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with highly trained in-house techs. The new approach is called "going rep-less."
Is this staffing model as promising as it sounds?
To find out, we talked to leaders at Loma Linda (Calif.) University Medical
Center and Wayne County Hospital in Corydon, Iowa, about their decision to go
rep-less. Represent-atives from implant manufacturers no longer have a perma-
nent place at the surgical table in those facilities, and the bottom line may be bet-
ter off because of it. By going rep-less, you work directly with the implant manu-
facturer, meaning you pay no costs associated with "rep services." Because
you're paying only for the implants, you should be able to significantly reduce
overall case costs.
How? By turning the supply chain on its ear. Third-party companies offer to
provide your facility with FDA-approved implants directly or connect you with a
manufacturer of generic implants. Cutting out implant manufacturers bypasses
pricier options inflated by the costs of marketing, distribution and managing a
sales force. Companies following this model will also train and certify surgical
techs and supporting OR personnel on site to perform the functions traditionally
handled by reps.
Some of the companies in the space suggest they can reduce a facility's cost
per implant by as much as 80%. Daren Relph, CEO of Wayne County Hospital,
can't confirm that number, but says going rep-less has helped his hospital create
a more cost-competitive joint replacement program. Wayne County started
down the rep-less road about 3 years ago after key implant vendors refused to
negotiate on price. About that time, a company came calling with a direct-pur-
chasing model to cut implant costs and train OR techs to assume the duties tra-
ditionally handled by vendor reps.
Mr. Relph wanted to know what the company's training program involved and
what kind of support the company offered after the initial educational sessions
were completed. "In very short order they had the techs trained to be on par
with the reps that had been coming in through a traditional program," says
