Sales representatives from medical device companies can provide training and expertise on the latest implantable gadgets but may also be encouraged to upsell physicians on the newest, most expensive products, according to a Nov. 23 article in NPR.

The story highlights the benefits and drawbacks of the common practice of allowing sales reps into the operating room. These employees stand to make a 10 to 25 percent commission on the equipment used in procedures, according to the report, so there is a legitimate concern they would be influenced to push for the highest-cost product even when another version is more proven or appropriate for that particular patient.

"The newest device is not necessarily the best device," Adriane Fugh-Berman, MD, a Georgetown University professor who studies pharmaceutical marketing practices, told NPR. "In fact, it may be the worst device."

However, sales reps often fill the logistical role of delivering trays of instruments to be sterilized and ready to go so the physician can perform the operation as smoothly as possible. They may also aid in device programming or educating clinicians on the nuances of new equipment.

"You say 'sales rep.’ I look at them more being somebody that's expertly trained in their field to provide support for the implants that they happen to sell,” said Marley Duff, an operating room manager at TriStar Centennial Medical Center in Nashville, Tennessee.

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