You know I'd love to love you, and above you there's no other
We'll go walking out while other's shout of war's disaster,
Oh we won't give in, Let's go living in the past
Yes fellow bloggers based on the weekend's scuttlebuttin', you continue to validate that the spine nation continues to be living in the past. The ongoing dialogue amongst yourselves and those that have now fallen victim to the DePuy/Synthes acquisition are getting a taste of loyalty when it comes to dealing with Corporate America. If you've never had tasted it before, you are in for a treat. Here are some of your own words, "cutting jobs," " bottom line," "opportunity to put food on your table," "this company is cold and heartless," "cuts are coming," "don't worry about your territories," "they got Medtronic arrogant," "I'm not liking my chances," "start interviewing now," "don't trust what your AVM or RSM says," "there will be high quality talent that will be available to a company who cares about it's people." Before TSB goes any further let's get one thing on the table, "THERE ARE NO COMPANIES OUT THERE WHO CARE ABOUT ITS PEOPLE!" You are a piece of meat, whether you like it or not.
Hopefully, the infantry at DePuy/Synthes is waking up. TSB endorses all infantry men and women because you do fight the fight and are treated like collateral damage. If you haven't awaken, you're in for a surprise. The more things change, the more things stay the same, and that my friends is not only a problem in spine, it is epidemic in America. The "reverend shareholders" are more important than the people that produce the revenue. Unfortunately, you are learning a hard lesson about words like "loyalty," "integrity," and what it means when the company you work for mandates that you"show a united front" in front of your customers. By playing the common folk off of one another, the top of the pyramid continues to rule. This tactic is not as sophisticated as you think, it's been used since the beginning of time. Those in power never want to relinquish power. Show a united front my derriere. This is your opportunity to make a statement. Get out while the going is good. As upper management in both company's fellate each other during the integration process, all along they have been making contingency plans for all of you. That's why there was a lack of transparency up until this point. You are now learning how dispensable you really are. TSB is sure that some corporatist or some gnome is going to get on the blog and start pontificating about the survival of the fittest, or how only the strong survive, unfortunately it's not a 1999 spine market. Since some of us at TSB have been through multiple mergers, we are empathetic to your plight. Here's what some of you are going to learn.
1. Starting over with a new product line is not that simple. There will be wins, but there will be some losses.
2. You will convert some business, but not 100% of your business. You notice we used the word "some."
3. Learn to be patient in making decision on choosing one of the smaller or mid-cap companies that you may be interested in aligning yourself with. Not everyone is all that they like to make themselves out to be.
4. Look at the management team, the scope of the product portfolio, the quality of instruments, and ask questions. As much as you need them, they need you. The worst thing you can do is become "trigger happy." Many of these smaller companies salivate when they read your comments. They will obfuscate the truth just for the opportunity for an immediate windfall.
5. Negotiate up for your business. The more options you have, the more you have to leverage. Remember it's a two-way street, especially with the small companies.
6. Get it in writing. No one said that some of the people running these small companies are the second coming of Earl Bakken.
Whether you agree with it or not, this is the new world. The old spine world is dead. It doesn't exist anymore. It's always been about the bottom line, but short-term has a new meaning. America has set a course in the direction of countries like Greece, Ireland, Spain, and Italy. As a recent visitor to Europe stated, austerity and manipulation doesn't work. Even the bastion of capitalism, the Wall Street Journal is starting to question austerity. If you are making $150-$250K per year, you're not rich, you're lucky. You've got mortgages to pay, you have to put food on the table, you have to run a business, you have overhead, you have to meet tuition obligations, and by time you're done balancing your check book there's nothing left. Unfortunately, the perception by the1% in our industry is that you are spoiled and bring no value. That's plain Bullshit. Just read the crap that people like Robin Young write about. How original was that Moneyball article? Could anyone feed you more propaganda? That formula may have worked for the A's in 2002, but based on their lack of success since that season, money talks and bullshit walks, think NY Yankees. Just keep thinking that you are part of the American Dream and the 1%. Because those people have you exactly where they want you. You are their "SHEEP." Those ridiculous metrics are especially tailored made for the SHEEP. Do these people have any clue as to what you are dealing with on a day-to-day basis?
Call your local large distributor ASAP. It's very personality dependent, but a good distributor will bring you products you only dreamed of while inside the fences erected by the corporate leeches. Your business will actually be apreciated by your smaller manufacturers instead of taken for granted by said leeches. Be careful though, lots of dirtbag distributors/companies too. Good luck and you all will look back on this as motivation to become an entrepreneur instead of a cog in some bean-counter's spreadsheet.
ReplyDeleteCheers and On to Berlin Soldiers!
That's the problem with the big companies, BEAN COUNTERS and SHAREHOLDERS who cares about the employees, then you wonder why Unions were formed
ReplyDeleteMy advice to you... Start drinking heavily. Also whatever you do don't sign that Nazi 18 month noncompete. It's not enforceable but it will require some attorney to defend and lots of mental distraction.
