tag:blogger.com,1999:blog-126852961571725269.post3229422601481705983..comments2024-02-24T06:25:59.743-08:00Comments on The Spine Blogger: Thursday Op-EdMusculoskeletal Manhttp://www.blogger.com/profile/14873819014357051373noreply@blogger.comBlogger31125tag:blogger.com,1999:blog-126852961571725269.post-90495021707870248782011-10-18T22:33:45.427-07:002011-10-18T22:33:45.427-07:009:24, what is really going on is that half the pat...9:24, what is really going on is that half the patients operated on today would be better off without it. The show must go on in the name of the holy dollar! That however will change, long before Globas goes public.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-73210190581411153702011-10-17T21:24:44.825-07:002011-10-17T21:24:44.825-07:00Amazing posts- as a non surgeon I can only gasp at...Amazing posts- as a non surgeon I can only gasp at the ignorance of some who think a minimal change in a pedicle screw deserves millions in royalties. And that someone in practice for two months really thinks the company is after her innate intelligence and amazing innovations. Spine surgeons are their own worst enemies. Look at the studies and reflect on what is really going on.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-85927565153403766092011-10-17T14:17:05.291-07:002011-10-17T14:17:05.291-07:00Hey, I want my royalty for that IP ;-)Hey, I want my royalty for that IP ;-)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-29950861945992407122011-10-17T12:19:26.614-07:002011-10-17T12:19:26.614-07:00Globus何時將公之於眾?Globus何時將公之於眾?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-74956370176199090302011-10-17T08:45:46.385-07:002011-10-17T08:45:46.385-07:00Religion is just the Vehicle to steer the masses t...Religion is just the Vehicle to steer the masses to the part the power brokers really want to control.....the MONEY! Once in control the masses are not necessary.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-13276508418545798012011-10-17T08:28:52.634-07:002011-10-17T08:28:52.634-07:00Hey 4:36
A historical perspective clearly demonst...Hey 4:36<br /><br />A historical perspective clearly demonstrates one thing counter to your point and it is that:<br /><br />"Religion IS the root of all evil"<br /><br />Not M$ney! <br /><br />More people have died in the name of religion than money by a long shot. Think about it...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-62243272680890486562011-10-17T05:48:40.260-07:002011-10-17T05:48:40.260-07:004:11
No I'm not, please explain.4:11<br /><br />No I'm not, please explain.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-77965976231771927762011-10-16T17:03:37.170-07:002011-10-16T17:03:37.170-07:00No, 'The LOVE of money is the root of all evil...No, 'The LOVE of money is the root of all evil!'Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-16822841782791263932011-10-16T16:36:13.524-07:002011-10-16T16:36:13.524-07:00Anyone who has worked within the healthcare indust...Anyone who has worked within the healthcare industry during the last two decades has been witness to the growing metastatic greed. When 20% of GDP falls within one system, veiled corruption is inevitable. Everyone can point fingers; the truth is every facet holds responsibility. Justification is always viewed and filtered through the almighty dollar. <br /><br />Payers, providers, industry, physicians, attorneys, representatives, hospitals…legions all scrambling to siphon off their due from the source. Every day, more and more come to drink from the “bottomless” cesspool. <br /><br />A myriad of Medicare Fraud and Abuse Laws, Stark Laws, Anti-Trust Laws…all passed to protect the greatest healthcare system in the world. They are all worthless Congressional masturbation without proper enforcement. A Department of Justice only interested in enforcing laws with political expediency attached. The drunken suction and depletion continues; how will it end?<br /><br />It is time for healthcare professionals with a conscience to insist the cancer is revealed. The public deserves to understand the problem. The DOJ will only respond when enough people demand a cleanup. It is time to get organized and expose all of the dirty, greedy, shady, schemes on a public forum. Everyone reading this knows what I mean and knows of instances which should be eliminated.<br /><br />The simple fact: Money IS the root of all evil.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-16986593211253692972011-10-16T16:11:38.375-07:002011-10-16T16:11:38.375-07:001:14,
Are you kidding?1:14,<br /><br />Are you kidding?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-37804181938774654422011-10-16T13:14:46.697-07:002011-10-16T13:14:46.697-07:00New to this site...
