The lure of a Monopoly in Orthopedics.

Yes, there are Monopolies in Orthopedics, and they are fantastic!

A few savvy orthopedic companies create a new category or new procedure, that result in zero competition. These are real Monopoly businesses and they typically don’t last long. The copy-cats and fast-followers react, or an acquirer buys them and ruins it.

For your career, you want to find a Monopoly early, join them and ride the wave.

The benefits of working in a Monopoly business.

In a Monopoly business, you will be the only solution in your new category.  

  • Surgeons will seek out and find you (pull versus push).
  • Your Sales/Marketing team will have a tail wind.
  • Distribution partners will beg to carry your product.
  • You will dictate pricing (there Is no comparable) without negotiation. 
  • You will have the leverage in all negotiations.
  • Life is good.

What are some examples of real Monopolies?

  • Kyphon (kyphoplasty)
  • MAKO (MAKOplasty, first useable TJR robot)
  • SpineTech (the first cage)
  • Ellipse Technologies (remote control implants like MAGEC)
  • Active Implants (total meniscus replacement to delay TKA)
  • Trice Medical (dynamic joint diagnosis in Drs office)
  • Active Protective (Tango, smart airbag belt to prevent hip FXs)
  • OrthoSpace (biodegradable balloon protects cuff tears)
  • Treace Medical Concepts (brand monopoly in bunions called Lapiplasty)

These guys literally had ZERO competition in the early years.

You want to build a Monopoly business.
You want to work for a Monopoly.
You want to sell for a Monopoly.

The pain of working in the non-Monopoly businesss

On the pain side are commodity businesses. Today there are around 250 spine startups. Every single week, a spine startup will die or get acquired, then next week a new spine startup one will be born. The majority of these 250 spine companies are selling “me too” spine devices – pedicle screws, cages, rods, cross-links, plates, etc. 

The message here is to avoid commodity markets like “spine hardware” as they have many built-in challenges.

  • Pricing competition
  • Thin implant margins
  • Higher cost of sales
  • No leverage in contract negotiations
  • 10 sales reps calling on the same spine surgeon selling roughly the same products.
  • Life is a grind.

In a commodity business there is simply too much selling friction and too much noise to get attention in the marketplace. Look around at NASS.  You don’t want to play in a market that is super-competitive. It’s like running one of 250 restaurants in your neighborhood.