Now comes the fun part. As many of you know, with the acquisition of Synthes, Johnson & Johnson will be challenged with the daunting task of integrating Synthes into their organization. Analysis paralysis is already setting in. Having an integral role in acquisitions and mergers has taught many a valuable lesson. The first lesson is that just because you have money to buy something, doesn't necessarily mean you are going to be any good at merging a company. Unfortunately, wealth should never be equated with intelligence or competance. It just means you are wealthy. Neither does it mean that hiring a consultant is going to make your life any easier.
The biggest challenge for J&J will be the integration of trauma and spine, where there is tremendous overlap. Contrary to what some analysts are saying, the worst that can happen would be allowing the trauma and spine business units to continue independently while corporate attempts to figure out how to assimilate the busiess units. Identify the plan and move swiftly, if not, you will create confusion in the marketplace. Honesty and transparency are important even if you have to hurt some people's feelings. Communicate with your customers. Regardless whether you believe it or not, a business as usual attitude will come back to haunt you. Deciding on whether you will continue to sell via distributors or direct sales people will alleviate the trepidation and anxiety that alredy exists in your respective business models. Today, your sales people are confused and distracted as to what awaits their futures. By identifying the plan and implementing it, you will establish continuity while transitioning.
The cultural differences will be exasperating. J&J has always exhibited a stiff collar mentality, while Synthes has been more of a gunslinger. The posse will learn quickly that there is a new sheriff in town and that some of the old mores and values will not be tolerated. It is interesting to read outsiders opinions of how different these two organizations are. Contrary to what is said, selling is selling regardless whether you work for one or the other organization. Synthes salespeople have one of the best educational sales training platforms in the industry. Unfortunately, there will be collateral damage in the rank and file, as well as in middle management. Like TSB said, this will be a golden opportunity to get rid of the dead wood in management across the board. Don't make the mistake that companies like Biomet and Stryker made by allowing total joint reps have access to trauma products and trauma selling recon. This will diminish your salespeoples focus. In addition, trauma salespeople are more Type A personalities in comparision to recon salesmen. It's evitable that there will be people that are on the chopping block, if you haven't begun looking for a new job, now may be the time to polish one's resume. The bad news is that the market sucks and unless you can flip immediate revenue, good luck in finding a new job in this economy.
So in the spirit of debate, TSB wants to know, will this be easy or is Johnson & Johnson heading into the perfect storm?
Thursday, April 28, 2011
Wednesday, April 27, 2011
HAPPY TOGETHER
Spine Nation and Fellow Musculoskeletalvites, if you"ve never been to a Flo and Eddie Concert follow the bouncing ball;
"Imagine me and you, I do, I think about you every night it"s only right to think about the girl you love and hold her tight, so happy together......I can"t keep from loving nobody but you, you"re on my mind, when the wind blows baby the skies will be blue for all my life...."
Well fellow bloggers a deal is a deal. In the world of high finance Synthes offered her honor and J&J honored her offer and the rest is history. It was announced today the J&J will acquire Synthes in a cash and stock deal, by offering $21.3 billion or $181.30 per share. Unlike the Wall Street Journal who called him Dr. Wyss, having worked with Hansjoerg Wyss it was time for the Wyssmeister to hang up the old spurs and move on out, he"s on the clock and desires to add to his legacy and life"s work. Mr. Wyss owns 47% of Synthes and will be worth an estimated $10 billion when all the papers are signed. Both companies boards have unanimously approved the transaction. Now that it"s done TSB would like to send an open letter to William Weldon at J&J.
