Sunday, February 19, 2012

Sunday's Funnies, Not So Funny

As the smoke settles from the former Stryker CEO Steve MacMillan's resignation, and, if the allegations are true that Stevie Wonder had a Wondering eye, questions must be asked of our readers, have we truly become a shameless society? Is leadership truly overhyped? And what does it say about Stryker?

Based on the latest stories that have graced major publications a la The Wall Street Journal and NY Times regarding POD's, POC's, the Blackstone and Orthofix DOJ settlements, the conviction of former Synthes executives and MacMillan's resignation, it has become evident that shameless behavior has become pandemic in our country.  Maybe, the fact is that "shamelessness" has become an accepted disease within the American gestalt.  Americans love to rationalize their shameless behavior.  As long as you win, haven't killed someone, or for that matter make lot's of money, it is okay to behave and act out in a certain manner.  As shameless behavior dominates our psyche what does it say about the direction this society and future generations are heading for? What kind of country are we becoming?  It's just not spine industry employees, it's athletes, entertainers, investment bankers, and CEO's, and worst of all politicians. We have lost our sense of humanity, we are slowly becoming that dystopian society that TSB once wrote about.

TSB is sure that the righteous will accuse us of being liberal, phony, or pandering to the weak, but the truth is that everyone must conduct oneself with some order for a society to truly prosper and for people to coexist. There must be balance when it comes to laws of the jungle. Man's selfish nature dictates why laws are necessary and government exists. You don't believe it? Wait until the curtain is pull backed on what's been going on in California in spine for years. Contrary to some of our readers opinions, there cannot be two sets of rules.  There cannot be one set of rules for you and another set of rules for us. Maybe there are too many companies, too many products and maybe money has come too easy becoming the driving force in many of your lives, but the reality is that contrary to popular opinion everyone cannot be a winner. Maybe that's part of the problem? Just look at your children, they are a reflection of your insecurities and behavior. Regardless of what you think, everyone cannot be a winner, no matter how far one stretches the rules or thinks that you are not breaking any laws. How many of you actually promulgate good citizenship and fair play all for the love of the Almighty Dollar? How many of you espouse free markets, yet use every tactic in your power to manipulate or rig the market? Disappointment is a part of life, making adjustments is reality. Too many people in this industry behave the same way that America raises its children, everyone must be a winner, everyone must succeed, everyone deserves a medal even if you finish in fifth place. You know what?  That's BS! That's why America has become what it is today. The bottom line is the pie is only so large and has to be shared by many people, some will win and some will lose and some will have to learn to live with the blues.

The recent California Dreamin' post exposes how many of you defend your unethical actions. Calling other commentators out on their anonymity, while you cloak yourselves in your own veil of secrecy, using sophomoric language, threatening libel as though some of you had a law degree, exposes your immaturity, insecurities and shamelessness. Justifying your behavior by casting aspersions onto the system doesn't excuse one from raping the system. Who do you think pays for someone buying implants at $3,000 and then selling them for $47,000?  We all do!  Who do you think will be hurt by this shameless behavior? The entire industry is effected! But you know who's to blame for this type of behavior?  We all are.  NASS, AANS, or CNS don't have the authority or the BALLS to step in and police its own members or peers. The companies CEO's and upper management teams look the other way using their best Wally Karew and Dave Lyons "Hear no evil, see no evil" defense because they have become the Streets bitch.  Surgeons and reps cannot control their urges or desires and hospitals have become nothing more than sweatshops for perpetuating an unhealthy society. This in itself exhibits our aberrant and sociopathic nature.  Don't believe it?

Let's use some examples. What would you do if you found out that a surgeon who had his license revoked was still practicing and collaborating with his peers to funnel workers' comp patients to a hospital, and the hospital was working with these people in concert to drive profits? How would you react if that was your mother or father, sister or brother, son or daughter? TSB is sure you would react with outrage.  How would you react if your family member went in with a degenerative problem at L5-S1 and was told that they needed a three or four level procedure? How would you react if your loved one went in for a simple ACDF and left the hospital in a hearse, because some surgeon used a product off label without truly understanding the consequences or biological response from using that product? Some of you may even go to extremes and take matters into your own hands. Well, this is why spine finally needs a thorough cleansing. The con artists, scam artists, the dealmakers, those that do nothing more than bilk the system for every nickel and dime that they can get out of the system while dragging the industry further and further into a death spiral. And yes fellow bloggers we have many people to thank, you know who you are, because we know who you are.

The waste and theft in our industry is enormous.  The U.S. spends twice as much for delivering medical care than the next most prosperous country.  The incentives for everyone involved is misaligned.  Fee for service is really not a healthcare system, it is a treatment sales system.  Don't believe it?  Come to California.  Patients must take control of their lives and health if medicine is going to change.  If 3% of all healthcare spending, an estimated $68-70 billion annually, is lost to fraud, California is definitely doing its best by contributing with its POC's and POD's.  Governor Brown should be proud that he oversees and encourages this illicit behavior.  Recently, it was reported that in the Sunshine State, aka Florida, Medicare fraud is bigger than the illegal drug trade. This is something that we should all be proud of.  Of course rather than reflection, many will respond that it is the politicians, insurance companies and lawyers fault.  And yes indeed, they do their best to add to the increasing cost of delivering healthcare.  Today, what we have is a market free-for-all.  Companies hire surgeon consultants and rationalize that this does not influence their decision making abilities, yet, behavioral research has proven that incentives create reciprocity.  So in closing, maybe its time for the DOJ, the OIG, and the FBI blow the lid off of this industry. But until some CEO's, surgeons or distributors don an orange jump suit, it will be business as usual. TSB wants to know what our readers think?  Maybe what many of us have found out is that it pays to commit white collar crime.  Some poor schlep rips off a gas station for $50 and serves 10-15 years, while some companies rip off the taxpayers and the government and they get a slap on the wrist and the proverbial whitewash in their settlement.

What I want, I want now, and it's a whole lot more anyhow
I wanna climb a mountain, I understand all destructive urges
it seems so perfect I see no evil

      

189 comments:

  1. Well said. If the sleaze and fraud was removed from the system we would not be arguing about the price of implants. The truth is we can give our stuff away for free and nothing will change for the healthcare system. Physicians need to be rewarded for positive outcomes and not how many prodecures and tests they order. If I do a better job than my competitors I get a raise and make more money. It is a huge task but tracking outcomes and rewarding the best is what will remove costs and save our system.

