Your looking at this from a micro perspective (ie Ethicon the company) and not a Marco perspective (the med device market). The challenges at Ethicon are no different than most other med device companies. As there is increased competition, and less innovation, everything gets commoditized. Prices go down, and thus so does the compensation. Even for an innovative company, that is not the end all solution. Young innovative companies are also challenged in the new market place of getting market access due to large IDN contractual purchasing policies that favor larger portfolio companies. So, profitability is also challenged here by lack of big volume, and again compensation needs to be adjusted. throw in other variables such as hospitals being forced to reduce further costs, the medical device excise tax, and some hospitals believing they can self-train on any technology and ask for discounts for elimination of service reps, and you have further reduction in available profits for enhanced compensation. This is just the new world of medical device sales no matter where you go, Sure there can be some anomalies out there but they won't last long as a capitalistic market will eventually return things to balance.