The non-profit ECRI Institute suggests that "hospitals should be diligent about the presence of anyone who isn't a staff member in the OR because of potential risk management concerns."
This article appears in the October issue of HealthLeaders magazine.
They stand alongside the physicians and nurses. Like the medical professionals, they scrub in and wear masks before entering the operating room, where they check out the nuts, screws, braces, and other orthopedic devices.
They stand alongside the physicians and nurses. Like the medical professionals, they scrub in and wear masks before entering the operating room, where they check out the nuts, screws, braces, and other orthopedic devices. They are medical device sales reps.
Having sales representatives in the OR is a common practice, even though some healthcare leaders say it is an unwelcome presence.
"Vendors go in and tell about a new item; it's an angle they are going to take," says Larry Kennedy, CMRP, the materials management director of Jefferson Regional Medical Center in Pine Bluff, Ark. He says it's obvious some reps are trying to influence sales. "That's their job. But we don't allow them to push products in the OR or cath lab. We make them schedule a meeting with us."
The ECRI Institute, a nonprofit based in Plymouth Meeting, Pa., that researches cost-effectiveness in patient care, said in a July report this year that while hospitals generally do not allow "outsiders" in the OR, exceptions are "frequently made" for medical device sales representatives. That especially occurs when the sales reps can provide "assistance with a particular device."
As ECRI notes, however, "hospitals should be diligent about the presence of anyone who isn't a staff member in the OR because of potential risk management concerns and should establish policies to oversee sales representatives involved with devices."
While hospitals allow vendors in operating rooms, in part because physicians often press for that presence to ensure they are properly using the medical devices, leaders are crafting policies that place limits on such vendor involvement. The Loma Linda (Calif.) Medical Center has reduced the number of cases in which sales staff are in the surgical suites, especially for a majority of routine cases, says Gary Botimer, MD, chairman of the orthopedics department at the 970-bed facility.
"This is only for the cases that the surgeon does not feel he needs them there," he says. "There will always be legitimate advances in care [for which] it is helpful to have a company representative there, but for the routine cases [as established by the surgeon evaluation team], the presence of a company representative is unnecessary."
William Martin, PharmD, administrative director for sourcing and value purchasing at Beaumont Health based in Troy, Mich., acknowledges that while physicians are ultimately responsible for decisions on medical devices, "the device representative is there in the operating room as well. While his or her intent is to make money, there are select procedures that are complex, and it's not all negative when they try to help physicians. I think there may be some value when you are undertaking a complex revision surgery, because the device representative is incredibly familiar with the product."
For the most part, though, Martin says that the presence of the vendor representatives is "an unnecessary activity." The vendor sales staff "gets paid a very handsome wage and may live in the same subdivision as the doctors. The rep may represent anywhere from 30% to 40% of the costs of implants. It's unbelievable, and in my mind, it's what is upside down in healthcare."
This article appears in the October issue of HealthLeaders magazine.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
