You are the OR Director at Metropolitan Suburban Hospital. You’ve come to realize that there are two major companies that manufacture sutures for the operating room. At this time, your operating room is using the most popular sutures on the market. The leading competitor gives you a proposal for switching sutures. By using their comparable sutures your hospital could potentially save almost $2 million next year.

In order to see if the sutures are acceptable, you begin a clinical trial. The trial consists of new sutures being offered to the surgeons, with a representative explaining the similarities and differences. After using the suture, the surgeon is to fill out an evaluation, assessing how he/she perceived the suture to handle and whether or not it was truly equivalent to the old suture.

The company supplied a representative to be in charge of this evaluation. The representative was an extremely attractive young lady, who not only explained the sutures, but was also quite flirtatious toward the surgeons. She wore loosely fitting scrub suits and made a habit of bending over and picking up product from her cases that were always on the floor. The surgeons, for the most part, found her attractive and pleasant. After they were done with the surgery, she would hand them the evaluation form. Not surprisingly, most of the surgeons gave the new suture very high ratings.

The data were compiled and showed that the new suture was not only comparable, but may be even preferred over the old suture. The results of the survey were presented at a meeting of the Surgical Executive Council, a group comprised of the leadership of surgeons in the hospital. Interestingly enough, the presentation was done in the absence of any representatives from the company. After the presentation was completed it was suggested that, since the two-suture product line were equivalent, there did not seem to be any reason why the hospital should not go with the product that would have save the $1.8 million.

At that point, there was a lot of dissension among the surgeons, who stated that they would not use the new suture. Furthermore, if they were forced to use a new suture, they would consider taking their work to a nearby hospital. Being perplexed by this, you asked them how they could have evaluated the suture so highly even they thought so poorly of it. To a person they all stated they did not wish to offend the representative and they falsely evaluated the sutures.

The repercussions of switching the sutures became so great that the hospital was forced to return the original suture, despite several of the senior surgeons indicating that it probably made no difference in terms of outcome as to what suture was used. This was definitely a minority opinion.

Case Questions

1. What are the pertinent issues in this case?

2. What were the problems with the way evaluation of the product was designed and carried out?

3. What are the supply-side and demand-side implications of this scenario?

4. Design a method for product evaluation that would eliminate bias and assure the collection of accurate data.

5. Knowing surgeons are creatures of habit, how might one design a clinical trial that could make surgeons more comfortable with using a new product?