August 25, 2016
“….a talk by Dr. Raymond Kim in which he said he applied a tourniquet to his own leg to see what it was like and he found he could not stand the intense pain for more than 10 minutes and had to release it at that point. He also found that he could barely negotiate stairs the next day!”
By Bob Bruce, VP, Global Sales & Marketing
As we noted in the last Kinamed Newsletter, CarboJet sales have been growing nicely and we have had a significant increase in inquiries lately from hospitals and surgeons via our website and by phone, asking to be set up with surgical evaluations for CarboJet. We think some of this interest is due to the movement to tourniquet-free knee replacement. We also think that, in turn, a big driver of the tourniquet-free approach to knees is the “episode of care, bundled payment” mandate that has been applied to a major chunk of the US orthopedic market as of April 1st of this year!
‘Bundled payments’ is an interesting topic in itself as it is probably the most profound change agent acting on the orthopedic device market in decades. In any case, it’s important to understand these dynamics driving CarboJet sales because selling CarboJet provides you, the sales rep, with steady, low-maintenance income while potentially broadening your footprint in your territory in ways that can help you sell more of the other products in your bag. Kinamed has individual sales reps who have managed to amass a portfolio of more than 20 accounts, using CarboJet on almost a daily basis, providing them a significant stream of income that does not tie them down while they pursue other opportunities.
Kevin Hughes, our Eastern Regional Sales Manager, attended an ICJR meeting in Charleston and heard a talk by Dr. Raymond Kim in which he said he applied a tourniquet to his own leg to see what it was like and he found he could not stand the intense pain for more than 10 minutes and had to release it at that point. He also found that he could barely negotiate stairs the next day! Dr. Dickey Jones and others have also spoken out about the many other negative medical sequelae caused by tourniquet use – many of these potentially adversely affecting recovery and rehab.
In the Bundled Payment system the hospital is financially responsible for the cost of all care, including post-operative care, during the 90-day episode of care period. A patient satisfaction metric is also factored into the financial equation. Surgeons typically have an opportunity to share in episode of care cost savings. Given the motivations built into this new payment system, it is not at all surprising that both surgeons and hospitals are interested in taking a hard look at tourniquet-free knees as a way to reduce post-op complications, speed recovery and reduce pain. Speaking of post-op pain, surgeons are also very concerned about minimizing opioid use and its attendant risks. If one is interested in reducing post-op pain and minimizing opioid use, the tourniquet is not your friend.
The bottom line for hospitals (literally) is that they need to be very concerned with minimizing the cost of the treatment throughout the 90-day period, and they need to be very concerned that their patients report having a good experience with their knee or hip replacement process!
Because of all these factors it seems more and more surgeons are trying tourniquet-free knee replacement. When doing tourniquet-free-knees, it’s almost essential to utilize CarboJet to manage the extra bleeding that typically occurs. This creates a situation in which you may be able to get the hospital on-board, so that instead of fighting you on cost, they see CarboJet as a tool that can reduce total treatment costs. Even if the hospital is not in an Episode of Care geography currently, the hospital may understand that, since the surgeon is making a fundamental change to his operative procedure, a new product may need to be added to facilitate this change.
As always, when selling CarboJet, you should continue to promote the increased cement penetration benefit – explaining how this will increase implant longevity. The deeper the cement penetration, the longer it will take for the bone to resorb out of the cement mantle (see the 2013 Miller paper, linked here). Also promote CarboJet’s visible inter-operative removal of fat. This increases protection against significant cardiovascular disasters that can result in return trips to the hospital and/or operating room.
Using CarboJet in UKA continues to be a great way to get your foot in the door at new accounts. Let us know how we can assist you with any of these strategies so you can grow your CarboJet account portfolio!
Good Selling!
Bob Bruce
VP, Global Sales & Marketing