5 min reading time

As originally asked by Hannibal Bray.

My Totally Biased Argument FOR Surgical Sales Reps in the Operating Room & The 6 Qualities Outstanding Reps All Possess #medicaldevices #surgicalsales

Did you know that when you go in for surgery or a hospital procedure that there is often a company (sales) rep in the room?

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Julie Omohundro
Principal Consultant at Class Three, LLC
I would hope that any rep who tried to get into an OR to make a sales pitch would be promptly escorted out of the facility by security. But this does raise a question that I don’t have the answer to. How often are reps in the OR post-market, to provide technical guidance in the early use of a device that the HCP has already purchased, and how often are they there because the HCP wants to try to the device in surgery before purchasing it? I think the presence of the rep is likely to be helpful in either scenario, but it’s also true that their presence pre-market would be a sales function, rather than a customer support function. I can see where this can be misunderstood, but also has the potential for abuse.

Julie Omohundro
Principal Consultant at Class Three, LLC
David Walker, I’m familiar with never events, but don’t see what they have to do with this discussion?

Julie Omohundro
Principal Consultant at Class Three, LLC
David Walker, there is no patient privacy in surgery, trust me on that. They call it a “theater,” after all.
As for passing out, the same is true of medical students. I don’t know the full range of surgical sales reps; the ones I do know can perform the procedure quite competently on a cadaver, which they do regularly to train physicians, and could probably do so on a patient as well, were they legally allowed. How representative they might be of surgical sales reps generally, I have no way of knowing.

Julie Omohundro
Principal Consultant at Class Three, LLC
Jonathan, how is “too large” calculated? Are you saying providers don’t want to purchase enough surgical products at a price point that will cover this expense?

Roger Cepeda, JD, MBA, RAC
Medical Device and Biotech Attorney
This is a great discussion and, while I agree that access to real-time product expertise may be valuable to a medical professional in the OR, it’s important to remember can be said or done by a manufacturer’s representative. When the clinician practices medicine, he or she is generally not regulated by the FDA but is subject to the state’s medical licensing authorities (and personal injury lawyers). Conversely, the sales leader is directly regulated by the FDA, but not by the state medical authorities, and it’s unlawful for a company employee to engage in anything that appears to be the practice of medicine. The physician can use a product off-label but the sales rep cannot promote it for that purpose, so I think it’s important to keep in mind that different players in the OR may not be bound by the same rules while talking to one another.

Hannibal Bray
Disruptive Technology Expert (Medical Device Sales) Seeking New Challenge! [DC / MD / VA]
Thanks James!

Hannibal Bray
Disruptive Technology Expert (Medical Device Sales) Seeking New Challenge! [DC / MD / VA]
Thanks for weighing in Dr. Moosdorf!

Clarisa Tate
Medical Device Professional, RA/QA/Engineering
What’s interesting is most of the time the sales reps aren’t in the OR to sell anything by that point. They are there to train/observe the physicians on the proper use of their company’s device. This helps prevent injuries to patients and users due to use errors. Besides, device manufacturers are required by regulations in many regions to train healthcare practitioners on their devices after all.

David Gomez
Nurse Anesthetist (CRNA), CEO/CTO of Infinitus Medical Technologies (iMT), and Patient Positioning Process Ninja!
David Walker that makes no sense😂. They are usually there to guide a product, not pitch the sell. Unless specifically needed at beginning of case, they aren’t usually in there to see naked patients. Respectfully

Rainer Moosdorf, MD, PhD, FAHA
Cardiovascular Surgeon, Medical Consultant, Member of Healthcare Shapers
Let me pick up two points again. The information about a new product and its introduction into daily routine do clearly not belong into the OR. The whole(!) OR team has to be introduced into the technical details and the use of the product before. Especially the physician in charge has to know exactly what to do and how to do it! Learning by doing with a “Rep” as an online teacher is not appropriate. However, the “Rep” may play an important role as a backup assistant, offering tips or tricks during the special case, based on his/her experience. Any golfer will try his new clubs on the driving range and not during the tournament, however, a reminder to some special features in a special situation by an experienced caddy is always welcome.

Matthew Van Der Ross
Arthroplasty and Trauma Sales Representative at Johnson & Johnson
Great article Hannibal.

