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Archive Orthopedic Surgery 2017

Is Going Rep-less the Way to Go?

Why some facilities may be looking to usher vendor reps out of the OR.

Bill Donahue, Senior Editor


rep-less arrangements WORTH THE EFFORT Rep-less arrangements may lead to clinical savings that surgical facilities can pass on to patients.

Medical device reps have long played a vital role in the OR by advising surgeons on implant usage during total joint cases, but something's wrong with this picture when vendor reps make more than the physicians they're assisting. A growing number of facilities have replaced vendor reps with highly trained in-house techs. The new approach is called "going rep-less." Is this staffing model as promising as it sounds?

To find out, we talked to leaders at Loma Linda (Calif.) University Medical Center and Wayne County Hospital in Corydon, Iowa, about their decision to go rep-less. Represent-atives from implant manufacturers no longer have a permanent place at the surgical table in those facilities, and the bottom line may be better off because of it. By going rep-less, you work directly with the implant manufacturer, meaning you pay no costs associated with "rep services." Because you're paying only for the implants, you should be able to significantly reduce overall case costs.

How? By turning the supply chain on its ear. Third-party companies offer to provide your facility with FDA-approved implants directly or connect you with a manufacturer of generic implants. Cutting out implant manufacturers bypasses pricier options inflated by the costs of marketing, distribution and managing a sales force. Companies following this model will also train and certify surgical techs and supporting OR personnel on site to perform the functions traditionally handled by reps.

Some of the companies in the space suggest they can reduce a facility's cost per implant by as much as 80%. Daren Relph, CEO of Wayne County Hospital, can't confirm that number, but says going rep-less has helped his hospital create a more cost-competitive joint replacement program. Wayne County started down the rep-less road about 3 years ago after key implant vendors refused to negotiate on price. About that time, a company came calling with a direct-purchasing model to cut implant costs and train OR techs to assume the duties traditionally handled by vendor reps.

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