Chapter 14: Buying medical equipment – getting value for money
|"One machine can do the work of fifty ordinary men. No machine can do the work of one extraordinary man. "
- Elbert Hubbard.
Modern medical practice uses technology liberally, and you may need to buy quite a lot of medical equipment, depending upon your area of specialisation. Since this equipment can be quite expensive, it is important that you have a system to maximize the cost-effectiveness of the equipment you purchase. You are likely to be faced with lots of options, including: What to buy ? When to buy ? New ? Second hand ? How to raise the money ? Buy ? Rent ? Lease ? Imported ? Indian ? and you must do your research well. Dont buy a major equipment item without a cost-benefit analysis. Youll need to make assumptions about anticipated patient load and the cost of delivering the service, but dont shy away from the work.
Uptil now, most medical equipment needed to be imported and doctors were forced to buy what was available. After sales service was usually poor and doctors often smuggled in medical equipment, to save customs duty. Today, however, the situation is much better. Medical equipment manufacturers have realized that India is a huge market, and most have distributors in India today, so that doctors can pick and choose. In a buyer’s market, you must demand excellent customer service – remember that your patient’s life can depend upon it.
Cost out the equipment you need and develop a list of priorities. The most essential items must head the list followed by the equipment you will want to add as your income becomes more supportive of the practice. Shop around ! It is a good idea to compare prices from local sources as well as national companies, in order to establish which firms are the most competitive. You may be swamped initially with brochures of equipment, followed by frequent calls from representatives and medical suppliers, hoping to sell their companys products. These representatives provide an important and valuable service since they will keep you informed of what is new on the market and give you some research statistics which will back up their products claims . They will also educate you about their competitor’s drawbacks and limitations !
Articles in medical journals can provide valuable information on the newest trends in technology. Most manufacturers have their own websites as well, which are packed with information. Medical conferences also usually exhibit medical equipment, and visiting these exhibitions is a good way of seeing a lot of the competing products at one time, and will allow you to compare features and prices with ease.
Bank loans are usually easily available to help you finance your purchases; and options include leasing it. Often the manufacturer will help you arrange for financing as well. In order to make your purchase cost-effective you will need to let your patients and referring colleagues know about the special features of the new equipment you have bought, and how it can help them. Being the first doctor in the region to buy the newest technological advance can help get you considerable publicity, thus helping you to promote your practice. However, remember that newer is not always better – and a number of doctors have wasted lakhs of rupees on buying equipment which either did not work properly, or did not perform as promised.
For expensive equipment, you may want to use " requests for proposals " or tenders, in which you can invite competing vendors to bid against each other. Try to seek at least two competitive bids using the same specifications; and let vendors know they are competing on price and value. Unfortunately, the medical equipment industry in India is still not doctor-friendly, so while supplies will promise you the earth when selling the equipment, their after-sales service will often leave a lot to be desired. If you want to avoid having your fingers burnt, don’t buy the cheapest equipment available – this may actually turn out to be much more expensive in the long run ! Check out the track record of the supplier and ask for a client list, so you can interview doctors who have bought equipment from them in the past.
If you are planning to buy expensive equipment, insist that the manufacturer let you try it out in your clinic for some time. What may perform extremely well in another doctor’s hands may not be the best piece of equipment for you ! While it’s not always necessary to buy new equipment, specially when finances are limited, you must take care to ensure that any second-hand items are sound.
Service is vitally important. Make sure the length and coverage of the warranty is clear, and whether this is comprehensive ( includes both labour and spare parts) and on-site ( or do you have to take the equipment to the manufacturer ?) Read the fine print carefully ! Good companies should be able to offer a 24-hour service. A friendly service engineer who comes promptly can save your practice time and money. Preventive maintenance done on a regular basis can help to prevent expensive breakdowns. Good companies must be able to provide replacements in an emergency, if yours is being repaired.
An annual maintenance contract will ensure that the equipment is maintained in an optimal condition for its lifetime and is very valuable for your peace of mind – don’t scrimp on it ! Keep a log book, which describes the history of the machine; the problems it had; when it was serviced; and when the next servicing is due. It’s also a good idea to insure expensive equipment - this is very cost-effective. Technology changes so rapidly these days, that you may soon find that your equipment has become obsolete. Try to buy machines which are modular and upgradeable, so that you remain state of the art.
You may also find it worthwhile to sell your old equipment to doctors in smaller towns when you need to buy a new model. A good supplier will be willing to buy-back your old equipment, when you plan to upgrade to the newer model.
When you buy medical equipment, make sure that you also get the training needed to use it properly ! For very expensive equipment, companies may be willing to send you abroad for advanced training, and you should explore this possibility to ensure you are comfortable with the new technology. Make sure at least one member of your staff knows how to operate the equipment.
Investing in high quality equipment is one of the most important investments you can make in improving the quality of the medical care you provide – spend your money with care !