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Before a routine surgery begins, someone has already done a lot of work. They've pulled items from different shelves, checked that nothing is missing, opened what's needed and put back what isn't. On a busy day, they'll do it all again for the next patient. You run the procedure, and we won't tell you how to do that. We know supply, so this is about what happens before you pick up an instrument. Where the cost really sits The price on an invoice is only part of what surgical setup costs a clinic …

A clinic in Western Canada lost a product they relied on when it was discontinued in Canada. It's a familiar problem, and the first instinct makes sense: find whatever stock is left and buy it. That works for a while. Six months, a year, maybe two. Then the clinic is right back where it started, with less time to fix it. We had samples on our desk We went looking for where that product, or an equivalent, could be made, and we got samples in. There were three variations, each with a different pur …

Pick up a medical product and look at the name on the box. It's natural to assume that company made it. Often, it didn't. Medical device companies increasingly hand production to specialized contract manufacturers around the world. The brand owner may design, market and sell the product, while another company runs the production line. That matters if you buy for a clinic, a co-op or a distribution business, because it means there's often more than one way to get a product. Going back to the fact …