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So You Want to Buy an Ultrasound Machine?
What do medical ultrasound machines and wood floors have in common? Nothing, except that I happen to be an expert in both. My education in ultrasound was on purpose; wood floors a sheer accident. We had grand designs of putting wood floors in our house and we chose beautiful bamboo. We ordered the wood and had it delivered and chose a contractor to perform the installation. He recommended that we should apply a sealant on our concrete before installing so that moisture wouldn’t get into the wood and make it swell. Made sense, so we took their advice and had them install the moisture barrier. However…within a couple of weeks we started hearing hollow sounds under our feet as we walked… and within a few weeks after that there was, to our amazement, 2-6 inch rolling peaks in the wood throughout the entire home. Apparently moisture did swell the wood even though a sealant was laid down. But why? This is the question that set me on my journey of becoming a lay expert in wood floors. I wish had I had come across an industry insider article on wood floors, like the one you are about to read on ultrasound machines. (oh and uh… not to leave you hangin’ but if you ever want to install wood floors over concrete, be sure to have a “calcium chloride” test done.)
Okay, so here’s the who, what, when, where and how on buying an ultrasound machine:
Who: Are you a first time buyer with a new practice? Are you a first time buyer with an established practice? Do you have an established practice with dinosaur equipment and need to enter the market again after many years of technological advancement?
Who you are determines what you need. So develop a budget based on the following criteria and stick to it!
- First time buyer/new practice: First time buys with no established practice have the most risk to consider. With no procedure statistics, a new practice should be very realistic about its choice for an ultrasound machine. Know the reimbursement codes you will be using most frequently. Are most of your patients going to require the use of an ultrasound machine, i.e. cardiology? With an idea of all the numbers, a monthly return on investment should be derived.
- First time buyer/established practice: Many first time buyers are established practices that had been referring procedures to hospitals, imaging centers or other practices with an ultrasound machine. These first time buyers have data to plug into a formula that will establish a base line. Using type of exam, frequency and a realistic projection for volume increase, a reliable budgetary guideline is established.
- Established practice/old equipment: If you are an established practice looking to replace an existing ultrasound machine, your formula is simple; calculate your monthly ultrasound revenue, apply realistic volume increases and derive a budget.
What: Okay, here’s the skinny on medical ultrasound technology, no matter what fancy words an OEM labels their particular features, there are really only a few basic functions, anything else is just workflow or visual enhancements. We’ll just go over the basics here because if you need a specialty feature you will KNOW it. Everybody wants the biggest and baddest, newest thing, but reality strikes the pocket book. Maybe you need some options maybe you don’t, that’s why you should base this decision on who you are to determine what you need and at the very least have your basics covered, which are:
- 2D/B Mode
- M-mode
- Color Doppler
- Pulsewave Doppler (PW)
- Continuous Wave (CW)
- DICOM – for sending images over a network digitally
Buying pre-owned ultrasound equipment will save you lots of money, while still getting up to date technology. Also buy a brand and model that is well known. Well known makes and models help give you service provider choices instead of just the manufacturer. Service provider availability is very important throughout the life of the medical ultrasound system.
When: When you have done your homework! Refer to who you are as described above, and do your homework (or you’ll regret it)
Where: Buy regionally! Shopping on the internet is convenient and can potentially save some money, but a few thousand dollars saved at purchase time can evaporate quickly with poor service response. Make sure that the company you buy from employs a service engineer regionally and ask to speak to them. If they sub-contract the repair, guess what? You won’t be a priority and you may even see several different companies coming through. If they have to shop the cheapest service rate for their sake, then you suffer the down time. Evaluate the consequence of poor service response: Once you’re up and going, let’s say your practice is generating $1000 in ultrasound scans per day (a very realistic number). 1) A typical service response is within 24 hours. If a part is needed, then you typically can get it a day after the on site evaluation. If all goes well, then you have been down two days. Minimal cost to you, if the repair is covered under warranty or contract: $2000 in lost revenue for one single service call. 2) If the company has to subcontract the service work, you are not a priority to the sub contractor and you may wait additionally (!) if the service is being shopped around. Two days can easily pass just waiting for a service response! Do the math. If you saved a few thousand dollars at purchase time, you easily will pay it back in lost revenue while waiting. REGIONAL service response is the key.
How: Believe it or not, even if you have the cash, a lease purchase is a good way to preserve cash flow and get tax benefits. Below is an excerpt from www.section179.org
“Leasing and Section 179
Did you know that your company can lease equipment and still take full advantage of the Section 179 deduction? In fact, leasing equipment with the Section 179 deduction in mind is a preferred financial strategy for many businesses, as it can significantly help with not only cash flow, but with profits as well.
Non-Tax | Capital Lease
The main benefit of a non-tax capital lease is that you can still take full advantage of the Section 179 Deduction, yet make smaller payments. With a non-tax capital lease you can acquire and write off $250,000 worth of equipment this year, without actually spending $250,000 this year. A small business that is managing cash flow can leverage a non-tax capital lease and still take the Section 179 Deduction.
Examples of non-tax capital leases include a $1.00 Buyout, and a 10% Purchase Upon Termination (PUT) Lease. In many cases, the amount you save in taxes will be MORE than the total of your first year's payments.”
So there you have it, the who, what, when, where and how to purchase ultrasound machines. Happy shopping and good luck with your practice!
Author: Will Martinez of Trident Imaging Services, Inc. www.TridentImaging.com
Toll Free: 866.535.7717 Local: 281.614.0790 email: wmartinez@tridentimaging.com
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