Dear Mr. Weldon:
Congratulations on winning the Irish Sweepstakes. J&J/DePuy has a golden opportunity to continue the legacy of a great company. If you really want this transition to succeed, don"t just think about the challenges that await you in integrating two companies of this size, start thinking how you will replace the dead wood that exists on both sides of the management aisle at both trauma companies. If there ever was an opportunity for a cultural cleanse, now is the time. Not only will you be considered a player in trauma, you will have an immediate impact on spine, maxillofacial and power equipment. Many readers frowned upon the probability of this acquisition two weeks ago, today it is a reality. In addition to the aforementioned products you will have inherited the greatest marketing tool that the industry has ever seen, the AO/ASIF surgeon and ORP trainng/educational programs. Who ever said you needed a marketing department? If you don"t believe it has great value, imitation has always been the greatest form of flattery, that is why companies like MSD and NuVasive have succeeded, they realized that knowledge is power. For those that had doubt regarding this deal, any company that controls its manufacturing cost with a just in time model and carries minimal debt for a company the size of Synthes is a deal made in heaven. Once again the Great Vampire Squid prevails, you know what Bogie once said, "here"s lookin" at you sweetheart."
"Imagine me and you, I do, I think about you every night it"s only right to think about the girl you love and hold her tight, so happy together......I can"t keep from loving nobody but you, you"re on my mind, when the wind blows baby the skies will be blue for all my life...."
Well fellow bloggers a deal is a deal. In the world of high finance Synthes offered her honor and J&J honored her offer and the rest is history. It was announced today the J&J will acquire Synthes in a cash and stock deal, by offering $21.3 billion or $181.30 per share. Unlike the Wall Street Journal who called him Dr. Wyss, having worked with Hansjoerg Wyss it was time for the Wyssmeister to hang up the old spurs and move on out, he"s on the clock and desires to add to his legacy and life"s work. Mr. Wyss owns 47% of Synthes and will be worth an estimated $10 billion when all the papers are signed. Both companies boards have unanimously approved the transaction. Now that it"s done TSB would like to send an open letter to William Weldon at J&J.
Dear Mr. Weldon:
Congratulations on winning the Irish Sweepstakes. J&J/DePuy has a golden opportunity to continue the legacy of a great company. If you really want this transition to succeed, don"t just think about the challenges that await you in integrating two companies of this size, start thinking how you will replace the dead wood that exists on both sides of the management aisle at both trauma companies. If there ever was an opportunity for a cultural cleanse, now is the time. Not only will you be considered a player in trauma, you will have an immediate impact on spine, maxillofacial and power equipment. Many readers frowned upon the probability of this acquisition two weeks ago, today it is a reality. In addition to the aforementioned products you will have inherited the greatest marketing tool that the industry has ever seen, the AO/ASIF surgeon and ORP trainng/educational programs. Who ever said you needed a marketing department? If you don"t believe it has great value, imitation has always been the greatest form of flattery, that is why companies like MSD and NuVasive have succeeded, they realized that knowledge is power. For those that had doubt regarding this deal, any company that controls its manufacturing cost with a just in time model and carries minimal debt for a company the size of Synthes is a deal made in heaven. Once again the Great Vampire Squid prevails, you know what Bogie once said, "here"s lookin" at you sweetheart."
Saturday, April 23, 2011
What's Going On
Over the last few months, the criticism of spine reps has intensified. Is the spine industry a mirror image of a larger epidemic effecting America? We have become our own worst enemy, a divided society, no less a divided industry. Us against them, rich against poor, business against government, the unregulated against regulation, red against blue, right against wrong. Whether our readers agree or not, there has been a blatant assault on the sales rep. Some of it is justified. Some of it is not justified. Some of it attributed to good old A1, red, white and blue greed. So in an effort to set the record straight for our readers, here are the facts.
Whether management, surgeons, or hospital personnel believe it, your hard work is what makes this industry thrive. You are the stimulus that pumps life into a company. Whether TSB has been in sales or in management, the bottom line is the infantry gets the job done. A visit into the Korengal Valley would expose that there aren't too many generals waiting for a firefight. The publics perception is that you are all making $250K per year, drinking Bordeaux, smoking Cohiba's, and investing in Broadway musicals, and we all know whom we can thank for that. People believe that most of you have banking hours, are overpaid, and are the primary reason for the escalating cost of delivering healthcare in the U.S.. Just because you did not go to medical school doesn't make you any less valuable in the food chain. As baby boomers enter their golden years, they have been programmed demanding the fountain of youth. They want bionic knees, hips, ankles, and spines, demanding a return to normalcy after all is said and done. Insanity at its best. We may be a civil society, but based on what is going on around us, not a very intelligent one.