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    Replies
    1. Might a good cleansing start with each one of us naming those questionable practitioners in our territories? And the specific relationships with questionable distributorships? And how some occasionally, or routinely over-instrument/take out old instrumentation that's perfectly fine to re-instrument on what pays them.

      Naming names. Too high of risk?...

      Delete
  2. Stryker is garbage from the top to the bottom. Macmillan is proof....0 class

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  3. Ethics in this industry fell by the wayside a LONG time ago. Nice blog, but what's it going to take to change it? Nothing has seemed to have a positive impact as it only continues to get worse, while this industry continues to promote this type of behavior. MacMillan's behavior is simply the latest example,, it certainly will not be the last.

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    Replies
    1. I understand your skepticism, but there is a simple economic concept that will lead to the "cleansing" - a skeptical public will continue to put pressure on the industry to clean up simply by changing its consumption patterns and electing its officials. As these changes take hold, profit margins for providers and manufacturers will continue to decline and entry barriers will go up. At some point, only the most financially sound will survive and only those willing to play ball will be allowed to participate. Will it cure everything? Certainly not. However, the two bit abusers as well as those that lack the financial fortitude to operate in a hyper regulated environment will certainly fall by the wayside.

      Delete
  4. @12:19 Not exactly sure of the point of your post? As for "only the most financially sound will survizee,,"? THEY are exactly the ones who are guilty of some of the worst behavior? MDT, Globus, Stryker, Zimmer, etc have been found guilty of some of the most glaring acts and have paid the price,,

    Your observation is pointless as this industry has been & continues to be run by the very companies who bend the rules in order to stay at the head of the pack.

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    Replies
    1. hey don't forget Depuy was part of the DOJ lawsuit, and Depuy settled a 70million dollar bribery suit, and Synthes execs got jail time for Norian,
      Funny how you name a few but omit others and their Glaring acts.

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    2. we can't all be LANX

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  5. Until the root of the problem is dug out the problem will continue to find new ways to sprout. Surgeons demanding quid-pro-quo emanating from a third world mentallity is the root problem. If industry leaders refuse to "play" they find a POD to feed their insatiable greed. Until our government enforces the law the problem will continue to flourish...OR the free market will disrupt the system and we will all live in a very different environment.

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  6. Lanx is corrupt and Stryker has crap products!

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  7. Great post TSB.

    As a veteran in this once great industry I am curious how people are dealing with the POD model if they should start to form in your territories? Is there anything one can do at all?
    Aside from working for it which I would never do, and writing the WSJ which likely would not help either, what can someone do? Local press questioning ethics? Get the info to referring physicians questions ethics? What?

    Curious how cooler heads have handled these situations and what if anything has been successful at thwarting these models until the government makes a decision one way or another. You obviously have to be careful how you react as a professional because it will make or break you.

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    1. I had half my business taken by a POD and another quarter by sham consulting...and there is nothing I can do about it. I try to stay in second place and hope those "business" relationships go away. Hard to swallow for sure.

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    2. The OIG is gutless and has done NOTHING to prevent the abuses with PODs. The ONLY way that PODs can be at all controlled is only after the hospitals realize they lose money on implants from these spinomaniacs putting in way too many implants. It's the hospital system that will have to take a stand against the PODs. Don't hold your breath that the OIG will do anything. The state medical boards don't care unless patients report abuses, bad outcomes, etc. It will take docs losing their licenses AND going to jail to stop this abuse.

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    3. I do like the thought of going to the referring physicians with other area docs that do not play the POD game. This is indeed a scorched earth strategy because when the POD docs find out they will never do business with you again regardless of POD legality in the future.
      Its just business as "they" say...:)

      Delete
  8. Jerry Brown--- a liberal piece of trash here to save the day...California deserves him. Good luck suckers!

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  9. Nothing is going happen until they start busting more physicians. A surgeon in my territory well known his greasy palm had the audacity to ask a president of a company for stock iin exchange for using their product. Literally sayiing, "no consultant agreement just equity for using their product.". DOJ are you listening, We all know who these guys are. Frankly, I am sick of these scum bags.

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    Replies
    1. Was All Good when these Scumbags were in YourSide Though Right..... ?
      Surgeons Wise up and take Stake in Their Practices and Y'all are Livid!
      Too Funny ;-)

      Delete
  10. Please remember that every WSJ article, DOJ investigation, and scrutiny of spine only serve to hurt the broader industry, not just the bad apples. Trying to purposely ramp up media or governmental scrutiny on the industry is a monumental stupidity: once that fire starts everyone associated with the industry will be tainted forever, our self-righteous TSB included.

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    Replies
    1. You're probably the same guy who was threatening to sue everyone who commented on the last post for libel. So which is it? Are you a rep, a lawyer, or an expert on mass media and public relations? Your "all-knowing" comments beg for us to believe that you are all three, but I'm not yet convinced. Please tell us more dear wise leader!!

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    2. None of the above. I am just someone who knows the dangers of negative publicity. Who the hell do you think reads those WSJ articles? How about the insurance execs who decide how much you get paid? How about the patients who need an operation but will now refuse to get one? How about the trial lawyers who are salivating for the next opportunity?

      Believe me those folks are not going to limit their feelings to the few bad apples in those articles. Guilt by association is a powerful thing and everyone in the spine industry is interconnected - like it or not. You may say "But wait, I 'm one of the GOOD guys!", but no one will give a shit.

      Yes, there are scumbags in this industry who need to be called out, but inviting in the government and media attack dogs is a nuclear option that will wind up hurting everyone in the end.

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    3. Can't wait for the news to break on 60 Minutes. The public has the right to know how their tax dollars are being used for shenanigans.

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    4. This war has been building for twenty years. It is time for the "nuclear option". Enough already!!!!!!!

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    5. 10:16
      You must be German.
      Staying quiet and trying not to bring too much attention to a troubled industry because you might get harmed is indefensible. By not culling the rotten individuals from our ranks makes us guilty by association. Doing the right thing is never easy. But doing nothing in the face of evil will corrupt those who turn their eyes away and pretend everything is o.k.
      J

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  11. 10:16's logic is flawed, that is all.

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  12. SPINAL USA? Any word yet?

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    Replies
    1. It's Penile USA because those turds are definitely pulsating blue-veiners, feeding the greed, lowering the bar.

      Delete
  13. It's been awhile since I last read/posted on this Blog. The downward spiral of the spine world has been breathtaking. We used to say "pigs get fat, hogs get slaughtered". But I think 10:16 is right. Even Bambi is being taken out.

