SPINAL COLUMN August 11, 2006 Volume 1, Issue 6

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1 THE In This Issue: Surgical Skills Education Update... 1 Ambassador s Corner... 6 Meetings & Events Schedule... 6 SPINAL COLUMN August 11, 2006 Volume 1, Issue 6 Excellence in Spinal Technology SURGICAL SKILLS EDUCATION UPDATE Stevens Institute Workshop: Great Success! The Stevens Institute Workshop on May 20 th was a huge success. The workshop featured two seasoned surgeon faculty members, Dr. Patrick O Leary and Dr. Federico Girardi; a group of residents, fellows and attending surgeons from the Hospital for Special Surgery; the local distributor, Apex Medical; as well as Jim Leible, Northeast District Manager, who supported the production. May 20 th Workshop Increased Sales $37,000 in First Month The attendees, under the direction of Drs. O Leary and Girardi, found the lab experience to be very engaging. They were so totally engrossed and focused on the surgical skills and techniques that even after the allotted time expired, the surgeons continued for more than an additional hour. Even more impressive, June cases increased dramatically and boosted sales by $37,000. The Alphatec Sponsored Workshop: We Create the Agenda The primary benefit of conducting our own workshops is that our products are featured exclusively. In addition, we can select faculty, write our own agenda, and target surgeons to invite. This enables us to tailor clinical education to directly drive sales in specific institutions, geographic areas, or aim it at supporting key product May 2006 June 2006 Alphatec Avg. # of Cases per Month Alphatec. Avg. $5,000 $42,000 Monthly Revenue Four HSS Surgeon Attendees lines/launches. Another benefit of holding our own courses is that it gives us an unadulterated license to combine sales training as an adjunct to the surgeon program. A total of four workshops are to be held at the Stevens Institute this year. The next workshop is scheduled for July 22 nd and will focus on anterior cervical. The concept for this workshop series developed as a result of Dr. O Leary s VIP visit to the Alphatec headquarters in Carlsbad with Jim Leible. He met with Marilyn Mantle to discuss his interest in clinical education. This discussion eventually resulted in an agreement with Dr. O Leary to act as course director for a series of four courses at the Stevens Institute of Technology in Hoboken, New Jersey.

2 The Spinal Column 2 ALPHATEC SPONSORED WORKSHOPS Name of Course Where When Course Director Posterior Cervical Fixation Stevens Institute of Technology, Hoboken, NJ May 20 Patrick F. O Leary, M.D., F.A.C.S., P.C., Hospital for Special Surgery Course Director, Dr. Patrick O Leary & Featured Faculty Presenter, Dr. Federico Girardi at the Stevens Institute of Technology in Hoboken, New Jersey Anterior Cervical Stevens Institute of Technology, Hoboken, NJ July 22 Patrick F. O Leary, M.D., F.A.C.S., P.C., Hospital for Special Surgery Excellent outcome enhanced by support of James Leible, Northeast District Manager, and local distribution team, Apex Medical Alphatec Will Sponsor Workshops Through CORE at Scripps Encinitas, CA CORE Orthopaedic Medical Center has been providing a broad spectrum of operative and nonoperative treatment for orthopaedic injuries and disorders since 1978 in North County (San Diego) Community. Early in 2004, CORE moved into facilities on the Scripps Memorial Hospital campus in Encinitas, well known for providing advanced orthopaedic surgery and physical rehabilitation. $180 million CORE facility expansion and renovations progressed in phases: 1) Physical Therapy and Clinical Research areas opened May 2004; 2) Clinical Private Practice area was completed in May 2005; 3) MRI and Advanced Diagnostics area was completed in March Currently, the final phase is Up to 24 times per year, we can provide surgical education programs. underway: the Physician and Patient Teaching Center. In Fall of 2005, Alphatec Spine signed an agreement to sponsor development of this Learning Center which includes a state-of-the-art cadaver operating theater, dry lab and didactic session room. We are very enthusiastic about the opportunities this Learning Center will provide within 10 miles of our corporate headquarters. Up to 24 times per year, we can provide surgical education programs. The complexities of the agreements between CORE and Scripps Health have just one more hurdle to clear before the final build-out can proceed. Once given the green light, the Learning Center can be ready within three months, according to Tom Dawson, Chief Executive Officer of CORE Orthopaedic Medical Center. This will be the keystone to our Clinical Education program.