Unlike salaried employees, sales reps are solely responsible for what they earn. Essentially, you are no different than a stock broker in that you eat what you kill. You deal with a pernicious, apathetic, and selfish healthcare environment. Did I miss any other adjectives? You are stonewalled by hospitals, operating rooms, nurses, doctors, and hospital administrators whom frown upon you as a necessary evil until they need something, and then they want you to drop everything you're doing to help them out, and you do it. When did this assault begin, and whom do some of these people think they are in contributing to the escalating cost of healthcare (Do you hear me Dr. Steinmann)? Hospitals complain about cost, yet continue to expand and build newer, bigger and better facilities. There are new cardiac centers, children's centers, women health centers, cancer centers, and parking garages, yet no one seems to be questioning and demanding accountability on their part. There is no excuse for the behavior that is exhibited by these people. Unfortunately, courses in professional behavior is not taught in med school or grad school. 80% of your business comes from 20% of your accounts, because your days are spent brokering rather than selling. Thank you corporate America and Dr. Famous for your contribution to our day. When you do have something innovative or clinically beneficial for the patient, you have to move mountains to motivate a surgeon to try it. During the interim, the patient suffers. On average you spend $100-$125 per week on gas (thank you speculators), in addition to tolls and parking (someone needs to pay for the construction) and you are obligated to buy a prospective customer lunch if you have any chance of getting their attention, whom no less has no problem telling you that there will be 10-15 employees attending. TSB usually tells the nurse that I will be glad to meet the surgeon one on one and buy him a sandwich. Some even have the audacity to tell you where they would like it catered from. (that's my favorite). A shameless society. Besides these expenses, hospitals want you to register with various vendor management services to protect the patient, a bogus rationalization. What about your protection? It's bad enough that hospitals are squeezing you for every penny on the dollar, but some want you to pay to play in their facility. Aren't these people embarrassed? And then you have to deal with management at your respective company. So in an effort to set the record straight, here are the facts.
Management is in denial when it comes to market dynamics. Some still believe the party is going on. Publicly traded companies continue to push you to your limits by promising their Master, Wall Street, that they will continue to grow in spite of all the barriers that you face everyday in growing your business, no less the ones that you cannot control like insurances denying surgeries (can't wait for NuVasive's analyst call). Attrition has become a norm in sales. You're on the clock. If you can't increase revenue in a short period of time, you're gone. Just look at some of the companies out there. Management is more concerned about share holders value than whether they have delivered the necessary tools so that you may be successful. How many empty promises have been made to you? How many product development timelines have been missed? Yet, the game continues by increasing your quotas and demanding results. Some companies can't even provide you with samples and marketing collaterals. Your middle managers have grandiose expectations. They accept whatever is spoon fed to them by the senior management team and never question the validity of any strategy let alone revenue expectations, because they cower for their jobs. They're great at giving you a quota when they have no clue as to the demographics of your territory, or the obstacles that you are confronted with on a daily basis. Product evaluation committees (what free market), preferred vendor lists (discrimination), vendor certifications (violation of your rights), surgeons protecting other companies turf and their own consulting agreements, if that isn't the decline of the empire, what is? TSB wants to what's going on? You know what Marvin Gaye once sang;
"Picket lines, and picket signs, don't punish me with your brutality, talk to me so we can see, what's going on, what's going on, what's going on, we've got to find a way to bring some understanding today."
As a side bar to our discussion, TSB hopes our Jewish and Gentile brethren had and have a wonderful holiday season! L'Chaim!