    Our system is a socialist system, where someone else pays for your healthcare. Don't believe me? When is the last time a patient negotiated directly with you about the cost of your pedicle screw?

    The most honest medical cost transactions occur when patients pay directly for their care. In that scenario, I bet the screw would not cost more than $300, and the surgical fee's would likewise be decreased.

    But currently, although a patient may pay a co-pay, and part of an insurance premium or paid into medicare (I know that a small minority does pay for their own medical issurance, but that is an exception), in reality, someone else pays for the bulk of the care. In that scenario, the patient does not care about costs. In that scenario, efforts of cost containment is demonized by the patient, the vendor and the surgeon. And, as a result, we get the perverse state of Spine today.

    I do not have any solutions to offer. But, I know we have now become the demons. It will be awhile before we lose that label.

    Compete well and survive.

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    1. Nice post doc. You are dead-on about costs going down. There would be much more transparency also. Unfortunately, we have become a society where spending $2000 on a new TV seems like a great idea, but most people won't shell out $60 for an extra dental visit.

      We have become the demons in part from the behavior of a few bad apples in our industry...and in part because populist socialist politicians can only come into power if they and their followers demonize some successful segment of society.

      Delete
  14. Three Rivers Pittsburgh/Cleveland pay doctors like a pod -they should be investigated. Along with the Drs.

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    1. Start with Dave Hannan at Stryker Three Rivers and his free hockey tickets to the local docs.

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    2. You think he has all business because of hockey tickets? Stop being a baby, it's not illegal to take a customer to a dinner or sporting event.

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    3. 9:28 that depends on who you work for ...

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    4. 9:28, actually since sporting event tickets are not patient care related, they are illegal.

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    5. Hey 7:21 idiot - how can you make such a grand accusation without proof????

      You claim they PAY doctors - maybe you should contact the Cleveland Plain Dealer - www.plaindealer.com. I'm sure that they would be very interested.

      You're such a pathetic dumb ass. When I read the article in the newspaper with PROOF, then I'll apologize.

      Sincerely,
      The Guy Eating Your Lunch and Soon to Be Banging Your Wife!!!

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    6. 9:28
      You are a fool. It is against the rules, laws and guidelines to buy and/or give tickets to a surgeon for some event such as a sporting event. Tell me, what purpose is served in providing this type of activity to a surgeon. Are you doing a saw bones by the rink side? Maybe you have a cadaver laid out on the ice afterwards to engage the surgeon in a bioskills lab. Pathetic! If you're going to work in the industry, educate yourself as a professional and stop crapping in our swimming pool.
      J

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    7. 4:27 you are a fool. I said it is not illegal. We cannot be charged with a crime for taking a surgeon to a hockey game. There are Advamed guidelines that reps must follow if their company Is Advamed compliant. I don't care if my competitor takes a surgeon to a hockey game, that is not going prevent me from getting business. Every other industry can entertain clients but you somehow feel it plays no role in medical sales? The reason the rules were put in place was a result of the legacy companies flying docs around on jets and furnishing their houses, not a dinner or a hockey game. Stop your bitching and get some hockey tickets.

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    8. Why don't you try on the Stark anti-kickback laws. I think you will find this law very enlightening as to how illegal it is to use inducements to influence a physician's decision when providing care for either a Medicare or Medicaid patient. When the DOJ comes knocking on your door you will wish you only had Advamed to worry about.
      J

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    9. I do not have hockey tickets but I promise you there will never be a case of inducement over a hockey game. I wish a surgeon would use my stuff if I took him to a game, that would solve a lot of issues with this industry. The DOJ should be tackling PODs, fraud, paying for referrals and all other sleaze bag scams before busting a rep for taking a doc to a Flyers game.

      Delete
    10. Inducement under the Stark laws is illegal regardless of the value. Most chronic criminals start small with the belief that their small infraction isn't going to be worth prosecuting but the actions get bigger and bolder over time.
      With regard to other businesses (industries) being able to entertain without legal issues is our customers (physicians/hospitals) receive FEDERAL money. That, unfortunately, is the litmus test which puts each of us in harms way. Too bad Congress doesn't apply the Stark laws to themselves.
      Stay strong, ethical and focused on doing what's right for the patient and you should never feel ashamed of being a medical device rep.
      J

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  15. Nick Ansari is going to sink LANX ship.

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    1. What would a TSB blog be without the obligatory Lanx bash? Lanx will grow by eating away at the big guys, just like the rest of the small / medium size players in this business. And if they don't, Nick will hit underperforming sales reps in the kneecap with a baseball bat!! 'Cause Nick is OG from Philly! NOW GO GET YOUR FUCKING SHINE BOX PURPLE BOY!!!!

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    2. So true. Hell be trading lanx reps for us(with half million dollar guarantees to sit on the sidelines) and well watch you try to sell. We will own your next national sales meeting. MARK MY PURPLE WORDs. I heard we taught all your meetings this year. Next year we will be sitting where you once did. LMAO wait and see. You can shine my purple shoes while we teach your meetings and labs and take your territories. Dont believe it? Just look and see what is already happening. Texas and Florida done. Your territory is next.

      Delete
    3. Lanx is a joke. Good luck selling that bag.

      Delete
  16. Jewish Business Ethics

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    1. Awesome. This blog is great!

      Delete
    2. Thanks for chiming in Adolf.

      Delete
    3. You know us heebs... what a great blog!

      Delete
  17. How would you react if your loved one went in for a simple ACDF and left the hospital in a hearse, because some surgeon used a product off label without truly understanding the consequences or biological response from using that product?

    ----Really, people are dying from biologics in a 1 level ACDF, C'mon man, you are just stirring the pot, no one is dying in a 1 level ACDF from any Biologic. Nice try!

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    1. It was a 4 level ACDF that 2 previous surgeons said no surgery was needed. He used OP-1 and the patient died. That is not stirring the pot, it's reality.

      Delete
    2. Happened with InFuse in the neck (off label) also. Airway swelling. That is why the FDA put out that warning a couple years back.

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    3. the post was "simple acdf", not ridiculous 4 level re-do with some jackass going way off the reservation with a product not even cleared other than an HDE.

      Swelling in the neck is not death, the guys who is writing the post is just going way overboard in making such broad generalizations, seems he is just as green as you.

      Delete
    4. Medtronic Infuse FDA Warning

      In the FDA warning concerning Medtronic Infuse Bone Graft, it was emphasized “that the safety and effectiveness of rhBMP in the cervical spine have not been demonstrated and these products are not approved by the FDA for this use.”

