I have been calling on hospitals my entire career. The process was simple. An appointment was made with a person in the hospital who had either requested product information or who was someone who was likely to have interest in the manufacturer we were representing. For most of my career I simply went to the office of the person I had the appointment with and met with them at the appointed time. If there was interest then I would follow up by meeting with others involved in the decision or possibly conduct a trial of the products. Often I also met with Material Management about the products.

In later years, mostly due to the advent of national GPO contracts, the hospitals became less available for the introduction of new, non-contract products. They began to restrict the free information flow between vendors and providers (doctors, nurses) to "protect" and ensure the utilization of their GPO contracts. The reasons for the restricted access were to prevent the providers from requesting trials of products which were shown to them regardless of the potential clinical or cost benefits that the "off contract" products might provide. The true reason for the restrictions was that the GPO system had set up a monetary reward for contract compliance. Those GPO members that bought a large percentage of their products from their GPO contracts received very large dollar "rebates" at the end of the year. Buying "on contract" became a profit center for the hospitals. The negative effect of the system was that information about small product innovations that improved the clinical efficacy or incrementally lowered costs that "non-contract" vendors might develop, became increasingly more difficult to present directly to providers. The stated reasons for these restrictions were that the providers did not have time to bother with sales people. However the result over the last 20 years has been to effectively strangle clinical innovation in deference to the bureaucratic lowering of cost above all else.

The ever increasing restricted access for "non-contract" vendors had the chilling effect of helping the large vendors to get bigger and the small vendors to struggle. Over time there became less and less reason for the contract vendors to innovate because to do so would only increase their costs. GPO's who receive 3% and more of every dollar spent by their members have very little reason to award a better, fewer selling, product on contract if it didn't already have huge sales. I have personally seen a GPO survey their members to see which vendor the members were already buying most of so that when the contract was awarded it went to the vendor who could provide the largest fees to the GPO rather than the product that might be clinically the most innovative and effective.

Vendor Credentialling is simply the logical extension of this Restricted Access System. Making it more difficult for sales people to enter the hospital by requiring registration further protects the status-quo. One major hospital system in the Pheonix, AZ area requires that a vendor enter a valid GPO contract number into their Vendor Credentialing system before it will issue a badge to the sales person. This requirement strains the argument that the hospital is "protecting" their patients and personnel from the diseased riddled, suede shoe, fast talking, snake oil charlatans that apparently professional medical sales people have evolved into. The entire purpose of Vendor Credentialing is to tighten and further restrict access to providers. All other arguments are specious as I will show in future Blogs.