Transforming Orthopedic Care: Innovations on the Horizon

Welcome to this special issue of "Pulse on Devices." While orthopedics isn't my primary specialty within medical devices, the growing number of connections and industry friends in the orthopedic space have inspired this edition. Their passion and groundbreaking work have compelled me to spotlight some of the exciting advancements happening in this field.

Orthopedics has a special place in my heart, profoundly impacting those I care about. From my grandfather, a farmer who underwent two knee replacement surgeries, to my uncle, a double amputee, and a former weight training buddy who had hip replacement surgery 15 years ago—these personal connections drive my admiration for the field.

In this issue, we bring you a variety of content that highlights the dynamism of the orthopedic industry:

• Q&A with Stu Brandon: Discover the inspiring journey of Stu Brandon , a respected medical device leader who transitioned from being a sales rep to founding his own distribution company. He shares insights on overcoming challenges, selecting the right products, and his vision for the future of orthopedic sales and distribution.
• Spotlight on Startups: We feature five trailblazing startups—Moximed, ZSFab, Loci Orthopaedics, Field Orthopaedics, and ActivOrtho—each pushing the boundaries of orthopedic care with innovative solutions. These companies are transforming the industry with their advanced technologies and patient-centric approaches.
• Medical Sales Planner: Learn about the "Medical Sales Planner: BIG RED" written by two orthopedic alums, Alexander Frekey and Jameil ‘Jay’ Pendleton™ . This clinical organizer is designed to enhance the strategic acumen of medical sales professionals, complementing their previous work, "The Big Blue Book."
• Sports/Exercise Themed Comic: Enjoy a nostalgic comic inspired by the gym culture of the late '90s, capturing the camaraderie, competition, and unique characters that made gyms more than just places to work out.

As you read through this issue, you’ll discover how these elements come together to spotlight a market I admire from the sidelines. The orthopedic innovations featured here promise improved patient outcomes and a glimpse into the future of personalized and minimally invasive treatments.

Thank you for joining us in exploring the exciting advancements in orthopedic care. I hope you find the stories as compelling and inspiring as I do.

From Sales Rep to Distribution Entrepreneur: Unveiling the Journey of Stu Brandon in Orthopedic Sales and Distribution

In this Q&A, I have the pleasure of featuring Stu Brandon, a respected medical device leader and change agent at ASCdx. In this insightful interview, Stu shares his inspiring journey from being a sales representative for big orthopedic companies to founding his own distribution company. He sheds light on the challenges he faced during this transition and how he overcame them, as well as his approach to selecting the right products and brands to distribute.

Additionally, Stu delves into his success stories and memorable experiences, showcasing the boundless possibilities within the orthopedic industry. He concludes by sharing his vision for the future of orthopedic sales and distribution, emphasizing the importance of flexibility, innovation, and strong customer relationships. Join me as we delve into Stu Brandon's remarkable story and gain valuable insights into the evolving landscape of medical device sales and distribution.

What inspired you to transition from a sales rep for big orthopedic companies to founding your own distribution company?

For me, it was a familiar tale shared by most of the sales representatives from major orthopedic companies. Over the years, our selling prices had been steadily declining, and in order to maintain profits for shareholders, the company had started reducing commission rates. Consequently, we experienced a period where average selling prices dropped due to contracting, while commission rates were slashed for consecutive years. As a result, our commissions decreased by forty percent over a couple of years. This is a common situation faced by everyone in our industry.

Even small companies are not immune to the decline in average selling prices. However, they may be more willing to pay higher rates since they are not market leaders. In my specific situation, I also faced the challenge of operating within a limited geographical area. Therefore, I recognized that in order to adapt and stay competitive, I needed to explore opportunities beyond the large orthopedic company I was employed by.

Can you tell us about some of the challenges you faced in making this transition, and how you overcame them?

The initial challenge I faced was navigating the restrictions of my previous employment agreement, particularly regarding non-compete clauses. While the enforceability of such clauses varies across different states, it is common for companies to include non-solicitation agreements to limit soliciting business from existing customers after leaving. Overcoming these contractual limitations became a top priority and posed a significant challenge.

Prior to that, I had to meticulously develop a plan for transitioning from my previous role to pursue my own business venture. This required thorough planning and strategic considerations in order to build a solid customer base. It's important to note that even if I had a successful track record as a representative, it did not guarantee immediate customer support for my personal endeavor. However, I recognized the potential for finding new clients who were open to exploring alternative options. Engaging in thoughtful discussions about the future and how my services could benefit them became crucial as I approached potential customers. Establishing these connections and expanding my customer base was a challenging aspect of achieving the freedom to operate and devising a successful business strategy.

