Overheard at the coffee shop

TheCommuter, BSN, RN · Jul 22, 2015

I could never work in any sales position, including medical device sales, healthcare marketing, and so forth. I'm simply inept at talking around the truth, especially when attempting to sell a good or service I personally do not believe in.

lindarn · Jul 22, 2015

Clearly, some of us, including you, are ethical, and some of us are not, as demonstrated by the individual in the above scenario.

And, no, I will NOT try to sell you the Brooklyn Bridge!

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN (ret)

Somewhere in the PACNW

elkpark · Jul 22, 2015

They're in sales. What do you expect?

JustBeachyNurse, LPN · Jul 22, 2015

She was wearing a mini dress, no stockings, peep toe stiletto heels. He had on khakis and a polo shirt. They were talking about visiting a facility to try and watch a device insertion. She'd be barred at the door in that attire or very uncomfortable in paper scrubs given to vendors & visitors. Not exactly safe in spiky heels.

I bit my lip when he was spouting off medical misinformation he uses in his pitch. I can only see Dr Nick Riviera of the Simpsons possibly believing his tales...

Orca, ADN, ASN, RN · Jul 22, 2015

Having been around the business for a while and having gone to more than my share of drug company presentations, I know that drug companies hire eye candy, young, attractive females as field representatives (because most physicians are male). Most of the ones who I have encountered are pleasant enough, but they get uncomfortable very quickly if your questions take them very far outside their prepared script. I make it a point to try to ask at least one that they probably don't have a prepared answer for. :)

The attitude that the OP referred to about the profit-centeredness of it all doesn't surprise me one bit.

I did sales for a brief time while I was in college. I worked at a big and tall men's clothing store. I absolutely hated it. I knew that our customers had few, if any, other options (this was before the internet), and that we were ripping them off while trying to convince them that they were getting a great deal. Our cost on any item was half or less of the ticketed price. The sales people weren't racking up, either. My commission was three percent of everything over $8,000 for the month (and this was at 1977 prices). We existed to line the pockets of our owners, who were not short of cash before they got into this particular business.

Asystole RN · Jul 22, 2015

I currently work in sales on the medical device side of "industry."

Like any profession, there are ethical people and unethical people.

I am first and foremost a registered nurse and take my ethical covenant with my patients seriously. I never have and never will sell or advocate for a product or service that I do not 100% believe in. In fact one of the products in my bag I will not sell it for one of it's indicated uses because of issues. Most of the sales reps I work with in my company and others in the field believe the same, not because they all are nurses (most are not) but because they have ethics and value their reputation.

In medical sales it is very common for a sales rep to move from company to company, it's as natural as nurses moving from hospital to hospital. The difference is that those who we deal with in the hospital tend to be a very small group of individuals. Snakes and used car salesmen tend to not last long because once you burn a bridge with one hospital while at one company, that bridge remains burned for any other company you go to.

Asystole RN · Jul 22, 2015

She was wearing a mini dress, no stockings, peep toe stiletto heels. He had on khakis and a polo shirt. They were talking about visiting a facility to try and watch a device insertion. She'd be barred at the door in that attire or very uncomfortable in paper scrubs given to vendors & visitors. Not exactly safe in spiky heels.
I bit my lip when he was spouting off medical misinformation he uses in his pitch. I can only see Dr Nick Riviera of the Simpsons possibly believing his tales...

Should have said something, speak up and call them on their pitch.

Personally I love discussing EBP with nurses, sometimes I can point them towards new studies and sometimes they point me to new studies.

Sounds like she came from the pharma side of the house. Pharam reps are notorious for dressing inappropriately and trying to sell more than their product. In fact, my company does not hire pharma reps simply because the mentality is sooo different.

I wish I was allowed to wear scrubs It would make packing for traveling so much easier. Most hospitals frown upon reps wearing scrubs and some systems like Banner Health outright prohibit reps from wearing them to avoid confusion.

If anyone has any questions about industry or odd things they have noticed, or the process, I would be happy to answer them.