ReplyDeleteContracts are very negotiable, no matter what they say. They need you more than you need them (if your surgeon customer-base is built on relationships, that is.) It took me months to negotiate my last contract. Plenty of back and forth. Now, both me and my bank account are happier. Non-competes and automatic quota increases are not even possibilities as far as I'm concerned.
ReplyDeleteDo tell...How do you fight the quota increase?
DeleteI simply told them that it was not realistic in an environment of price decreases to have an automatic quota increase. Not if they wanted to maintain solid yet still attainable quotas. If however, they wanted to force aggressive quotas with automatic increases that are not tempered by changing environments, then they could make it a billion ga-jillion dollars per Q if they want, I won't even be paying attention to it. Oh, and my lack of a non-compete and the fact that my business is relationship driven allows me to switch companies overnight if I want. Do they want $5M a year in business or would they rather I take it to company X? Oh my, thank you for the realistic mutually agreed upon quotas with bonuses! Now, let's sell some product, help patients, give our docs great customer service and make some money together. Simple is almost always best.
Deleteplease mail me some of your killer grass.
DeleteWhen is Globus going public?
ReplyDeleteNot in this market Bro
DeleteThat's a clown question bro
DeleteWhen they stop paying their surgeons
DeleteCan I thank Goldman along with all the other banks for f'ing up the economy, all 'em bastards should be hung.
ReplyDeleteWhy is it that everyone only seems to cry and worry about the sales guy? I realize that TSB seems to be weighted heavily in that direction, but there will be just as many, if not more, internal engineering, marketing, quality, regulatory, manufacturing, etc. jobs lost for the same exact reason, maximizing the almighty shareholder value.
ReplyDeleteAnd more importantly, most of those people have been making far less over the years than their sales peers. Most, if not all companies, large and small, lavish generous compensation packages on their sales teams, from the internal VP Sales, regional VP's, on down. Even when Medtronic cuts a distributor and/or salesman's percentage, it is often because they were making so much. That lower percentage still equates to a very nice income, especially when compared to their internal counterparts.
It came as quite a wake up call when I figured out the decent salary I thought I was making at a VP R&D level was 1/3 what my respective regional VP's were making (and they were all crying about lower income making it tough to pay for their fishing boat, vacation condo, Harley payment, 5 family vacations per year etc). And when all internal bonuses were cut to zero multiple years in a row due to crimped profits as a result of this ugly recession/depression (a phenomenon experienced industry wide) guess who still got that generous bonus?
So I hope you have been banking those nice compensation packages over the years for a rainy day, verses enjoying all those nice perks (like the Globus reps referenced a few weeks ago) because someone other than those at the pinnacle of the pyramid should be able to walk away with more than a paperweight and pics of wife and kids from their cubicle.
Simply put, you are a fool blinded by jealousy and your own inability to man-up and take a risk. The most successful sales reps and managers earn higher compensation across ALL industries compared to their internal counterparts because they take on more risk. In sales, you either sink or swim. Most sink and those that are able to swim do so knowing that one can only tread water for so long. You internal pussies--unless you screw up royally--will always have a job and a steady income for as long as you are disciplined enough to maintain it. Even the most successful sales guys are forced to switch companies (or industries in some cases) every 4-6 years because they cannot continue to meet the ever increasing quotas lopped onto them by their corporate overlords. Think about it, if quota increases every year by 30-40% (yes, these are the growth numbers expected in the spine biz), NOBODY can continue to be successful forever. NuVasive, for example, had a very successful sales rep in San Antonio slip through its fingers earlier this year because it no longer appreciated this particular rep's value. He had been one of the top performers in the country for many years, but he--despite driving revenue growth comparable to the years prior--did not receive one single congratulation or award at the last national sales meeting. You see, a rep is only one person, and one person can only manage a certain amount of business. Is it in the company's best interest to alienate these reps that have hit such a high ceiling? Judging from the cluster F that resulted from this particular example, one might start to wonder if there could have been a better way.
Delete11:24pm here.
DeleteLet me just clarify; I do not think that all internal folks are pussies. Just the ones that bitch about sales folks making more money when they know good and well how much crap reps have to deal with. If they--the pussies--think that it's so easy to make a ton of money in sales, why don't they just get a job in sales and prove to everyone just how easy it really is?
I'm another internal guy, and I agree with 11:30/11:24. I wouldn't do sales if it paid 600K. In my opinion, it's a thankless and awful job, and god bless those of you who do it.
Delete...comments remind me of all the whiney Master Sergeants who used to bitch that the 1LT making $35K/year were making more money than them. Get your degree and go to OTS....get out of corporate and start selling...
DeleteWhoa, the guy was just saying that there is more to a company than the reps. The fast and acerbic reaction just shows what pussies sales reps are. Without R&D, Ops, and Marketing, you wouldn't have sh!t to sell. All those people have highly skilled jobs and should be recognized for the value they bring. They're not sales reps that hop to wherever the money is good.
DeleteR&D, Ops, and Marketing are all great but the bottom line is who brings in the fucking revenue? The sales department.
