Monday, July 16, 2012

Spine: In The Newsroom

Spineophiles, if you haven't had the opportunity to watch the Newsroom on Sunday nights, take the time to surf over to HBO and give this series a look with an objective mind. Is that possible? By now many of you are wondering, is TSB becoming a television critic?  In order to assuage your cynicism, the answer is unequivocally NO. In many respects, "The Newsroom" is an indictment of the current state of news, regardless of whether you are a liberal, conservative, or independent, but who cares about labels, hey? Just ask some of our readers. The Newsroom questions our objectivity as we transition from a nation state to a market state, more concerned about sponsors feelings rather than delivering the truth.  It questions accuracy, our insanity as a nation, along with business, politics, the media, and the government's failure in reporting the truth, even if it means offending some peoples feelings or beliefs. So how does this pertain to Spine?

The vast majority of people that work in this industry are hard working professionals. It is the 20%, a minority, that truly tarnish our industry. These are the same few individuals that snicker and sneer, while espousing free markets wrapping themselves in the American Flag, as long as it doesn't hinder their ability to game the system.  Ever read a comment and wonder how someone can go off on a tangent and introduce a topic unrelated to the blog? What does it say about that individual's ability to focus, let alone do their job? Why can't TSB challenge this unholy industry when it is warranted?  Where have all the geniuses gone from the last ten years which TSB calls the lost decade in spine.  Have we learned anything from the pitfalls of success? What began as an innovative industry led by young visionaries has mutated into an industry that is bloated and bureaucracy laden.  Spine is about as aberrant of an industry as anyone can work in. Our industry rewards executives that strangle ideas rather than reward creativity, because creativity or out-of-the box thinking may threaten the established order of things.  Today, the start-ups and early growth stage companies are mirror images of their big brothers.  Fiefdoms and internal politics have emerged as a key to ones success and longevity. God forbid you point out a deficiency or inadequacy of a system or implant, or ask why the company is spending capital with no return on their investment?  Some of our current CEO's would better meet the criteria for psychoanalysis rather than an expose in Harvard Business Review.  No one individual is bigger than the sum of its parts.

Turnover has become rampant. Rather than sustain continuity and realistic growth expectations, many of these companies go five steps backwards to go one step forward. Question my decision making, you're fired, even if the individual's decision making SUCKS. If you don't listen to your customers needs, you will never succeed. But then again, it is always easier to blame someone else than take responsibility for ones actions or decisions. Just ask Ken Lay, Jeff Skilling or better yet the former CEO's of Vertebron, Archus, CardoMedical, or IST. It was always someone else's fault. Never have I heard anyone admit, "I just wasn't prepared." Even the BOD and Investors buy into their BS. Some of our readers believe that they know TSB or our motives for this blog. Those are usually the smartest guys in the room accusing TSB of being anti-business. On the contrary, those that contribute to your blog love making money. The difference is that we do not justify making money by behaving unscrupulously with no conscience. Our response is that those few individual are entitled to their opinion, and they could keep reading OTW the mouth piece for the industry.

The industry has lost its nimbleness, it has lost its passion.  It will blame everyone else except itself.  It's the FDA's fault. It's Obama's fault. It's the sales persons fault. What about the people that truly drive the industry? What about the greed exhibited by our illustrious CEO's and our surgeon customers? "You bring no value. You are overpaid. You are the cause of the United States healthcare crisis."  But what about their own contributions to an industry once revered now loathed. Where are all the visionaries that lacked the wherewithal to properly assess where healthcare was heading?  It's churn and burn baby. What happened to all the innovation? Another pedicle screw? Another cervical plate? Another inter body device? We no longer innovate to improve clinical outcomes?  We are now focused on improving existing technology asking the question, "how are we going to use this to make more money?" Today, at day's end, you are more concerned with your stock price and whether it has gone up or down than whether you had a productive day.

The reason you read TSB is because we make you think.  We stimulate you to ask the right questions and hopefully hold your companies accountable for what they do well, and what they do poorly.  You are the engine that drives the machine on a daily basis, not the shareholders or hedge funds that play roulette with your companies shares. The reason Spine is in this state is because shareholders and BOD's place more value on bean-counters than the individuals that understand the clinical and development side of the business.  They don't want a product guy, they want a businessman or woman that can cut a deal or put another marketing spin on a me-too product.  As we enter the dog daze of summer it will be interesting to assess where we are and how we intend on adapting to an ever shrinking market place?  Vacation time is over and its back to the grind.  Have a great week, and sell something will you the investors are getting antsy.

21 comments:

  1. Great post! You have defined the culture of a merger between two monster companies in spine.

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    1. I had spine surgery that was not needed it's so sad DRS NOW ADAYS DONT GIVE A DAMN ABOUT THE PEOPLE ITS ALL ABOUT THE MONEY WHAT HAPPENED TO GOOD DRS.

