Pay Attention to Training and Service Mistakes to Avoid When Buying Used Medical Equipment IntroductionWhether you need an examining table, a Holter monitor, ultrasound equipment, or a nuclear imaging camera, you can save from about 30% to 50% or more by buying used equipment. While there are plenty of good deals available, you need to be careful so that you're not stuck with a lemon, or end up with machinery that's in far worse shape than described.
"Three years ago, doctors wanted to buy everything new and take out a loan to pay for it," says Mark Zirinsky, President of PEMED ( www.pemed.com ), a used medical equipment stocking dealer in Denver, Colorado. "Now the focus has gone away from getting equipment that's brand new and is the latest and greatest. It just has to work and be okay."
"Our traffic is up by about 20%," adds Robert Garment, Marketing Director of DOTmed ( www.dotmed.com ), an online marketplace of new and used equipment. "One reason is that some big equipment manufacturers that previously financed heavy-duty imaging equipment no longer do so."
A nuclear medicine camera that cost $300,000 new sold for under $200,000 when it was about 2 years old, with the same warranty, notes Richard A. Staab, president of InterMed, a medical technology service company in Alachua, Florida. A fully loaded LifePack defibrillator, which could retail for $16,000 to $18,000, sold for $7,000.
Buying used equipment can save anywhere from about 30% (just because it's not new) to 70% (if the item is old or in fair or poor condition). "Typically, the price of used equipment is 50% of the original price," says John M. Krieg, publisher of Medical Dealer magazine and President of MDPublishing, a company involved with the used medical equipment industry.
Buying used equipment makes sense when the technology hasn't changed much; when you're strapped for cash or are starting out in practice; and when the device itself has a proven record of performance -- like a car known for top performance that holds its value over many years.
For that reason, ultrasound equipment is among the top-selling items, says Garment. "The technology hasn't changed radically. A used ultrasound or refurbished CT will get the job done."
While some used equipment can be in terrible condition, much of it is high quality, says Krieg. "Used medical equipment dealers get their stock from hospitals that purchase new equipment and no longer need their existing equipment, through liquidation or doctors going out of practice, or sometimes directly from the manufacturer when it takes a trade-in."Beware of the Pitfalls
Still, there are downsides to buying used medical equipment. You won't get the training on complex equipment that you would typically get with new pieces. Instructions may be missing. The equipment may be difficult to have serviced.
Some purchasers have complained that the equipment is in worse condition than described, that it's not what they ordered, or that there were lengthy delivery delays.
You also won't always get the convenience that comes with buying new. "Don't expect a liberal return policy," says Zirinsky. "Some people expect a 90-day trial. That's not a realistic expectation."
Finally, you may have to make your own delivery and installation arrangements. The seller will typically not come to your office or clinic to install the equipment, although some companies facilitate such arrangements for an added fee.
To avoid getting burned, be cautious and do plenty of research. The following guidelines can help.
About 4000 companies participate in the used medical equipment market, according to Krieg. There are also numerous online used equipment brokers and marketplaces where you buy from the individual owner, and eBay lists some used medical equipment.
It's important to deal with a reputable company, not only because they're more likely to be trustworthy but because you may have some recourse if something goes wrong. Start by asking for recommendations from colleagues, or check with your local medical society. Investigate any company you're considering, and look for a solid business record and testimonials from credible sources. Ask for references as well as whether they sell their own used equipment as well as new pieces.
One source of information about used medical equipment dealers is the preferred dealer list at www.MDPublishing.com. Or check the directory at the International Association of Medical Equipment Remarketers & Servicers (www.iamers.com). IAMERS also has an annual industry trade show -- MD Expo -- where dealers display the equipment they're selling.
Types of sellers include dealers, online marketplaces, and brokers. A dealer has the equipment in stock and is more likely to refurbish and improve some of the equipment being sold. A marketplace hosts listings from individuals or institutions with equipment for sale. If you don't see the piece of equipment you want, a broker will try to find it for you.
If you buy at a marketplace, look for one that screens or evaluates sellers -- such as eBay's seller feedback ratings. DOTmed, an online medical equipment marketplace, asks users to rate other users with whom they have done business on a scale of 0 to 5 stars. The site also keeps a blacklist of users no longer welcome because of problems or ethical violations.
Used medical equipment might be sold through an auction or as a straight purchase. Make sure you research the appropriate price range for the product you want. Unlike the used car market, there's no Kelley Blue Book with values for used medical equipment. You'll have to do your own comparison shopping.
Just as with buying a used car, kicking the tires isn't good enough. You need to do research and be cautious.
Refurbished equipment is often of good quality. "Similar to buying a preowned certified car, you can get a refurbished machine that would come with warrantee, parts replaced, and software upgraded," says Garment. "Or you can buy equipment in 'as-is' working condition, and you take your chances."
Refurbishing often includes repainting and other cosmetic improvements, which can be important from a "patient-confidence" perspective -- patients want to feel that the technology is first-rate.
"With refurbished equipment, most dealers will bring the machine up to the original manufacturers' specifications," says Krieg. "You'll save less on it, but you'll typically get a warranty and some service."
Buying used equipment "as is" can be dicey. Although hardly failsafe, some used equipment sellers have a rating system to help the buyer gauge the machinery's condition. For example, PEMED classifies their equipment into such categories as "new in the box," "works well," "some scratches," "shows signs of use," "needs repairs," or "cosmetically poor."
Still, there are no guarantees. If possible, test the equipment to make sure every function works, advises Krieg. Very expensive equipment may warrant a trip to the seller who has it in stock. Or if you don't feel comfortable evaluating the equipment yourself, hire a technician with experience on that machine to test it.
If you're buying from a dealer, ask for a contract. During the contract period, the dealer has full responsibility toward any malfunction of the equipment, says Krieg.
How to use an examining table is pretty obvious, but a digital fluoroscope is another story. "Some pieces came with books, training, and instructions when they were new, but now the original instructions are missing," says Garment. "The selling company may or may not provide training for used equipment."
"The availability of training should always be a focal point for new or used equipment. Make sure additional support is available," Krieg adds.
Check with the original manufacturer, which may provide training or instructions -- for an additional fee -- even if you bought the machine used. Or look into third-party training and service companies that support used equipment. Independent service organizations, such as InterMed, have specialists and trainers to service biomedical, nuclear, ultrasound, and computed tomography equipment.
Getting used medical equipment is often financially wise, but potential pitfalls abound. Here are some common mistakes to avoid:Don't buy the wrong equipment for the space where it will be used. Some buyers discover after delivery that the space wasn't big enough to allow people to walk around the equipment and use it easily, or that the building lacks the power to support the equipment. Check the original manufacturer's specifications to learn about the needs of the equipment.Anticipate features you might need in 6 months or a year, not just what you need right now. No matter how attractive the price, if you have to resell the equipment or you can't provide important new services to your patients, it wasn't a bargain.Research the price range for a particular piece of equipment. Although price varies by seller and condition, there is a generally acceptable range for pieces of equipment, says Krieg. If a seller is asking much less than the going rate, investigate to see whether there are hidden flaws.Find out how much training and service are required. You may be wise to pay more for a piece of equipment that is easier to use and service than one that will cause problems or that you won't be able to use effectively.Remember to consider installation in your pricing and purchase arrangements. Brokers and dealers typically do not install the equipment, although some companies facilitate installation arrangements for an additional fee.Ask colleagues about their experiences buying used medical equipment. One way is to post on Medscape Physician Connect and hear from other doctors.