AutumnApple · Jul 22, 2015

I was going to point out that these two could have been having this convo right in the hospital administration's offices and no one would have blinked.

Truth is, this mentality of theirs survives because it caters to something on our side of the street.

They spout medical misconceptions and seek loop holes because, there are people on our side who turn a blind eye but insist on getting a small......discount for doing so.

Corruption is like C-diff. Once one person has it, unless you are very careful, the whole hallway eventually has it.

When it comes to corruption, we definitely have it in our hallway. Best we can do sometimes is keep our own hands clean.

Asystole RN · Jul 22, 2015

I was going to point out that these two could have been having this convo right in the hospital administration's offices and no one would have blinked.
Truth is, this mentality of theirs survives because it caters to something on our side of the street.
They spout medical misconceptions and seek loop holes because, there are people on our side who turn a blind eye but insist on getting a small......discount for doing so.
Corruption is like C-diff. Once one person has it, unless you are very careful, the whole hallway eventually has it.
When it comes to corruption, we definitely have it in our hallway. Best we can do sometimes is keep our own hands clean.

I have to disagree.

There is a misconception that the C-Suite only care about the bottom line. Most administrators I meet with are PASSIONATE about patient care and their nurses, they just may not have the best ideas or ability to implement them :dead:

Now I am not going to say that contracts and costs are not a large percentage of the decision making but if it came down to just dollars my job would be far, FAR easier. Dangling a cost savings or contract compliance is a way for a company to get their product into the value analysis committee or into an evaluation but the decision almost always comes down to the 4-5 nurses who actually filled out their eval form out of 400-500 that tried the product :roflmao: Voting counts! lol

The process and politics as to how any given facility has any given product is somewhat complicated and was a real eye opener for me.

JustBeachyNurse, LPN · Jul 22, 2015

I think this was more clueless than conspiracy/corruption. The woman looked like barely a college graduate not an experienced pharmaceutical rep. The bits I could overheat she had minimal background.

I have nothing against reps that know and believe in their product. Promoting off label use of an FDA regulated product borders on illegal. Yes physicians and providers can prescribe off label use but sales reps cannot legally promote off label use whether it's a drug or device.

Sure a rep needs to be savvy and personable and know how to turn a light "no" into a definitive "yes"

Asystole RN · Jul 22, 2015

I think this was more clueless than conspiracy/corruption. The woman looked like barely a college graduate not an experienced pharmaceutical rep. The bits I could overheat she had minimal background.
I have nothing against reps that know and believe in their product. Promoting off label use of an FDA regulated product borders on illegal. Yes physicians and providers can prescribe off label use but sales reps cannot legally promote off label use whether it's a drug or device.
Sure a rep needs to be savvy and personable and know how to turn a light "no" into a definitive "yes"

Makes sense.

On the off label use thing though that topic is somewhat complicated. It is obviously a very big deal in industry not only because the FDA can fine your company but it also puts the manufacturer on shaky legal grounds when they promote a product for off label use.

That being said, pretty much everyone in industry has to know how and why something is being used off label and how to teach to it. I do not want to go into details about my own products, simply because many nurses here have probably seen me if not spoken to me on this board in person, but a few of my products are purchased expressly for an off label use.

Now I will not go in and sell to the off label use of a product but I will help educate them on it's proper use, interventions, and troubleshooting all the while fully disclosing that it is an off label use. It is up to the hospital whether they wish to us a product off label or not, it is up to the manufacturer to let them know exactly what the product was designed for and what it is approved for.

For example (not my products), if someone buys a securement device for a central line (what it was indicated for) and decides that it works just as well securing surgical drain tubing (off label use) it is up to the hospital to take on the liability. The manufacturer has the duty to inform the hospital of it's use and educate the hospital on how to safely use the product without harming the patient. The manufacturer must disclose though that the use is off label.

A product may be designed for one use and is sold to be used that way but 0.5% of the product may be used for some weird niche application. The manufacturer cannot afford to spend literally millions to have the indications changed through the FDA so Billy Bob RN can secure his surgical tubing that he does not have a good alternative for. Just an example.