The story reveals how some hospitals are changing the way they work with sales representatives employed by medical device manufacturers in order to reduce the costs of the orthopedic implants they’re buying while also limiting the longstanding influence sales reps have had with surgeons. For years these reps have assisted surgeons and nurses during surgery by helping with product selection or utilization. But this can mean that the reps are influencing what products are used, regardless of cost or quality. The shift reporting in the story is part of a growing trend of hospitals pressuring manufacturers to offer better pricing and take on new contracting practices for high-cost implantable devices as they seek to cut supply costs and help improve quality.