How Salesmen Showed Up In Operating Rooms, And Why Hospitals Are Scrutinizing Their Presence

In an operating room, there’s the surgeon, the anesthesiologist, a surgical tech and a scrub nurse. And in many procedures that involve an implanted medical device, there’s often someone else standing quietly along the back wall — a sales representative working on commission for the maker of artificial joints or bone screws.

With the exponential growth of procedures like total hip and knee replacements, their presence is under new scrutiny.

Medical device reps are more often business majors than biology buffs, but they train on-the-job as if they might have to conduct surgery themselves. At an educational center in Colorado, future reps learn how to saw off a hip bone and replace it with an artificial hip.

The corporate training also frequently uses cadavers, helping them develop the steel stomach required for the unsettling sights and sounds of an orthopedic OR — like hammering a spike into a bone.

“Before we’re allowed to sell our products to surgeons, we have to know the anatomy of the body, go through tests of why physicians use these types of products and how we can assist in surgery,” says Chris Stewart, a former rep based in Nashville.

Stewart spent his sales career with Stryker, an industry behemoth that makes everything from surgical robots to artificial foot bones. Now, he helps manufacturers navigate relationships with hospitals at Ortho Sales Partners.

Reps are supposed to have explicit permission to observe surgeries. Big companies like Stryker have detailed policies about boundaries for their reps. But they don’t have to be there. In fact, reps can’t touch the patient or anything that’s sterile.

Some use a laser pointer to guide surgical assistants who need help locating a little part or tool in the trays of parts and tools often delivered by the rep prior to the surgery. They want the procedure to run as smoothly as possible and turn a busy surgeon into a steady customer.

“Obviously, there’s a patient on the table being operated on, so that’s where the sense of urgency is,” Stewart says. “You have to become an expert in understanding how to be efficient with helping everyone in the OR making sure your implants are being utilized correctly.”

By Blake Farmer | NPR (Nashville)

Image Credit: Blake Farmer / NPR (Nashville)

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