3 ms·

Ok. I am very familiar with the medical device industry, and how they are used in healthcare. I am not familiar with food services equipment. What I’m having

by ska 3y ago

Ok. I am very familiar with the medical device industry, and how they are used in healthcare. I am not familiar with food services equipment. What I’m having trouble with is seeing a parallel with the franchisees position in this story, in medical devices. If you’ve seen something you think is equivalent , I’d be interested in hearing about it , but it just doesn’t match my experience. From and engineering and prod dev point of view I can see some parallels, fwiw. That is pretty obvious .

iancmceachern 3y ago
A good parallel in medical devices is dialysis. The dialysis industry is dominated by 2-3 large players who dominate the market, reimbursements, everything. They are Da Vita, Fresenious and I think there is a smaller third one. Dialysis machines are very similar in practice to ice cream machines. They have peristaltic (and other) pumps inside with wearable parts that need to be replaced on regular intervals for not only reliability and safety concerns, but for biological concerns. Bugs grow inside them, even though thy have a daily self sterilization cycle they run. So they need to do preventative maintenance every few months and change out plastic wear parts inside like pump heads, seals, valve seats, etc. Keep in mind these machines are used constantly, these companies view an empty seat at a dialysis center like lost revenue, so they do there best to keep the machines busy. Da Vita buys Gambro Dialysis machines, Fresenious makes their own. In both these cases there is a huge volume of disposables and accessories that go with these machines, both the daily disposables but the PM stuff too. Lots of these dialysis centers do things to improve their bottom line that is off label. They do things like washing and reusing dialyzers which are explicitly single use. They do so with other stuff also. Some newer systems are starting to use different techniques to not allow this, not allow these kinds of practices. This isn't just dialysis. So many medical products have the classic razor/razor blade model and they typically actively design in proprietary lock in features so as not to loose out on that precious razor blade revenue.
- ska 3y ago
  Ah, I think I see where we diverged. You were focused narrowly on the technology, I was focussed on the broader situation, where I don't see the equivalent of the franchise owner or the ice cream consumer in your dialysis example; if nothing else unlike the ice cream machines the dialysis units mostly function well for reasons related to how the two situations differ. There is some tech parallel I agree in e.g. protecting consumables , but that’s an aside in this context , and largely symptomatic if the way health care is paid for in US that drives towards a razor:razor blade model. Anyway that was a long walk for a short drink of water!

by ska 3y ago

iancmceachern 3y ago

A good parallel in medical devices is dialysis. The dialysis industry is dominated by 2-3 large players who dominate the market, reimbursements, everything. They are Da Vita, Fresenious and I think there is a smaller third one. Dialysis machines are very similar in practice to ice cream machines. They have peristaltic (and other) pumps inside with wearable parts that need to be replaced on regular intervals for not only reliability and safety concerns, but for biological concerns. Bugs grow inside them, even though thy have a daily self sterilization cycle they run. So they need to do preventative maintenance every few months and change out plastic wear parts inside like pump heads, seals, valve seats, etc. Keep in mind these machines are used constantly, these companies view an empty seat at a dialysis center like lost revenue, so they do there best to keep the machines busy. Da Vita buys Gambro Dialysis machines, Fresenious makes their own. In both these cases there is a huge volume of disposables and accessories that go with these machines, both the daily disposables but the PM stuff too. Lots of these dialysis centers do things to improve their bottom line that is off label. They do things like washing and reusing dialyzers which are explicitly single use. They do so with other stuff also. Some newer systems are starting to use different techniques to not allow this, not allow these kinds of practices. This isn't just dialysis. So many medical products have the classic razor/razor blade model and they typically actively design in proprietary lock in features so as not to loose out on that precious razor blade revenue.

ska 3y ago
Ah, I think I see where we diverged. You were focused narrowly on the technology, I was focussed on the broader situation, where I don't see the equivalent of the franchise owner or the ice cream consumer in your dialysis example; if nothing else unlike the ice cream machines the dialysis units mostly function well for reasons related to how the two situations differ. There is some tech parallel I agree in e.g. protecting consumables , but that’s an aside in this context , and largely symptomatic if the way health care is paid for in US that drives towards a razor:razor blade model. Anyway that was a long walk for a short drink of water!