6 6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E A U G U S T 2 0 1 7
Medical Center, is regarded as one of the
pioneers of the rep-less movement. He
led the medical center down the rep-less
path starting in 2013.
"Most routine equipment in total hips
and total knees has not changed much
over the years, and I've seen no studies to
show any particular implant is providing
better patient outcomes in most cases,"
he says. "There's also the issue of cost.
Two-thirds of the cost of these products
is associated with things like marketing
and staffing and managing a sales force,
not the actual manufacturing."
Loma Linda contracted with an outside
firm to teach 2 of its most proficient OR
techs how to provide support for sur-
geons during joint replacement proce-
dures. The medical center does as many
as 90% of primary total knee and total hip
cases using the rep-less model.
"You have to do the training and buy the [implant] inventory, and it takes a
year to recoup those costs," he says. "Because we have our whole inventory on
the shelf, there are no problems with implants coming in unsterile. You have to
give your people the dedicated time they need to do the job right, and you'll face
some increased costs there, but it's minimal compared with the savings."
Dr. Botimer says implant costs have dropped considerably under the rep-less
model — from a high of more than $4,000 per implant down to $1,500 and
$1,900 for total knee and total hip implants, respectively. These savings could be
just the tip of the iceberg at Loma Linda, says Dr. Botimer, who notes that simi-
• VENDOR VALUE Manufacturer reps help manage needed sup-
plies and provide a valuable safety net in cases of urgent need.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