How do you determine which products and brands to distribute through your companies, and what criteria do you use in making these decisions?

This has become one of my favorite aspects of my work. Ironically, I have undergone personal changes along the way. To provide some context, when I left the big orthopedic company, I initially believed that I needed to find a total joint company to replace what I had, along with potentially adding a trauma or sports medicine company depending on my sales focus. However, my experience has taught me that there are numerous exceptional products and small companies to collaborate with. Now, it has become much easier for me to determine which companies I want to partner with. If there is a product that one of my customers desires, I have the flexibility to pick up that product line. Additionally, when I come across unique technologies or new developments, I engage in conversations with my customers before reaching out to the company. This helps me gauge their interest and determine if it aligns with their needs. If there is no demand for a particular product in my area, I may choose not to pursue it, even if it is an excellent product. My philosophy is rooted in being strategic about the products I choose to represent.

Early on, when I had the freedom to choose any product at the American Academy of Orthopedic Surgeons conference in 2019, I experienced what I now refer to as "shiny object syndrome." I found myself wandering through the exhibit hall, thinking, "That's cool! I'm sure I could sell that to someone!" However, upon reflection, I realized that many of those opportunities would have been distractions, potentially taking me outside my usual business scope. It would have been purely driven by the possibility of making a sale, rather than considering the long-term implications.

Currently, I have potential customers with whom I am not yet doing business. I engage with them in discussions about various offerings to assess if there is a suitable fit for their needs. The most enjoyable aspect for me is the freedom to approach someone I don't currently work with, and it is perfectly acceptable for them to decline if it doesn't align with their interests. That's perfectly fine; it just means it's not the right fit for them. The relationships I have developed with many of these individuals involve a desire for me to continue bringing them new opportunities. Instead of being solely associated with one company, repeatedly pushing the same product, I understand the value of providing them with diverse options. I also acknowledge that there may be companies that do not wish for me to represent their products, and I respect that. However, this does not limit me, as there is no shortage of excellent products available for me to consider.

Can you share any success stories or particularly memorable experiences from your time working as a sales rep or running your own distribution companies?

The more I distance myself from the big companies, the more enthusiastic I become about the possibilities within our industry. Let me share an example: during one transition, I encountered a situation involving a small company and a surgeon who was leaving his group to relocate from northern Illinois to Tennessee. I approached the company and suggested, "I believe this surgeon who is moving to Tennessee could be an excellent fit for your company." To my surprise, the regional manager responded, "Stu, I would love for you to introduce us to him. If he wants to pursue our products, we want YOU to take care of him." This completely blew my mind. How could I manage business both in northern Illinois and Tennessee? However, as I discovered, surgeons are embracing a different mindset as our market evolves. In orthopedics, anything is possible.

As a result, I now find myself traveling to Tennessee multiple times a month to collaborate with my friend who relocated from northern Illinois. This is something I never imagined was feasible. Consequently, my company has expanded its operations to include Illinois, Minnesota, Wisconsin, South Carolina, Alabama, and Tennessee. This experience has opened up a whole new perspective for me. I have transitioned from thinking narrowly about the confined boundaries of doing medical device sales within a small, predetermined region. I have realized that if there are individuals who wish to do business with you, there are ways to facilitate those connections within our industry. However, it requires a different mindset from both the representative/distributor side and the surgeon side. Many people within our industry anticipate forthcoming changes, and it is advantageous to proactively embrace those changes rather than waiting for them to be imposed upon us.

What do you see as the future of orthopedic sales and distribution, and how do you plan to stay ahead of the curve?

The key to staying ahead of the curve is maintaining flexibility. One significant advantage my company possesses is the absence of non-compete agreements with the companies we represent. While we work with numerous companies that we appreciate, this flexibility enables us to adapt to the changing and evolving market, as well as the shifting wants and needs of surgeons.

For instance, as more surgical cases transition from hospitals to ambulatory surgery centers (ASCs), surgeons' preferences and requirements can differ from what they were a year ago, and they will likely differ even more in the next five years. By having the freedom to act as consultants to physicians, we can provide unparalleled support to our group. If a surgery center approaches us and expresses their struggles with finding quality products that do not compromise reimbursement for specific cases, we are liberated to explore various options on their behalf. We can thoroughly investigate what's available in the market and present them with a range of alternatives in every product category they currently utilize. This approach empowers them to avoid being solely dependent on one vendor and maintain autonomy in their decision-making process.

Learn more about ASCdx:

Orthopedic Innovation: Five Startups Revolutionizing the Future of Bone Health

As the orthopedic industry continues to evolve, innovative startups are driving significant advancements in medical technology. These companies are not just improving patient outcomes; they are reshaping the landscape of orthopedic care. Here, we spotlight five trailblazing startups making waves in the field: Moximed, ZSFab, Loci Orthopaedics, Field Orthopaedics, and ActivOrtho.