Whether management, surgeons, or hospital personnel believe it, your hard work is what makes this industry thrive. You are the stimulus that pumps life into a company. Whether TSB has been in sales or in management, the bottom line is the infantry gets the job done. A visit into the Korengal Valley would expose that there aren't too many generals waiting for a firefight. The publics perception is that you are all making $250K per year, drinking Bordeaux, smoking Cohiba's, and investing in Broadway musicals, and we all know whom we can thank for that. People believe that most of you have banking hours, are overpaid, and are the primary reason for the escalating cost of delivering healthcare in the U.S.. Just because you did not go to medical school doesn't make you any less valuable in the food chain. As baby boomers enter their golden years, they have been programmed demanding the fountain of youth. They want bionic knees, hips, ankles, and spines, demanding a return to normalcy after all is said and done. Insanity at its best. We may be a civil society, but based on what is going on around us, not a very intelligent one.
Unlike salaried employees, sales reps are solely responsible for what they earn. Essentially, you are no different than a stock broker in that you eat what you kill. You deal with a pernicious, apathetic, and selfish healthcare environment. Did I miss any other adjectives? You are stonewalled by hospitals, operating rooms, nurses, doctors, and hospital administrators whom frown upon you as a necessary evil until they need something, and then they want you to drop everything you're doing to help them out, and you do it. When did this assault begin, and whom do some of these people think they are in contributing to the escalating cost of healthcare (Do you hear me Dr. Steinmann)? Hospitals complain about cost, yet continue to expand and build newer, bigger and better facilities. There are new cardiac centers, children's centers, women health centers, cancer centers, and parking garages, yet no one seems to be questioning and demanding accountability on their part. There is no excuse for the behavior that is exhibited by these people. Unfortunately, courses in professional behavior is not taught in med school or grad school. 80% of your business comes from 20% of your accounts, because your days are spent brokering rather than selling. Thank you corporate America and Dr. Famous for your contribution to our day. When you do have something innovative or clinically beneficial for the patient, you have to move mountains to motivate a surgeon to try it. During the interim, the patient suffers. On average you spend $100-$125 per week on gas (thank you speculators), in addition to tolls and parking (someone needs to pay for the construction) and you are obligated to buy a prospective customer lunch if you have any chance of getting their attention, whom no less has no problem telling you that there will be 10-15 employees attending. TSB usually tells the nurse that I will be glad to meet the surgeon one on one and buy him a sandwich. Some even have the audacity to tell you where they would like it catered from. (that's my favorite). A shameless society. Besides these expenses, hospitals want you to register with various vendor management services to protect the patient, a bogus rationalization. What about your protection? It's bad enough that hospitals are squeezing you for every penny on the dollar, but some want you to pay to play in their facility. Aren't these people embarrassed? And then you have to deal with management at your respective company. So in an effort to set the record straight, here are the facts.
Management is in denial when it comes to market dynamics. Some still believe the party is going on. Publicly traded companies continue to push you to your limits by promising their Master, Wall Street, that they will continue to grow in spite of all the barriers that you face everyday in growing your business, no less the ones that you cannot control like insurances denying surgeries (can't wait for NuVasive's analyst call). Attrition has become a norm in sales. You're on the clock. If you can't increase revenue in a short period of time, you're gone. Just look at some of the companies out there. Management is more concerned about share holders value than whether they have delivered the necessary tools so that you may be successful. How many empty promises have been made to you? How many product development timelines have been missed? Yet, the game continues by increasing your quotas and demanding results. Some companies can't even provide you with samples and marketing collaterals. Your middle managers have grandiose expectations. They accept whatever is spoon fed to them by the senior management team and never question the validity of any strategy let alone revenue expectations, because they cower for their jobs. They're great at giving you a quota when they have no clue as to the demographics of your territory, or the obstacles that you are confronted with on a daily basis. Product evaluation committees (what free market), preferred vendor lists (discrimination), vendor certifications (violation of your rights), surgeons protecting other companies turf and their own consulting agreements, if that isn't the decline of the empire, what is? TSB wants to what's going on? You know what Marvin Gaye once sang;
"Picket lines, and picket signs, don't punish me with your brutality, talk to me so we can see, what's going on, what's going on, what's going on, we've got to find a way to bring some understanding today."
