This Week's Editorial

Recently one of our readers commented, "what this industry needs is an independent, professional, moderated blog!" Are you serious?  First of all Einstein let TSB explain some facts before anyone reads the proceeding post.  This blog has been as independent of anyone's influence as any public forum has ever been.  We have never taken one dollar from the industry. As for professional?  Well, TSB and those that have contributed to our forum continue to represent themselves with some modicum of decorum unlike many of you that work in the industry believing in words like "ethics and integrity." You are  correct in stating that a blog needs to be moderated, but then, wouldn't you be one of first to declare that your first amendment rights have been violated if TSB decided to delete your comment because I did't like what you said about me or for that matter someone else. As usual there are rules......try not to be too vulgar, don't bring anyone's spouse or children into the picture and everyone is fair game.  Don't be so thin skinned, I've been called more names than anyone else and have never censored someone's opinion. TSB is not the N.Y. Times, the WSJ, or the Washington Post, or for that matter Orthopedics This Week (if ever there was a shill for the industry and proud of it). If TSB wrote about how wonderful everything was, you and your cohorts would declare that TSB sold his soul to the industry. That's what today's journalist lack, the truth. Making those types of comments brings you some temporary relief, its like ibuprofen, yet your comments are as funny as reading that Tom Horton, CEO of American Airlines did a tremendous job leading the company out of bankruptcy, only to be rewarded with a severance package of nearly $20 million.  But on to our next post.............................

We know that the U.S. Healthcare Industry has become Barnum and Bailey's greatest show on earth. Clowns to left of me, jokers to the right. The words that are synonymous with spine include; chiseler, gouger, scammer, swindler, con artist, cheater, rip-off artist, con man, con woman, charlatan and off-course "puttana," which is the most appropo word that clearly defines this industry.  Many of you experience or even exhibit this type of behavior on a daily basis. Whether you are dealing with hospital administrators, surgeons, company management teams, O.R. supervisors, the companies you work for, the patients, the thieves (who's getting those kickbacks) that created RapeTrax, VendorRape, the POD's, POC's, Orthoworld, OTW, and last but not least Physician Owned Hospitals. The bottom line is that there is no honor amongst thieves, at least not in this lifetime. Greed rules and selfishness takes precedence over any sanity. But then again, when you have never thought for yourselves, many of you deserve to be herded like cattle or sheep. Wonder why the government finally got involved in slapping around healthcare? How many senseless procedures?  How many more diagnostic tests?  We are an industry that continues to sprial out of control, while the CEO's and surgeons blame tort reform. Hell, forget about the industry, just look at the behavior of our elected officials. Who ever said that great dynasty's don't collapse? History has proven that, and will prove that our success and greed was our own demise. Let's go to China, the next medical device frontier, where then?  Space?  The final frontier?

The recent brouhaha regarding the medical device tax has been a joke.  The hoopla surrounding the tax resulted in AdvaMed justifying its existence (does anyone actually listen to this lame duck organization) by making statements and creating blow-charts is an embarrassment as to how the tax will impact company employees and innovation (what innovation) when companies have every intent of passing on the tax to its customers in one shape or manner. It's called creative finance. But this tax has provided medical device companies the impetus to rationalize decreasing your commissions by blaming the big bad boogie man. Let's take an example. Has anyone in the medical device industry truly questioned a company on how it can substantiate laying-off 100 employees in response to the medical device tax, and then state in a press release that there was redundancy in their job descriptions?  Even Olivier Dohuon, Smith and Nephews CEO had to back track on Joe Metzger's press release.  Hey, Joe try not stepping on your Johnson (as they say in England). The reason that no one has the "chutzpah" to question this type of response is because the same platforms that report on the industry are as complicit in their behavior as they are in shaping industry news. Let's make it positive. Let's create confidence in our marketplace.  It's the same bullshit that is regurgitated by those manipulating the stock market. How many medical device CEO's have ever made concessions in their pay or bonuses? Actually it's mind boggling there are CEO's in the spine industry managing $5-$10 million dollar companies are paying themselves a $250k salary in addition to bonuses while they manipulate investors, their employees, and their Board of Directors. But what does it say about the investors? To politicize a lame corporate decision is an embarrassment. The reason the industry behaves this way is because many of you have forgotten where you came from. You blame everyone else for the lack of innovation except yourselves. If the industry and the individuals that run these companies spent as much time on innovating as they do deal making, or bullshitting the analysts on their calls, the device would be a noble industry to work in. How ironic, August can't come fast enough.

