1. Salcido, Richard MD

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More than a few decades ago, I read a fascinating newsmagazine article about the future of hospitals and health care organizations, envisioning what they might look like beyond the year 2000. It forecasted that modern health care organizations would certainly look different in the future. The authors predicted that hospitals would be more integrated, cooperative, and, in some cases, even collaborate with their competitors. For example, employees from multiple organizations could be working side-by-side within the walls of the structure we know as a hospital. Their forecast was right on!

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Today in 2008, we are witnessing this collaborative connectivity in the form of alliances, joint ventures, hospitals within hospitals, and employees from differing organizations working side-by-side. These partnerships galvanize expertise, economy of scale, appropriate reimbursement for patient care services, and provide better outcomes for specialized patient care services, including wound care.


Co-opetition: Definition and Concept

In the book, Co-opetition: A Revolution Mindset That Combines Competition and Cooperation: The Game Theory Strategy That's Changing the Game of Business, authors Adam M. Brandenburger and Barry J. Nalebuff, present a cogent position for business cooperation.1 Co-opetition essentially means cooperative competition. This business practice allows competitors to work together on a project, joint venture, or co-marketing basis to enhance their market share. In concept, co-opetition encompasses decision making, problem solving,1 and a strategy to make each competitor's piece of the "pie" bigger. It is a win-win approach, as opposed to the aggressive win-lose tactics and skirmishes that often result in a smaller share of a large pie for competitors.


The principles outlined in the book have been adapted to the health care industry in general, and specifically to the pharmaceutical industry. There are many current examples of how pharmaceutical companies are combining drugs and repackaging them as new brands. For instance, combining lipid-lowering agents with antihypertensives is a smart strategy with the increased emphasis on lower lipids and the management of hypertension in the prevention of cardiovascular disease.


How is this concept working in the wound care industry? Given the global economy and the global wound management pie, it is an important question. Specific examples of recent cooperation in the development and adaptation of wound care technology include KCI USA, Inc (San Antonio, TX) and Healthpoint (Fort Worth, TX), using the combination therapy of negative pressure wound therapy and chemical debridement for the management of chronic wounds. Another recent collaborative example is Alltracel's Nanopeutics subsidiary who recently signed a new professional wound care technology development agreement with ConvaTec, a Bristol Myers Squibb Company (Skillman, NJ).2 Alltracel Pharmaceuticals Plc (Dublin, Ireland), is a health care innovation group focused on wound care, oral care, cardiovascular health, and dermal health markets. ConvaTec is a world-leading manufacturer of ostomy and wound care products. This collaboration is expected to lead to an exclusive royalty-bearing license and supply agreement between both companies. The bottom line with this agreement is the opportunity for both companies to experience growth.


Future Vision

Do other opportunities exist for co-opetition in wound care? I believe they do. Let's consider the possibilities for a moment. Visualize an ever-expanding global wound care pie, with its slices representing patients, practitioners, manufacturers, educational conferences, and accreditation and certification programs. Imagine more and more entrants to the wound care industry, joining forces with each other to gain a piece of the greater pie.


In June of this year, wound care societies, product manufacturers, professional journals, and caregivers from all over the world will convene in Toronto, Ontario, Canada for the Third Congress of the World Union of Wound Healing Societies ( All the leaders in our industry are supporting a common theme, "One Problem - One Voice." The Congress recognizes that treating acute and chronic wounds is a global challenge faced by clinicians, and various social, economic, and technological differences can greatly affect their approaches to wound care. But despite these differences, clinicians are united in their effort to tackle the difficult task of preventing and managing wounds. By sharing knowledge and experience, clinicians contribute to the advancement of wound care and the improvement of patient care. Everyone benefits, thus creating a win-win situation.


For our profession to continue to grow and provide patients with the best possible outcomes, we need to cooperate and collaborate whenever we have the opportunity. Combining resources is a valuable step in our efforts to advance the field of wound care.


Richard "Sal" Salcido, MD

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1. Brandenburger AM, Nalebuff BJ. Co-Opetition: A Revolution Mindset That Combines Competition and Cooperation: The Game Theory Strategy That's Changing the Game of Business. New York, NY: Doubleday; 1997. [Context Link]


2. Alltracel Pharmaceuticals Plc Announces Nanopeutics Agreement. Dublin, Ireland: Market Wire; November 12, 2007. [Context Link]



In the FAQs column titled "Measuring Toe Brachial Index" in the January 2008 issue of Advances in Skin & Wound Care, the last sentence of the first paragraph of the first answer should read: "TBI is suggested for persons with an ankle brachial index (ABI) of greater than 1.3 because the digital arteries are less affected by calcification and incompressibility than ankle vessels and consequently, offer a perfect alternative examination."