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A BLUEPRINT FOR

Incorporating Ultrasound into

Veterinary PracticeThe Machine, The Curve, the ”Me Too" Industry, and The Reality

FOSTERING THE ART OF VETERINARY MEDICINE™

TeleradiologyTeleoncologyClinical Sonography & Telecytology SDEPTM Ultrasound EducationOnline Forum & Clinical Archive

SonoPath

WHATTYPEOFSYSTEMISRIGHTFORME?

WHATTYPEOFSYSTEMISRIGHTFORME?

Notallmachinesarecreatedequal.Yougetwhatyoupayfor.

Thisarticlewilloutlinesomeofthedifferentoptionsyouhaveasaconsumer,questionsyoushouldbeasking andwhattobemindfulofwhileyoushop.

Ofcoursethereareexceptionstoeverythingyouwillreadbelow,butafterhavingmanagedabout70ultrasoundmachinesovertheyearsfromstickertowearingthetreadoffthetires,thisismyglobalstatementonmachinereliability.

LOW-ENDUTILITYMACHINESIfyouarejustlookingfora‘cystogetter’,fluidvs.non,utilitymachinethen$10-15korlessshouldbefine;however,don’tdotheindustryaninjusticeandthinkyouwilldoanysignificantdiagnosticswiththesemachines,asyouwillneedyourownpersonal“imaginascope”todiagnoseanythinginmid-sizedtolargeranimalsespecially.

Thislow-enddiagnosticapproachotherthanutilitysonographycanimpedetheprocess withmisdiagnosis andharmsthediagnosticintegrityofclinicalsonographyespeciallyforthepatient.

FASTscanprotocolslookingforfluidandconsolidationshavebridgedtheneedforhigh-endmachinessomewhat,butatthesametime,imagequalityisparamount.Spendasmuchmoney asyouneedtoinordertogetsoliddiagnosticimages(liketheonesbelow)andforegothe“bellsandwhistles”that youdon’tneedbutinevitablypayforinthemachineprice.

Investigatewhatallthosefeaturesareinthesalesbreakdownandshavesomeoftheunnecessaryfunctionsthatpadtheprice soyouhavewhatyourequireanddon’tpayformorethanthat.Justlikethesmartphoneindustry,theultrasoundindustryisalwayscompetingonnewfeatureswhicharesellingpointsandresultantlyincreasethepriceyoupayforamachine.

• Everymodelvariesinreliabilityandqualitybasedonlotnumberandsoftwareversion.Dosomediggingandreadreviews.

• Bemindfultopurchasetheexactsameprobesandmachinesyoumaybelookingatelsewhere.

• Targetestablishedreputablesonographers,mobilesonographersorsellerswithgoodsellerreviewsoneCommercesites.

• Arrangetodrivethemachineforaweekortwotoconfirmtheunitisnotalemonandthatyouliketheworkflowandimageaspects.

• Avoidunitswithscratchesanddentsasthisusuallyreflectshowtheunitwashandled.

• Warrantiesvaryanddiminish.• Ifit’slikeagaragedmotorcycle

(boughtnewandcollectingdust)expecttoplayaroundwithitabitorpaytohaveitservicedtooptimize.

PRE-OWNEDMACHINES

• Presetsarelikelyalreadystableandoptimizedandthesettingsareplugandplay.

• Bigexpensesdon’ttypicallyoccurforacoupleofyearsdependingonhowtheunitwasdrivenandofcoursehowitwasbuilt.

• Expecttopay$18-25kforasemi-solidunitthat's3yearsolddependingonhowmanyprobesithas.

• Probestypicallyadd$3-5knewor$1500-4krefurbishedontothevalueoftheultrasoundmachineperprobe.

Benefits Risks

ShoppingTips Costs

Ifyouwantasemi-solidunitforthenextfewyearsthenusedmachinesthatare3yearsoldorsocanbehelpful.Thisissimilartobuyingausedcarwiththesamecriteria.Thecarlosesitsvaluerapidlythesecondyoudriveitoffthelot.Thisconceptisveryvalidwithnewmachinesales.

• Justliketradinginausedcar,youtypicallywon’tgetthevalueyou’dgetontheopenmarket.

• Advertising,wordofmouth,oreCommercesitesarethemosteffectivewaystogetthewordout.

• Oftenitmaybetaxbeneficialtokeepthemachineasaback-upordonateittoashelter/501c3asopposedtotradingitinfor$8-10k.

• Iadviseyoutoaskyourtaxadvisortohelpyoudecipherwhichoptionisthebest.

• Evennewmachinescancomefromadefectiveproductionlineaseachlinecanvaryasmuchasasoftwareversion.

• Don’teverbuyamachineonsight.Theimagessalesrepsshowarealways“bestcasescenario”scansgiventothemusuallybysomeonelikeme,aseasonedsonographerthatknowshowtooptimizeanimageforartisticsonography

NEWMACHINES

• Noissuesregardinginappropriateuseordefectsinthemachineacquiredfromtheuseofsomeoneelse.

• Latesttechnologyandsoftwaresystems.• Warranty - assumingthesellersupports

thewarrantyinanefficientandrapidformat.

• Maybeabletoincorporatethecostinwithyourlaboratory,digitalradiographyorothercapitalequipmentpurchases.

