Purchasing a Veterinary Ultrasound System
Nothing is ever easy and purchasing an ultrasound system for the first time, or upgrading your existing system, is no exception.
Fri Mar 10 2017
Nothing is ever easy and purchasing an ultrasound system for the first time, or upgrading your existing system, is no exception.
Veterinarians use many modes of imaging, X-rays, CT scans, and MRI. While CT and MRI units are rarely seen outside of large specialty practices, ultrasound technology is becoming more and more common with many clinics using ultrasound machines on a daily basis for diagnosis and other procedures.¹
“Ultrasound can provide a lot of information for its cost and is often more readily available compared with other imaging modalities. Fluid can be distinguished from soft tissue masses or foreign bodies, which is sometimes difficult to differentiate on X-rays. Using ultrasound and X-rays together form a great diagnostic tool,” according to Dr. Drew Sullivan, Medical Director of the Medical District Veterinary Clinic at Illinois, a small animal clinic in Chicago run by the University of Illinois College of Veterinary Medicine. Dr. Sullivan is certified in small animal ultrasound.¹
When purchasing an ultrasound system there are definite attributes you need to explore before making the investment that best fits your clinic’s needs. First, regardless of the manufacturer you might be considering, consider these questions and answers:
Do I need to purchase a “veterinary” ultrasound system, or (and why) should I consider a “human” system?
1. Some manufacturers offer both human and veterinary systems, and they are marketed as different systems. These are fundamentally the same systems, the difference being in the software and presets.
2. Human systems are generally better and cost more because they have to have FDA compliance, the images are clearer and more clinically correct because they have to hit minimum human parameters, and manufacturers build into their pricing the added expense they incur to avert risk and liability issues common to human machines. With that said, the image quality between “apples to apples” systems is negligible.
3. Can a human system, without “animal” presets meet the ultrasound needs of my clinic? Very definitely. Ultrasound systems, when used with the proper transducers (probes) can perform the same functions as a veterinary system, and often have a greater selection of probes available to meet your needs.
4. Human systems do not necessarily have to cost significantly more than veterinary systems. Shop carefully. Many human hospitals upgrade their systems routinely, thus offering very good “used” systems that are excellent. Further on, we will discuss why the “used” systems option, when purchased from the right vendor, offers a superior system as an economical alternative.
What are some other equipment criteria I need to consider?
1. Do I need a cart based system or should I consider a portable system?
If you have a mixed practice you might want to consider a portable system you can take into the “field”. Therefore the system you choose needs a battery power option. Am I willing to subject my new system to the rugged demands of in-the-field large animal work? Do I need the same capabilities in the field as I need in the clinic? Some portables are as sophisticated as cart-based in the office systems. Am I willing to pay for a more comprehensive warranty to cover potential machine damage, if I can get it!?
2. Archive data management must be considered. Will I be transferring my data to the office pc, will I be archiving data for future use and referral, will I be sending data elsewhere for evaluation and consultation?
What vendor should I choose when buying an ultrasound system?
This is the second biggest part of the purchasing equation. The choices are limited, but complex.
1. While the internet can give you many options to choose from, this is not the best source for vendors that can meet your specific needs because the list is endless. Instead:
a. Question your fellow veterinarians and learn of their experience with various vendors
b. There is a website, www.DOTmed.com which is a listing of medical equipment suppliers. Check out the ones with 5 star ratings and/or DOTmed 100 ratings. These are reviews by customers. Then, check them out on the internet. Also, go to any regional or national veterinary conference and visit with the exhibitors. If a company is exhibiting they are serious about serving the veterinary market.
2. You can purchase through basically 4 types of vendors.
a. Original Equipment Manufacturers (OEM’s). These are the people who manufacture the machines. Big names are GE, Philips, Siemens, Toshiba, Esaote, etc.
b. OEM dealers. In some cases the big OEM’s assign licensing rights for exclusive distribution to the veterinary market.
c. Veterinary Products distributors. Veterinary products distributors you are familiar with such as Animal Health International, MWI, MidWest, Schein, PennVet, Webster, etc. sell ultrasound equipment as part of their desire to be full service to their customers.
d. Third party vendors. These are companies that specialize in the sale of medical equipment, in many cases not just ultrasound but also x-ray, anesthesia, monitors, etc. Search for those specializing in ultrasound.
