lying and making things up on a blog!

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    1. "Sells call"

      Priceless!

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    2. What was made up about K2 7:11? What lies are you referring too? Kosta comments are spot on. Management is full of little people. Most products are me too. What are your referring to as lies? I am going to bet you must be from overseas with that Engrish.

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    3. Give us some examples of this Kosta guy? Seems "mafia like"???

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  31. TSB, please put a bullet in this blog. It's become a gathering place of soon to be jobless morons. Useless.

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  32. Yay yay! That's gwate! I wanna go to Hawaii!

    I not dumb. I smart hard worker guy, yay yay!

    Tell me to do my life right big brain man! You smart too! Yay yay!!

    I wait here all day for plan from you! Yay yay! I got mail! I got mail! Yay yay! That's gwate!

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    1. Wow, sells vs sales. I remember that time I got a 2 million dollar doc after I showed my awesome grammar. I love you grammar fanatics! Keep it comming skinners, and I'll keep taking your bizz. How did all you English teachers get into this business? Shouldn't you be making 8 bucks an hour as a substitute teacher? Have any of you ever actually sold a damn thing? Thats right I forgot its the name badge and "fellows" purchased, sorry I mean trained/brainwashed to use your metal. That must be so hard siting around, waiting for a big user of your company to move to town. Most of you guys should be cpa's making 60k or better yet librarians...shhh, no talking, shhh, it sales not sells. Shhh I'm an anal loser who's never sold anything in my life.

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    2. Man, you must be great in the OR. I can see you now yelling at the scrub "No not that handle you dummy, he no like that handle. How many times do I tell you?"
      Minimizing CPA's, Librarians and English teachers as losers. Such a bitter angry little person.
      And I am 100% confident that you have not flipped a $2M doctor, ever. K2 should be ashamed to have you as a representative. Maybe that's why the bashing above?

      Now go make sells call!

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    3. Little? 6-3 ..220 and I would own you fag.

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    4. And Bigoted. Nice combo!

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    5. He wants to own a fag.. that sounds kind of gay

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  33. Let's see if all K2M products are "me too products".
    Mesa - taper lock system, no other pedicle screw on market like it. Utilizes crickets and couplers for deformity correction. The fact that other companies are copying the crickets and couplers illustrates the unique abilities of the Mesa system.
    Everest - a CoCr/Titanium Pedicle screw system that accepts 5.5 and 6.0mm rods. Again, unique and no other device on the market like it.
    Serengeti - utilizes a flexible screw based tube. All other systems are rigid metal tubes making rod introduction difficult. Why do you think there are so many articulating rod introducers on the market. Again, a unique device that solves problems of other companies products.
    So Mr 7:11 (ironic that your time stamp is indicative of where you should be working) ignore the competitive advantages of K2M if you want, but don't so openly show all of us who take the time to study not just our own products but those of our competition just how ignorant and naive you truly are.
    JS

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    Replies
    1. This post is directed at 8:59, not 7:11. I retract that statement about working at a 711.

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    2. mmmm Kool Aid.

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    5. Kool Aid is all you know how to respond with. Me too, Me too.
      You legacy companies rarely develop anything unique. But when you do, oh boy, it is unique.
      Danek brought us; Mavrick. Don't think it's being sold anymore. They also brought us Infuse - how many billions is that product going to cost MSD?
      Synthes brought us Norian Vertebralplasty - millions in fines and 4 execs in prison. They also gave us Synex II that had unexplainable failures and was pulled from the market.
      Stryker, not to be left out; well, too many no shows to list.
      Zimmer? Gosh, they just suck.
      You boys keep whispering to yourselves about all the Kool Aid drinkers every time we take a percent of market share from you. One of these days you will be begging to drink from our cups of Kool Aid.

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    7. Irregardless is not a word.

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  34. How did this turn into a K2 discussion?
    I don't disagree with some of the novel products that K2 has. But market share is very low, less than 1%, and distribution is limited. Everest is nice but incomplete and so you still need the fiddle-some Denali with the cross threading set screws. They will have a chance to survive when someone buys them.
    You bash us Legacy companies but you would fit nicely in my bag and it would assure sustainability of your products, probably not your job though, and I could use a new tzotchke to pull out.
    I love the over the top response. An enthusiastic employee for sure. I wonder if you have a K2 tattoo on your arm? And how hard will it be to turn that into a MDT?

    And ignore the Penis Power Ranger. He acts hard headed but he's mostly a softy!

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    Replies
    1. Everest is perfectly complete for Degen cases which make up over 70% of all lumbar cases. As for cross threading of locking caps, those who live in glass houses built by Legacy shouldn't throw rocks. Lots of cross threading there as well as demonstrated by surgeons who have left Legacy over the years in my area to use other systems.
      A K2 tatoo on my arm, no. But a kick-ass bag of products coupled with a solid, competent skill set is tatooing the likes of MSD and Synthes ass' all day long and gobbling up over $100K in new business this month alone.
      Don't get me wrong, MSD, Synthes, DePuy and Stryker are good companies. What's wrong with them are the complacent "we're the biggest doc so you should use us" attitude of the reps and management. There's a reason reps are leaving those companies in spite of full bags, market share and a stable company settings. No one wants to be micro managed, and truly Entrepreneurial individuals want the ability to maximize their earnings while controling their own destiny.
      You stay with MSD earning 7.75% and you will do o.k. I on the other hand intend to continue expanding my geographical territory while earning 25% or more and will retire by the time I'm 50. 8 people working for me and each are earning 15%. Territory sales now in excess of $9 million (most at the expense of MSD and Synthes). My reps all earn a great living and so do I.
      Cheers from the shores of success.

