Anyone having joint replacement surgery expects to have individuals in the operating room other than their surgeon. Nurses, anesthesiologists, andsurgical technologistsare all people we probably expect to encounter in the moments before we go under. But would you expect a representative from the company who made the implant device?
Well, the truth is, they are often there. Representatives from device companies that may have afinancial interest in what is used during your surgerymay be in the room while you are having surgery.
During joint replacement, most surgeons have an industry device representative in the OR during the surgical procedure. These representatives may perform different functions, and while they are not actually performing surgery, they can have a significant influence on your operation.
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Normal Operating Room Staff
Device Companies
Medical device companies manufacture and sell the implants used during joint replacement surgery. There are many companies that do this, some are very large (Johnson & Johnson, Stryker, Zimmer), and others are very small companies you likely have never heard of. Each company wants the surgeon and hospital to use their product when appropriate, and oftentimes, your surgeon or hospital has a choice in which company’s product to use.
Many companies will have a representative present in the operating room at the time of surgery. These device reps perform several functions:
The medical device reps are not part of the operation in that they are never at the surgical field assisting in an operation. While this was a practice decades ago, this does not occur any longer. Device reps are prevented from any direct patient contact.
Concerns About OR Device Reps
While there may not be any direct patient contact, critics would argue there is significant influence the device reps can have in the OR that directly impacts the care of the patient. A device rep may communicate directly with the surgeon who is making a choice about the implant selection during a surgical procedure. However, most of these decisions are made prior to the surgery, and many hospitals regulate these choices. Device reps may also interact with surgeons in their office and at conferences and meetings in an effort to win their business.
The question comes: Why does anyone allow reps in the OR at all? Well, the functions listed above, in terms of managing inventory and ensuring staff knowledge, can be extremely helpful and efficient. A good representative can help ensure a surgery moves along quickly and efficiently, with all of the proper equipment and implants at hand.
A Word From Verywell
There are different approaches to managing device reps in the OR. Some hospitals have taken dramatic action to ensure the emphasis is on the patient. For example, some hospitals have made sure patientsgive consent before any device representative is allowedin an OR for their surgery. Other hospitals have eliminated the use of device reps all together, instead of working directly with companies to purchase inventory and training their staff to manage and use it appropriately. The reality is, most hospitals allow device reps to enter the OR without specific disclosure to patients.
So what should you do? Ask your surgeon which implants they will be using, and why that implant was selected. Ask if there will be company representatives in the OR and if their role is essential to the surgical procedure. If you have concerns about the role of the rep, ask that they not enter the OR during your surgery. Bottom line is that you should feel comfortable and confident that the attention and decisions made are in your best interest.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaiser Health News.Medical device employees are often in the O.R., raising concerns about influence.Bernstein J.Not the last word: two patients, two operating rooms, one surgeon—does the math add up?Clin Orthop Relat Res. 2016;474(10):2094-2099. doi:10.1007/s11999-016-5001-2American College of Surgeons.Statements on principles.O’Connor B, Pollner F, Fugh-Berman A.Salespeople in the surgical suite: relationships between surgeons and medical device representatives.PLoS One. 2016;11(8):e0158510. doi:10.1371/journal.pone.0158510Additional ReadingAmerican College of Surgeons.Revised statement on health care industry representatives in the operating room.Bedard J.What should patients be told about device representatives’ roles at the point of surgical care?AMA J Ethics. 2021;23(9):692-696. doi:10.1001/amajethics.2021.692
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaiser Health News.Medical device employees are often in the O.R., raising concerns about influence.Bernstein J.Not the last word: two patients, two operating rooms, one surgeon—does the math add up?Clin Orthop Relat Res. 2016;474(10):2094-2099. doi:10.1007/s11999-016-5001-2American College of Surgeons.Statements on principles.O’Connor B, Pollner F, Fugh-Berman A.Salespeople in the surgical suite: relationships between surgeons and medical device representatives.PLoS One. 2016;11(8):e0158510. doi:10.1371/journal.pone.0158510Additional ReadingAmerican College of Surgeons.Revised statement on health care industry representatives in the operating room.Bedard J.What should patients be told about device representatives’ roles at the point of surgical care?AMA J Ethics. 2021;23(9):692-696. doi:10.1001/amajethics.2021.692
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kaiser Health News.Medical device employees are often in the O.R., raising concerns about influence.Bernstein J.Not the last word: two patients, two operating rooms, one surgeon—does the math add up?Clin Orthop Relat Res. 2016;474(10):2094-2099. doi:10.1007/s11999-016-5001-2American College of Surgeons.Statements on principles.O’Connor B, Pollner F, Fugh-Berman A.Salespeople in the surgical suite: relationships between surgeons and medical device representatives.PLoS One. 2016;11(8):e0158510. doi:10.1371/journal.pone.0158510
Kaiser Health News.Medical device employees are often in the O.R., raising concerns about influence.
Bernstein J.Not the last word: two patients, two operating rooms, one surgeon—does the math add up?Clin Orthop Relat Res. 2016;474(10):2094-2099. doi:10.1007/s11999-016-5001-2
American College of Surgeons.Statements on principles.
O’Connor B, Pollner F, Fugh-Berman A.Salespeople in the surgical suite: relationships between surgeons and medical device representatives.PLoS One. 2016;11(8):e0158510. doi:10.1371/journal.pone.0158510
American College of Surgeons.Revised statement on health care industry representatives in the operating room.Bedard J.What should patients be told about device representatives’ roles at the point of surgical care?AMA J Ethics. 2021;23(9):692-696. doi:10.1001/amajethics.2021.692
American College of Surgeons.Revised statement on health care industry representatives in the operating room.
Bedard J.What should patients be told about device representatives’ roles at the point of surgical care?AMA J Ethics. 2021;23(9):692-696. doi:10.1001/amajethics.2021.692
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