Sacred Cows in Orthopedics |

Sacred Cows in Orthopedics

“Sacred Cow” is a firmly held belief that is rarely questioned and is exempt from criticism or opposition in an industry.  Every industry has its “Sacred Cows”. 

Sacred Cows create blind spots that can kill companies.


Example: In the photography world, we all watched the market leader in photography fall victim to the Sacred Cow mindset.   Kodak had actually invented the first digital camera, but instead of marketing the new technology, they went on defense. They buried digital to protect the lucrative film business, even after digital products were reshaping the market. Kodak declared bankruptcy in 2012.


What happened?


Fundamentally, Kodak just asked the wrong question.  

Management asked “How do we sell more products?”…  instead of “What business are we in?


This is a great history lesson for the leaders in orthopedics today. The big orthos like, Stryker, ZB and DePuy, are not immune to a defensive mindset.

Most big orthos are driven by short-term financials, and thus, are asking the wrong question, “How do we sell more products next quarter?”.


So, what are the Sacred Cows in our industry today?  I see these 7.


#1 – We sell implants, disposable instruments and capital equipment. Our sales and profits come from these tangible products.

Here is the blindspot – Software is becoming the product 


#2 – Implants come in a variety of sizes, shapes, constraints, angles and coatings for best fit and function for the patient. 

Here is the blindspot – The future is moving towards a single printed implant for each patient. 


#3 – Selling biologics products doesn’t require clinical studies or outcomes evidence. 

Here is the blindspot – Biologics companies that provide outcome data will win in the future. 


#4 – A patient is a patient. The diagnosis is the diagnosis. We don’t need to know the patient’s genome to figure out the best treatment for a fusion, a joint replacement or a fixation. 

Here is the blindspot – Genomics is advancing so fast and the price is dropping so fast that future orthopedic patients will receive individual treatments to solve their musculoskeletal problem based on their DNA for best possible outcomes. 


#5 – Total joint replacement is a very successful procedure with excellent longterm outcomes. Just go to any ortho conference and watch the total joint clinical results presented. Dominated by “Good” and “Excellent” results.

Here is the blindspot – In the US, roughly 160,000 out of 1,000,000 yearly total joint surgeries are revisions.  That’s 16% revisions. Plenty of room for improvement.


#6 – Device manufacturers should to follow industry trends in order to be successful. Today the trend is robotic assisted surgery. Get on board.

Here is the blindspot – Some of the biggest wins for ortho companies come from looking beyond the trends. Watch the contrarians.


#7 – Sales reps are the last line of defense to ensure quality in the hospital. Service-based sales reps should be inside the OR during the case to make sure there are no mistakes and to keep the competition away.

Here is the blindspot – Today, service-based reps are getting kicked out of the OR. Tomorrow reps will be replaced with software.   


Did I miss a cow?    email:  tiger@tigerbuford.com