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  35. Need some basic information:
    1. How much does it cost to manufacture a set of instruments for a single level lumbar fusion case? Just the instruments not the implants.
    2. How much does it cost to manufacture a set of instruments for a five level lumbar fusion case? Scolio case?
    Thanks

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    Replies
    1. I am not sure what the cost difference is, but I would believe it is much different. With a one level fusion the chance of having to use reduction instruments or implants is minimal. In a deformity case you will need a few more tricks in the bag. I would say, just because you have a great one level fusion system or implants does not make that system capable of 5+ levels of deformity. Although, if you have a very capable system that is made for advanced deformity it should translate very well to one level fusions. One level cases for most instruments and implants is comparable between the spine manufactures. When you get into deformity the game changes and not every company can play. From what I have seen most of the companies (except mdt, dpy, k2m) develop these systems for lumbar degen and deformity is an afterthought.

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    2. The costs are substantial if you are starting from scratch. You need a CAD designer, several prototypes, instrument trays, raw materials, insurance etc. In this economy it is a loosing proposition. If you have the money to move forward on this level buy some rental properties, the return will be much better.

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  36. K2m is a good company but I shall the new Nuvasive new prec system and that going cause some trouble for K2m..Its a slick system also the new corpectomy system is going to a lot of market share in the area of cervical to lumbar

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    1. Where did your learn English grammar? The English customer service school in f**king Bangladesh?
      Pathetic.

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    3. Nuvasive's new perc pedicle screw system Precept has heads popping off the screws. Nuvasive is covering this problem up and not reporting to FDA as they are required. Nuvasive needs to do the right thing and not compromise patient safety! The system needs to be fixed. Step up Nuvasive and do the right thing!!!

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    4. That's an erroneous claim! Tulip heads popping off? That's never happened to a screw system before...where did you come from? You must of just fallen off the FNG bus. Needless to say Nuva has a record of fixing issues with lightning speed. IF this is an issue, which I highly doubt because the system has barely launched so you may have witnessed an isolated instance, then Nuva has more than likely already corrected it. Get a clue. The top company in spine does not launch crappy screw systems. The engineering dollars spent on that system is ridiculous. There is not another system even close to how elegant that system is...please tell me what. Answer = 0.

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    5. Top company in spine, damn that was good... Still laughing, thanks for the humor! Cheers, have a great wkd, but seriously no more alcohol tonight...

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    6. 5:49
      SpineArt's K-wireless system makes the NuVasive system look like a model T. You havn't seen elegant. Grow up and get a clue, your system is next gen of the same crap everyone else has.....actually it's a Viper knock-off.

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    7. One of my docs used the spine Art system and said it SUCKS .....He would not use it again....Sorry

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  37. What's a prec system? Did he mean you have to be a systematic Prick to work with K2? Confused...

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  38. I think NuVasive reps carry around consulting deals for every surgeon that puts in an XLIF cage. The purple pissers will try and deny this but they know it's true. If you want to prove me wrong answer this: How many surgeon consutants/teachers/royalty holders does the company have in San Diego, Orange County and Los Angeles? 10 would be alot but they have more than 10 in San Diego alone. My guess would be 25+ in those three markets but that is a low ball estimate.
    I have to admitt I always admired NuVasive but am learning they are no different than any other company. Being a consultant for NuVasive is like falling in love and marrying a girl only to find out she is a whore banging everything that moves. The only difference is that being a consultant for NuVasive won't give you herpes.....well actually they have a rep, and you know who you are, that I am sure has herped up a few docs.

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    1. Agree. Dead on. W/o consulting agreements (buying docs, Nuva is nothing) can't wait for the story to come out on their bad accounting practices and watch them burn. I keep making a killing shorting Nuva stock...dang, I just gave away my best stock tip.

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    2. Nuvasive giving out agreements is a drop in the bucket compared to Depuy in Florida. There are offers to help redo their lateral system going out to any surgeon who has a pulse.

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    3. Fact is EVERY company (at the very least the top 10) do the same agreements and consulting deals. Depending on what part of the country your in, the manufactures all sell with consulting agreements etc... It's a unfortunate and dirty reality to our business. Also, the local representation has a big impact on how prevalent these deals are in your area. For example I see a lot of DePuy, Medtronic, Stryker, Globus, K2M consulting and design team offers. I do hope for the Surgeons that do not appreciate these business practices. They seek out the representatives that refrain from these deals. The chances of that, unfortunately, are slim.

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  39. Hey 12:53...I bet you're in a team at Medtronic? Do you guys share 3-5 million? At 7% you might want to get a second job. When it gets real bad you can interview for my spine associate opening w K2... I should need someone in 12 months (sorry, hope the timeframe works/more medtronic bizz to take first) Considering you work for the 800 pound gorilla...let's be honest here. Technically, you have never sold anything. No offense, but we both know it was your name badge and since your a pu$$....that needs the MSD name badge and is otherwise incapable of converting business, I think you are the perfect guy to work under me. You MSD guys are content with a terrible pay structure, and don't have the balls to leave (no nuts is good though, I don't like turnover)...Considering all the facts, I think you may be the perfect sub rep! Congrats, you may have a future after all! I'll start you out at 50k. Your main responsibilities will be to cover cases and not sell... You're 150% qualified since that's all you have ever done.

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    1. Wow, the K2 reps are pathetic. Publish your name tough guy.

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    3. Truth hurts 8:26. Weak come back

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    4. you....me...after school. the playground!

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  40. Mdt, is best spine company. You all wish you worked for Medtronic. There the best and you no it. Spine is nothing w/o Medtronic. After we fix solara, we come for all your business.

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  41. Ah, the hubris abounds in here....

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    1. Hubris? And all this time I thought it was Humis!

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    2. Silly, Hubris is a dish made with garbanzo beans. Quite delicious with crudites or pita bread.

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