      The FDA goes on to state that it has received at least 38 reports of complications with Medtronic Infuse Bone Graft when used in cervical spine infusion in the last 4 years. All of these complications were a result of swelling of the neck and throat tissue, which can result in airway constriction and compression of the neurological structures in the neck. Some effects of these and other Infuse Bone Graft complications include:

      Difficulty swallowing
      Difficulty speaking
      Difficulty swallowing
      Male sterility
      Ectopic bone growth
      Inflammatory cyst formation
      Uncontrolled bone growth
      Impingement of nerves and nerve damage
      Cancer
      Paralysis
      Retrograde ejaculation
      Death
      These Infuse Bone Graft side effects are made more serious by the proximity of the cervical spine to airway structures, and often require emergency medical intervention.

      Most Medtronic Infuse Bone Graft complications occurred between 2 and 14 days after the operation. Treatments for these side effects may include respiratory support with intubation, tracheotomy, anti-inflammatory medication, and in many cases, a second surgery.

      Delete
    5. A number of pateints have died from complications of InFuse being used in ACDF's. Single leve to multi level. It is a fact.

      Delete
    6. A spinomaniac did a 4 level ACDPF (only one level needed to be done) but to make matters worse used Infuse. Now the notice from Medtronic came 2 months prior to that 4 level ACDPF with Infuse. Needless to say the patient nearly died, required a PEG and trach and spent 2 months in the hospital. Of course the patient had no idea what had happened until I saw him for a second opinion about his lumbar spine of which the spinomaniac wanted to do a 4 level lumbar fusion for LBP. This shit has to stop!!!! Docs HAVE to go to jail to stop the abuse.

      Delete
  18. Madame Toussaint here, just swooping in for a short visit. I saw something interesting in the tarot cards last night. Globus is going public soon. Look for an announcement in 30 days or less. They finally found a lead underwriter to swallow consulting agreements as arms-length transactions.

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  19. so does that mean Globus is finally going public?

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  20. @ 8:04. As a veteran I would think you should already be doing this. To combat these pod's find out who is referring to these a holes! Then make some appointments for one of your good, loyal, ethical surgeons and do some meet and greet/here's what I can do lunches or dinners. If you can change the referral pattern then you are combating them on a very high level.

    Of course these pod surgeons won't notice because they are making the extra money. But, when the shit hits the fan and the pods are busted up. They will be screwed.

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  21. Is this one of the guest editorials? It sure isn't MSM.
    Not that it's a bad commentary, it's just not MSM himself.
    I think he has sold out.

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  22. The only thing necessary for the triumph of evil is for good men to do nothing.

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    1. Exactly. I am a spine surgeon and I direct all my patients who see me who have had a botched POD surgeon do a multilevel fusion I direct them to report to the state medical board. I've referred many cases over the last couple of years and still have not heard anything. I reported to the Medicare Fraud and Abuse. Took a year for a agent to contact me, 2.5 years to investigate and then, despite the guy doing 10 level fusions in 85 year olds for low back pain, claimed that he could find nothing illegal and stopped the investigation. The OIG seemingly could care less.

      Delete
    2. "I am a spine surgeon." No you're not.

      Delete
  23. MSM- I am not trying to citicize you as being a liberal or a phony, but it is comical to read you feigning outrage and questioning where all of this greed and underhandedness is coming from! Take a good long look at the politicians.

    Bill Clinton gets head and no one really cared that he had a wife and kids, and lied under oath, on the contrary, he gets paid thousands for speeches delivered around the country and is still well respected around the world....why would Steve Mac think he should be treated any different? He was only running an instrument company for Gods sake!

    Our politicians have double standards when it comes to their healthcare as well as the healthcare of their friends and donors who all get exempted from Obamacare, Oh, and lets not forget that they are just now getting around to exposing all of that insider trading they have been doing all of these years and getting fabulously wealthy off of. It is okay for them, but we get sent to prison if we get a little stock tip???

    Then we have gov't funded corps like Fannie and Freddie that get away with financing shit loans to citizens incapable of ever paying them back. How is this any different than the Work Comp system in California overpaying thousands of dollars for POD products ? It is the taxpayers getting stuck with the bill in the end. The work comp system in Cali. is a perfect example of why government needs to stay out of healthcare.

    I think 1:18pm said it best (even though he was not referring to TSB) "Your observation is pointless as this industry has been & continues to be run by the very companies who bend the rules in order to stay at the head of the pack." Except instead of companies, substitute the word "government officials".

    Until our elected officials stop demonstrating all of this blatent hypocricy and double standards, why should we expect anything different from the executives running our industries?

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    1. 2:12...spot on. Noting the last paragraph in your post...elected officials will never stop behaving this way. That is why our Founders tried to keep government power limited.

      If we could only get the retard liberals to understand that simple concept.

      Delete
    2. The conservatives don't even understand the concept of limited government. That's why I'm a libertarian. Democrats and Reupblicans think too much alike for my tastes...

      Delete
  24. It's so funny to read some of theses post's. You can see who people work for and who is kicking who's ass in what market. I work for Stryker, I love the company. We might be a little slow coming out with new tech but other than that we are a solid major. What happen with our CEO happen with my accountant also but nobody is bloging on him. His acctions are an issue to his wife and children only. He did the right thing by stepping aside. I don't see how any personal actions has anything to do with running a company. What he did is not illegal just not the best husband material.

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  25. 3:21 It's called LEADERSHIP, that why you lead. You lead by example of how you live your life, how respectful you are of other people, regardless if its your wife or your employees. Remember what my granddaddy taught me, you don't shit where you eat.

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    Replies
    1. Respectful of other people, just like your blog here? I think if your granddaddy read this blog, he would puke.

      Delete
    2. 5:27, man up or go put on another PAD to control your flow.

      This isn't a blog about kissing each others asses, its about a no mercy industry that pays the victors big stakes and sends the whimps packing.

      So shut the hell up.

      Delete
    3. II think TSBZ granddaddy would b proud of the way he"s lived his life. AZ4 5:27 go read OTW so you can get fed the kool aid

      Delete
  26. Sarah from three rivers is banging doctors too. oh by the way thanks for admitting guilt (tickets) on a public record your sunk

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    Replies
    1. Is she hot? How big are her sweater puppets?

