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The Extended Role of Company Representatives

The Extended Role of Company Representatives

(OnTarget. Vol 4, issue 4 2005)

Both Hospital Managers and Companies have duties under the legislation to be proactive in ensuring the safe provision and use of technology. Until the late eighties development in both Clinical/Surgical technology and instrumentation were incremental. However with the technology revolution, advances became transformational and the dependency on the companies for technical support much greater, resulting in Hospital Managers allowing medical device company representatives routine access to clinical areas in order to benefit from their expert knowledge and the product training that the companies can provide to contribute to successful patient outcomes.

“see one - do one - teach one”

In the past the ‘see one – do one- teach one’ method was frequently used and product support was a peripheral task for many company representatives once accounts had been established. The most successful company representatives would sustain high volumes of sales by persuading surgeons to select their product, in preference to similar devices marketed by competitors. The scope for company representatives to directly influence sales was considerable, irrespective of how competitively products were priced. Consultants had little budgetary pressures for the purchase of devices and the rate-limiting step for the introduction of new products was almost exclusively surgeon preference.

We now have a leaner NHS/private sector and the NHS funding of established technology is often driven by fiercely competitive contracting deals between companies offering ‘me too’ products. The NHS has realised that the purchasing power of block contracts in the devices sector is a powerful driver for reducing costs. New devices today are often associated with a paradigm shift in surgical technique, and the limitation for the introduction of these new surgical procedures has more to do with NHS funding and training than surgeon preference. Consultants are learning new surgical techniques and industry support for them to become proficient in new procedures is paramount to their success. Poor clinical results with new technology at best can lead to a device being branded as ‘unreliable’, which can have huge commercial implications, and at worse, lead to litigation.

What legitimate role does the company representative have in clinical areas?

The legitimate role in a clinical area of the company representative is providing information and training to the clinical team. This takes place, preferably, prior to use, throughout assessment, and the ongoing risk management of “high tech” equipment. Product expertise brought to the clinical team is essential and the interpretation of technical assistance has become flexible, and blurred between the margins of “hands off” and “hands on” assistance. The clinical team cannot be expert in every aspect of every piece of technological wizardry now found in hospitals and the question posed is how best to utilize the expertise and role of the company representative to the patient’s advantage.

Recognition of this legitimization of the representatives’ extended role identifies that they are not in the clinical setting as a sales person. If they were solely “sales people” their activities and presence would be restricted to the purchasing department. Now the relationship between company representatives and surgeons is far more likely to be about product support, education and sales technique. It is about the clinical team being able to rely on the company representative to be realistic about the limitations of their product, being able to impart practical knowledge sometimes under difficult circumstances and at critical times.

All personnel with access to clinical areas must show evidence of competence and continuing professional development. Hospital Managers should expect no less from company representatives. The patient expects no less and the hospital management demands professional qualifications in order to manage the hospitals liability.

Product support and training now feature prominently in bids when block-order contracts go out to tender. The service provided by the company representative to members of the clinical team now translates into commercial success. The key to winning the first order and not losing it when it comes up for renewal may hinge on the feedback from senior doctors/clinicians regarding product support and education during the initial contracting period. The focus for the successful company representative has to be the ongoing risk management and risk assessment of their company’s product and its ongoing life cycle.

In summary, recognition of the extended role of the company representative will achieve and maintain commercial success. Working in partnership to deliver good patient outcomes is a “win win” situation for both the hospital and the medical device industry.

Lynn Graham
RGN, RSCN, MBA, Theatre Manager,
Theatre Skills Training Faculty


Theatre Skills Training Ltd.
Golden Jubilee National Hospital,
Glasgow G81 4HX
t: +44 141 951 5646
e: info@theatreskills.com
w: www.theatreskills.com

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