DeleteMSM doesn't weigh heavily on the sales people, but without generating revenues you can't turn on the lights, but I also respects the engineers, marketing, regulatory, and manufacturing people because the sum is greater than the individual parts. If you want to use an old football analogy the reason the scorer gets paid more than the lineman is because he puts points on the board, and like everything else you are compensated commensurate with your skills. MSM doesn't make the rules even though he has attempted to change them in the past. Yet, MSM has always believed that the internal people should have a better compensation program, unfortunately, the pigs on the top don't believe in sharing of course unless its going into their own pockets. Peace.
ReplyDeleteFair enough. Forgot to mention that I was traveling at least once a week supporting sales in the OR due in part to inadequate marketing team, in addition to running R&D, wearing Operations/Manufacturing hat as well. I was the sales team's go-to-guy, responsible for convincing many surgeons to use average-to-problematic products, often on my own. Should have gone into Ortho sales two decades ago when offered. Would rather flip burgers now than even consider the meat grinder, inside or out.
DeleteNeedless to say the company's ROI on me was excellent.
Why in the world would you "convince many surgeons to use average-to-problematic products"? A long term successful sales rep is looking out for the surgeon and patient and should be steering the Dr. away from "average-to-problematice products".
DeleteBased on your comment, I would say you stayed inside because that is where you belong.
TSB offers sage advice. However, only the top 10-20% will be afforded such negotiating leverage. The rest will be abused at best, raped at worst. Too many of my peers can't survive long without that healthy income, because they lived above their means like many Americans.
ReplyDeleteBought a house (or two) well above the suggested mortgage to monthly income safe target. Minimal savings due to multiple family vacations, wife doesn't work anymore, kids go to best local private schools, leased BMW or Merc for self and wife, mistress on the side (sorry, that's just the $1million plus surgeons), essentially the American dream.
So they are going to take the best opportunity that they can negotiate in their limited window. What would TSB advise this majority? And not getting into the bind described above by managing things better doesn't really help when the house is literally burning down around their heads.
There are only a select few (5-10?) companies that have safe/decent products, aren't outright thieves, and have deep enough pockets/credit lines to back up promises. What is a discerning unemployed industry rep to do?
Start your own POD?
DeleteDear 11:30 inside Product Manager guy,
ReplyDeleteI have worked for several companies direct and now many manufactuers as a distributor. In EVERY instance, I know more about the products than the inside guys. Don't even begin a conversation with the 23 year-old whippersnapper about the competitive products, that is, if you can even get ahold of them after 1pm on a Friday...
I have been F'd with on mutiple occasions by the Compliance Prick (excuse me, the Inside Legal Guy Who Can't Get a Real Job Suing People), questioning me on expenses on Sat/Sun. We actually never get off the clock if we're doing this job correctly, and then Compliance Prick questions the very way I pay for his bloated salary!!!!
Inside Guy, I dare you to put you and your family's financial ass on the line every day with bad products, contracting nightmares, recalls, backorders, Blowbamacare, etc and see who deserves the extra pay.
Jealousy is an ugly emotion.
As far as I know, no one's putting a gun to your head to carry the bag. Then again you must be one of the guys calling me every other day asking for info that is in a training manual, email, handout, mailing, text message you've received but your too lazy to read or look for them.
Deletewell there you have it. the marketing philosophy. salesmen should carry their training manuals with them.
DeleteThe future of spine is here! The $83.99 Chinese pedicle screw direct from Ebay:
ReplyDeletehttp://cgi.ebay.co.uk/ws/eBayISAPI.dll?ViewItem&item=221051505938
Brand new, order as many as you like, all sizes. PODs are so 2010. Surgeons can now just order direct with PayPal. Who needs a distributor? Who needs anybody? Just think of the convenience and profit!
You can buy a car and cell phones on Ebay too. Has it put those businesses out of business? I bought a phone on ebay once when I wasn't eligible for an upgrade. Paid a $100.00 dollars for a blackberry pearl (loved the original phone and ATT no longer sold them) and it never worked right. Always had this hissing and crackling on it. A hundred less dollars I am worth with a phone I threw out.
DeleteJust out of curiosity who brings the sets, moves the sets, restocks the sets, assumes the liability and guarantees the craftsmanship? What do you do if you have back to back cases or three in a day. Who helps you from getting into trouble and bails you out when you get into trouble? The vending machines and internet screws sound great but how many of us have had to move stuff around at 2am to get ready for cases only to show up at 7am with four hours of sleep stressed out with a smile on and the doctors never knew. Now who is going to do that from the hospital and/or physicians office? That is what I thought. I know the doctors will settle for less if their making money on it. Maybe but I don't see a lot of car dealerships or cell phone stores going out of business. Service is still worth something especially for surgeons and hospitals that are still making money and don't have the time, resources or patience to deal with what we do. You know you can make a cup of coffee for 37 cents but there is a reason Starbucks is a 12 billion dollar company.
I ordered a set but the shipping was more than the screw! Next time a hospital wants another discount I am going to send them the link and show them some real savings.
DeleteThis must be the same manufacturer Gobus uses as they manufacture in India. I gues Globus should sell their screws for $83.98.
