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cians, and my reassurance that additional supplies and a prepared
team would always be at the ready, resulted in their agreeing on a
standardized middle ground, eliminating the use of a full GYN pack
for those procedures.
Consign and commit. One way to place products on the shelves
without an initial outlay of cash is to pursue consignment agree-
ments. Products are placed at the center and only charged after they
are used and replaced on the shelf. This is a great way to have accessi-
bility to products without tying up operating dollars on the front end,
especially for de novo centers and new service lines without a usage
history. The theory is that by the time the products are used and
replaced — resulting in an invoice from the vendor — some money
will be coming in from either patient or insurance payments to cover
the replacements costs.
Letters of Commitment (LOCs) can facilitate better pricing if your
surgeons agree to use a certain percentage of supplies or implants
from a dedicated vendor or commit to a certain dollar amount in
annual expenditures. This is common with larger suppliers that work
with distributors and group purchasing organizations.
If you opt for either of these options, take extra caution to read the
fine print in the signed agreements. The days of a gentleman's agree-
ment for consignment or tiered pricing are gone, and contracts hold
both the buyer and seller accountable on many levels. I've seen some
consignment contracts that are a single page, but very constraining,
while others are multiple pages with more flexible terms. All contracts
are negotiable, so don't be afraid to approach reps with your concerns
about language that makes you uncomfortable. If a proposed contract
is tricky to understand or work through, consider bringing in legal
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