It is likely that you have either had a total joint replacement, or know someone who has. Of course, the surgeon is the expert on whatever device she decided was best for you, and was solely responsible for implanting it correctly.

Or was she?

Most folks who are not involved in health care do not know that hospitals make deals with device manufacturers like Stryker and Medtronic for joint replacement and other implantable devices. Part of that deal routinely involves support with those devices, including while in the operating room.

These representatives rely upon close relationships with surgeons for their commissions, and as a result must be intimately familiar with the device in question so he or she can answer any questions the surgeon may have during the procedure. Sometimes surgeons are lax in research a particular device and are unprepared when time comes for surgery. In such circumstances, reps become necessary to a successful surgical outcome.

A recent survey was conducted asking device representatives a series of questions. Of note, 88% of responding representatives said they had provided verbal instructions to a surgeon during a procedure, while 37% participated in a surgery in which they themselves felt their involvement was excessive because the surgeon was not sufficiently prepared to implant a device.

Recently an orthopedic surgeon at Loma Linda in California convinced his hospital to negotiate for devices directly with the manufacturing companies and train employed surgical techs in a fashion similar to how the device reps were trained. Whether other hospitals will follow suit is unclear at the moment.

You can read an article about the culture of device representatives in the operating room here:

[Medical Device Employees Are Often in the O.R., Raising Concerns About Influence]