2:16 Besides the point it is illegal to buy products and resell them to yourselves if your the physician accepting Medicare or Medicaid. Everyone seems to have moved to accepting PODs and the legality of their business model. Most reputable law firms still think surgeons selling themselves implants violate Anti-Kickback and Stark Laws. This/these models have yet to be tried and proven to be legal entities and in my minority opinion will be in the future much to the dismay of the surgeons involved.
DeleteYou know you can start a Coffee company call it Starfucks, put a coffee stand outside of every Starbucks, charge 99 cents for coffee, and use Starbuck cups you copied, and who amongst us would say that is a good business model and/or legal. Saving money doesn't make it legal. In addition, PODs and self referrals are illegal for the very reason that the the conflict of interest may lead to increased utilization, prevent fair competition and lead to higher costs for taxpayers. You want to use the cheapest shit available stop taking government money and see how long you last in private practice when the word gets out on what your implanting.
On second thought you know how many stupid patients pay 15-20k to go to the laser spine institute, I don't know you might make a great living implanting $83 dollar Chinese screws.
Chinese Dog Food, Chinese Toys, Chinese Drywall, hey let's start implanting cheap Chinese screws. That is a great idea! I know someone will cite a study saying the quality of implant makes no difference. Ok, but... they were using stuff from hardware stores that didn't have chemicals and toxins on them that were bad for patients and led to the implants premature failure. My guess is if we can judge by the past Chinese manufacturing is suspect at best.
DeleteMy personal opinion is there is a special place for those that would sell cheap Korean and Chinese screws to maximize their profits. Care to take a guess, one hint is it is hot.
Can anyone give me information on this new one. We have surgeons here in Michigan that are going to use product, because they are enrolled in a "study". It's the newest version of a POD, or finding a way to illegally pay a surgeon to use products. Has anyone heard about this???
Delete10:11 I have heard about this in Michigan and have seen and heard this popping up more and more as an alternative to POD's. I only know of one POD in Michigan, but hear that many different versions might exist, but the study version does seem to have some merit, what are you hearing?
DeleteAre they available sterile?
DeleteNice! OR, meet your new Sales Rep for this system. A one page flyer:
DeleteFeatures:-
Our Screw are Available With 4.5 mm,5.5 mm & 6.5 mm Dia.
Our Screw are Been Proceed In Line With Strength International Specification Aver Standard.
Screw That Accommodate With 3.0 mm And 5.5 mm Rod Based System.
Our Spine System Is A Revolutionary Spine Solution With Technologically Advance.
A Wide Array Of Standard & Self-tapping Pedicle Screws For Added Versatility.
Colour-coded For Easy Selection During Procedures,Ergonomic Case/Tray System.
The Fixation Screw Utilizes Patented Buttress Threads That Minimize The Potential.
Thanks for a good laugh, 9:48
DeleteYeah good one. LOL!
DeleteI have been in spine for a relatively short period of time, five years. One of the biggest lessons I have learned in working for two of the top five companies is this: If your company can make $1.00 more on your territory with out you there, they most certainly will! Loyalty is not calculated into the equation with any of these companies. It is certainly a stark contrast to the inside/outside promotions of these "I used to be a 5 million dollar Kyphon rep 10 years ago" managers. What a joke taking sales advice from guys that have not sold a pedicle screw in the last decade. As MSM has said, the industry has changed. Continuing to do the same thing over and over and expecting different results, is the definition of insanity!
ReplyDelete2:44
ReplyDeleteYou are right on. If hospitals want to trim the fat, might as well get rid of scrub techs while they are at it. Surgeons can grab everything themselves. Why do you need to have someone there to help? Sure it will be an inconvenience for the surgeon to have to open everything in the room to prepare for surgery. Then the surgeon can also go down to SPD to grab his sets that he ran the day before, peel packs, and various extra special instruments they may need. If they run into a problem with instrumentation they can break scrub and get on a video conference to help them fix their issue. All of this makes a lot of sense, and will save the hospital money. If the next wave of spinal surgery is more advanced MIS procedures, I'm sure purchasing them off ebay and cutting the reps out of the loop will help advance patient outcomes and safety.
They may be able to get away will vending certain supplies for spine surgery but there is no way they will replace reps. I rely on their expertise and contingencies on a weekly basis.
DeleteYou made some good points .I did a little research on the topic and found that most people will agree with your blog. Thanks.
ReplyDeletespine surgery
Great Blog. How could you not enjoy the upper management fellatio comment? Im watching this thing unfold as a competitive rep and licking me chops. Depuy reps are running around telling MD's to call them for cases using Prodisc while the Synthes reps can't tell doc's if they have a job past July. I've been in cases where MD asks Synthes rep if he is happy working w/ Depuy and you can read the disgust even under his surgical mask.
ReplyDeleteNobody wants to admit at a rep level, these people hate each other. Management treats this merger as if you were traded from a sports team, when in reality your being asked to integrate your livelihood with a person who has been a rival for years.
