Materials managers and surgeons are taking steps to cross the chasm that separates them. They say it's key to controlling hospital spending on medical supplies and equipment.
Many hospitals are trying to clamp down on product waste and supply costs by standardizing surgical products to one or two vendors and creating protocols for their use. But such "supply formularies," like pharmacy formularies, work poorly without the support and participation of physicians, materials managers say.
Good working relationships with physicians also help managers carry out some of the basic tasks of their profession, such as negotiating vendor contracts.
Judging by the rancor of comments at a recent panel discussion, however, such good relationships are rare.
Airing complaints. The panel, which
convened at the American Society of Hospital Materials Management meeting in Dallas earlier this month, included materials managers, vendors and surgeons.
Materials managers aired a host of complaints about the other two parties. Among them:
One manager said not a single surgeon returned a survey asking what equipment purchases should be budgeted for the following year. That meant the hospital didn't know what its equipment expenditures would be.
Several managers said they'd been stripped of their price-negotiating power when surgeons told companies they would use products exclusively.
Other managers accused vendors of misleading surgeons about the real cost of products and providing them with biased data on efficacy.
Vendors on the panel countered that salespeople might be too eager sometimes, but responsible firms would discourage such actions.
Surgeons' say. For their part, surgeons said they wanted a simpler process to obtain the products they need. Many surgeons are struggling to reconcile the demands of patient safety and cost, said Michael Kavic, M.D., a general surgeon at 124-bed Ohio Valley General Hospital in McKees Rocks, Pa. They also are trying to balance standardization efforts with their desire for choice.
"We need to sit down and talk," Dr. Kavic said. "Sending me papers about amortization is going to scare the life out of me. I don't want to learn the nuances of cost analysis, but I feel physicians have to learn it today."
Although the discussion made clear the distance between materials managers and surgeons, the fact that it took place also showed the progress they've made, observers said. The panel was put together after the Society of American Gastrointestinal Endoscopic Surgeons asked to make a presentation at the meeting.
One likely outcome of the discussion is that materials managers will participate in a similar panel at the SAGES annual meeting next March in Orlando.
Working together. Audience members also outlined their facilities' programs to help materials managers work better with surgeons.
For example, at 490-bed Veterans Affairs Medical Center in Dallas, biomedical engineers help physicians write out the specifications for new equipment purchases, said Robert Thomale, chief of acquisition and materiel management. The engineers also tell purchasers how easy equipment is to maintain and how well its maker services it.
"They're a good bridge between the technical with the surgeons and the layman with the materials managers," Mr. Thomale said.
Starting this fall, 878-bed New York University Medical Center will put new employees through "procurement orientation," said Martin Edelman, its director of materials management.
The medical center's purchasing department has to request additional information on about 40% of the supply orders it receives. Often, people forget to fill in simple information, such as how much of an item they want, Mr. Edelman said.
Current employees will be invited to attend the orientation sessions. The medical center also is considering developing an equipment acquisition "map" to define the process for physicians and other healthcare workers.
The intention is to smooth relations with the purchasing department and make it easier for both parties to do their jobs, Mr. Edelman said.
"We are not trying to set up red tape, but things do have to be accounted for," he said. "People do have budgets."