Say you have exhausted all non-surgical options, and your surgeon has recommended an orthopedic implant. You’ve spent years on this journey, trying to avoid implanting hardware, but you’ve run out of options. You schedule the surgery and discuss the hardware your surgeon will be implanting. You’re getting wheeled in to the surgical suite. Who’s in your operating room? Surgeon, anesthesiologist, nurse anesthetist, OR nurse, and….a medical device sales representative?

It might surprise you to learn that a patient’s surgical team might include a representative of the implant manufacturer. Sales representatives have been present in operating rooms for decades now. They are usually not medically trained, and are not employees or agents of the hospital. They work for any one of the medical device manufacturers, and they have, in many cases, made themselves critical components of the surgical team. Orthopedists, for example, often expect the manufacturer’s representative to be present during a hip replacement, in order to benefit from the rep’s specialized knowledge of that particular device.

For example, some surgeons might only use a particular device on specialized patients once or twice a year. The sales rep, however, has been specially trained specifically on placement of that device, so, in theory, their technical knowledge makes operations safer.  

They educate surgeons about updates to and new technology. Reps – and their sales commissions – are not confined to the operating rooms – they are frequently present all over the hospital. While they spend time educating physicians about their products, they are, in fact, selling surgeons on new devices and new components. Very rarely are any of those new products bringing down the cost of any procedure.

Medical device manufacturers like Medtronic and Stryker argue that sales reps are necessary for patient safety and surgeon efficiency. Opponents argue that the reps are not necessarily there in the patients’ best interest – they’re looking out for the manufacturer, and often upselling the surgeons. And their involvement can – and has – contributed to significant injuries from malpractice.

And those increased costs become expenses for the rest of us to bear through any version of health insurance the patient has.