POD's or working for a newer company all sound great, but the reality of this business in most area's is this- Contracts limit vendors to the Big Boys. Even if you have a novel product, it takes three meeting to maybe get approved and than you need to cut your price 50 percent (wow a tlif cage that expands does this mean I get better fusion rates?)
If Depuy/Synthes reps had any clue, they would both go to see the globus, k2, alphatec, etc and start their own distribs.
Anybody else out there starting to see an up-tick in revisions for these expandable TLIF cages by Globus? For some reason, they are causing pseudos, and docs are having to yank them out at an alarming rate. They have been on the market now for about a year (no fusion after 1 year = pseudo = revision). Tell your surgeons to get ready.
DeleteI haven't noticed an issue locally, but most TLIF psuedos are due to inadequate discectomy rather than an IBF device.
DeleteWaaaaaaaaaaaaaaaa..........the sound made by reps who have seen how slick these new expandable things are, but dont have one in there dusty old depuy bag......dont worry prodisc to the rescue....haaaaaaaaa
DeleteDoes this system have expandable trials, or does the implant expand itself until a desired height? What if i over expand and want to lessen the height? Can the implant height be released or do I waste the 6k cage all together?
DeleteCool looking implant, but does zero for increasing surgical effectiveness. It does cost a lot, so I am sure the manufacturers are happy!
DeleteGlobus' expandable cages cause pseudos because they do no allow the graft material within the cage to make direct contact with both end plates.
DeleteIf you're doing a TLIF, it's not going to be the graft material in the cage that makes things happen, it will be the 360 of graft placement around the interbody. The graft volume of non-expandable TLIF cages is just not enough surface area to support this argument. I can see this being valid in comparison to ALIF or XLIF procedures that allowed more graft material in the interbody device.
Delete@8:01 fully agree. Ideally, I would like to see a boney bridging inside the lumen too. Although, cutting the lumen of the graft by 50% would arguably provide a less ideal interbody fusion site.
DeleteI think the argument with the expandable spacers is more of cost vs. effectiveness of fusion. If the cost increases exponentially without providing a more effective fusion, I would not see a large need of the product. As far as I see the devices it may save one or two trials at the cost of a smaller graft window and loss of tactile feedback. Not to mention the revision stories I have heard about these types of devices.
Yep - I have a very busy group here in the southeast that was one of the 1st on board with the expandable Globus cages. They have since abandoned them due to multiple failures. Please dont tell me to identify myself and my location and suggest that I am a liar for not doing so. You know it's happening and I am not an idiot who's going to blow my chance with this group. It was a pure stroke of marketing and engineering genious on the part of Globus to come up with that cage. Still, the facts are the facts and the basic principles of spine surgery are as stern and immutable as the laws of physics - and you broke the law. Bone doesn't fuse to an empty peek cage. Back to the drawing board.
DeleteStryker experienced the same issues many years ago when they acquired, ahem, I mean they were acquired by Howmedica. Brown kissed Lawson's ass so much that he got blisters on his lips. There was intra-rivalry fighting at the NSM between sales reps from both companies, Lipes had a brilliant idea of rooming a Howmed rep with an Stryker Osteonics rep, went over like a lead balloon. It's okay to admit that reps hate one another, you wouldn't be a competitor if you didn't. It's the nature of the industry. As for upper management, they still haven't learned any lessons about transparency and defining a plan prior to implementation, it is the "duh" moment in an acquisition, you know, now that I bought it, what the hell do I do with it? 4:50 is correct, if you are a Synthes or DePuy Rep find other opportunities and run, if you think the integration was bad wait until you see how aberrant of a culture develops when you mix these two sociopathic cultures.
ReplyDelete4:50 AM - You are pretty dead on for now....
ReplyDeleteThese guys are already leaving in droves... especially in CA. The management royally f-d up that "merger"... what a debacle!
ReplyDeleteNo way you're crazy - nobody left
Deleteonly one dummy left to Stryker in nor cal. dummy...
DeleteTSB is correct. When the news of this aquisition broke a year ago, there were postings from ( I believe TSB) and others that the Depuy/Synthes sales force would go direct. Depuy reps posted replies that it would NEVER happen. NO way they said. Denial - up until they were told they would be direct and sign a monster non-compete. Common sense says they will allow some sort of co-existence with both reps (Depuy and Synthes) until the customers become accustomed to the combined product line, and within a year the cuts will be made even further. There will be many Synthes reps cut, but even more Depuy reps cut. Because thats probably the way Hans wanted it. Who really is running the spine business there. The irony is that there are Depuy reps telling their surgeons that they will be carrying ProDisc soon, when the Synthes rep is the one who will keep the territory in a year. Depuy reps, sharpen your resume. It is gonna be bad, real bad.
ReplyDeleteFor a dollar more, I could supersize your order.
ReplyDeleteHey Mark and all your little cronies...ie Carl, Kevin...look whos crying now!!! Karma is a bitch!!
ReplyDeleteCarl is awesome, don't you dare slander his name on the internet!
DeleteSkid marks cause care crashes. Think about it.
ReplyDeleteJohn Maynard Keynes -- learn about him.
