Help Your Customers Get Unstuck

Edition: February 2003 - Vol 11 Number 02
Article#: 1454
Author: Laura Thill

Hospitals had no choice. There was no question that strict Occupational Safety and Health Administration (OSHA) regulations applied to them. The threat of expensive personal liability suits initiated by injured employees and surprise inspections by OSHA were pretty much all it took to convince them to convert traditional needle systems to needle safety or needle-free devices.

But physicians and small clinics are quite another story. For one, some medical associations initially advised physician clinics to hold off on safety conversions until they could confirm that the new regulations applied to them, according to Jim Berdela, director of marketing and distribution management at Becton Dickinson (Franklin Lakes, N.J.).

In addition, many doctors misinterpreted the law. “Many thought, ‘If I try a safety device and don’t like it, I’m not required to use it,’” notes Berdela. It was only in recent months that OSHA clarified to physicians that they must comply with safety laws, he adds.

But there’s no mistaking – OSHA means business, and doctors are catching on. For instance, the Joint Council of Allergy, Asthma and Immunology (JCAAI) informed its members last June 2002 that OSHA requires physicians to convert to needle safety systems unless such a move compromises patient safety or medical ethics. As to whether OSHA would grant an exemption pending a study of facilities providing childhood immunizations, OSHA had this to say: Such an exemption would be inappropriate, especially considering that the Needlestick and Prevention Act specifically aims at ensuring that sharps with Engineered Sharps Injury Protection (SESIP) are used to reduce injuries. Between 62 percent and 88 percent of sharps-injuries can be prevented by using safer needle devices, according to OSHA.

Docs Trail Industry

“Doctors need to be educated before they can develop an appreciation for safety,” says Berdela. “With 450,000 office-based doctors in about 250,000 settings, it’s going to take longer to educate these market segments, and reps can’t let themselves become frustrated.”

That’s not to say the situation is hopeless. “I think doctors have come a long way,” says Mike Bakkar, sales rep for PSS (Atlanta). “Still, we have to be tactful.”

“Doctors definitely are starting to open up to the idea of needle safety,” adds Brent Bechard, PSS sales rep (Atlanta). “Even some small practices will sometimes request safety products on their own.”

Bakkar agrees that the more education reps offer their customers, the better chance they have of convincing them of the importance of converting to safety systems. “At this point, we only see about 40 percent of doctors complying,” he says. “Some doctors actually buy safety devices, but never use them.”

Ed Thompson, senior director of advanced protection technologies for Becton Dickinson, concurs. “We’d like to see doctors extend the same concern for their employees’ safety as they have for their patients,” he says. “But, OSHA’s presence has been far less common in physician practices compared with hospitals. Essentially, there’s much less pressure on these physicians to convert.”

Are physicians not aware of the increasing number of citations OSHA has recently issued? For instance, in the period from Jun. 1 to Aug. 31, 2002, OSHA issued 24 violations. This compared with 89 violations handed out between Jul. 1, 2001 and May 31, 2002, and 54 citations issued between October 2000 and September 2001, according to the National Alliance for the Primary Prevention of Sharps Injuries (NAPPSI).

“OSHA doesn’t publicize these citations,” says Thompson. “So, the doctors aren’t aware of enforcement practices. The hospitals know about it, but doctors really don’t.” Still, he adds, “OSHA enforcement activity is likely to increase in 2003, and physicians need to be aware of this.”

Educating Your Customers

Just as hospital employers have been aware of their increased exposure to personal liability suits should they fail to comply with safety regulations, physicians are starting to see how this could apply to them as well, according to Thompson. “The cost of complying is much less than taking on a personal liability suit,” he says.

“If doctors understand this, they’ll understand why it’s important to convert to safety systems,” adds Berdela. “It’s an insurance policy. Doctors must put measures in place to prevent problems from arising. Plus, it’s the law now. Reps need to educate doctors on this.”

But, getting doctors to accept the idea of converting to new devices has been somewhat of an evolutionary process. “The reps must act as consultants, informing doctors why they need to convert to safety products,” says Thompson. “Reps must take a consultative standpoint and explain laws and liability problems that can arise if doctors don’t comply.”

Doctors are ready to be educated, says Bechard. “I’ve seen more receptiveness lately,” he says. “When I give a presentation, it doesn’t end right away. Doctors want more information.”

“Doctors definitely are better educated today,” adds Bakkar. “They shop more carefully, especially given the constraints of managed care. Service is still important to them, but it’s not the only thing. Price has become a big issue as well.”

Just How Big a Deal Is Price?

According to Bakkar, the cost of needle safety devices remains a big deal for his customers. “It’s a huge obstacle,” he says. “At the minimum, a customer triples his or her cost by purchasing safety products.”

While Berdela acknowledges that pricing probably is one of the first issues doctors raise to reps, he doesn’t believe this really is their biggest concern. “Doctors are looking for minimal change in their clinical technique,” he says. “It’s hard for them to change, especially considering that the safety issue is only one of many issues they must deal with.”

Thompson concurs: “If something feels different, it will take a doctor time to adapt to the new device. The psychological change is a bigger issue than economics.”

“Doctors have a lot on their plates to deal with,” Berdela adds. “They can’t afford to impede their technique. That’s why it’s good to offer them several technology options in each category of safety devices.”

“We don’t want our customers to feel they have no choice,” says Bechard, pointing out that he always warns physicians about OSHA regulations and informs them about the different options available.

What Doctors Want

Educating your customers is just half the battle. Helping them decide on the best safety solutions to meet their needs can be equally challenging.

“There probably are as many opinions about what are the best safety options as there are physicians,” says Thompson.

“Sometimes, doctors will test out safety devices and complain that they are cumbersome or that they feel less safe,” notes Bakkar. “For instance, if a safety device locks, the doctor must open up a new scalpel. Other times, devices must be pushed forward or backward (to activate them) and this can be difficult.”

Are needle-free physician practices in our future?

“Eventually, it would be great to see needle-free healthcare,” says Bakkar. “But, the technology isn’t there yet. Yes, some doctors may use needle-free IVs. But for the most part, doctors still need needles.”

Helping Doctors Take the Safety Leap

As the drive accelerates to convert physician practices to OSHA-compliant environments, companies are stepping in to help ease the transition.

B. Braun Medical Inc. (Bethlehem, Pa.) recently introduced the Ask the B. Braun Safety Expert program. The free service is designed to answer questions on healthcare safety issues for clinicians and consumers. Topics covered range from medication errors to needlestick injury prevention and the use of PVC/DEHP in medical products. In addition to offering individuals their own expertise, B. Braun consultants (made up of a panel of clinicians and nurses) provide information from various published documents, as well as government statistics. Interested persons can access the program by calling 888-800-6668 or by e-mailing

Meanwhile, Becton Dickinson (Franklin Lakes, N.J.) seeks to provide doctors with an easy, turnkey approach to compliance with OSHA regulations. “We try to look at the whole picture,” says Jim Berdela, director of marketing and distribution management for Becton Dickinson. The company focuses on the following areas:

· Providing customers with safe and effective devices with a range of options. Offer different technologies for each product category.

· Providing a self-paced in-service education kit, which includes a video, poster and reference cards.

· Providing distributor reps with third party education tools to better inform them on how to teach their customers.

· Offering the Safety Compliance Initiative (SCI) program to educate customers on complying with OSHA record keeping and administration requirements.