As a side bar to our discussion, TSB hopes our Jewish and Gentile brethren had and have a wonderful holiday season! L'Chaim!
Wednesday, April 20, 2011
Spine Uprising
Paranoia is in bloom
The PR transmission will resume
They'll try to push drugs that keep us all dumbed down
And hope that we will never see the truth around, So come on!
Another promise, another scene
Another packaged lie to keep us in greed,
And all the green belts wrapped around our minds,
And endless red tape to keep the truth confined, so come on
-MUSE-
So come on fellow bloggers, the federalis spent the other day touring the office of Dr. Sanjoy Sundaresan at the Texoma Spine Center. By the sounds of it, Dr. S may have some unexpected legal issues with the Federal Government. Leaving with boxes of evidence, potentially a little more than the practice of medicine was going on at the TSC.
A little pain, a little dream
A potent elixir another scheme
A frequent visit to my dealer
Pharma grade from my healer
"They give me injections because my lower lumbar is tore," Obviously one of Texas finest,. Ironically, people don't even know what they are being injected with. Shocking no less. If it makes you feel good, go for it. Nothing what a l'il ol morphine will do for you. So as Dr. Sundaresan makes the news, he now joins Dr. Makker as a one hit wonder, and the hits keep coming.
The PR transmission will resume
They'll try to push drugs that keep us all dumbed down
And hope that we will never see the truth around, So come on!
Another promise, another scene
Another packaged lie to keep us in greed,
And all the green belts wrapped around our minds,
And endless red tape to keep the truth confined, so come on
-MUSE-
So come on fellow bloggers, the federalis spent the other day touring the office of Dr. Sanjoy Sundaresan at the Texoma Spine Center. By the sounds of it, Dr. S may have some unexpected legal issues with the Federal Government. Leaving with boxes of evidence, potentially a little more than the practice of medicine was going on at the TSC.
A little pain, a little dream
A potent elixir another scheme
A frequent visit to my dealer
Pharma grade from my healer
"They give me injections because my lower lumbar is tore," Obviously one of Texas finest,. Ironically, people don't even know what they are being injected with. Shocking no less. If it makes you feel good, go for it. Nothing what a l'il ol morphine will do for you. So as Dr. Sundaresan makes the news, he now joins Dr. Makker as a one hit wonder, and the hits keep coming.
Saturday, April 16, 2011
Going Once! Going Twice! ............................Sold
Friday's late report on the potential acquisition of Synthes by Johnson & Johnson has raised numerous questions and analyses about the magnitude of such a deal, and, how it would affect the spine, trauma, and maxillofacial markets. If an acquisition would occur, integration of these two companies could be a logistical nightmare. Those that are liabilities on one side or the other, would become collateral damage. Yet, the mere fact that Hansjoerg Wyss would entertain an offers does not bode well for Synthes employees. The current management team is old and tired, and still using the same old tricks of the trade that has been their modus operandi for years. The ride has been good. As TSB stated in the April 15th post, when hasn't Hansjoerg entertained an offer? It has always made his ego feel good, and rightfully so. Everyone knows that J&J has the financial leverage to consummate this deal, just like Medtronic. The only question this time is whether Hansjoerg intends on pulling the trigger? Regardless whether our bloggers like Synthes or not, one must respect Synthes for what they have accomplished. At one time Synthes was a near trauma monopoly. Synthes has lost some market share due to pricing and a steady decline in a culture that once was the jewel of the industry. Yet, the company continues to develop and market quality trauma products unlike the lap dogs Zimmer, Richards, Biomet and DePuy offer. Imitation is the highest form of flattery. Like their spine division, Zimmer Trauma could mess up a wet dream, while companies like Biomet and DePuy have been mere contenders. Richards could be a threat but any implant company run by ex-GE gnomes has no vision. In addition, Synthes Trauma would be a tremendous boost to the DePuy trauma portfolio, which is mediocre at best. Outside of the 2006 acquisition of Hand Innovations, DePuy has never been a "real" player in trauma, contrary to what their highly esteemed management team will tell you. Visionary is not a word that comes to mind, when one thinks of DePuy Trauma. If there ever was a time for Synthes to be sold, now would be the time. Why?