Here is the basic problem. Health care is not a commodity and disease is the enemy of all people. Disease is the friend of the medical industry who sees it as something to exploit for obscene profits. The vulture capitalist see disease as good thing then they swoop in and begging fighting over the scraps until the pack of hyenas runs them off. It becomes very cut throat but that is the nature of vultures and hyenas. Then it becomes a good place for maggots.
The medical industry will always suck so long as it is run by vultures and hyenas.
Let's try the sports analogy. Children can play sandlot baseball and govern themselves accordingly. Sure, some little brat may take his ball and go home but must of the time they get along. Add financial incentive and they will not get along so well. Then the game needs umpires.
The medical industry has no umpires or at least none that aren't on the take.
I pointed out many times that the American medical industry has not cured a disease in 50 years. I can't tell how naive MSM is. He rails about this segment of dirty industry. Does he know that 2 of Medtronic's board members work for Goldman Sachs? These people don't just look at the bottom line that is the job of the bean counting CEOs and other company officers. They board looks at the big picture. Here is a glimpse of the big picture.
20% of the US GDP is health care. by 2020 it will be 25%. For you mouthy salesmen that will mean that 1 in every 4 dollars spent in the US will go for health/sick care. The more disease there is the more money the pigs make. You salesmen are disposable.
Your clients, most of them are corrupt by the process. They did not become orthopedic surgeons for altruistic reasons. They did it for the money. That is why they are so inept. Bad medicine in lucrative medicine. MSM has opined on why there is no innovation and why most of the companies sell me too products. Innovation is bad for business. Devices that work well and fix the problem are very much like tire that won't wear out.
You work in dirty filthy industry whose overseers are pure filth. There is a name for you salesman. You are called pawns. With help, a pawn can defeat a king.
The problem with the medical device industry is that there is a medical device industry. Only a slime ball would monetize human suffering. You, pawn/salesman are as bad as your masters.
Fat Bastard you sound like a disgruntled douche bag.
DeleteYes...you are a Fat Bastard indeed. An idiot, too if you truly believe that American medicine hasn't cured anything in 50 years. Let's see...by your thinking, we're practicing medicine at the effectiveness of what was done in 1962, except that somebody is making money in the process.
DeleteWe know about Keynes. His misguided economic theories have provided little despots and populist politicians the world over plenty of ammunition to create government dependencies, stifle scientific progress, and accelerate inflation. The latest incarnation of his brilliance has been our repetitive "stimulus" borrowing/spending. It was working "great" last time I checked. Effing genius that one.
Monetize human suffering? So food and shelter should also be free? since starvation and exposure to the elements is human suffering. Lets tell the farmers and builders to vote for socialism next go around.. Do you have access to history and ecomonics books Fat bastard?
DeleteOk Fat Bastard now you got me going....why dont you go and suck a Goldmember!
DeleteFB, we all agree (at least those honest with selves) that the Industry isn't perfect. Human nature and greed will always yield a dirty underbelly, especially when margins are so large!
DeleteHowever, a majority of patients undergoing orthopedic procedures wind up in better shape. Trauma rebuilds enable patients to walk, or move, or live. THA and TKA (prior to M-on-M) restore debilitated patients who were bed ridden, wheelchair bound, or otherwise impeded. Spine fusions, while likely having poorer outcomes than above procedures, still help an overwhelming majority.
Are there problems? Undoubtedly. Surgeons, unbeknownst to the general populace, are human. That means that just like your plumber, auto mechanic, accountant, everyone, there are good ones, gifted ones, average ones, and of course, below average. Unfortunately, revising a pseudoarthrosis isn't equivalent to flooding due to busted pipes, but it happens.
And yes, there is a minority (one can still hope) of surgeons who put cash ahead of patient care. But I would still chalk up a majority of revisions to other causes, smoking, infection, poor carpentry, etc. (not intentional monetary skullduggery).
So should we go back to hip and knee arthrodesis? My Mother-In-Law would vote resoundingly NO! The FDA actually needs to do its job and approve efficacious products that are safe and actually help patients, rather than rubber stamp me-too crap that may or may not work.
AMA, AAOS et al must take responsibility as well. Those metal-on-metal hips didn't get implanted by Industry reps (at least not 99%). That POS spine device implanted by a POD shareholder was very likely against the wishes of the Big Five. And that below average surgeon who has been chased out of four previous regions probably should not have been allowed scalpel credentials.
Is the system broken? Without a doubt. Our 37th global ranking while paying at least double, triple, or more than countries 1-5 is indefensible. Are we going to solve it by quitting our inglorious job carrying a bag for the Man? No.
The entire US political system is corrupt and run by money, controlled by the 1% of the 1% of the... They control corporate America, your US Senator, your US Congressman, POTUS, and now likely your SCOTUS. So it is only natural that an industry accounting for 20% of GDP is being gamed to line the Man's pockets.
Please offer realistic solutions, or at least theories, rather than berating the salesman, of whom only a small percentage are culpable and deserving of your scorn. It may make for riveting Blog reading, but like the Far Right and Far Left radio talk shows, has little to no relevance to Reality, that 80% in the middle called life, where at least 80% of us average Americans reside.
