Will a salesman for a medical device be ‘guiding’ your surgery?
If you’re having any type of orthopedic surgery, chances are very, very good that there will be a visitor in the operating room you were never told about.
And it’s not another doctor or nurse — or even a medical student.
No, this person is a sales rep, someone who makes a living selling and encouraging docs to use medical devices — whether they’re appropriate for you or not.
And these reps, who often have no medical training, may play a big role in your surgery.
The presence of salespeople in the operating room is one of the most devious and outrageous things going on in the surgical world today.
And it’s something that’s common knowledge to everyone.
Everyone, that is, but the patient.
It’s one of the biggest secrets in health care. One that a hospital vice president called an “incestuous bucket of worms.”
We’ve heard a lot about how Big Pharma reps visit doctors and gift them with trips and expensive dinners to push drug sales. But device reps have gone light years beyond that.
Now, researchers at Georgetown University Medical Center have spilled the beans on what’s going on in a just-published study. By conducting interviews with sales reps, doctors and others, the researchers tell us a story that patients might find hard to believe.
For example, we learned that a device rep is a “fixture” in the OR during orthopedic procedures, often for the entire operation. And that they’re available 24/7 to join in.
The study also revealed how sales reps stalk surgeons at doctors’ lounges and meetings to “shop” for ones who are in charge of what equipment (things like knees, hips and rods used in surgery) will be purchased.
And some surgeons who aren’t sure how things work during an operation have even asked these salespeople for medical advice, saying things like “walk me through this, I don’t know how to do this.”
And they’re asking for this advice, in some cases, while you’re stretched out on the operating table.
Seriously?
Last I heard, the surgeon is the one who is supposed to know how to perform the operation, not the guy who sells the tools.
The head of an industry group for device manufacturers told The Washington Post a few years ago that many of these implanted items could “not be used” or “used safely” without sales reps guiding doctors.
And that’s what Dr. Catherine Matthews calls “a frightening argument.”
These reps, are “not in any way motivated to recommend what might be the best thing for the patient,” Dr. Matthews pointed out. Plus that, she said doctors shouldn’t have to rely on them for know-how.
Exactly!
Other studies have found that the presence of these salespeople can be the “tipping point” for a surgeon to say “yes” to the latest (and most expensive) knee or hip on the block without really knowing just how safe or reliable it is.
Combine that with the slipshod way the FDA approves these devices and you’ve got a recipe for disaster.
That’s how things such as the DePuy hip replacement system got on the market. And most of them were likely put into patients’ bodies solely because of sales reps coercing doctors and following them into the OR to guide them.
But five years later, almost 100,000 of them were recalled as being defective. And unlike a car or toaster oven, recalling a new body part isn’t so easy.
It all boils down to picking and choosing your surgeon carefully. Make sure he’s done your particular procedure many, many times and knows how to do it from start to finish — without the help of a guy who might just as easily be selling used cars
Sources:
“Salespeople in the Surgical Suite: Relationships between Surgeons and Medical Device Representatives” PLOS ONE, August 3, 2016, journals.plos.org
