Never mind wearable technology, how about do-it-yourself implantables?

It’s a big, diverse, weird world out there when it comes to people experimenting on their own bodies. There are subcultures devoted to whole body tattoos and others seemingly dedicated to placing a fantastic array of metal pieces in or through just about every appendage imaginable (and probably a few that I haven’t imagined).

It looks like the latest development is to implant functional “things” inside the body. There’s even a name for it: recreational cybernetics. The article highlights a man who implanted a magnet into a finger. He stated that it gives him a new sense, for example, being able to detect his mobile phone ringing. I bet it’s also handy for picking up small screws and nails when doing home maintenance.

“Grinders, as they call themselves, represent a unique niche of the do-it-yourself (DIY) culture. These are people who experiment on their own bodies, creating their own implants—often for recreation, but also with a true spirit of academic experimentation. The message is clear: Implants are the future, and some people aren’t waiting around for FDA or the medical device industry.”

A few years ago, there was a trend where people had RFID tags embedded under their skin. The tag could be used to “open” an electronic lock using proximity. There were the predictable howls from conspiracy theorists and fundamentalists and the fad seemed to die out. And who can forget the “cyborgs” at various universities who pioneered wearable computers? One cyborg had metal bolts implanted into his skull so he could mount his head-worn display most securely.

I guess the advantages to self-modification are no need for biocompatibility testing, informed consent, IRB approval, HIPAA compliance, regulatory compliance, etc. And who knows? Perhaps there is a new medical device company waiting to be born out of these early experiments.

Read more: On the Grind: The World of Do-It-Yourself Implants | MDDI Medical Device and Diagnostic Industry News Products and Suppliers.

On a related note, there’s a developing niche in assistive devices for the disabled. Looks like The Six Million Dollar Man isn’t just a character in a cheesy ’70s TV action show anymore.

“Bionic prostheses, which use electronics to restore biological functions that have been lost or compromised, are among the most exciting medical devices. Thanks to bionics, babies born deaf can hear, people who have lost their sight can see, people living with paralysis can walk, lower-limb amputees can run, and upper-limb amputees can type on a keyboard. Bionic medical devices make occurrences once considered miracles happen every day.”

While not truly bionic (not electrically powered), Seattle’s own Cadence Biomedical and its Kickstart Walking System is an example of innovative technology benefiting patients who may have been dreading being confined to a wheelchair.

The article makes the point that it’s tough to succeed as a business in this segment. Patient populations are relatively small. VC investment is difficult to obtain (not that it’s easy anywhere these days…). Finally, obtaining reasonable reimbursement can be challenging and a long-term process.

One company found a way around the challenges through market diversification. They are marketing their bionic walking suit for lower limb paraplegics to the military as an exoskeleton to give infantry soldiers extra-human abilities. Another example of science fiction blurring into reality!

Takeaways: Pay attention to early trends where technology is used in innovative, perhaps unsettling ways. It could be the start of a new industry! Also, don’t be reluctant to find alternative uses, markets, or niches for your technology. The Prime Directive is for your startup to survive long enough to become a going concern.

Read more:Bionic Medical Devices: What’s Holding Them Back? | MDDI Medical Device and Diagnostic Industry News Products and Suppliers.

Sales reps not included: On e-commerce site, device firms discount routinely used implants | MedCity News

This story is another good example of how the Internet helps create a new business model and saves money. I call it the selective democratization of information along with decoupling products and services.

The basic premise is that commodity products, e.g., screws, anchors, etc. should not require much, if any, sales/technical support. And sales support can be very costly in medical devices. Think of a rep making mid-six figures and spending a half day in a hospital surgery suite.

For those customers that do want that support and are willing to pay for it, the device company charges list price. For everyone else, MedPassage provides a virtual market for a cut of the action. The device companies can also control which customers have access to the MedPassage marketplace. Device companies cannot see each others’ prices or transactions.

Everyone wins. The device companies sell more products, the hospitals save money, and MedPassage sells an innovative, profitable service.

