Why Read
Over time in orthopedics, we have all seen the focus shift away from clinical innovation and patient outcomes and towards contractual control and market access barriers.
This has allowed Big Ortho to dominate hospital access through high-volume contracts, GPOs, and VACs.
This "Customer Capture" strategy excludes smaller startups, stifles innovation, and prioritizes cost over advanced care. This article aims to shine light on these "Customer Capture" mechanisms—essential reading for surgeons facing reduced autonomy, patients curious about their implants, industry professionals encountering barriers, or anyone concerned with stagnating medical progress and rising healthcare costs.
The Shift from Clinical Value to Contractual Dominance
Orthopedic sales evolved significantly over time:
2000: Surgeons selected implants, with reps managing logistics.
2015: Hospital reviews became required.
2020: VAC approval was necessary.
2025: Surgeons often lack influence over VACs, sometimes unaware of third-party product decision makers.
This reflects commoditization, where cost prevails over innovation, leading to mediocrity in supply chains.Key drivers include:
Hospital mergers formi...