Moximed: Shock Absorption for Osteoarthritis Relief

Moximed is leading a transformative approach to osteoarthritis treatment with their MISHA Knee System, an implantable shock absorber designed to reduce joint load and pain. Unlike traditional knee replacements, the MISHA Knee is placed outside the joint, under the skin, avoiding bone cutting and anatomical alterations. This device, which received De Novo clearance from the FDA, offers a less invasive option for patients not ready or qualified for knee replacement surgery. The system's ability to provide functional improvement while ensuring safety has garnered significant interest from both surgeons and patients across the United States.

ZSFab: Custom Implants with 3D Printing Precision

ZSFab is at the forefront of personalized orthopedic solutions, utilizing advanced 3D printing technologies to create patient-matched implants and surgical guides. The company's first 3D-printed cervical interbody device received FDA 510(k) clearance, underscoring their commitment to innovation in spinal surgery. By integrating proprietary algorithms, advanced modeling, and optimization methods, ZSFab is revolutionizing the way implants are designed and manufactured, offering highly customized solutions that cater to the unique needs of each patient.

Loci Orthopaedics: Revolutionizing Thumb Arthritis Treatment

Loci Orthopaedics , an Irish startup, has developed the InDx implant, which addresses the complex motions of the thumb joint. This innovative device features two points of rotation that move independently, allowing for a full range of natural thumb movements. This is particularly beneficial for patients with thumb base arthritis, a condition that can severely impact daily activities. Additionally, Loci Orthopaedics has developed OsteoAnchor, a 3D-printed surface architecture that enhances the stability and longevity of orthopedic implants.

Field Orthopaedics: Precision Solutions for Small Fractures

Field Orthopaedics , based in Australia, focuses on the challenges of treating small fractures, which require precise surgical instruments. Their FO micro screw is designed to improve the success of surgeries involving small bones by providing the precision needed to facilitate healing. This innovation addresses a significant gap in orthopedic surgery, where traditional instruments often fall short in managing small fractures effectively.

ActivOrtho: Accelerating Bone Healing with Active Compression

ActivOrtho has developed groundbreaking technologies to promote faster bone healing. Their Nitinol Compression Screw and Continuous Compression Screw provide active compression throughout the healing process, significantly reducing the risk of nonunion and promoting more rapid recovery. These devices, which have received FDA 510(k) clearance, offer an alternative to fixed-length rigid implants, ensuring continuous compression and better outcomes for patients with bone fractures.

These five startups—Moximed, ZSFab, Loci Orthopaedics, Field Orthopaedics, and ActivOrtho—are pushing the boundaries of orthopedic innovation. Their cutting-edge technologies and patient-centric solutions are set to transform the future of orthopedic care, providing new hope and improved quality of life for patients worldwide. As these companies continue to grow and innovate, the orthopedic landscape will undoubtedly be reshaped by their groundbreaking contributions.

Medical Sales Planner: BIG RED: 'My Bag' Clinical Organizer"

In the dynamic world of medical device sales, Alexander Frekey and Jameil Pendleton have already set a high bar with their "Medical Sales Planner: The Big Blue Book." As I approached their latest offering, "BIG RED: 'My Bag' Clinical Organizer," I was initially skeptical about the need for another workbook in the series. However, upon delving into BIG RED, my doubts quickly dissipated, revealing its indispensable role as a complementary tool to BIG BLUE.

Distinctive Purpose

Unlike its predecessor, which serves as a traditional sales planner, BIG RED carves out its unique niche by empowering sales representatives to master their medical device portfolios. This workbook guides users through meticulously structured prompts, focusing on a deep understanding of product features, benefits, competitive positioning, and market strategies. It’s designed not just to organize but to enhance the strategic acumen of medical sales professionals.

Detailed Features and Content

BIG RED excels in its detailed exploration of medical products. Each section prompts the user to consider various critical aspects: from clinical and financial benefits to competitive analysis and objection handling. It encourages sales reps to think critically about their products, why they matter, and how they stand against competitors. Additionally, a section dedicated to integrating clinical case studies allows reps to solidify their arguments with data-driven insights, making it an invaluable tool for those looking to elevate their sales pitches.

Utility and Impact

In practice, BIG RED has proven to be more than just a workbook; it's a strategic asset. It has empowered me to organize and articulate a comprehensive understanding of the products I represent, enhancing my confidence and effectiveness in the field. This workbook not only complements BIG BLUE but stands strong on its own merits as a crucial tool for any medical sales professional.