Takeaway: If you are on the commercial side of a medical device business, don’t accept the status quo when it comes to distribution and sales. You can differentiate your offering with value-added or value-subtracted services.

Read more: Sales reps not included: On e-commerce site, device firms discount routinely used implants | MedCity News.

Healthcare Social Media Efforts of Medtech Firms Deserve an “F” [? No!] | MDDI Medical Device and Diagnostic Industry News

I disagree with the basic premise of this article. The medical device marketers I know and have managed are extremely media-savvy. They “get” social media and use it personally. What they don’t see or get is any return on investment in social media for their hard-won device marketing budgets.

And these days, if you can’t measure it, it isn’t worth doing.

Yes, there are a few examples like Biomet Orthopedics where a direct-to-consumer (DTC) advertising model was innovative and made some sense. Unfortunately, even Mary Lou Retton’s endorsement could not prevent the recalls, class-action lawsuits, and negative publicity that followed deployment of a flawed product. In most cases, however, the typical patient/consumer doesn’t know and doesn’t care much about the brand of device being employed or implanted, etc. Further, in my experience, the physician or surgeon would not be amused or grateful to get this sort of “assistance”. The docs have their preferences and are reluctant to change, to put it mildly.

Yes, the pharmaceutical industry has had a disruptive effect over the past twenty years with direct-to-consumer marketing. Drugs are very different from medical devices, however. Patients can learn about their medical condition online and compare drugs for effects and side effects and then make a “request” to their doctor. The doctor can then grant the request, deny it (perhaps driving the patient to a different physician), or agree to a trial of the new medication.

Because drugs work (or don’t) over a period of time, there is an opportunity to evaluate one or more brands. The acute nature of device use/therapy means that there is typically only one chance for evaluation, raising the stakes and minimizing the incremental benefits of one brand over another.

I think it’s absurd that a typical patient can self-educate using online resources and become more knowledgeable than his/her physician or surgeon about a highly specialized piece of medical equipment and the procedure in which the device is used. And just because a pacemaker gets 1,000 likes on Facebook or 10,000 retweets doesn’t mean it’s right for you.

Is there a place for DTC in medical devices? Certainly, if it is used for education, as in informing patients about new procedures, directing them to patient-oriented consumer web resources, referring them to physicians experienced with the new procedure, and only indirectly reinforcing the device brand.

Takeaway: Medical device marketers have limited budgets, especially compared to drug marketers. They need to focus with laser-like precision on creating awareness and leads among their target market, healthcare professionals.

Read more: Healthcare Social Media Efforts of Medtech Firms Deserve an “F” | MDDI Medical Device and Diagnostic Industry News Products and Suppliers.

Large Device Firms Working More With Startups Than Before But Want Some Rights In Exchange | MDDI Medical Device and Diagnostic Industry News

This can be welcome news for medical device startups. We frequently read and hear and get advice about the importance of partnering. Given the difficulty in creating an IPO and becoming a publicly traded company for most medical device startups, the other option for an exit strategy has been acquisition by one of the large multinational device companies, e.g., Johnson & Johnson, Medtronic, Covidien, Abbott, et al.

“Some rights” essentially translates to being able to buy the startup at a future date once they invest in it.

“Corporates increasingly want some rights,” Nielsen said. “Historically the data shows that the ultimate buyer of a company may not be who the strategic investor had been.”

While in my experience it’s been relatively easy to create a “relationship” with a venture or business development exec or group in a large device company, it’s much tougher to get any sort of financial commitment. After all, they want to keep up with new developments and innovations in their markets. If they can get that for free, why not use that approach?

I’m not sure what’s changed recently. Perhaps there is more competition among the large device companies for the few good opportunities out there. Certainly there is less innovative development taking place at the large device companies, which appear to be using startups as a primary source of low risk R&D.

In any event, an option to be purchased can be a huge credibility advantage for a medical device startup in terms of attracting angel investors, clinical luminaries, and employees.

Read more: Large Device Firms Working More With Startups Than Before But Want Some Rights In Exchange | MDDI Medical Device and Diagnostic Industry News Products and Suppliers.