Carl B. Derenfeld
Derenfeld Group
See it as a privilege and a chance to contribute toward a better outcome and recovery. Reps are specialists and bring the latest knowledge to the table.

Abhishek Choudhary
Strategic Advisor on Digital Health, AI, IoT & Robotics | Founder, AyeAI – The Inclusive Artificial Intelligence #ai4all
Maybe video feed for the reps would suffice…

James Ciesielski
Senior Clinical Specialist at SynCardia Systems, LLC
Hannibal Bray Thank you for the article!!! Very well done!! Great points to remember.

Chander Bhushan Sharma
Certified Lean Six Sigma Green Belt
The idea is good to involve OT technicians and Surgeons assistants to improve the surgery outcome . The goal is less trauma, less discomfort and less pain.

Carlos de la Oliva
Sales rep Itaipharma. More than 25 years experience in ENT. 10 years experience with Coblation in ENT.
Big true.

Todd Abraham
Medical Device Executive / Advisor & Strategic Consultant
If I am on the receiving end of a complex device I want the best Doc working with the best device technical guidance from an outstanding clinical / sales representative. As Roger points out there are clear boundaries but let’s not lose sight of the fact that typically that representative has seen 100X the number of clinical cases using the technology that that physician. Great reps are seen as critical clinical partners by the docs that rely upon them.

David Walker
Computational Storage Contractor
Respectfully Dissent.

A patient’s privacy during surgery is not the proper venue to evaluate a sales opportunity.

Plus, without significant surgical training and experience I guarantee the Surgical Sales Rep will pass out and hit the floor face first if present during a knee or hip replacement procedure.

The power tools, saws, hammers and smell of burning bone, flesh and blood is not an event the uninitiated can just walk into and tolerate.

Mehdi Tergou
Orthopedic Territory Sales Manager at ConMed Corporation
Thanks for fighting the good fight Hannibal.

Michael Klevens
CVI- Surgical & Peripheral Interventional Sales
Good read, I read it when you posted in July.

Rainer Moosdorf, MD, PhD, FAHA
Cardiovascular Surgeon, Medical Consultant, Member of Healthcare Shapers
Let me add some comments as a surgeon. A rep should not be selling anything in the OR . The decision for a product should be made before and also, the responsible surgeon should exactly know what to do and how to do it! The comparison to a caddy during a golf tournament fits quite well, as it needs a good golfer first and then, a caddy is more than helpful. Discussions or an online training mostly lead to bad strokes. I know some real good reps and appreciate their contributions during a case. However, the surgeon should mainly concentrate on his job and the rep should best be a background caddy. Discussions do not belong into an OR, nor do any nice stories about other colleagues.
A nice talk with a cup of coffee later in the office is a different thing.

Eddie Groce
Territory Manager III at St. Jude Medical
Great article.

Lesley Durham
People developer, Customer Service, MDRD and Training
Part of the reps’ job is to ensure that the device is also accepted within other departments of the hospital. I work in MDR and I can’t tell you how many times doctors are encouraged to advocate the purchase of devices that we are not equipped to reprocess (clean/disinfect/sterilize) with our existing equipment and/or processes and practices. The same problems exist when different surgeons have different preferences for similar devices, causing problems with things ranging from storage capabilities to purchasing contractual issues, associated ongoing necessary supporting equipment, etc.
A great rep will spend time outside the OR as well, to ensure the device is accepted and best supported throughout the hospital.

Joe Tomko
Improving Lives: Investors Get Better Returns & Borrowers Keep Their Homes through Delinquent Note Investing
A succinct synopsis of what we do, Hannibal.

Sujit Chakravorty
SEI Soham
Very Very True. Qualities of Sales Rep. Should be such that ultimately benefit the Patient Surgeon and the Company He is representing.

Karan Garg
Healthcare Professional
Very well written Hannibal Bray.
Must read for the Surgical Sales Representatives.

Taz Singh
Medical / Surgical Sales Agent / Theatre Support / Surgeon Product Trainer ~ Durban / Jhb / CT
👌

Elizabeth Gillman
HEALTH CARE ADVOCATE
I’ve been in the OR as a patient. Had a device implanted and having the Rep. in the OR was VITAL to the outcome of the procedure. If the operating surgeon took a course about the device he/she was implanting and was VERY knowledgeable about it, THEN the Rep. would not be needed. However, in my personal experience, the surgeon knew the technique for the the implantation of the device but that’s where his/her knowledge ended.

