FEB 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Page 93 of 114

by Rand Larson Pride of ownership or wisdom of renting? or to buy used. The rental model, however, works differently. The out- sourcing company that my office contracts with, Sightpath Medical (Bloomington, Minn.), charges a fee per procedure. For practices with sufficient case volume, the rental company can leave the equipment onsite indefinitely, or for smaller practices, the equipment can be brought in periodically. In either case, the facility pays for the service according to how many procedures are performed. Therefore in order to compare costs between renting and purchas- ing, it may be beneficial to look at a projection of your case volume for the next several years. However, this provides only one piece of your comparison, and costs of ownership can be significantly more than the purchase price when other factors are taken into account. Maintenance Acquiring equipment, whether via purchase or rental, is only the begin- ning of the process. Once you have a piece of technology in your practice, you also have a responsibility to maintain it. As with many other things in life, ophthalmic laser tech- nology requires both preventive maintenance and occasional unfore- seen maintenance. This is one area where it's important to remember that ownership comes with addi- tional costs and challenges. I have personally observed that in some practices that own their lasers, serv- ice intervals may be extended by one to two months in an effort to be more cost efficient. In my mind, this is problematic when dealing with the very minute tolerances of laser technology, as postponing mainte- nance denies patients from receiving the laser's very best treatment. With renting, on the other hand, the rental company is responsible for servicing the equipment and has a strong motivation to keep it running at its peak performance and there- fore performs maintenance on a very regular basis. In the event of an unplanned service outage, the ability to get the laser back up and running quickly is invaluable. When you have between 15 and 22 patients scheduled on a surgery day, rescheduling those pro- cedures after equipment goes down can be very difficult and costly. In our 14 years of experience renting a laser, we have had only one occasion in which the equipment went down and wasn't back up the same day. This took place on a Friday, and thanks to our rental company's commitment to service, we were able to treat those patients two days later, on a Sunday. This highlights an additional advantage of renting equipment— the rental company has much more buying power with manufacturers, and can therefore demand faster servicing and maintenance when it is needed. Compare this to the buy- ing power of a solo practice that only has one laser and may have to wait longer for service availability. Very large practices may have more clout and negotiating power on maintenance agreements but it is EW Ophthalmology Business F ebruary 2014 91 W hen considering whether to rent versus purchase surgical equipment and diagnostic tech- nology, practice decision makers must take a long list of factors into account. The decision is not only a matter of estimating how many procedures you may perform in a month versus what your purchase and financing costs would be; you must also think about the long-term commitment you are willing to make to equipment and mainte- nance, and what level of support you might find beneficial down the road. This article will describe some of our findings from our 14 years of experience in laser vision correction. Upfront costs Estimating the upfront costs of a purchase is one of the more straight- forward parts of your calculation. Any piece of equipment has its purchase price, and it is possible in some cases to negotiate a better price than you are initially quoted, continued on page 92 Considering whether to rent or purchase high tech ophthalmic laser equipment 91-97 OB_EW February 2014-DL2_Layout 1 1/30/14 11:51 AM Page 91

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