3 The Spinal Column 3 commented Marilyn Mantle, Director of Clinical Education. Artist s rendering of the CORE state-of-the-art cadaver operating theater, dry lab and didactic session room. In this scenario, the vendors role is to provide loaner instrument trays, an unrestricted educational grant and technical/sales support to staff lab. It s a cost effective opportunity to support clinical technique education without shouldering all the logistical legwork, said Marilyn. And, of course, it is vital that Alphatec gets to showcase product there right along side all the big players such as Synthes, DePuy Spine, Medtronic, etc. [Workshops are] a cost effective opportunity to support clinical technique education without shouldering all the logistical legwork. Artist s rendering of the CORE Orthopaedic Classroom. The large screens at the front of the classroom can teleconference live surgeries from the operating room at Scripps Memorial Hospital Encinitas. Workshops = Win-Win Opportunity Alphatec has participated in a number of surgical skills workshops this year providing clinical medicine education to surgeons. Those organized by professional groups are multi-vendor sponsored (while those organized by Alphatec are workshops exclusively focused on Alphatec products). Surgical skills workshops proliferate primarily because they are an opportunity for surgeons to receive advanced cadaver training on surgical techniques. It is also an opportunity to become familiar with instrumentation. These courses offer unique marketing opportunities for Alphatec. Typically, an organization like Practical Anatomy & Surgical Education (PAWS) designs a workshop with specific educational objectives such as spinal decompression and fixation. The meeting organizer performs all the pain-staking coordination of securing faculty, a lecture room, a cadaver lab, lab equipment, and specimen scrubs...all the way down to the coffee and donuts. It s labor-intensive like running a miniuniversity for just two days, Small Group Lab Setting Provides Unique Advantage The lab environment is an ideal setting for representatives to interact one-on-one with the surgeon faculty and the surgeon workshop attendees. In order to give each student-surgeon adequate time to get hands-on experience on the cadaver, there are only two studentsurgeons per workstation under the direction of one or two facultysurgeons. For example, in Bethesda, the student to teacher ratio was quite high with 21 facultysurgeon presenters and lab station instructors to 27 surgeon attendees. And, typically, only one vendor per

4 The Spinal Column 4 ALPHATEC AT CME ACCREDITED SURGEON WORKSHOPS Name of Course Where When Presented By Advanced Techniques in Cervical Spine Decompression & Stabilization St. Louis University, April 7-8 Sept. 8-9 Practical Anatomy & Surgical Education of St. Louis University Spinal Decompression & Fixation St. Louis University, May 5-7 Nov Practical Anatomy & Surgical Education of St. Louis University Spine Study Group 2006 Palm Beach, FL May Spine Study Group Symposium 18 th Annual International Bethesda Spine Workshop Bethesda Naval Base, Bethesda, MD Cervical Course June 2-3 Thoraco- Lumbar Course June 4-6 Uniformed Services University of The Health Sciences, Bethesda, Maryland Walter Reed Army Medical Center, Washington, DC National Navel Medical Center, Bethesda, Maryland workstation. Throughout the time period, there are sufficiently long periods of lab time for reps to interact closely with surgeons to build rapport, demonstrate trays, gain information on design improvements, etc. There are sufficiently long periods of lab time for reps to interact closely with surgeons to build rapport.... Marilyn remarked, The surgeon attendees really get a lot of clinical value from the workshop. Not only do they hear a recap and review of each technique in lecture by esteemed surgeon experts, they then move into the lab for a demo and opportunity to participate handson under faculty guidance. Even in strong fellowship and residents programs at teaching institutions, cadaver work time is at a premium and may be limited to one hour time blocks, sandwiched among pressure-scheduling of other patient-care responsibilities. Focusing on two-three hours in a cadaver lab is a much appreciated learning opportunity. The Surgeon Faculty Is Also A Captive Audience Almost more important than marketing to attendees, is marketing to the surgeon faculty. The faculty members, assigned to a particular workstation by the course director, stay at that workstation while the surgeon attendees are encouraged to move from station to station to work with each vendor s products. Because the faculty members demonstrate and instruct the techniques being studied, they are already very comfortable at them. This provides Alphatec with an ideal opportunity to show (often introduce) all our products and let them know what differentiates us from what they are currently using. Moreover, the surgeon faculty are often key opinion leaders so making a good impression with them will go a long way. In Bethesda, we showed Solanas, Reveal, Zodiac Degenerative and Deformity, Novel LCC & ACC and Tamarack sets. The faculty members commented that they liked Alphatec products, several had not yet worked with them before. Taking note this was Alphatec s first time as a sponsor of this course, many faculty made a special point of thanking us for our participation.

