Medical device sales representatives are common in the operating room (OR), but debate continues regarding how appropriate their presence is, according to a November 23, 2018, NPR article. Supporters of the practice say sales reps bring expertise to the operating table; device-dependent procedures, such as total joint replacements, are on the rise as baby boomers age, and sales reps typically "train for the job as if they might have to conduct surgery themselves," the article notes. Having this expertise on hand is helpful, according to one orthopedic surgeon who specializes in hip replacements: "I can't keep my socks together through the dryer. You can imagine trying to get 100 pans or 300 pans of instruments all set up correctly," he said. But as insurers such as Medicare have begun cracking down on healthcare costs, hospitals have been obligated to take a closer look at the price tags of the devices and the impact of sales rep presence on surgical costs, and many judge these costs to be too high, according to the article.

HRC Recommends: Healthcare industry representatives are often welcome in the OR for their knowledge of and experience with the equipment surgeons and other personnel may use during procedures. However, industry reps should be present only to provide assistance. Physicians and appropriate hospital staff members must know how to operate a medical device and how to apply it to patients, and it is reasonable for hospitals to insist that they obtain this knowledge, particularly for new devices. In addition, any hospital that allows someone who is neither an employee nor a medical staff member to participate directly or indirectly in a surgical procedure may risk liability, even if the procedure is a success. Hospitals that allow sales reps in the OR must have policies and procedures in place that delineate the actions allowed and behavior required of healthcare industry representatives.