Venkateshwaran Iyer
Managing Director at ENVISION SURGICALS
Great artice. …. bringing in knowledge , respecting OR etiquttes and having a confident disposition as a guest expert is key…

David Walker
Computational Storage Contractor
@David Gomez. Respectfully, the operating theater is not a not a theater regardless of your presense there.
Have you ever heard of the medical errors term “Never Events?” This may be an American legal term you may or may not be familiar with.
Do not you appreciate your ridicule of me as since I am an experienced blood soaked combat corpsman (medic) and a lawyer who specializes in Medical Products Liability.

Wasantha Abeyasinghe
Business Development Manager
Pretty much agreed.

Blake Chartrau
Principal Owner – BC MEDICAL,LLC and Marketing Executive at Welcome Wagon
If I had a nickel for every surgery case where my presence saved time, money, tissue, etc I could retire tomorrow! When I started in the OR as a Certified Stapling Technician for U.S. Surgical back in 1989 it was very common and necessary to scrub into cases in order to be able to provide the expert verbal technical assistance that surgeons demanded in order to achieve the best patient outcomes possible. Keep in mind, in 1989 cholecystectomies were performed open with a subcostal incision. However, within just a couple of years we had these same surgeons doing Lap Chole’s because the benefits for all were just too incredible to ignore. Now that I think of it, if I had a nickel for every surgeon, nurse manager and/or C-Level that threw me out of their office for trying to get them to convert from open chole to lap chole….. you get my point! I take great pride in my experience of being an integral part of so many incredible surgical teams over the decades. The flaming hoops (and associated costs) one must now traverse in order to even walk into a hospital in a suit as a rep to simply attend a meeting has made what once was a highly valued daily activity into a big production of effort for reps and companies.

Scott Bryant
Independent Manufacturers Representative
I was there many times in my early years. A seasoned, relaxed surgeon with a tight surgical team is the secret to a successful product in-service in the OR. I cannot imagine taking the chance of introducing a surgical item right out of your trunk!

Tricia Dittlau
Director of Sales/ Disruptive Technology/Award Winning Medical Sales Executive
Sales reps are trained on their products and are there to assure proper set up and use of the devices.

Helene O’Hagan
Territory Manager – Sedena Ltd
I do wish people would stop calling us “reps”. I’ve worked hard to build my career and deserve the title of representative.

Gavin Cooper
CEO UK Medtech – Helping Device Companies Access the NHS
Great article – this should be shown to all those procurement people that are trying to drive down prices or even worse have sales Reps banned from theatres. Sales reps bring value and without them there would be no new products going into operating theatres, innovation that improves patient outcomes and can generate additional savings into the hospital. We would still be in the dark ages if the companies didn’t bring out new innovative technologies – it is better that we work together and engage with sales reps as you might just be very pleasantly surprised what value they do actually bring to healthcare providers.

Theresa Russ Brewer, RN,BS
Surgicaltoolbox.us Medical Device Sales/Education Specialist
Only if they have a medical education background as most patients have said.

Bill Niland
CEO Regeltec
I like Clinical specialists in the OR with surgeons.

Jonathan Wacks
Vice President Of Quality at Flexan, LLC
Unfortunately, too large a expense to avoid future cost cutting…

Abhishek Neogi
International Sales Executive for West Europe at Meril Life Sciences India Pvt Ltd.
Great article, lot of motivation for Reps in there early stage 🙂

Pushkal Kumar Gupta
Senior Sales Account Specialist at Johnson & Johnson
For core medical devices, a Rep is an add on expertise in the OR . Working close to top notch Surgeons who encounter critical challenges in OR , a Med. Device Rep can be a common interface who can refer/suggest the preventive measure and line of approach in an OR of another operating surgeon at a different venue for a similar kind of complications.

John Clennan
Director, National Accounts at Hologic, Inc.
The value of a med device rep is undeniable, but the time in the OR can be even more effective. Simulation is an important and valuable way to provide high fidelity interaction between, patient, surgeon, and the medical device. The 6 qualities don’t change, they are enhanced. It enables multiple use of a device with no risk or exposure, creating value to the rep, surgeon, and ultimately the patient.