      Delete
  27. This blog is pathetic,, Every blog for the last 6 months turns into mothing more than a forum for all of you to bitch, complain and rip each other. Add something constructive, a throughful, meaningful response would be nice. The fact that this industry has turned to shit is clearly reflected here on this blog but the wasteful, worthless, bashing that permiates these posts day after day.

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  28. Sorry to hijack this thread, but can some of you guys/gals point me towards sources (ie/medical publications if possible) to post-op failures of dynamic stabilization devices? I am aware of the MDT recall of the Agile device and to some degree Synthes' recall of N-Flex, but I can't find ANY information about failures in PEEK rods and other materials/devices beyond interweb/forum anecdotes. Is there any solid information out there? Thanks!!!

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    1. Search MAUDE reports. PEEK rods are difficult to see if they fail. Research dynesis from zimmer, transition from Globus, DSS from somebody. Also research follower load in the spine and interpedicular distance in the flexion and extension of the constructs. McAfee put out a paper called gradations of lumbar fusion the rationale behind transition, which is an interesting read. As one of my favorite ortho spine surgeons say, "its a big con."

      Delete
  29. 5:35 So why are you reading TSB and commenting? Why aren't you contributing "something constructive, thoughtful, or a meaningful response?" It has become evident that you are the same person or entity that continually bashes this blog and TSB. Either you are a competing platform, i.e., OTW, Wally's World, or OSN, hey, don't read it if you don't like it, that's how you exercise your first amendment along with your other rights. No offense but our people and readers are sick of listening to your rant.

    ReplyDelete
  30. This blog was clearly a set up for slanderous comments from anonymous posters. Way to fall for MSM's trap...

    ReplyDelete
  31. My post was deleted....wtf?

    I only speculated that this wasnt the original MSM. I didn't say you sucked dude.

    ReplyDelete
  32. Oops. No it wasn't. Carry on.

    ReplyDelete
  33. Reading this blog is like watching the video of that poor guys head being sawed off alive by terrorists. It's sadistic and terrifying but you just can't look away. MSM is an evil genius, indeed.

    ReplyDelete
  34. Medtronic numbers are in all your futures.... Minus 6% hardware, minus 20% biologics. Get used to it.

    ReplyDelete
  35. TSB! There are some topics you could introduce that facilitate better discussion and would greatly improve the spirit of this blog. I still love Spine and assume most posters here do too. But the posts are getting out of hand as are the responses. Comparing the ethical implications of an alleged private extra-martial affair to those responsible for the PODs that are ruining spine and jeopardizing outcomes ... is a real stretch. No this doesn't make you "liberal/phony/pandering" it just makes you boring. If I want to read or hear about that junk I'll pick up a "National Enquirer" when I'm standing in the grocery checkout line. You had a great blog a couple years ago, please don't let it turn into TMZ type gossip garbage.

    Here are some topics that would be interesting and helpful!:
    - posted some flouro pictures of spine pathologies and implants (minus patient names)
    - failed cases and what went wrong
    - what are the potential approaches to treat the pathology, what construct works best, why a device has a biomechanical advantage or clinical advantage etc
    - discuss positive and neg of increasing outpatient/ASC based spinal procedures, what could and should be done there, what should not
    - what are the technologies in europe that will win in the US

    ReplyDelete
    Replies
    1. Absolutely. Great suggestions. And no need to pull images, if that's a pain. Just create hypothetical situations where we see differing treatments by the docs, and let's bounce around the merits and the technologies.

      As one poster says, the a-holes won't care for it. But who cares. Many of the rest of us who sit on the sidelines for the BS rants will step up to fill the space.

      Delete
    2. Nobody was comparing the BJ with Pods you moron, it was a comment that equated the self righteous and narcissistic behavior of politicians with that of the CEO's running business today.

      Delete
    3. 5 years ago this would have been a great idea. The fact is that this blog has evolved into what it has due to the circumstance of the industry. The fact that you want to broaden your knowledge of spine tells us all that you haven't looked outside in a while.
      Step out into the here and now where none of that crap matters. Technology, service, innovation, you can piss it all away because they do not matter to a surgeon involved in a POD. What does matter is what has the largest profit margin that they can stomach using on a day to day basis.

      Dude, wake up.... Train just left.

      Delete
    4. It's sad to say 02:32PM I think you're correct on so many levels.

      Delete
  36. Agree with 09:54 100%! I'd like to add another topic: What cellular products are really working? Is Osiris' Ovation the best of the bunch? Is the BioDlogics product gaining traction? What are some of the positive outcomes of both?

    ReplyDelete
    Replies
    1. Sorry, this is the wrong forum for useful info. The agenda here begins and ends with slamming surgeons who engage in business, and spine company management. If that's what you dig, this is the place. I'm here because I'm an asshole. Thank you.

      Delete
    2. Useful information would be going to OTW which writes the most ridiculous stem cell articles. Of course no one thinks that would not be influenced by the fact that Mr. Rainmaker himself Robin Young has financial interest in a stem cell company now would it? So as TSB likes to say what is real and what is memorex? No one slams surgeons that are truly engaged in real consultancies or developing real products, but to pontificate how a company like Spinal USA is developing cutting edge technology is propaganda at its best. You reap what you sow.

      Delete
    3. Two words = No data

      Delete
  37. Let's talk about Amedica. They seem to be making some big moves in the market. Who is running their Sales now?

    ReplyDelete
    Replies
    1. Jim Enright is the VP of Sales. I am not sure if that is a big or bright move. He comes from world class companies such as Orthofix/Blackstone and Aescualp.

      Delete
    2. No one is currently the VP, Sales at Amedica. Sales are up. New paradigm?

      Delete
    3. Making big moves LOL !!!!!!!!!!!!!!!!

      Delete
  38. Let's talk about Medtronic's numbers and the greater implications for Spine. Everyone has been bashing Zimmer, Depuy, Synthes and Stryker's numbers but I don't see Big Blue doing any better. This should be a wake up call to all that the Legacy companies are in real trouble, which begs the question if this is really good for the industry. Obviously pricing pressures are up and volumes are down but every other industry within healthcare are facing those same headwinds or at least similar. Add in PODs in obviously it is very difficult for the companies at the top to maintain there market share. Is this good or bad for the industry and what is the game plan at the local level to navigate these treacherous waters. Has the cheese moved and it is time to find a new job? If PODs are legal is it time to start them in other high profit sectors of medicine? If they are illegal how do we go about facilitating there demise without ostracizing our customer base? Obviously Medtronic and Depuy have been unwilling to aggressively fight PODs feeding that they will upset and lose their customer base and have instead been content to slowly lose their customers as more of them join PODs? Go figure, I guess they will wait until their numbers start heading south at more than double digits?