In due time, Hansjoerg will be an octogenarian. At this juncture in life, his days are consumed with the Wilderness Society, the Grand Canyon Trust, Rails to Trails, and the Southern Utah Wilderness Alliance in addition to his 900 acre Halter Ranch, and other philanthropic ventures like his beloved Harvard University. Knowing Wyss, he would rather be hiking, cross country skiing, playing tennis or flying in his Lear Jet to his next exotic destination than listening to the non-sense that his lieutenants are up to. The biggest factor is that Hansjoerg has always been ahead of the curve and knows that the industry has changed, and that now may be the time to get out while the going is good. Yet, before he does, it behooves him to play the market to see whom else has the fire power to buy Synthes. For all we know, Wyss may be posturing to see if J&J is willing to up the ante. If J&J can entice Wyss, the company stands to increase immediate market share in trauma, spine, maxillofacial, and power tools. Many bloggers fail to realize that Synthes has a great presence in other global markets. This will only increase J&J's presence in other markets.
So in closing, many of our bloggers are compelled to talk about Zimmer buying NuVasive (Dvorak doesn't have the Boards backing), about NuVasive buying Trans1 (wishful thinking), and whether Lukianov wants to exit spine for the entertainment industry, but those are not the story. The question is whether Woody has a woody for expanding his kingdom and whether Wyss is ready to ride off into the horizon looking for more innovative and challenging things to do? You be the judge, As the great Lowell George once sang; "time loves a hero."
In due time, Hansjoerg will be an octogenarian. At this juncture in life, his days are consumed with the Wilderness Society, the Grand Canyon Trust, Rails to Trails, and the Southern Utah Wilderness Alliance in addition to his 900 acre Halter Ranch, and other philanthropic ventures like his beloved Harvard University. Knowing Wyss, he would rather be hiking, cross country skiing, playing tennis or flying in his Lear Jet to his next exotic destination than listening to the non-sense that his lieutenants are up to. The biggest factor is that Hansjoerg has always been ahead of the curve and knows that the industry has changed, and that now may be the time to get out while the going is good. Yet, before he does, it behooves him to play the market to see whom else has the fire power to buy Synthes. For all we know, Wyss may be posturing to see if J&J is willing to up the ante. If J&J can entice Wyss, the company stands to increase immediate market share in trauma, spine, maxillofacial, and power tools. Many bloggers fail to realize that Synthes has a great presence in other global markets. This will only increase J&J's presence in other markets.
So in closing, many of our bloggers are compelled to talk about Zimmer buying NuVasive (Dvorak doesn't have the Boards backing), about NuVasive buying Trans1 (wishful thinking), and whether Lukianov wants to exit spine for the entertainment industry, but those are not the story. The question is whether Woody has a woody for expanding his kingdom and whether Wyss is ready to ride off into the horizon looking for more innovative and challenging things to do? You be the judge, As the great Lowell George once sang; "time loves a hero."
Friday, April 15, 2011
Is Synthes on the Block?
