ICBioethics Blog 

Remove medical device reps from the OR?

Written by: Dr. Kathy Gennuso

As more hospitals consider eliminating medical device reps’ role in the OR, a lot of discussion will revolve around how to best replace them. The goal = lowering risks and reducing costs ≠ incurring more!

By eliminating the device salesperson role, hospitals hope to offer less expensive high-demand procedures like hip/knee replacements, as they feel more competitive pressure and the demand for staying closer in line with Medicare reimbursements. (They probably wouldn’t miss the added liability – informed consent issues, infection risk associated with reps’ presence — or the opportunity for undue influence and financial conflicts of interest either!).

But for decades sales folks have been in the OR aiding clinicians with decisions on products and instrument use, even giving guidance about the procedure itself. And changing mindsets and habits never comes easily . . . .

Still, times are a-changing and the appeal of rep-less models is obvious. Moving that direction and changing the training paradigm can reduce costs by nearly 50%.

But how to best fill that hole, that training gap that could not only create more staffing costs, but significantly affect patient safety?! Loma Linda University Medical Center does their own training now, but what about facilities lacking staff to dedicate to this undertaking?

Creative, 21st century training tools can get the job done efficiently and effectively. The technology already exists to provide an alternative to salespeople’s training and expertise. With the right strategies and technology, hospitals canprovide surgeons with in-house customized support to advise them before and guide them during procedures. The effort seems to be worth it – 50% savings on a typical $5000 hip replacement.

Last year ECRI Institute published a report advising hospitals to develop policies regarding sales reps in ORs, and NIH is calling for greater transparency regarding those problematic financial conflicts of interest  . . . .

Is your organization moving to a direct-service model for devices or are you wondering how that could work for you?

Mitch GennusoComment