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    2. I had spine surgery that was not needed it's so sad DRS NOW ADAYS DONT GIVE A DAMN ABOUT THE PEOPLE ITS ALL ABOUT THE MONEY WHAT HAPPENED TO GOOD DRS.

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  2. "These are the same few individuals that snicker and sneer, while espousing free markets wrapping themselves in the American Flag,"

    What?

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  3. MM,
    Three letters: F-D-A. At Spine Week this year I saw a dozen technologies that I'd love to sell, but in every case the manufacturer said that Obama's drones at the FDA would not allow it unless they got shaken down for 25 million dollars. I love you MM, but it's getting embarrassing how far you are in the tank for Barack Hussein.

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    1. It's always the FDA's fault isn't it? At times we haven't done anything to circumvent the system, have we? The FDA hasn't done enough to police the improprieties that exists at many small companies in spine. Would you implant a device without proper investigation? That's why companies go to Venezuela, or Pimentaland. No one complains even when the devices they implant fails, do they? I mean they're only foreigners, who cares. let's use them as guinea pigs.

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    2. The FDA has blood on its hands by legislating without representation by unaccountable drones. You know what's up people, the breaucracy is doing what Congress wouldn't do: regulate innovation away because it may cost a few pieces of silver more. Don't believe me, ask your Product Development folks how fucked up the new rgime is.

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  4. Nice post but there is a false premise. Innovation will kill business. The problem is human health should not be a business.

    Let's say that there was a treatment that made orthopedic implants obsolete. It would destroy the industry. The industry should be destroyed.

    There are I believe 3 companies that make motion constraining shock absorbing ADRs. None of these are available in the US in spite of the fact that they are better.

    The industry runs the FDA.

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    1. Innovation kills business!? Riiiiight.

      You just went full moron.

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    2. Shock absorbing disk replacements are a failure going all the way back to the Acroflex disk. You can neither restrain motion or absorb shock over the long term with a TDR, despite claims that certain companies or inventors make. No conspiracy here- the FDA actually has this one right.

      The next generation of treatments will be biologic in nature - it won't be about the latest gizmo you stick in the disk space.

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    3. I love the fact that a guy with no knowledge of the spine industry, an enthusiast for Marxism, a conspiracy theorist and full time internet blogger knows what the best solution is for patients with spine pathology. And the fact that his chosen panacea is not popular leads him to the conclusion that republicans and Medtronic prevent his cure from being available because if they can't make money on it, nobody will.

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    4. Yes, innovation will kill business. The healthcare industry has floundered for the last 50 years because of all of the innovation. And patients have suffered too. Those Stealth machines and daVinci robots are maiming people left and right. You are a moron FB. Everything is a business. Even if we go to single payor (God forbid), there will still be businesses that provide ALL of the product and services to the providers of care. That doesn't necessarily mean that a person's health is business, but all components of their care require businesses to provide the care. To reduce the influence of business on patient care, the single best option would be for all doctors to be paid a salary with no incentive to run more tests or operate more. If they have no opportunity to make more than salary, you would see drastic reductions in costs with marginal or no ill effect on outcomes. As long as they can own MRIs and get paid by fee for service, they will keep running the tab up for their personal gain.

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    5. @2:33 Good Post. I agree, innovation will not come from a new widget for the disc space. Instead, it will be in the form of a biologic. Either a biologic that will turn disc material into a controlled fusion mass, or nucleus replacement.
      I do wonder what major advancements are being made for IAS or NMS.

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  5. The worker bees always hate their higher ups.

    Why do you think snoozeroom is so popular?

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    1. And the higher ups love their workers, you must bra tool.

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  6. What? No musical references? Dog daze indeed!

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  7. After reading the last 2 blogs that you've written TSB, it's obvious that while 80% of this industry is out moving the business & making money,, it's the 20% that you reference, the knitwits & knuckleheads, those that aren't very talented or that struggle to be successful in the industry, that continue to post & respond. So much of the information or opinions posted in the responses is opinion, inuendo, inaccurate, rumors & hearsay. If half the people who post on here would focus their efforts in a more constuctive fashion, this industry might actually stand a chance.

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  8. Looking at industry consolodition in biologics/biomaterials in the last 3 years (Apatech/Osteotech/Orthovita etc.) and the pulling of funding by large corps in stem cell technology (Sanofi-Oriris for Chondrogen and others), my question is to the experienced reps on this blog: which company in biologics has the right qualities to be the next acquisition target - good management, evidence, reimbursement, corporate reputation, sales channels that are competent. Thanks from a European fan of the blog.

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  9. I am one of the RD guys. I agree we have primarily done it to ourselves, buy the FDA has their share of the blame. You should see some of the questions submitted on 510k filings.

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