And they we have the "new new thing" in corporate tactics that some of the smaller companies or start-ups are employing. It's called poaching your business or stealing your customers right out from underneath you, while you are a distributor or even an employee, aka "tortuous interference." The behavior of these individuals is despicable at best. Many of you even know who they are. How many of you have been involved with these characters? You know the ones that get hired as a VP of Sales and continue to keep their distributorships, bastardizing the marketplace by driving down competitive pricing. As Oliver Wendall Holmes once said, ignorance is no excuse for lack of jurisprudence. Tortuous interference is when a company or individual (we know who you are) intentionally damage(s) your contract or business relationships resulting in a loss of capital and livelihood.  Of course, some of these companies will pooh-pooh this commentary, but considering that this tort is broadly divided into two categories, one pertaining to contractual relationships and the other to business relationships, you do have legal recourse. How many of you have been duped by providing these assholes your customer information only to find out that they went out and cut their own deal by undercutting the pricing that they had established for you. Some of these people need to get their legs broken. Ethics? Integrity? The mob had more honor. Maybe the industry needs a hit squad, ey? Isn't it time to give some of the same people that you thought were your acquaintances (friends would be to nice of a word), that run these companies an old fashion ass whooping? Hell, there are even physicians that are just as complicit it doing this by collaborating with the companies that hire them as consultants. They also should be sued. TSB knows that many of you have been screwed.  Power is in numbers. You can run or you can fight, in any event, it is easier to bring together multiple parties and collectively stick the screws to these assholes.

While we are on the subject of Nuvasive, Nuvasive was recently skewered by some analysts as to how this company is being managed by a team whose time may have potentially come and gone.  It's entertaining to sit in on their analysts' call and hear "Da bear" make excuses as to how his "cheetah's" are being poached by the competition. As Warren Zevon once sang, "poor, poor, pitiful me." Excuses! Excuses! Excuses!  Even the analysts are starting to laugh.  Could time be passing this management team by? How does this team retain talent when they burn everyone out?  Even the Area VP's are stressed out. It gets funnier when Alex makes innuendos that the competition are using unsavory tactics that are not based on "innovative products or responsive customer service." Customer service? If anything, Alex is starting to run out of ideas considering he is implementing an old program called the "nuva touch."  Didn't Ma Bell have a program like that?  As for surgeons leaving for greener pastures, you know what they say on the Street, "money talks and bullshit walks." How quickly have some people forgotten who helped them get to where they are today? As for reps leaving, well let's put it this way, when you treat your people like dog meat, chew them up, burn them out and spit them out, you are always going to have employees looking for greener pastures.  I mean isn't spine all about the art of the deal? Unfortunately, the psychology of managing people is not a course requirement at many MBA programs.  As my grandpappy use to say, "you get more accomplished with sugar than you do with a flamethrower.  It's all about market conditions son!" And the market is not getting any easier.  Hospitals are attempting to redefine what free-markets constitute by keeping vendors and sales people out by creating immeasurable and ludicrous barriers.  Hey Team Cheetah, this isn't Sofamor Danek circa 1973.  If a company like Nuvasive is so confident that their technology is far superior to anything out there, why are they compelled to sue their employees when they opt to leave for greener pastures?  Not so confident, ey? It's funny how the Cheetah's running the zoo place the blame on everyone and everything else instead of their own inabilities to adjust to a changing marketplace. It would be interesting to see if Alex and Keith can survive as the Street continues to question and challenge their strategy, tactics, and excuses. Why would anyone believe that this company is prepared for its billion dollar run? As for Alex, he is a disgrace to his profession for calling out the POTUS on his conference call as a socialist. He is a poor loser, just like Vanilla ice. In business, no one wants to know your political persuasion, it's poor etiquette. Besides, if Alex is so concerned about Obamacare maybe he should move his manufacturing to his beloved Russian where they would really teach him about being critical of the government.

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