pacemaker reps

Hello all, hope everyone is having a good day. I looked all over the internet and hope you can help. What type of background do pacemaker reps have? Like RN, LVN etc are or they just that reps??? As a female pacer had a negative run in with a male pacemaker rep yesterday. Thanks guys :)

17 Comments

Good Point

by Moner - 2012-07-10 05:07:24

Casper raises a good point.


>^..^<

Good Question

by Casper - 2012-07-10 05:07:35

Hi Electricmom,

I wish I knew, that is an excellent question.

I often wonder sometimes, because it seems like the pacemaker represenative is running the show.

I get a little concerned when I see my EP call in the rep to ask certain questions.

I realized EPs are very busy, but it's a little scary when I see them defer to the rep.

No offense to any of your reps out there, but I prefer my doctor to be somewhat knowledgeable about this also.

Casper

I wonder

by IAN MC - 2012-07-10 07:07:16

Here in the UK , PM reps have no involvement whatsoever with patients. We are seen by Cardiology Physiologists who have a minimum of 3 years of intensive training. They are trained in all makes of PM and not just one.
I was discussing the American system with a couple of them last week and they were very disparaging about it.

They felt , as I do, that in comparison reps will receive minimal training and their knowledge will be fairly limited.
I'm sure that there are some good ones around but it doesn't sit happily with me that my health would be in the hands of someone who is part of a marketing ploy by the PM manufacturer

Ian

depends

by Tracey_E - 2012-07-10 07:07:20

I heard a speaker once who is a pm rep, he was in car sales before. He was still pretty knowledgeable and I enjoyed his talk, but it was a little scary thinking he takes care of people.

My rep has a background in bioengineering, has been doing this for almost 30 years, is proactive in keeping up with case studies... I trust him more than my dr with fine tuning my settings because he knows the device better than the doc.

I would imagine most of them are somewhere in the middle. Some are simply trained to run the machine, others are experts. There is no set requirement to be a tech as far as I know.

PM Reps

by TalkinCardio - 2012-07-10 07:07:38

Hmmm, good question. I dont have the answer but look forward to reading more responses. The rep I see is very knowledgeable and spends a lot of time with me to get my settings right. He knows how important it is to me and seems to care.

My experience with the nurses and docs is that they just seem to want to set it at what they think would be good for me.

I do realize not everyone's experience is like mine.

Cathy

PM Reps

by Roys - 2012-07-10 09:07:17

Yes i would like to know what qualifications a PM rep has? Australia has the same system as the US, the EP does nothing and the rep does the lot.
Roy

EP / rep.

by Alma Annie - 2012-07-10 09:07:28

I also live in Australia, and that is not the system that happens to me. The rep downloads then in comes EP, looks at download, and they discuss anything necessary. Only then does EP talk to me and I have learned to ask many questions. I also ask rep questions before EP comes in. They seem to work together.

Alma Annie

my problem w/rep

by electricmom - 2012-07-10 10:07:19

If this is TMI I'm sorry, but at the practice I go to, first you get a EKG, then the pacemaker guy comes in, then his RN then the EP, so its a non stop people the (entire time clothed). I complete understand exposing yourself for the EKG tech and RN and EP, but the rep in my mind just "helping" himself to my body for the pacemaker ck and the leads. I don't know this guy from adam and he just putting on ekg electrodes and stuff. Yes he is the same rep for the last 2 or 3 appts I just didnt feel comfortable with him just assuming that its ok for him to pass that line. I hope I am making sense.Ive been to my fair share of cardiologist, EP's, had a pacemaker put in and had 2 children naturally so Im ok, if asked to have other people touch my body. Thats why I was asking about their background. Thanks for listening and your responsive.

Rep vs EP

by ElectricFrank - 2012-07-11 02:07:17

These are two different breeds. The EP is qualified to perform surgery including implant, ablation, etc. They are doctors with a specialty. The manufacturer rep seems to be at minimum a biomedical engineer. Sometimes they are called techs in which case I would guess they are only a person trained to use the pacemaker programmer.