Would someone explain how POD...New to this site...<br /><br />Would someone explain how PODs represent such an evil relationship in the spine industry? I think people are confusing the issue of surgeons who will operate on anyone for any reason and are "outside the bell curve" with this POD situation. If a surgeon is in spine to make a lot of money, it is very possible to do so even without PODs. Lumping conservative surgeons into the category is to miss the point on all of this. <br />Eye doctors, ENT and most primary care make "extra" money either in the office or with some type of ancillary service. This could include glasses, hearing aides, lab services, DEXA scans, Xrays, MRIs, PT, etc. What makes surgeons involvement in PODs so diabolical in and of itself as a business model ?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-18521957423218802272011-10-16T11:01:52.322-07:002011-10-16T11:01:52.322-07:00Americans will always need spine surgery. A solid...Americans will always need spine surgery. A solid rep will always be able to make a living, either as a rep, distributor or a POD bitch. Most of the postings on this site lately sound like a bunch of wussies who feel entitled to 300k for opening boxes and writing up usage sheets, just like the old Medtronic-dominated days. <br />Get over it! Obamacare will insure that everybody makes less money (even with M.D. after your name), it's up to you to navigate it and still be able to look in the mirror. Man up and stop whining.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-40157063018775852062011-10-15T13:44:51.096-07:002011-10-15T13:44:51.096-07:00It is obvious that things are changing. Everyone ...It is obvious that things are changing. Everyone involved in the process is trying to preserve income flow - from the hospitals, to the rep companies, to the surgeons. There is nothing wrong with that, businesses want to keep their doors open.<br /><br />Implant companies face downward price pressures and the industry will be consolidated - fine. Everyone along the line will not make what they made in the 80s or 90s.<br /><br />Hospitals scrounge for their dollars, just like the implant companies. Ethically or unethically. Fine, they are the hospitals and let them run their businesses.<br /><br />Physicians in private practice run a business - they too face increasing overhead and decreasing revenues. While they treat patients, they have to consider the business side of medicine - if you don't consider this, you can take down your placards and sell out to the hospital (75% of all private practice ortho surgeons will be hospital employed by 2020).<br /><br />Unethical arrangements such as bogus consulting and, in my opinion, PODs, should not be a solution. The responsibility for this problem lies on both the physicians and business entities involved. Whoever is involved made that decision to be involved. Let them decide, and let them face the windfall from this, if that happens - fine. That is their business. <br /><br />If a physician has an idea to make a better product, even if it is incrementally improved (such as a slight change to a pedicle screw), fine. Let them help design that and negotiate a consulting deal with whatever company-fine. That company may be small, who cares? Let them have a run at it, and if they get swallowed up by a big company or fall off by the wayside great. That is business, that is entrepreneurship (even if it seems like a minor, useless change) who are we to judge them?<br />Without clinician input, medical device development<br />is hampered. This input has a value and shall continue to have a value and ETHICAL arrangements can be made to benefit the people with the ideas, and the company looking to EXPLOIT the ideas.<br /><br />If you want to impose stiff regulations on product development you risk hampering truly meaningful medical device/procedural development. If you really want more regulations, then you should also consider whether or not you want your business to succeed or have the freedom to develop new products.<br /><br /><br />Stop the anticapitalist ranting here, or, as one person wrote on the thread, join the occupy wall street protest downtown. Stop whining and figure out how you and your company will succeed in the future. Stop pointing fingers at the hospital, the physicians, or anyone else; accept the fact that things are changing and position yourself and/or company to maintain or grow your business.<br /><br />Who knows, maybe that surgeon 2+months into practice will design a new pedicle screw that doesn't go anywhere. Who cares that this surgeon is talking to a small, noname company? Maybe that surgeon has another idea that will become the next breakthrough in spine implants and that idea is patented, 510k'd and sold to Stryker. Great! Who knows? Don't judge that surgeon from the sidelines. Get in the game, be innovative and figure out what your are going to do to keep your businesses open.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-16841774967373980262011-10-15T12:34:49.790-07:002011-10-15T12:34:49.790-07:007:48
Thanks for your civility. And thank you for...7:48<br /><br />Thanks for your civility. And thank you for giving me this opportunity to discuss revenue.<br /><br />2:41<br /><br />This Blog is one of many that I monitor. I am a spine surgeon, and often times the grassroots (Reps, Industry, patients, attorneys) have a better insight than medical journals. Besides,don't you think everyone else is also monitoring your comments?<br /><br />There are two "Dr. Revenue Stream"'s.<br /><br />One is the surgeon who uses your products because he likes the product, and like you as a person. You are dependable, and make sure that you appreciate Dr. Revenue Stream's business by always making him look good in the Operating Room. A smooth case is worth everything. This Dr. Revenue Stream would never ask you to find a consulting deal or ask for royalties on a product he never designed.<br /><br />Then, there is the other Dr. Revenue Stream. He is the rain maker. He always has a ton of surgeries. He realizes he is a revenue stream. He is the target of all your competitors. One day, Dr. Revenue Stream tells you that you are a great friend, but your competitor has offered him a sweet consulting deal, and he is thinking of switching to them. He thinks you will understand, after all, it is all about the revenue stream. Later on, this Dr. Revenue Stream decides POD's are the way to go. Don't worry friends says Dr. RS, we'll still have dinner won't we?<br /><br />Do you really just look at your Doc as a revenue stream? Should he look at you as one? What are you willing to do to protect your revenue stream? How ethical is your revenue stream?<br /><br />Compete well.Old Spine Docnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-19655565259339991932011-10-15T07:48:26.975-07:002011-10-15T07:48:26.975-07:00Old Spine Doc,
