If a medical device is so complicated that a rep needs to be there, the FDA will never approve it anyway

what? Nope. That’s not how the fda works in regard to devices and their application. There are plenty of devices MANY that require a physician be trained on their use. There are also many instances when the same device finds new applications. I’ve SEEN with my own two eyes a rep show a doctor how to use a new endoscope with a small saw attached and a hydration system to cut out polyps. I’ve seen the same rep show a doctor new techniques using the same device to help treat bronchioplasty. I also saw the same rep attempt to sell in their ancillary products at the same time. Reps don’t “just sell shit,” they train docs on how to use the equipment. They see hundreds of procedures using the same device from dozens of doctors and pick up on best practices. They then share these. You could argue that the company should have heads of product that sell nothing but just show doctors daily how to use the device and new emerging approaches. But you can’t ague that the reps don’t assist in the surgeons getting knowledge. Talk to a surgeon, they’ll tell you the reps are helpful. Even in my work with Forever Labs I see the Arthrex reps we work with assisting doctors in improving outcomes. I didn’t help develop a pacemaker but I have been in a lot of OR’s. Med reps are helpful. You can change their title to med advisors and remove the selling component. But their role as educator is needed.