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fied with one group of mesh."
That kind of ongoing communication is crucial. "Our MDs and the
mesh reps work together and then the chosen products must be on
contract pricing," says another administrator.
"Finding a good product that is also cost effective is a challenge,"
says Kathryn Loretta Rice, BSN, CNOR, administrator of the
Gwinnett Surgery Center in Lawrenceville, Ga., "but our doctors have
agreed upon a certain mesh and that volume drives the cost down.
It's also important to make sure you have a good buying group or
GPO."
"We work on getting the cost of the mesh down," says Michael
Westmiller, executive director of the Surgery Center of Southern
Oregon in Medford. "The ultimate decision is the surgeon's, but we do
review the cost of each type and brand with them."
Of course you never want to sacrifice quality or patient care in the
name of price, but the folks we heard from feel strongly that you don't
have to give up one for the other. "Some of the so-called off brands
are coming in at some really good prices and really good quality mate-
rial," says Mr. Pankey.
Keep in mind, however: Getting the message to stick may require
eternal vigilance: "All doctors have their own personal preferences,
usually based on experience, sometimes on a relationship with the
rep," says another facility leader. "We have had some success with get-
ting them to consider more cost-effective mesh short term, but after a
while they always go back to their comfort zone."
If you can't get paid …
Communicating with physicians is also the key to making sure they
don't make promises you'd prefer not to keep.
"You have to educate your surgeons as to where they can do the sur-
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