A WOC nurse is elbow deep in a complicated wound dressing when the pager calls out for attention. This person is likely to wonder whether this represents another consult in addition to an already-overcrowded schedule. Upon responding to the pager, the hospital operator states that a sales representative is on site with a new product; the representative anticipates the encounter will require only 5 minutes. The lure of a new product is substantial [horizontal ellipsis] it will take only 5 minutes.
In the office, the industry representative paces nervously; does the WOC nurse remember his or her appointment? The representative has found the WOC nurse to be keenly interested in any new development in the market but has yet to bring a new product into the facility. The representative enjoys their chats about current issues, news from other facilities, new research in the field, and even small things from their personal lives, but the ultimate goal of this visit is the purchase of appropriate products.
This is a common scenario for many WOC nurses and sales representatives. The relationship is important to both participants, the associated clinical facility, and, ultimately, the patient. There are several things that both the WOC nurse and the sales representative should keep in mind to ensure a mutually beneficial relationship.
Some WOC nurses may be unaware that the Advanced Medical Technology Association's (AdvaMed's) Code of Ethics on Interactions with Health Care Professionals provides guidelines for such a relationship. In contrast, nearly every industry representative knows about the code. The AdvaMed code is a gold standard for interactions between medical technology companies and healthcare professionals. While adherence to the AdvaMed code is voluntary, nearly all companies endorse the code and use its guidelines to ensure ethical and socially responsible business practices among its representatives. It would benefit all medical professionals to realize that not only the purveyor of illegal gifting may face the negative consequences but the recipient may also be held accountable. The code outlines limitations on what the sales representative can do for the WOC nurse. I recommend investing the time to become familiar with this code; it is specific and easy to understand. It may be accessed from the URL: http://www.advamed.org.
An understanding of facility policy regarding contracts and purchasing is also essential to forthright communication between the WOC nurse and the sales representative. What WOC nurse has not at some point been introduced to a wonderful product possessing the potential of making a real difference in everyday practice? However, this enthusiasm must be balanced against the reality that healthcare is a business. As a result of limited resources available to any business, we cannot have everything we want and sometimes not even what we think is needed. Most facilities have complicated contracts with terms such as preferred providers, sole providers, tier 1, 2, and 3 pricing, allowable off-contract percentages, just to name a few. These purchasing policies limit which products may be purchased and made available for routine clinical use. The WOC nurse has variable influence over these contracts, and the sales representative should understand and respect these limitations.
Mutual respect enhances the WOC nurse-sales representative relationship. Each of our roles is essential to the delivery of quality patient care. We can demonstrate respect for one another by recognizing that everyone operates under time constraints. Visits to the WOC nurse should be scheduled as an appointment, and all parties should arrive on time and focus on the task at hand. While everyone desires a friendly, relaxed atmosphere, our respective employers consider this as productive work time. We want to fulfill this obligation by making the meeting meaningful to our practice. It may be necessary for either party to redirect the discussion to a professional level if the conversation strays toward other matters.
By nature, the sales representative is easily approachable, friendly, and engaging. It is easy to develop friendship, and this is acceptable if business is business. Nevertheless, the WOC nurse must judge each product based on its objective criteria such as efficacy, safety, cost, and clinical utility to the facility. Developing personal loyalty to a specific sales representative may backfire if the facility discontinues the contract for a product, the representative changes employment, or another product is identified that is better suited to current needs. Representatives often devote a great deal of time and energy to an account, only to lose it to better pricing, a better product, or purchasing contract changes. This can not only be a great disappointment but may also result in significant financial loss.
Sampling of products is a common practice, and many facilities have strict guidelines on the use of samples. Handing out samples to one patient because we deem him or her to be in greatest need is often not an acceptable practice, because it does not ensure equity for every patient served by the facility. Product failure or adverse reactions are additional potential problems associated with the use of sample products since there are no formularies or policies to protect from litigation. For instance, applying a sample product to a patient's skin may result in a rash. How can this product then be reviewed and defended if it is not even approved for usage in the facility? In contrast, allowing samples to sit on our shelves is a poor use of resources and may cost the company providing the sample a great deal of money. Continually relying on a sales representative to provide samples to without the real potential for addition of the product to the shelf is an unreasonable and costly expectation. Therefore, WOC nurses and sales representatives should be judicious in the giving and receiving of product samples.
There are common and reasonable expectations on both sides of this relationship. We can expect those with whom we are interacting to have as their most basic focus the delivery of the best care possible to the person which we both serve: the patient. While it is understood that the sales representative is there to sell a product and thus generate income, and the WOC nurse is there to deliver care to a specific patient population, a relationship that is honest and forthright without hidden agendas will be the one to bring greatest satisfaction and positive outcomes for all. Prompt responses to phone calls and e-mails are reasonable expectations. In the event of product trials, support and communication are important to the outcome of the trial. The sales representative must be able and willing to educate staff on proper use of products, or make arrangements for other company representatives to provide the necessary inservicing. This may require the sales representative to interact with the education department and the procurement and central services personnel. If staff does not feel comfortable with the product or the presenter, effective product application may be hindered. We can expect a high level of knowledge on both sides about products, contracts, reimbursement issues, and costs. When expectations are not met, a frank discussion may be necessary to correct any misunderstandings.
The relationship between the WOC nurse and the industry representative can be rich and rewarding. Oftentimes, we brighten one another's day and provide just the repose needed in 2 greatly demanding and intertwining fields: healthcare delivery and sales. We develop friendships, network, support one another, laugh together, and bring the best we have to our patients. This is the reason we must work together to keep our relationships strong. Careful attention to respect, communication, and knowledge will ensure relationships that meet the needs of everyone affected. For the WOC nurse, productive relationships with sales representatives bring only more satisfaction to a profession that already offers so many rewards.