Texas Medtech Executive Admits to Cheating Shareholders Out of $400M | MDDI Medical Device and Diagnostic Industry News

Wow. The headline is a bit misleading, though. The ArthroCare exec, John Raffle, “hid” unsold inventory at a distributor while the company claimed credit for revenues and shipments in order to meet or exceed quarterly revenue and earnings targets. This was a not uncommon practice in the ’80s and ’90s and a number of medical device executives got into similar legal trouble back then. The $400 million is the amount that ArthroCare’s stock dropped in total market capitalization once the news broke. Looks like the ex-CEO and ex-CFO were in on the scam as well as they were recently indicted.

They almost got away with it.The execs acquired the distributor to hide their nefarious deeds but a subsequent internal audit revealed abnormalities and the auditors blew the whistle.

The market is a cruel and unforgiving mistress…

Raffle faces a maximum prison time of five years for his guilty plea.

Read more: Texas Medtech Executive Admits to Cheating Shareholders Out of $400M | MDDI Medical Device and Diagnostic Industry News Products and Suppliers.

Marketing a product to physicians? Think education and email | MedCity News

This survey is validation of what most of us realize intuitively. Many (most?) physicians don’t want (or can’t afford) to spend precious time during the day in a one-on-one interaction with a sales rep or telemarketer. While they say they want to be kept informed about new products and market developments, they prefer to receive that information offline, via email or actual mail.

Of course, receiving the information, reading it, and acting upon it are very different things. As a medical device marketer, how do you break through all of the clutter? As a medical device sales rep, how do you keep your interactions welcome (= infrequent) and still get what you need (= orders)?

For marketers, this is a perfect opportunity for testing. You should be trying different approaches in small tests and then scaling up the one or two approaches that work the best.

For sales people, it’s all about positioning yourself as a problem-solver and a person with recognizable expertise in your market category. Those sorts of relationships and reputations take time to build, so think twice about going for the quick and easy sale if it might cause a negative reaction.

Interestingly, the type of information physicians wanted least was panel and study recruitment and invitations to events and webcasts while the information they wanted the most was sponsored CME credits and also disease information and patient education materials.

The digital information revolution hasn’t reached the doctor-patient relationship quite yet. Marketers must keep this in mind as they develop and deploy more online resources.

“[The] content must be flexible though, as most said they communicate with patients mostly in traditional ways rather than through email. A white paper put together by PharmaLeaders using the data suggests that the best marketing materials will be sent to a physician in a way that’s easy to translate to the patient in person or over the phone.”

Read more: Marketing a product to physicians? Think education and email | MedCity News.

How Do You Design a Medical Gadget That Costs 95 Percent Less Than Before? | Wired Design | Wired.com

It’s relatively easy. Just put off compliance with regulatory requirements, adherence to a quality system, leave out nice-to-have product features, and omit the infrastructure for customer support, sales, training, etc.

I admire what this inventor is doing. He’s trying to meet an important need for an endoscope in developing countries. I don’t believe, however, that it can be considered the same product as commercially available endoscopes sold in the USA, EU, and other developed countries. In that respect, the Wired headline is misleading.

This innovation has the potential to have a large beneficial effect on public health in developing nations. It will be interesting to see if this design shift becomes “disruptive” technology and challenges the market in developed countries.

“Traditional endoscopes cost anywhere from $30,000-70,000, but by making different design choices and cutting out extraneous “nice-to-have” features, the price can be reduced dramatically. The EvoTech team found that off-the-shelf camera modules, only slightly better than the ones used in smartphones, could provide pictures crisp enough to meet clinical standards for just a couple hundred dollars. “The EvoCam is basically a webcam you put in your body.” says Zilversmit. Most endoscopes come with dedicated computers and complex image processing hardware. The EvoCam replaces all those expensive extras with software running on a standard laptop, using solar power if necessary, and soon hopes to have a version for tablet. Instead of sending a team of technicians to train doctors, EvoTech distributes training documents and video over the web.”

Read more: How Do You Design a Medical Gadget That Costs 95 Percent Less Than Before? | Wired Design | Wired.com.