    ReplyDelete
    Replies
    1. ps sorry for all the spelling and grammatical errors for the spelling police... their not there, feeling not feeding, and so on. Yes, I am in grade school but hopefully sound questions and points. I realize you all can spell but can anyone philosophically expand and add anything constructive on how to go about making a difference and positive change on an industry that by all accounts most of us are still in and enjoy.

      Delete
  39. Anybody know of a posterior cervical screw that is indicated fir c1-c7 to be used in the posterior cervical as opposed to using lateral mass screws which are indicated for T1 and down.

    Thanks,

    ReplyDelete
    Replies
    1. None yet. Medtronic is within a few months of getting clearance for this.

      Delete
    2. if you arent placing the screws in the lateral mass, where are you placing them? regardless of indications, its still a standard of care. Just be careful about what you say, demo, or show.

      Delete
  40. No screws are approved for cervical spine. Only hooks.

    ReplyDelete
    Replies
    1. Posterior cervical, but I presume that's what you meant.

      Delete
  41. MDT suffering...harbinger of things to come? Karma? Or maybe a bit of both. Do they deserve everything they get? Or more? Come the end of this quarter I expect the 3rd, yes, 3rd round of layoff's in less than 5 years.
    Not many a tear being shed I see. Can anyone make the case, other than the industry bellwether, why we should give a shit?

    ReplyDelete
    Replies
    1. The company I work for will no doubt benefit from MDTs woes, as will a number of other companies, which normally would have me jumping for joy. Whatever you like to call them the issue is not a series of bad plays in running their business but a fundamental issue with Infuse which is going to make surgeons switch to a different graft material and therefore give the opposition rep a shot at the hardware too. But ultimately across the world there are a huge number of patients who recieved Infuse and a % of them are going to pay a hefty price for it. In a live and let live world I dont wish any misfortune on the honest daily workers at MDT and I genuinely do wish them well in maintaining their livelihoods in such a challenging scenario. Lets just hope that Infuse dwindles to a point where its benefits outweigh the risks.

      Delete
    2. Boom.....MDT Biologics Sales down 20% and Core Spine down 6% in 3Q. WOW!! The complexion of the spine industry is on the precipice of disruptive change.

      Delete
    3. From the words of the MDT CEO today........................
      "The year-over-year decline is not sustainable. We urgently need to see signs of improvement" in Medtronic's spine business, Chief Executive Officer Omar Ishrak told analysts on a conference call. If improvement is not seen, he added, "we will need to assess our strategy and approach to this business."

      Delete
  42. It's just nice to see the showboat Medtronic turn into the tugboat when they actually have to compete, like the Kyphon 1 hit wonders.

    ReplyDelete
    Replies
    1. Funny...VP of Sales for MDT? Kyphon rep!
      Stock the shelves boys!!

      Delete
    2. Sad but true. that wont cut it on the spine side and it shows.

      Delete
  43. Sweet, someone from an insurance company just asked if any screw was cleared for posterior cervical use.

    And if it was a rep, that dipshit should know. Don't be quick to puke info, insurance companies are looking for any reason to deny payment.

    As for MDT or whatever you call them now, they are hurting but the market share lead they have even when Synpuy arrives will be huge. But it really doesn't matter I guess, it's about what happens in each of our own local markets. Compete hard and earn your share.

    ReplyDelete
  44. I enjoy that MSM wants to call people out for "hiding behind anonymity" when he lives behind the avatar of the Musculoskeletal Man. Glass houses....

    -Bigfoot

    ReplyDelete
    Replies
    1. MSM is a liberal coward.

      Delete
    2. Therefore you all post anonymously LMAO look at who is calling the kettle black?

      Delete
    3. Bigfoot should stick his Bigfoot up his arse, TSB RULES

      Delete
    4. "TSB RULES"??? You must be the 12-year-old son or daughter of a spine rep.

      Delete
  45. Surgeons are getting misled with POD's thinking that it is somehow OK to get paid on the instruments they use.....Reps who work with POD's are the reps who can't get a real job with a real company. What has Medtronic, Synthes, J & J, and Stryker done to shut them down? Why have the lawmakers let it go on? Now we even have reps double dipping and working full time for 2 companies at the same time...with the boss's approval at MDT. You know who you are in Oklahoma!!!! Where is NASS, AANS, and AAOS voice in all of this craziness going on today?

    ReplyDelete
  46. A perfect time to read what this astute blogger has to say about this general subject and the impending consequences of The Choices We Make:

    http://kunstler.com/blog/2012/02/the-choices-we-make.html#more

    ReplyDelete
  47. As so many others on here have commented, this blog is turning (or turned) into a mere copy of CafePharma. Bitch, moan, spew, call out, deride. Sorry, but nothing worth checking in daily for.

    ReplyDelete
    Replies
    1. There's one person's opinion....

      Delete
    2. He's right, though. As I've said before, I'm only here because I'm an asshole. Thank you.

      Delete
  48. This comment has been removed by a blog administrator.

    ReplyDelete
  49. This comment has been removed by a blog administrator.

    ReplyDelete
  50. Ok, so now we got that cleared that up....

    ReplyDelete
    Replies
    1. What was the rant about?

      Delete
  51. Please refrain from having a brain aneurysm on this blog site, as the surgeon general taught me your thoughts could be hazardous to your health. Peace TSB

    ReplyDelete
  52. Nuvasive supporters, another great quarter of growth w/ diminishing returns. Wasn't real shocking to read this on one of their press releases from yesterday: "NuVasive, Inc. reported a drop to a loss in the fourth quarter driven by higher costs. Reported a loss of $10 million (24 cents per diluted share) in the quarter. The medical instruments and supplies company had net income of $61.9 million or $1.39 per share in the year-earlier quarter."

    Bottom line is that it really doesn't matter how big you are if you can't figure out a way to make money. Good luck to all of the "shareowners" at Nuvasive as Cheetah Nation & the Costa Concordia are beginning to have a lot in common.

    ReplyDelete
    Replies
    1. But look...if you just ignore what you're paying your executives, pretend you didn't lose a massive lawsuit, and erase your tax bill, you can turn that $69.8M loss into a $43.9M gain! Are these clowns the last company in the US trying to pull the GAAP vs non-GAAP thing, as if any investors buy it.

      What triggered the 'intangible asset impairment charge"? Is there any more information out there? If they impaired one asset....are there some goodwill line items being currently overvalued...lying in wait to b!tchslap the balance sheet in coming years?

