Sunday Morning Op-Ed Piece

Recently, TSB was traveling with a principal of an early-growth stage company when this person exclaimed; "its amazing what we have done to ourselves as an industry." I would have loved to use the word "principle" but in all honesty, there are very few people in spine that possess the guiding sense of the requirements and obligations of right conduct. Years ago, spine was a well respected industry, one that focused on delivering innovative technologies that really made a difference in the clinical outcomes and the quality of life for those that needed it the most, the patient. With over one hundred companies, the industry is beginning to exhibit massive gridlock, where executive management teams resemble the United States Congress lacking in true leadership by bringing old values and strategies of self-preservation. The truth is that the industry is as dysfunctional as we have ever seen it. Somewhere along the way, the industry lost its moral compass by throwing aside the clinical and ethical obligations "of doing the right thing" by wanting to play in a game that few are qualified yet many long for. Based on conversations that TSB has had with colleagues held in high esteem because of their integrity and love of the industry, the belief is that the defining moments were the development and sale of Charite to DePuy and Spine Solutions, aka ProDisc, to Synthes. True innovation does not last very long.

Up until then, many companies were developing products incrementally enhancing their respective portfolios willing to build a business based on common sense and realistic financial forecasts. Suddenly, in one fell swoop, the game was on. Charite was brokered by former U.S. Surgical employees and Spine Solutions, gave us an introduction to a former Wall Street analyst turned merchant banker. With the sale of those technologies came entrepreneurial fever. The common theme heard was "if they can do it, why can't we?" Not only did this change the mind set of industry professionals and surgeons, it open the door to every private equity and venture capitalist around the world. With innovation came the craze to patent any and every idea that one could come up with. This was reinforced by the Michelson victory over Medtronic Sofamor Danek. With innovation, we were introduced to deal making. Today, our market is glutted and will be gutted because of our ability to imitate, rather than to innovate. The only true innovation comes from those companies that have the ability to come up with a better marketing spin. How does one develop another pedicle screw, another cervical plate, another zero-profile device, another cage, or biologic when it doesn't truly change the clinical outcomes? Simply, by the art of the deal.

Suddenly, everyone had to be in on the deal. Everyone had an idea. Products were churned out regardless of innovation or not. We heard the words; first generation, second generation, third generation, fourth generation. All this with no retrospective data. It was pure marketing at its best. The more capital that was taken in, the more we had to learn that nothing on Wall Street or by investors was done long-term, life became a short-term race. Today we pride ourselves as an industry that is constantly under scrutiny by the Department of Justice, an industry where we applaud a CEO who started a company by stealing his former employers IP and employees, conspiring against it. And, we applaud its success. Shameful. Many of you call it genius, I call it criminal. An industry where the leading question in an interview is, "how much revenue can you bring within a certain period of time, meaning how many surgeons do you own." Where distributors buy surgeons business by either hiring their brother-in-law, or kicking money back to the surgeons under the table. Where surgeons no longer want to be surgeons, but want to be distributors, where hospital CEO's are in bed with companies. Where an employee is no longer an asset but a commodity, treated disrespectfully because those that lead have no idea of what their doing.

It's become quite evident that we are in a race. The question is, "are we in a race with ourselves or is it a race with time, before someone has the wherewithal to put on the brakes?" Where are the Howard Beale's of the spine world that have the intestinal fortitude to stand up and yell, "we're mad as hell and we're not going to take it anymore." The fact is that we have become a see nothing, do nothing, hear nothing industry. TSB wants to know what our readers think?