5 The Spinal Column 5 information. You can readily observe competitor systems in action; conduct informal discussions with competitive reps on current and future product lines; and you can engage surgeons in informal comparisons/evaluations of our products. You Can Help With Future Plans for Regional Training Alphatec Spine s goal is to have a training site within each of the four regions. Marilyn is currently identifying suitable training facilities within each region. If you have a facility to recommend as a great training site, please let Marilyn know. Outstanding Clinical Education Opportunity for Alphatec Staff Alphatec representatives covering this meeting have the unique opportunity to learn side by side, in didactic sessions as well as cadaver labs, with surgeons in a relaxed and collegial atmosphere. Each morning and afternoon of the workshop, the invited faculty lecture on current clinical outcomes and techniques for the lab that will follow the lecture. As a courtesy, if space allows, the vendors can sit in on the lectures. The lectures do not favor any one vendor, but are objective, balanced and scientifically rigorous. They have educational objectives that are not focused on any particular vendor s implants, but are focused on the technology and cover anatomy and biomechanics, clinical studies and the current techniques and approaches to pathology. Also of tremendous value are the Q & A and comments from other faculty members or attendees. In Bethesda, some lab instructors were able to use portions of lab time for instrument demonstrations. At the Synthes station, for example, faculty delivered several short infomercials directly for the benefit of approximately ten of their reps in the lab. Build Loyalty With Alphatec Surgeon Customers It can also be a strategic advantage in some cases for Alphatec to get our surgeon customers involved in the workshops as guest faculty in the cadaver lab. This is an excellent opportunity to increase the surgeons corporate loyalty, along with building positive surgeon to surgeon public relations and marketing of Alphatec. In Bethesda, Alphatec sponsored Dr. Paul Asdourian and Dr. Ron Childs as guest faculty in the lab. They instructed at sessions using Reveal, Zodiac Degenerative and Deformity. In an impromptu development, Dr. Asdourian offered to proctor attendee, Dr. Pozzi, in a surgical technique post course. Lastly, There Is Competitive Reconnaissance In the workshop environment, you don t need to be suited up in your super hero garb with your x-ray vision glasses to obtain competitive

6 The Spinal Column 6 mbassador s Corner Upcoming Surgeon VIP Visits: Date Surgeon Host July 21 Dr. Ajay Ananda Robby Anderson July 28 Dr. John White Jenny Hayes Aug. 4 Dr. Larry Khoo Robby Anderson MEETING AND EVENTS SCHEDULE Sept. 8-9 PAWS 13 th Advanced Techniques in Cervical Spine Decompression & Stabilization St. Louis University Sept Scoliosis Research Society (SRS) Meeting Marriott Monterey Monterey, CA Sept NASS Annual Meeting Washington Convention Center Seattle, WA Oct Congress of Neurological Surgeons (CNS) McCormick Place Convention Center Chicago, IL Nov PAWS Current and Emerging Issues in Complex Lumbar Surgery St. Louis University Nov. 30- Dec. 2 Cervical Spine Research Society (CSRS) The Breakers Palm Beach, FL In Seattle, Washington, please visit us at NASS Booth #1816 from September 26-30