      Enjoy:


      On a GAAP basis, the Company reported a net loss of $10.0 million, or $0.24 per share, for the fourth quarter 2011, and a net loss of $69.8 million, or $1.73 per share for the full year 2011.

      On a Non-GAAP basis, the Company reported net income of $11.4 million, or $0.27 per share, for the fourth quarter 2011, and net income of $43.9 million, or $1.07 per share, for the full year 2011. The Non-GAAP earnings per share calculations for the fourth quarter and full year exclude, respectively, (i) non-cash stock-based compensation of $8.3 million and $32.1 million; (ii) certain intellectual property litigation expenses of $1.3 million and $7.0 million; (iii) litigation award expense of nil and $101.2 million; (iv) amortization of intangible assets of $2.4 million and $6.6 million; (v) acquisition related items of $1.4 million and $3.8 million; (vi) non-cash interest expense on convertible notes of $3.0 million and $6.1 million; (vii) the positive impact from certain transactions associated with convertible notes activity of $0.4 million and $2.1 million; (viii) certain discrete tax items of $0.3 million and $6.6 million; and (ix) an intangible asset impairment charge of $18.2 million and $18.2 million.

      Delete
  53. Dime Store AccountantFebruary 23, 2012 at 9:21 AM

    That is some fuzzy math. Check out this on FY only:

    GAAP: -69.8M
    non-GAAP: +43.9M
    delta: 113.7M (e.g. total losses turned into gains by the accountants)

    Now add up their line items:

    i: -32.1M
    ii: -7.0M
    iii: -101.2M
    iv: -6.6M
    v: -3.8M
    vi: -6.1M
    vii: +2.1M
    viii: -6.6M
    ix: -18.2M

    delta: 179.5M

    Hmmm....$65,800,000 need to be found!

    ReplyDelete
  54. The amazing thing is there is still a buy rating on their stock. Who in their right mind would invest money in a spine company with the industry trends. The whole market is a ponzi scheme.

    ReplyDelete
    Replies
    1. As the bear likes to say "On ward and up ward Cheetah's!"

      Delete
  55. TSB,
    Watup with all the comment removals lately?

    Everybody funny, now you funny too.

    ReplyDelete
  56. Anybody know of a good Neuro coil available for a 1099?

    ReplyDelete
    Replies
    1. We have had great success in our POD with coils....difficult to find a supplier. It can be done. How much is it worth for our due dilligence?

      Delete
    2. I will make it worth your while. email me at spinemaster9@gmail.com

      Delete
    3. I hope your pod burns in hell w you in it

      Delete
  57. As the bear likes to say "On ward and up ward Cheetah's!"

    ReplyDelete
  58. Having 1.5 Nuva consultants per 2 spine docs has obviously been an effective business plan...nothing like cheetah speed and and some cash to grow your numbers....I really can't wait for this company to burn itself out...with there shady accounting it's just a matter of time.

    ReplyDelete
  59. NC is full of NUVA consultants!

    ReplyDelete
    Replies
    1. I guess every Doc for GLOBUS or K2M is a consultant ....All companies have consultants ....GET OVER IT..".

      Delete
    2. Actually, Globus or K2M do not have 10% of the consultants Nuva has. In fact I wager Nuva has as many consultants and Medtronic, Globus and K2M combined. Nuva buys its business get over it. I know, I used to work for the arrrogants bastards.

      Delete
    3. So you couldn't get it done .....your just mad you couldn't sell.....Bunch of cry babies

      Delete
  60. The OIG should investigate NUVA for all the business it buys. Let them perform their investigation, and let's see if they belive it is fair and/or legal.

    ReplyDelete
    Replies
    1. People who live in glass houses shouldn't throw stones. It's an unfortunate and dirty fact of the industry. Saying one company is any worse than another is just petty sales rep bashing. I would rather the FDA/DOJ/OIG would put laws and rules in effect that would eliminate it all together.

      Delete
  61. As the bear likes to say "On ward and up ward Cheetah's!"

    ReplyDelete
  62. Has Alex gotten to the point where he's started to plug his Broadway Musical "Memphis" during the earnings calls w/ inverstors? Just thought perhaps he might throw it out there for those investors in the city if they might like to see his show,,

    You know, might help them form a more favorable impression of the company. Oh wait, isn't that what he already does w/ surgeons??

    ReplyDelete
  63. word is the Tornier just hired a guy from NUVA to be vp of sales. Any idea who this is and what his history is??

    ReplyDelete
  64. It is Terry. I am sure that Tornier will have a mass exodus as soon as Terry shows his true colors. I have never met anyone that is so universally disliked. His liabilities far outweigh his assets, and his arrogance won't fly outside of NUVA. I bet he cried in his purple panties when he was squeezed out. NUVA was his life, his identity, and his refuge. Karma is a bitch Terry, you have earned all the heartache you are certain to receive. NOBODY likes you!

    ReplyDelete
  65. You people really don't get it....Nuva has more consultants then ANYBOBY! Everybody they do business w/ over 1 mill is a consultant.. And there are some under a mill that are... It's not throwing stones, it's throwing facts. It's their business model.

    ReplyDelete
    Replies
    1. What company are you with?

      Delete
    2. All companies have consultants but NUVA is the new king. Their threshold is moving below $1million.

      Delete
  66. TSB and fellow readers-
    I would like to know your thoughts...
    A large hospital with several campuses in an enormous market has just masterminded its own pseudo POD. The hospital has set up an exclusive contract with two companies. These companies were chosen based on price and a portfolio that can handle such a large account. Nothing new, however, the savings will be bonused out to the surgeons as profit sharing at the end of the fiscal year. According to the two surgeons I spoke with, based on the numbers that were provided by the hospital administration, they are going to make "a killing in bonuses this year". Those numbers were based on the previous year's spine volume, which I believe will increase due to the new "savings". I was not told the exact projected bonus amount, obviously "a killing" is subjective, but they were already strategizing how to get even lower bids when the contract is revisited in two years. There are roughly 15 surgeons in this system.

    These surgeons now have incentives set up by the hospital to implant and the model keeps them happy and away from outside influence such as POD's. I suspect this model will become popular as it is the hospital's response to the prolific POD's that have put pressure on their business.

    Have you seen this in your markets?
    Is this legal or ethical....
    Does this model help lower the patients cost or healthcare cost in gerneral?