Things get murky with the reps. My experience with the Medtronic reps is that they know the pacemaker including all its options and quirks. My cardiologist always has a rep in the OR during implant or replacement to control the operation of the pacer. Where it gets tricky is that medical ethics are similar to that of a nurse. Theoretically the doctor makes the final decisions after consulting with the rep. The rep is never supposed to suggest anything in presence of the patient that would contradict the doctor. This can create confusion when the rep knows the problem, but the doc has other ideas. It can make the rep seem incompetent. I cleared the air on this one at my first checkup and demanded that any controversy include me. Things have been great since.

My experience is only with Medtronics reps and in the US medical system. I have heard complaints about other situations where reps seemed to be retrained used car salesmen. I wouldn't last 2 minutes if I had that experience.

I wish I could make things clearer,

frank

It could be convenient!

by IAN MC - 2012-07-11 04:07:44

Instead of making two journeys you can have your PM checked AND buy a second hand car..from the same person.

Cheers

Ian

Or maybe a Life Insurance Policy

by ElectricFrank - 2012-07-12 01:07:59

Only problem with them is they don't work. I've had several friends who had Life Insurance and they are as dead as the next guy.

frank

I'm not convinced

by IAN MC - 2012-07-13 03:07:59

Hi Don ... As I suspected there are good Medtronic Reps / Techs and bad ones. I don't care what job titles they have , they are providing the service for one reason only and that is to increase the market shares of their company. At that moment in time when the PM needs replacing they hope that the patient and the Dr will demand another Medtronic , because of the helpful service they provide.

So your health is determined by how slick a company's marketing operation is. It just seems unethical to me ; it shouldn't be like that.

I know that pharmaceutical companies, via their marketing, have a massive influence on the majority of doctors in determining what drugs we receive. But how many of us would be happy if a drug rep sat in on the doctor - patient consultations ? ( Actually, in some areas, drug companies are sadly achieving this; take asthma clinics for example. It is now becoming common for drug reps from one company to sit with the patient and practice nurse and help demonstrate the best way of using an inhaler.... guess which company's inhalers are now favoured by most doctors ! )

So a Dr doesn't make an objective judgement on which PM or which inhaler is best for the patient..it's after-sales service that swings the decision.

Also I'm not certain that engineering qualifications are the best background for someone doing PM adjustments . I would rather have someone with a deep understanding of cardiology and of my heart condition and knowledge of the knobs and twiddly bits on the PM !

I know that in the US , theoretically the rep is there purely to assist the Dr but once diverse personalities enter the equation, anything can happen.

Cheers

Ian

Rep vs Tech

by donr - 2012-07-13 10:07:10

I have always used & heard the terms used interchangably here in Atlanta. I know that I have vetted the Rep/Techs that come to my cardio's office for our annual mfgr's testing. They have been engineers by education & very knowlegable on the Medtronic PM's. A couple have been total AH's, but they did not last long at visiting the practice. They have also been willing to discuss what they see & when I stick my hand out & ask to see the report, they hand it over & answer questions, albeit a bit reluctantly on occasions. Those alternate w/ a test by his staff, who, before I get to ask, hands me a copy of the report to carry out w/ me. One of them will always stay behind to answer questions after the Great Man has departed.

The several that service his office have all been pretty good & NOTHING happens w/o his knowledge & approval - NOTHING. I've noticed what Frank mentioned about the Rep/Tech trying to not get into the discussion when my Cardio is present. Once he kinda edged his way in because he noticed something he thought was unusual, but for me is normal - I have a bi-modal distribution of heart rates, w/ a peak between 70-80 & a peak at 100-110. He was new to me & did not know this. My cardio was not excited - he's seen that for 10 yrs, now.

I've experienced Rep/Techs in two sections of Atlanta & one hosp in St Louis & all have been well versed in the functioning of the Medtronic devices.

Don

Missed the Point

by TalkinCardio - 2012-07-14 03:07:08

I think we all missed the point of electricmom's question. She posted a clearer explanation of her inquiry. She is very uncomfortable with the rep "helping himself to her body."

