Trilogy Tidings
November 2008
in this issue
     Well, I thought we had put to bed the "demise of the medical device industry" last month.  Not so fast!  The issue has raised its ugly head again recently by way of comments made by a senior industry exec.  I address those comments and their interpretation by many below.
     Coincidentally (I suppose), we have the much broader and much more significant issue of justifiable malaise in the 'ole USA.  (Remember Mr. Jimmy Carter in the 1970s?  Multiply that by four.)  I discovered some very encouraging perspectives on that topic that I'm delighted to share with you.
     Finally, I'll not say a word about our recently concluded elections.  You have surely heard enough about those already.  Time to govern and manage.


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Are Medical Devices "Finished"? 

Gene TherapyA recent keynote talk by Dr. Stephen Oesterle, Medtronic's Senior VP for Medicine and Technology, presented to the Center for Integration of Medicine and Innovative Technology (CIMIT) group in Boston has created quite a firestorm of controversy.  Referring to his own medical device industry, Oesterle reportedly said: "When biotechnology gets it right, we're finished.  Because it's restorative, not palliative as devices are."  Then he followed up with: "It's done.  Devices ultimately are done."  Interesting comments from a device industry executive!
     A report on this talk appearing in the Wall Street Journal's blog is worth reading in its entirety, along with a multitude of comments posted thereafter.  See the report by Keith J. Winstein and reader comments here.
     A few readers agreed with Dr. Oesterle, but most were critical - a few in the extreme - including Medtronic shareholders.  In my view the most rational comments were made by Dr. John Parrish, Executive Director of CIMIT, who bemoaned the reporter's shortchanging of context, and my colleague Ed Berger, who (wisely) mimicked my own views on the subject.
     Read the exchanges and judge for yourself.  But here's my take:
  1. There will always be a need for medical devices of many varieties.  If you make your living in the industry, fear not!  Today's medical devices, or something akin to them, will be essential to the practice of medicine for a very long time.
  2. Biologics, tissue engineering, gene therapy, translational medicine - add whatever buzzwords de jour you wish - hold great potential as real, life-altering therapies and preventatives.  But their application to human medicine is a long way off, probably decades to generations.
  3. Recognize both realities.  Work diligently on today's devices, which will certainly continue to enjoy clinical and commercial success.  Work diligently to support and conduct research on future technologies.  And - here's the important part - recognize the differences in content, time scale, and risk between these two worlds.  There's just no need for excessive optimism or pessimism about either track.  Just continue to create better, more cost-efficient medicine in whatever world you work.  You will prosper today, and you will prosper tomorrow, in proportion to the effectiveness of your efforts.

Thoughts to share?
Is America Down for the Count?
Pessimism/OptimismAlong similar, albeit clearly more important, lines some - perhaps many - are now wondering just how much trouble the U.S. is in.  Are we done as the preeminent world-leading nation?  Should we all pack it in and retreat to our caves?  (You do have your cave furnished, right?)
Fear not.  The answer is no!  I was really encouraged by an article published by Victor Davis Hanson that clarified the issues for me in a way I've not seen before.  I urge you to read this brief article.
     Politically, Hanson leans pretty hard to the right - not that there's anything wrong with that - but this piece is really apolitical and probably largely factual. He makes four points supporting an optimistic attitude:
  • Oil prices are crashing.  That's good for us.
  • Our debt problem pales in comparison to the financial crises in Europe, China and Russia.
  • The U.S. population continues to grow and age less rapidly than the populations of Europe, Japan, China and Russia.
  • The war in Iraq is no longer a war in the traditional sense.  It's quickly becoming less deadly and less expensive.
(Apologies to my non-U.S. colleagues and clients.  You have to endure a little nationalism from time to time.)
     Now, there is sure as hell plenty to complain about our American economy and political system today.  But it's good to hear Hanson's encouraging words.  Batten down the hatches; we're in for an interesting, bumpy ride!
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ContactInfoJoseph J. Kalinowski, Principal