I saw your Medical Holocaust Blog Fat Bastard and I agree with your readers that these criminals should face a firing squad. My aunt was maimed by the DePuy hip implant.
DeleteMark my words Fat Bastard, justice will be done.
Thank you for your blog. We need to be informed.
@ Skinny BassTurd,
DeleteYou would not know keynesian economics if it flew you and bit you on your undersized trickle down inchworm.
As to how these implants get approved:
Who pays for the studies and clinical trials? Answer: the company selling the product.
Who hires the doctors to conduct the clinical trials? Answer: the company selling the product.
Who owns the FDA? Answer: The guys with the gold.
We all know about the massive corruption and over 100 doctors who were bribed in the Medtronic Infuse travesty. We know that in any other industry that level of wrong doing would be punishable by jail time.
Anyone who defends this industry should be added to list of traitors headed for jail.
My reader overwhelmingly would like to see members of the medical industry executed. I would like to see the day when our government serves the people and brings these people to justice but I doubt that day is coming anytime soon. SO... when do it yourself justice happens in will be divine justice. There are millions of pissed off victims. It is only a matter of time before one of them takes some of you out. Your best bet is to confess and make deals with whistle blower lawyers. Stop by Medical Holocaust and read about how much money you can make hiring a qui tam lawyer and spilling the beans.
You turds are the terrorists so when some victim's loved puts a bullet in one of your black hearted corporate thugs I will leave a great big Fat Bastard turd on his grave and another one for the mouth pieces like you to munch on.
@ Peter Gunz, I'm glad you are on our side.
Ahhh the old internet death threat meme.... Yawn
DeleteNext you will invoke the name of Hitler and threaten to drive over to my house to settle things. Do your worst foul knave.
I have a permitt to carry a concealed weapon, which is my constitutional right. I am ready and waiting FB.
DeleteHow many of you boys and girls have gone through your talent interviews? Should be full of grins and giggles as you justify your existence within the new DePuy Synthes family.
ReplyDeleteWait. I thought we were all guaranteed a position within the family. You know what they say, " keep your friends close, but keep your enemies closer". Must be that kind of familia where they make you an 18 month offer you just can't refuse.
May we all come out on top, lest we be mauled from behind?
Bada bing baby!
Good take on the whole situtation! I think the Pacific NW got the message. That world blew up.
ReplyDeleteAll those childhood stories were entertaining and helped to keep our minds occupied as we searched for things to do on a warm summer day. I'm reminded of the story of the frog in the pot of warm water and how we could just as easily substitute a Synthes Rep for the frog.
ReplyDeleteThe pot of warm water would be all the statements coming from corporate telling you how everything is going to be o.k. and to keep your head down and do your job. All the while they collect fat multi-million dollar bonuses. To my knowledge, you reps who have sold the products and driven growth haven't gotten the promise or guarantee of a bonus other than, we will let you know within 90 days of the closing what your territory and comp plan will be.
The corporate hand reaches over and turns up the temperature a notch.
In just under 90 days you will receive your new offer from the DePuy/Synthes company. When you're hit with the 18 month non-compete do you decide to jump out of the pot and swim in cooler waters, or will you continue to put your head down and do your job? When you discover your territory is now a sliced and diced shadow of itself, will you jump from the pot? The temperature is rising.
The hand reaches over and turns up the heat another notch.
When it is explained to you in black and white that your comp plan will stay like it is through December 2013, do you jump from the pot and move to less restrictive fishing grounds or again put your head down and do your job? The temperature is rising!
The hand reaches over and turns the knob to the highest setting.
So by late 2013 you're trudging along in you territory with an 18 month non-compete anchored to your back and no idea what your comp plan will look like other than a menu of cafeteria style options. Of course, with each benefit option chosen by you your commissions will decrease.
The water is now at a gentle boil and your hide is cooked. You finally realize you don't have the strength to jump from the pot of water due to the 18 month non-compete anchor strapped to your back or all the so called specialist and territory assist reps who could easily walk into your accounts (or account as it may be) and replace you. FAHRENHEIT 212!!!
The table has been set right before your eyes and yet so many of you continue with the head down approach and believe JnJ is going to take care of you. All the DePuy reps for the spine distributors have their new contracts in place when they went as direct employees. They got 8% and an 18 month non-compete.
Remember one of the wise sayings your grandmother used to say "IT'S NOT OUR WORDS, BUT OUR ACTIONS WHICH DEFINE US". So keep your heads down and continue to listen to wordly promises as the temperature gets turned up and their actions indicate a different intention. You will make a fine appetizer on the JnJ table that has already been set.
J
How are the "Talent Interviews" proceeding?
***
Take the above parable analogy seriously. Once you have signed and submitted your new contract with the 18 month non-compete, they can and will at some future point come at you with a 30 day notice of a change in territory, change in commissions or both. If you are happy and content with a smaller territory and as much as a 38% reduction in commissions, then great. Be part of the cog which makes up the corporate machinery. If not, then blaze your own path with a company that will provide you greater potential in a territory with higher commissions.