Thanks for your comments. I don...Old Spine Doc,<br /><br />Thanks for your comments. I don't quite understand the abuse the last two posters heaped on you. <br /><br />I will say that I work for a company that is trying hard to "develop great products that everyone wants to use". The problem is that with the current 510K approval process, and all the IP that is presently locked up, it is increasingly difficult to find room to innovate. <br /><br />As far as "training a great sales staff that treats all doctors as respected customers instead of a revenue stream? A sales staff that competes on quality, knowledge, availability, not just on capacity to 'entertain'?", well, that <b>would</b> be a perfect world, now wouldn't it? But we don't live in a perfect world, and some doc's like to be entertained. And face it: you are a revenue stream. <br /><br />Thanks for the post though. I think it's valuable to hear from all members of this community.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-19152981360027481822011-10-15T07:43:06.480-07:002011-10-15T07:43:06.480-07:00A surgeon with 2 months in practice is consulting ...A surgeon with 2 months in practice is consulting with a company to design a new pedicle screw? Can you say "kickback"? <br /><br />How willfully blind do you have to be to not see this? <br /><br />The surgeon and the company that hired him should be fined an amount larger than any "fee" paid to him.<br /><br />Let's face it, there's not much new under the sun at this point. A pedicle screw is a pedicle screw.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-10726581600180160392011-10-14T14:45:28.370-07:002011-10-14T14:45:28.370-07:00Old spine doc. What does this mean and I quote fro...Old spine doc. What does this mean and I quote from your posting?".Surgeons are humans, and we behave just like anyone else."<br /><br />So you are weak and can be bought? You have sold out because your friends told you it was profitable?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-70925751018573760572011-10-14T14:41:02.293-07:002011-10-14T14:41:02.293-07:00Hello Old Spine Doc( If you truly are) . Why the h...Hello Old Spine Doc( If you truly are) . Why the hell are you on this blog?With all of the other issues you have to deal with.. It is comical that you take the time to post here?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-64924300003272940162011-10-14T07:28:20.469-07:002011-10-14T07:28:20.469-07:00Old Spine Doc,
I won't pay you use my product...Old Spine Doc,<br /><br />I won't pay you use my products, but I will pay to move you into my territory. You and I would get along brilliantly.<br /><br />Old Spine RepAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-64098837178258065752011-10-14T06:06:39.129-07:002011-10-14T06:06:39.129-07:00This blog is starting to sound like "Occupy S...This blog is starting to sound like "Occupy Spine Surgery".<br /><br />We as a community need to show value for our products and services. <br /><br />As a physician, I can only do what I hope is ethical and hope that no one offers me the deal that turns me into the "1%". I don't that will happen, as by being a prudent, conservative surgeon, I do not generate the volume that makes me the target of those deals.<br /><br />But the device companies need to consider change. The quota's are driving the deals to the docs.<br /><br />How about developing great products that everyone wants to use? How about training a great sales staff that treats all doctors as respected customers instead of a revenue stream? A sales staff that competes on quality, knowledge, availability, not just on capacity to "entertain"?<br /><br />How about setting prices that make hospitals pursue the relationship?<br /><br />You will lose the doctors that seek the consulting deals, POD's, and perks. But there is a vast majority of doctors that do want to do the right thing. It is just that the companies also know each and everyone of us have a price. And the companies are often willing to pay that price for our business.<br /><br />Surgeons are humans, and we behave just like anyone else. At a certain price, change of practice styles can be "rationalized". I would love it if companies stopped these practices, and terminate relationships with doc's that demand these arrangements.<br /><br />But do it silently. You do not need to bring down the whole community to flaunt your new ethical standard.<br /><br />Compete well.Old Spine Docnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-32543592416632652172011-10-14T05:54:47.810-07:002011-10-14T05:54:47.810-07:00Amazing,, another post & more of the same. Mor...Amazing,, another post & more of the same. More finger pointing, whining, crying, bitching & name calling from those posting.<br /><br />Any wonder that this industry finds itself to be in the state that it's in. The reps, companies, industry & surgeons are all to blame. There have been some great success stories in this industry over the years, but no everyone thinks that they have the next great idea or at the very least, the "here's how we're going to cash in" plan.<br /><br />The probloem is that there is so much corruption going on at this point, no one knows where to start to clean it up. The best analogy would be to compare the spine industry to the NCAA. Everyone knows that corruption exists, but while everyone wants to bitch & complain about it & point fingers, no one actually has a relly good idea of how to police it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-35285073389799762952011-10-14T02:52:00.988-07:002011-10-14T02:52:00.988-07:00Sorry but i don't blindly agree with 2:53.
