Medical device representatives, theoretical experts on the products being used in surgery, have become a fixture in the operating room. How much influence do they have, and what does it mean for patients?
According to a recent article in the Washington Post, these device reps are not just present in the operating room, but are acting as a live interactive resource for surgeons, particularly in the neurosurgery and orthopedic specialties.
Some believe that these reps are a positive addition. Terry Chang, Associate General Counsel of AdvaMed, says that reps “are only present at the behest of the physician and only as a trainer” and are an essential benefit for doctors and patients. Their value, Chang says, is due to their extensive experience witnessing hundreds of the same procedures, and ability to provide expertise that can make surgery faster and more efficient.
Lisa McGiffert, director of the Consumer Reports Safe Patient Project says the presence of device reps in the OR raises questions about the adequacy of consent, if patients are not explicitly informed. A major concern is about surgeons relying on the presence of reps to learn how to use devices on the fly. A 2014 study about the role of device reps in the OR shows that there’s a disparity between guidelines and actual practice. The anonymous survey responses showed 37% of reps believes they had been excessively involved in an operation and 40% questioned a surgeon’s competence during a surgery.
Other hospitals decided to forgo reps in the operating room entirely. Gary Botimer, a joint replacement specialist and chief of orthopedics at Loma Linda, negotiated a discount on the price of artificial joints and sent hospital surgical techs to the technical training given to device sales people. The program showed no difference in outcomes, but saved the hospital approximately $1 million each year.
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