    Regardless of right or wrong, I foresee the current administration being apathetic to these issues. Why challenge this when the hospitals and doctors are happy and not complaining about money or cuts to medicare. Also, the OIG and DOJ have bigger problems like medicare and medicaid fraud that extend into the billions.

    Comments?

    ReplyDelete
    Replies
    1. What market are you in?

      Delete
    2. Would it be an option to discuss this with the local news? They usually like to stir it up in the community. These type of deals usually don't hold up to the light been shed upon them.

      Delete
    3. Isn't this gain sharing? Which is illegal.

      Delete
    4. Gainsharing is not illegal. There is a safe harbor as long as it's properly documented. It's been done in cardio for a long time. OIG put out a letter a few years ago.

      Delete
    5. Agree with 8:19. This is gainsharing and I believe it is legal. While I used to question the ethics of this, in comparison with PODs it seems relatively tame.

      Delete
    6. Relatively tame? In a POD, the surgeon has to actually do things. Make plans, get a legal opinion, make an investment, form an entity, participate in overall management, etc. Granted, there is usually a businessman or lead surgeon who does the lion's share of those things, but its still a business that has to be started up and run. With gainsharing, the surgeon just uses the hospital's implants and cashes the checks. Both are "inducements" but at least the POD thing doesn't look like a straight bribe from the hospital. Which is what gainsharing is, in my humble opinion.

      Delete
    7. Does this explain POD's versus gainsharing?

      http://www.healthindustrycouncil.org/areas-of-involvement/events/webinars/physician-owned-distributorship-webinar/

      Delete
  67. It's called gainshairing and has been in practice for years. The jury is still out if it is legal, after all isn't it an inducement as well?

    ReplyDelete
  68. "Onward and upward my Cheetoh's!"

    ReplyDelete
  69. PODs are your best friend compared to hospital gainsharing arrangments. No rep, no distributor, just direct from the company to the hospital. Saves a ton of money and the savings are split between the docs and the hospital. It's a negative inducement, since the docs are paid more for not using product. The government loves this, and it will figure prominently in Obamacare.

    ReplyDelete
  70. NUVA is guilty and K2M, Globus, and Lanx are innocent? $540M and everyone is a consultant?

    I'm just shocked the NUVA bashing took so long to develop with this thread!

    ReplyDelete
    Replies
    1. Dude if you have 200 plus consultants at 1.5 million.... That's 447 mill devided by 540 mill.. Congrats only 82% of nuvasive business is bought and paid for...but that's not even accurate because of the 4-7million surgeons like Bill Smith working for you.

      Delete
    2. More like 300 surgeons at .5 million. Even Nuvasive wouldn't be so stupid to pay doctors as much or more than the implants they use. Keep in mind they have 20-25% percent in cost of goods, commissions and manufacturing. Surely they are looking for a good ROI. Oh, forgot they have never made money (not talking about the management).

      Delete
  71. No, they are guilty too, but NUVA is the king of consultants.

    ReplyDelete
  72. So does gainsharing mean Globus and Penile USA are going public soon?

    ReplyDelete
  73. Word on the street is that TSB is going public in Q2.

    ReplyDelete
  74. NUVA has to buy their business, otherwise they've learned that they can't hold on to it for a variety of reasons. Some of their biggest customer losses include: D. Cohen in Miami, P. Nunley, Cappuccino, & F. Sandhu in D.C.

    I believe each one of these docs may also have been or is a clinical site for their lateral TDR study. WOW,, nothing like doling out a clinical site on a very pivotal product, only to have the doc walk into the arms of one of your competitors.

    ReplyDelete
    Replies
    1. D. Cohen- whale consultant Globus
      P. Nunley- surgeon advisor board K2M
      A. Cappuccino- head of Lanx advisor board
      F. Sandhu- surgeon advisor board K2M

      You may want to site different people if your concern is Nuva consulting deals.
      It would appear that someone offered more for their services.

      Delete
    2. Sandhu was not a consultant with Nuvasive and he left because he is getting royalities from K2m .Nunley is getting the same royalities...Please get your facts right....

      Delete
  75. One of my referring docs used to use NUVA and then switched to Globus, and he was laughing hysterically when he got a personal phone call from the Russian Bear himself begging him not to leave!

    ReplyDelete
  76. You have to give him credit though, he reacted with Cheetah like speed in calling to retain the biz!! He is no hypocrite!

    ReplyDelete
  77. Oh God....Please someone stop this blog....please....

    ReplyDelete
  78. What's up at the surging (or is it purging) K2? I hear the money flow has run dry and they've stopped investing. Could they be restructuring for a sale or IPO?

    ReplyDelete
  79. TSB what's up with this stale old thread here? You were hot for a while. Tell us you're not losing your edge.

    ReplyDelete
  80. Pods & Gainsharing are a larger problem than any consulting agreements any company has, and everybody has them. Who actually uses a product for clinical advantages and outcomes anymore? A screw's a screw, pre-bend your rods and your in. Are products are commodity products and everyone needs to wake up.

    ReplyDelete
    Replies
    1. "Are" products?

      Delete
    2. Spine Products

      Delete
  81. GS Medical and McQuinn are a joke. Heard they got reported to the DOJ for paying kickbacks to surgeons and the State of California is investigating. Hopefully we will see action taken against these frauds.

    ReplyDelete
  82. It looks like a major shake-up at Phygen, 3 senior management have resigned (Paul Sedro, Kyle Webb and their CTO Laszlo Gramzegi) as well as several of their reps??? And if that wasn't enough they just got served a $25 million dollar lawsuit...could this be the end?

    ReplyDelete
  83. Is Laszlo going to sue? "constructive termination" I am told.

    ReplyDelete
  84. I have come across this BioDlogics company that a surgeon was discussing saying they are claiming living cells in their product they call BioDFactor which is a cryo amniotic injectable.This compamy is a sham they clearly copied a product called Osteo Sponge from Bacterin calling theirs Dynamic Bone, and then copied a Amniotic graft by Mimedx called AmnioFix because the one they had and still market is crap. It`s only a matter of time that these products especially the amniotic graft will be pulled do to patent rights.I`m sick of these little companies that piggy back off of legitimate practices and just put a different name on it and say that they developed the product.

    ReplyDelete
  85. Yeah I met the owner and he is a piece of shit liar. They are telling surgeons that their product grows bone and that there is millions of "living cells" in the product...Their isn`t!!!!
    I heard even their own investors wouldnt use the products which are surgeons ....talk about a conflict of interest....yikes

    ReplyDelete