It was reported on today's wire services that Johnson & Johnson has been sniffing around the arbeitsgemeinschaft osteosynthesfragen in a potential blockbuster deal, that if it was to go down, would be an estimated $20 billion dollar acquisition. If capable of executing a deal of this magnitude, how would this swing the pendulum for Johnson & Johnson when it comes to their trauma and spine business units? For years now various companies have courted Synthes, only to be jilted by the girl they covet. Years ago, Zimmer sniffed the Holy Grail to no avail. Then Stryker had delusions of acquiring Synthes prior to acquiring Howmedica only to be laughed at by this smug starlet. Yes fellow bloggers John Brown and Dave Simpson thought they had an inside track, too stiff to play that riff. Johnson & Johnson attempted to get to the alter, only to be jilted. Unfortunately, they just didn't exude the love and affection that the Wyssmeister was seeking back then. Even though there is some skepticism regarding this deal, one must admit as healthy as Wyss has been, it might be time to sell Synthes and ride off into the sunset so that he could spend whatever time he has on this earth in Big Sky country, riding the range and smelling the sagebrush. So the question must be asked, will this be the blockbuster deal that everyone expected, or, is Wyss up to his old tricks in hope of driving up the price between Johnson & Johnson and whomever else is lurking in the brush. There comes a time when every cowboy must ride off into the sunset, either on his horse or lear jet, and drink the fruits of his labor at the Halter Ranch.
You know what Poco sang many years ago;
"you and I counting desert stars and lovers, one by one
While mandolins and steel guitars help our love song along
who could show you, ever know you, fall into my dream
Turn around and, then you are in cowboy boots and faded jeans
TSB wants to know DEAL or NO DEAL?
You know what Poco sang many years ago;
"you and I counting desert stars and lovers, one by one
While mandolins and steel guitars help our love song along
who could show you, ever know you, fall into my dream
Turn around and, then you are in cowboy boots and faded jeans
TSB wants to know DEAL or NO DEAL?
Open Letter to NASS
Dear NASS:
TSB wanted to write an open letter to your organization commending it for the wonderful job that you continue to do as a medical society. Your organization is dedicated to promulgating the professions highest standard of evidence based and quality spine care. Unfortunately, the past few weeks have cast an image on your profession that leaves many believing that the foxes are guarding the hen house. Those of you that are members of NASS' executive committee must feel slightly embarrassed by last week's and this week's Wall Street Journal expose on Dr. Makker. Maintaining and preserving your professions integrity with America's public must be your top priority. It must be concerning to each of you that the actions of a few, is casting a black eye on the many spine surgeons that really do care. Words like honor and trust in your disclosure policy have no meaning if one does not live up to those standards.
The general public doesn't truly understand the importance of having collaboration with physicians in developing new modalities of treatment, assessing the potential of an idea, or simply providing their clinical expertise, all which result in enhancing the patient's quality of life. This synergy is vital for our mutual existence. What is concerning is that there a fundamental breakdown between doctor and patient when the patient is viewed as a profit center. And it should be a concern. Recently, TSB reviewed the program for the 2011 AANS meeting, granted another organization whose many members perform spine surgery. There were over twelve pages dedicated to disclosure along with five pages of surgeons that are not affiliated with any company. Many of those surgeons were from foreign countries. If a spine surgeon is working with five or eight companies on projects, how could this individual really focus on the task at hand? Undoubtably, we live in America and no one has the right to tell another person how he or she can pursue one's livelihood, yet, when outside financial interests and bias influence a surgeons decision making process, this behavior is damaging not only to the profession, but also to the patient.
With all the negative press that the Wall Street Journal and New York Times have published regarding the Dr. Makker's, Kuklo's, Polly's and Wang's, just to name a few, is there no concern that only one surgeon had the nerve to stand up, identify himself, and be heard in a public forum? What does this say about our industry and your profession? Contrary to what NASS believes, there are many surgeons that still fail to disclose the many side deals that they have initiated for their own financial gains. If disclosure is important to your organization then you need to expand the scope of the types of financial relationships that your members partake in. Unfortunately, past members of NASS have set a poor example of how to conduct oneself both professionally and financially by creating an atmosphere of gaming the system, and for those tenured in this business, we know who they are. How many of your members are investors in companies and have failed to disclose? How many are actively involved in POD's that have failed to disclose? How many are owners of Physician Owned Hospitals, and have failed to disclose?
The bylaws that you espouse can be interpreted as nothing more than lame duck principles in a futile attempt to create an image that you are a governing body for an organization that has no legal authority to police or monitor its own members. Hopefully, this will be a wake up call.
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