Pro’s and Con’s of each.
a. OEM’s are the manufacturers and as such offer the latest new systems with full service warranties. Most of them have a full service field sales force to maintain your equipment. Also, ask yourself if you are comfortable with systems not manufactured in the U.S.? Those that have licensed dealers in the vet market are showing their dedication to serving this industry.
b. OEM dealers in the veterinary market each sell only one brand of equipment. Therefore, it is obvious that both the OEM’s and OEM dealers will promote and feature only their brand of equipment and have an inherent bias.
c. Veterinary Products distributors generally offer one or two brands to select from. The advantage of buying from them is you already have a business relationship and a favorite salesperson. The disadvantage is that they are not ultrasound specialists. Another disadvantage is that their salesforce is not well versed in ultrasound equipment. And, very importantly, veterinary products distributors do not repair ultrasound equipment, they send it to 3rd party vendors.
d. Third party vendors. Third party vendors are medical equipment specialists. They are knowledgeable about the equipment they sell. One big advantage of 3rd party vendors is they work with many manufacturers and don’t have a specific loyalty to any one company, which makes them an asset in specifying the system that best meets your needs. Third party vendors sell new systems that meet your needs, at competitive prices. The other major advantage these companies offer is the ability to sell “used” systems that have been checked and/or refurbished to meet OEM specs and also carry warranties. Often the cost of a refurbished system is a fraction of the cost of a new system which allows you to “upgrade” to a more sophisticated “human” system if so desired, while still staying within your budget. Third party vendors do not have the large sales and service support teams that the big OEM’s have, meaning that, in some cases, the system will have to be shipped in, rather than being repaired on-site. Also, third part vendors are not able to offer as lengthy warranties on refurbished systems as what are available on new systems.
What criteria should I look for in a manufacturer and/or vendor?
1. How many years have they been in business?
2. What is their reputation in the market, both human and veterinary?
3. Do they offer warranties?
4. Do they stock replacement parts?
5. Do they offer loaner systems?
6. Do they offer training on systems new to you?
7. Do they do repairs themselves, or farm it out?
8. Do they repair “human” systems to manufacturer specs?
9. Do they offer field service?
10. Are they a USA based company?
Leasing versus Outright Purchasing
Purchasing an ultrasound system should be considered a business investment, and not an expense!
Adding ultrasound services to your practice improves your diagnostic capabilities and is a billable charge to the patient’s owners. We know from veterinary research done by the major societies that (depending on the demographics of your customer base, and the complexity of the scan) veterinarians charge anywhere from $100 to $400 for an ultrasound procedure. For the sake of this analysis, let’s say each customer is charged $150. Let’s also assume that your practice does 2 scans a week.
$150 per procedure x 2 procedures per week x 50 weeks per year = $15,000
If you purchase a system for $30,000, the ROI is 2.0 years.
When purchasing ultrasound equipment there are other initial costs that have to be considered when looking at the total investment.
Does the system have “add-on” options you will want? Most ultrasound systems come with a 1 year full warranty. In addition, you will be offered the option to purchase longer term warranties. Also, you must consider what transducers (probes) you want to go along with the system, depending on the medical needs of your practice. Will your staff need training on the new system? Tax can be a factor if you are buying the system from a vendor in the same state.
Once you have selected the system, options, warranty, and probes, and tax (if any) you should have the final cost.
Next, decide if you want to purchase the system outright, or make time payments, or possibly lease the equipment.
There are many articles available to guide you for what financially makes the most sense for your business. Also, solicit the advice of your accountant.
1. Outright purchase. – It is pretty much general policy for vendors to sell a system and expect 50% of the total payment at the time of the order and 50% at time of delivery.
2. If the vendor will work with you, some offer payment plans; pay (for example 20% down, and monthly payments for 24 or 36 months.) Vendors automatically build preventive maintenance agreements into the cost of the system to protect your investment (and theirs).
3. Leasing can be done many ways – money down, 24 or 36 months, etc., and you can have the option to buy the equipment at the end of the lease. There are two key things to know about leasing:
a. The IRS does not consider an operating lease to be a purchase, but rather a tax-deductible overhead expense. Therefore, you can deduct the lease payments from your business income.
b. Because an operating lease is not considered a long-term debt or liability, it does not appear as debt on your financial statement, thus making you more attractive to traditional lenders when you need them.
4. Shop for the best rates, whether through the vendor, your bank, or a recommended finance company.
Author
Henry Dinneen is Vice President of Operations of Advanced Veterinary Ultrasound (AVU). www.avuetulsa.com AVU is a division of Advanced Ultrasound Electronics, a multi-vendor ultrasound company specializing in the sales, parts, repair, and service of new and refurbished ultrasound systems
¹ The quoted portions of this article were reprinted with permission from “Ultrasound Has Many Uses in Veterinary Care”, which appeared in “Pet Health Columns”, an on-line series of useful veterinary articles published by the University of Illinois at Urbana-Champaign College of Veterinary Medicine. The author, and Advanced Veterinary Ultrasound, have no affiliation with the College of Veterinary Medicine or the University of Illinois.