Areas for Improvement

While BIG RED covers an extensive range of topics, the inclusion of a section specifically dedicated to the most common and challenging objections could further enhance its practicality. This addition would provide reps with a more robust toolkit to handle real-world scenarios more effectively.

Anticipation for Future Tools

The announcement of a forthcoming "Black Book" focused on Q4 strategies has me eagerly anticipating what Frekey and Pendleton will introduce next. Their commitment to expanding the Medical Sales Planner series, along with the planned digital solutions, speaks volumes about their dedication to supporting the medical sales community.

Closing Thoughts

Frekey and Pendleton have once again demonstrated their deep understanding of the sales field with BIG RED. Their ability to provide practical, real-world tools that cater to the nuanced needs of sales reps is unmatched. I am not only a user of their products but a staunch advocate for the value they bring to the medical sales industry.

For fellow professionals in medical device and pharmaceutical sales, "BIG RED: 'My Bag' Clinical Organizer" is not just a planner—it's a game-changer. It's a tool that enriches your understanding, sharpens your strategy, and ultimately, enhances your execution. I highly recommend incorporating it into your daily workflow and keeping an eye on what these innovative creators will offer next.

Nostalgia and Iron: A Glimpse into Gym Culture from the Late '90s

I’m thrilled to share the latest comic panel from “The Unusual Side Effects.” This piece is inspired by my days as a college student training and competing in powerlifting in the late 1990s, a time when gym culture was distinctly different from today.

Back then, locally owned gyms were the heart of the community, each with its own cast of reliable characters. These gyms were more than just places to work out; they were social hubs where friendships were forged and stories were shared. The atmosphere was a mix of camaraderie, competition, and mutual support, creating a unique environment that many fondly remember.

The late '90s gym scene was steeped in a rich history that dates back to the golden age of bodybuilding in the 1970s. It was an era brought to life by the legendary Arnold Schwarzenegger and immortalized in the documentary "Pumping Iron." This film, along with Schwarzenegger’s rising fame, cast a spotlight on bodybuilding and transformed the perception of gym culture, making it an integral part of popular culture.

By the 1980s, the fitness boom had taken hold. Jane Fonda’s workout videos revolutionized aerobics, while the "Rocky" films with Sylvester Stallone’s intense training montages inspired a generation to embrace weightlifting. The gyms of the '80s evolved, incorporating group fitness classes and a broader range of equipment, but they remained primarily places for serious lifters and fitness enthusiasts.

Fast forward to the 1990s, and the landscape had shifted yet again. Advances in fitness technology brought new machines and training techniques, but the heart of gym culture still beat strongest in the small, privately-owned gyms. These local establishments were often filled with the echoes of clanking iron and the hum of camaraderie. They were places where everyone knew your name and your max bench press.

One such character who embodied this culture was the mid to late 40s weightlifter who showed up every Wednesday—universally known as chest day. He'd load the bench with 315 pounds (three 45 lb plates on each side plus the 45 lb bar), following proper powerlifting protocol with the inside weights facing inward and the two outer plates facing outward.

Interestingly, you’d never actually see him work out. Instead, he’d stand next to his weights, one leg on the bench, arm on the bar, always looking like he was between sets. Despite his lack of actual lifting, he was well-liked at the gym, a sort of big uncle figure who came to chat with other members between their sets.

For him, it wasn’t about the workout. It was about 60 to 90 minutes each Wednesday, reliving his younger lifting days while enjoying good conversation with friends at the gym. This memory encapsulates the unique culture of those days, where the gym was more than a place to lift weights—it was a social hub for camaraderie and connection.

In this comic panel, I aimed to capture the spirit of this era, highlighting the sense of community and the unique personalities that made the gym a special place. This piece serves as a nostalgic tribute to a time when gyms were bustling social centers, bringing together people from all walks of life to share in the joys of fitness and friendship.

From the days of "Pumping Iron" to the aerobics craze of the '80s, and finally to the powerlifting and bodybuilding culture of the '90s, gyms have always been more than just places to get fit. They have been communities where stories were shared, friendships were forged, and iron was the common thread that united everyone. This comic is a celebration of that timeless spirit, a nod to the characters and the culture that made those days so memorable.

Your Voice in Healthcare: Connect with Pulse on Devices

I am always on the lookout for the next big story in medtech and healthcare. If you're a leader in these fields with insights on technology advancements, inspiring stories, or suggestions for future features, I'd love to hear from you! Reach out to me through LinkedIn or email me at mjbrowers@gmail.com to share your ideas and be a part of our dynamic newsletter. Let's collaborate to keep our community informed and at the forefront of innovation.