My rep has never even had to touch me when interrogating my pm. I think just the fact that she feels uncomfortable, she should confide in someone in that office, perhaps the RN or EP. My guess is, they would have someone else that can handle her pm checks.
Cathy

Agreed

by IAN MC - 2012-07-14 04:07:48

Yes , Cathy, we moved away from the original point and the advice you give electric mom is good, if the rep makes her uncomfortable she should definitely raise her concerns with someone..

This is just another reason why I believe that it is wrong for reps to be involved in the doctor - patient interface

There ARE better systems , like the UK system which I described in an earlier post.

I understand marketing,and the need for it, very clearly but this is a step too far in the marketing process.

Ian

Rep/Tech Functions

by donr - 2012-07-14 07:07:08

IAN: Point well taken! But here's where things turn sour:

Medtronics develops a brand new, all seeing, all sensing, all everything PM. How the Devil are they going to sell the devices f they don't have a marketing effort? There's big money invested in the development & somehow the word about this device has to get out.

Yes, they can put on demos & lavish presentations at cardio conferences, but they STILL need some one-on-one sales work.

Unfortunately, as we discuss all the time, the medical field is NOT peopled by electronics saavy folks at all. They need a lot of support, technically to have the devices work correctly - hence the close relationship w/ the Reps/Techs. Look at the length of time it takes Medtronics to train a Rep. Months/years. How many MD's have the time to invest in that intensive training while running an active practice? None, I'd say.

I've run into parallel issues when it comes to drugs. My cardio is pretty darned sharp, but get him into a discussion of drug interactions w/ drugs OUTSIDE his common usage & out comes the doorstop sized PDR book & a lot of page flipping by his accompanying nurse to find the answers. But - if I ask my local pharmacist, she has the answer at the tip of her tongue in infinitesimal detail - sometimes. But the other day, she had to rip out the package insert to find an answer for me.

There is just such a mass of info out there & devices have become so complex that it is nearly impossible for a physician to work un-aided. Naturally, they are going to develop favorites among all the competing devices - they become familiar w/ its bells & whistles & idiosyncracies, so they use that one.

I think my cardio's favorite is Medtronics - I've had two of them now. He has PM days every week, & I've never seen any other rep there for mfgr checks. He has several Medtronics programmers & he has several nurses pretty capable at using them. Now, am I being short-changed because he has taken this route? I dunno. At least he is competent at using that one brand - but what am I possibly missing by him not using other brands of device? Would I get less competence because he spread himself too thin across many products?

The answer is NOT to restrict the market to a single brand. Then you lose the technology advances brought on by competing ideas. Look at the varied characteristics of drugs. There are many that supposedly control the same problem - but do it in different ways, w/ different side effects. I've wallowed through several BP control drugs to find the ones that did not give me adverse reactions.

Ditto for a bladder exit -specific beta blocker. Of the 6 major side effects for the one chosen for the Dept of Defense formulary, I had 5 of them. Wound up having to take the more expensive alternative that gave me zero side effects. This particular case illustrates the slick marketing effort issue. DoD was sold a bill of goods by the firm making the "Bad" one. After the dust all settled & the practicing urologists kept justifying the more expensive drug that affected men less, the situation was reversed.

In a perfect world this problem would not exist - but our world is not perfect.

Don

Medtronics reps

by ChristieD - 2012-09-27 09:09:00

I'm new here. Just got my pm last week but when the medtronics rep did my post op pm check in the cardiologist's office this week my husband actually asked what type of qualifications are required to be a rep. The rep said the only requirement is a bachelor's degree, no specific field. He said most of them are nurses or radiology techs (which is what his background was), but a degree in a healthcare field was not required. They are similar to pharmaceutical reps in that after you are hired you go to an intensive pm school for several weeks.

I had a good experience with the rep I saw. I'm a nurse so I asked several more "technical" questions than he said he normally got. A few he was unable to answer and told me to ask the doctor but that was ok. I'd rather be referred to someone else for my question than given a bs answer.

And by the way, he didn't touch me at all. Handed me the device to place over my pm and told me where it should be placed. The lady that feels uncomfortable with her rep needs to bring it to the doctor's attention and possibly lodge a complaint with the manufacturer the rep works for.

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