Th...Sorry but i don't blindly agree with 2:53.<br /><br />The comment never said how much the doc is getting paid - or that they claim to be inventing. Not that it actually matters, the doc may be a really bright guy with some solid IP (I doubt it, but it possible).<br /><br />Regardless any company that doesn't get surgeons involved in the early stages of product design scary, a bunch of engineers in a lab cannot just churn out an entire pedicle screw set and hope to get everything right just bacause they copy someone elses system. It needs real world use by someone thats going to give you feedback - and as the company wants to make money out of it why shouldnt the person doing the work get their share too?<br /><br />Its just a shame that the patients dont get some kind of benefit from the increased risk they take in the earlier stages of product developmentAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-67283077977093402532011-10-13T22:33:38.924-07:002011-10-13T22:33:38.924-07:002:53 is absolutely right. If my mentor could, why ...2:53 is absolutely right. If my mentor could, why can't I? Unfortunately, there's only so many ways you can make a screw, and most variations mean nothing in surgery. After the true pioneers of the art, who with one or two exceptions now all are retired, the followers were more motivated by money and fame than by improving patients' lives. Unfortunately there is no single solution that will work to return spine surgery to where it should be: a specialty that focuses on helping patients. <br /><br />One radical option is to pay surgeons a fixed sum to see and treat a patient with back pain, whether the treatment is conservative or surgical. If surgery is necessary, he or she will be paid a fixed sum per hour. Lets play with some numbers: a fairly busy surgeon sees 60 patients a week, and performs 10 surgeries with an average duration of 1.5 hour per. For each patient visit he will get a fee of 150 dollars, per hour of surgery a honorarium of 500 dollars. The goal here is to make it about equally lucrative to treat conservatively as it is to do surgery, and the numbers will need tweaking. For insurance and general overhead of his outpatient clinic there will be a surcharge of 50%. The weekly revenues of our hypothetical surgeon thus would be 24,750 dollars, his income 16,500 dollars. Assuming he works 45 weeks a year, the annual revenue will be 1,113,750 and the income 742,500 dollars. Seems reasonable, and probably not much different from what the average busy surgeon earns make now. The main savings for the healthcare system will be found in the reduction of unnecessary surgeries. <br /><br />And last but not least, a minimum of 50% of any pre-tax royalties he receives for implants, whether he uses them or not, must be used to pay for the care of the uninsured. After all, most royalties in spine surgery come from Medicare/Medicaid patients, i.e. us tax payers.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-45804749041840936902011-10-13T21:42:37.795-07:002011-10-13T21:42:37.795-07:00Life is short! Pigs get fat hogs get slaughtered!...Life is short! Pigs get fat hogs get slaughtered! We r in this together believe it or not! Pods or distributors paying docs. It doesnt matter it is un ethical! Everyone call out distributors paying docs or doc in pods! Air it out. Lets put a list online of every distributor paying docs and those docs in a pod!!! Show some balls! We need to have a track record for OIG. If not we R just letting it happen and not reacting!!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-21972569568373017742011-10-13T21:41:37.046-07:002011-10-13T21:41:37.046-07:007:48 we are all dumber for having read your rambli...7:48 we are all dumber for having read your rambling nonsense.<br /><br />Thank youAnonymousnoreply@blogger.com