But other orthopedists, disgruntled by the pricing, simply found a way to reap more of the profit themselves. A number of group practices formed physician-owned distributors (PODs), a new type of company to cut out the layers of middlemen. Then they bought implants and resold them to the hospitals and surgery centers where they practiced, where they installed them in patients for twice as much, yielding a hefty, predictable profit. An active practice of orthopedic surgeons could do $4 million to $5 million in implant sales a year.