You are so right! I know who this is, its D*^# A::IS^&
DeleteLadies and gentlemen, by the time the integration process is complete, 1/4 of the DePuy Synthes Spine sales force will be working for another company (or themselves). Mark my word.
ReplyDeleteDepuy synthes to officially announces next week big news on their US sales distribution model. The last big 4 distributors to be bought out before the end of Q3 !!! Go direct ! Go direct !
ReplyDeleteNot all by Q3. The 2 big Atlantic area ones will be by Q2 or Q3 of 2013
DeleteHow is it possible the DePuy ortho twatt in Columbus continues to old onto spine?
DeleteDepuy reps are screwed. Screwed.
ReplyDeleteTo all Depuy Snythes reps:
ReplyDeleteAs a smaller independent distributor I would welcome a discussion with you to work with me. All options are on the table, from signing bonuses, earned equity in the distributorship, higher commissions, etc. When you move to this model you become a businessmen and move from a sales rep. The pool is open and the water is great for the right people, who want to really build something for themselves, their family and business partners. The others will be like Joe Pesci in good fellas and never see it coming, until they see the plastic.
Another piece of advice to the D/S reps. Read the book "Who moved my cheese" It take about an hour, but maybe that will wake you up.
The JnJ bean counters just eliminated my position after 15 months and re building the DePuy brand in my crappy territory and at great cost to me and my family. It's time to find another job and focus on the RED DOT.
ReplyDeletehttp://OrthoStreams.com/2012/06/will-steve-macmillan-run-depuy-synthes-post-merger/
ReplyDeleteWill Steve MacMillan run Depuy Synthes Post Merger?
The hyenas and jackals may have a new King Rat at the helm if Stryker's BoD gives MacNazi the nod to take the helm at DepuySynthes. MacMillan should feel right at home here. His predecessors are one doing time for murdering innocent people in unauthorized spinal surgeries. Maybe MacMillan will try to sell his MoM spinal discs that went nowhere during unauthorized clinical studies ( IDE never received FULL Approval and both studies (FlexiCore and CerviCore) to Johnson & Johnson for a second bite of the PMA apple. Or will MacNazi try to breath life into the Pro Disc? Whatever the outcome, there is no doubt that MacNazi is a perfect fit for J&J and birds of a feather....
Pleeeeze.
DeleteI work for DePuy and have for many years. I must admit, I am not entirely happy with the way this whole deal is being managed. I have seen many good, solid, talented reps swept up in this mess and spit out the backside. Management has done nothing to make anyone feel like they are safe. Let's just face the harsh reality of it, though. The minute you start feeling safe in this industry will be your last. It doesn't matter who employs you. Deliver the number or hit the bricks, pal ! Just for one minute, I would like to hear the sound of no bitching. Imagine that. The sound of no bitching. "It isn't hard if you try". nobody upstairs cares if you're not happy. Life isn't fair. Get used to it. Get to work.
ReplyDeleteWell said 5:27. I have been reading TSB for a long time but have never commented until today. I would like to say that I must admit that in most cases TSB has been dead on predicting what will happen with the future of our business. I'm most disturbed about the change in the people that are involved in spine sales. It started with the surgeons and trickled down all the way to the reps. This blog is very informative and I appreciate that. It has shown me how venomous people have become. I had hoped that things would get better but it is evident that they will not. I'm lucky that like so many on this site, I enjoyed the great times in the late 90's through the early 2000's. Got to make a good living and enjoyed work. Now, it makes me sick to get up and look at the scum that has polluted our business. What is happening with Depuy Synthes should be a wake up call to all of us out there. Go ahead with the BS and say "only the strong will survive."
ReplyDeleteThe end is not near...IT IS HERE. Are you next?
Safe????
Thanks for all you do TSB!
What do all the D and S reps think about the proposed super territories designed to dilute relationships and power of stronger consultants?
ReplyDeletethe average rep who jumps to another company will keep b/t 20-30% of their business. Your relationships are not all as solid as you think they are and surgeons are more of creatures of habit than you comprehend.
DeleteHave you heard about the one pot to pay for all functions within a territory? Say 10% for everything from commissions to your surgeons trip to the home office! Sounds ridiculous. Look out for 2014.
ReplyDeleteIs collateral damage can be applied on kugel mesh lawsuit?
ReplyDeleteAusterity works pretty well. My brother and his wife were spending more money than they were making. They cut back on spending and got out of debt. Really a quite simple concept actually. As far as the implicit capitalism bashing, it has produced the highest standard of living in the history of the world. You bitch about the greed and inefficiency of your big company but somehow fail to see the parallel to continually growing central government. They're both entities of individuals looking out for their own interests, not what's best for the whole. The MO of one is profit; the other is garnering votes. In both instances they will do what it takes to win. People who defend government as virtuous are as blind as those defending big business in the same manner.
ReplyDeleteVery informative post. Thanks for taking the time to share your view with us.Laser Spine San Antonio
ReplyDelete