It’s logical to assume there will be many medical staff members in the operating room during a surgical procedure. Everyone expects that in addition to the surgeons, there will be anesthesiologists, nurses and perhaps doctors in training. Surprisingly, there are often sales reps helping surgeons in the OR.
Why are sales reps in the OR?
These medical device sales reps are present to provide technical expertise on devices including artificial hips and knees, cardiovascular implants and spinal surgery devices.
However, these sales reps can also try to guide the surgeon to the newest, most expensive model of the device the surgeon is planning to use, even when the older version is more proven.
How well trained are these sales reps?
Although medical device sales reps receive technical training from the device manufacturer, their formal education may be limited. According to a Kaiser Health News article, device sales reps “have received little scrutiny”. In fact, there have been sales reps advising surgeons who have not even graduated from high school!
Is this a good thing or a bad thing?
As with most things in life, there are positive and negative aspects.
Sales reps can provide valuable guidance to a surgeon because they:
- Are very knowledgeable about the particular medical device the doctor is using.
- Have observed many, maybe even hundreds, of procedures using a particular device.
- Have seen a variety of techniques used by multiple surgeons
- Know troubleshooting options.
However, there have been cases where sales reps feel surgeons rely on them too heavily, providing advice and sometimes hands-on help to doctors who lacked sufficient expertise.
A survey of 43 device reps found that 88% said they gave verbal instructions to a doctor during a procedure, and 21% said they had direct “physical contact with hospital staff or a patient during an operation”, which may be in violation of the law.
Patients (or families) have sued sales reps and surgeons because the reps participated in surgeries in a “meaningful way”, and/or provided faulty advice. There have even been cases alleging that the sales rep was working on the patient while the surgeon was not present!
Additionally, sales reps might increase the cost of a procedure by persuading the surgeon to use a newer, more expensive device.
Do doctors tell patients about this beforehand?
Do all hospitals use these medical device sales reps?
Most hospitals rely on these reps to provide expertise to their surgeons. But, some hospitals ban the reps in an effort to control costs.
Interestingly, a program using hospital-employed techs who receive the same training as the sales reps has been successfully introduced at Loma Linda University Medical Center in California. The program saved the hospital money and resulted in no difference in patient outcomes. Perhaps this is the model of the future?
What can you do about sales reps helping surgeons?
There have been studies that show surgeon experience is an important factor in determining the likelihood of successful outcomes. However, there is no known number of procedures that will assure you that your surgeon is experienced enough to minimize his/her reliance on a sales rep.
As a patient or family caregiver, you should ask any prospective surgeons the following questions before scheduling a procedure involving a medical device implant to get a sense of their potential reliance on a sales rep:
- What kind of training did you receive on this device?
- Did you watch videos?
- Attend a training session organized by the manufacturer?
- Participate in surgeries being led by more experienced surgeons? How many?
- Other training?
- How many procedures have you performed with the exact device in your career? In the past year?
- Will a medical device sales rep be present during the procedure? For what purpose?
If possible, interview more than one surgeon, and use your intuition to determine your comfort level.
For more information on reducing the risk of surgical complications and harm, read these blog posts:
- Questions to Ask Before Surgery.
- Questions Seniors Should Ask Before Surgery.
- You Can Improve Your Surgical Outcome.
- Surgical Dangers – What You Need to Know.
- What is the Best Time of Day for Medical Care?
- How to Recover Faster After Surgery.
- How Safe are Surgery Centers?
NOTE: I updated this post on 12-4-18.