• Thistypeofpurchasewouldprovidenegotiatingvalue

• Expecttopay$35-50kforasolidnewmachine.

• Thelowerendofthepricerangemayhavedifficultyimaginglargeranimalsowingtopoorprocessorcapacityandotherinherenttechnicalissuesthatarelessapparentinthehigherpricedmodels.

• Probestypicallyadd$3-5knewor$1500-4krefurbishedontothevalueoftheultrasoundmachineperprobe.

Benefits Risks

Trade-Ins Costs

Pre-ownedmachinesaren'tforeveryone.Somepeopleliketohavethenewesttechnologyandthesecurityanewmachinewarrantybrings.

Itisquiteinterestingwhatyoudigupwhenyoulookattentivelyatwhatgoesintothemachine:

• HowISITsold• HowITISsupported• HowYOU supportedafterwardsoverthefollowingweeks,monthsand

yearsuntilyouarereadyforanupgrade.

• Thecompaniesandtheirrepresentativesthatareinitforthelongtermwillbethereforyouthroughanupgradesoaskthemaboutthattimeframeandseewhattheysayandensureyouarehonestlysatisfiedwiththeanswer.

Herearesomekeyquestions toaskonthephoneoronthewebsitewithultrasounddistributors:

Howlonghasthecompanybeeninbusiness?• Theindustryisalwaysinfluxanddistributing

companies:• Comeandgo• Losetheirdistributorlicense• Movetoadifferentmachinefortechnicalreasons• Changecorporateaffiliations• Selltolargerentities• Acquirenewaffiliations• Undergopersonnelchanges• andthelistgoesonandon...

Inthis“gold-rush”worldofveterinaryconsolidationthecompaniessellingultrasoundmachinesareoftenchanginghands,operationalcontrolandpolicies.Hence,thefunctionalityofthesupportingcompanychangesoftenandspansfromsolidtoinept.

THINGSTOASKWHENSHOPPINGFORAMACHINE

HowmanypeopledotheyhaveintheirU/Stechsupportandwhathoursaretheyavailable?It’simportanttoinvestigatewhoyouwillbedealingwithwhenyouneedtocallwithquestionsorproblemsafteryoubuythemachineandhowefficientthatprocessis.

Youwanttoseekasteadfastconsistentorganizationbehindyourpurchasewithreferencedindividualswhorepresentyourregionandensurethosehigheronthefoodchainaresimilarlyreputable.

Ican’temphasizeenoughhowimportantitistodoyourresearchinwhoyouwillhaveanultrasoundrelationshipwith.

It’snotasmuchaboutthemachineasitisaboutthosethatstandbehindthemachineandtheirworkhistory. Ialwayssaythe“box”isdrivenbythepersonalitiesbehindit.

Askthesalesrepresentativeandpossiblyhis/hersuperiorandgetitinwriting:“Mymachinecrashedandburnedandisnon-functional.HowsoondoIhaveasolidfunctionalplugandplayloanerinhand?Withoutafunctionalmachineyourdiagnosticworkflowwillslowconsiderably,willbrewteamfrustrationandyouwillsimplyhemorrhagemoney.

Ifyoucharge$350/scanwithnomachineandyoudo10scans/weekyoujustlost$3500inrevenueifittakesaweektogetyourmachineback.Therefore,youhavetocalculatethatintoyourpurchase.

THINGSTOASKWHENSHOPPINGFORAMACHINE

Servicecontractsarehighprofitcentersforcompaniesliketheyareforelectronicstores.

• Chooseacompanythatoffersasolidextendedservicecontractincludedinthepriceofpurchasethatiscomparableinpricetocompetitormachinesthatdon’tofferthatextendedcontact.• Guaranteeyouhaveawarrantyupfrontonanynewmachinethat

coverseverythingbumpertobumperforatleast1yearanddriveitharduntilabout10monthsandthenhaveitservicedtoensureit’singoodshape.

• Thendecideiftheservicecontractmakessenseandaskwhatchargestherewouldbeforafailedharddriveorreplacedmotherboardwhicharebigexpenses.

• Createyourownfundandpayalacarteforrepairs.• Apersonal“ultrasounddysfunctionfund”maybethebestoption.I

run6machinesinmyoperationsandIdoexactlythis;Ihaverevealedoneofmysecretshere.Iliketorollthedice,Iknowthepersonalitiesofmymachines,andcanrepairthebasicsoftwareissuesmyselfgenerallybyjustreinstallingthesoftware(whichcomeswiththemachineusuallyinathumbdrive);thisisthefirstthingtodoifoddbehaviorbegins.

• Makecertainyoursalesrepshowsyouhowtoreloadthesoftwareandvideoitortakenotesforthefuture,asthesoftwarecomeswiththemachineonpurchase.ComparingthenumbersovertheyearsIhaveneverspentmorethan½ofthemaintenancecontractprice.It’sstillarollofthedice;butIlikemyoddsaslongasIandmystaffarebeingvigilantonmachinecarethentherisksarecalculatedinmyfavor.

SERVICECONTRACTS&MACHINEREPAIRS

• NotdrivingthemachineenoughbeforebuyingisTHEnumberonemistakeIseeveterinariansmakeonaregularbasis.• Insistonit.Iftherepresentativedoesn’taffordyoutheluxury,then

moveontothenextmachine.• Seeifyourhospitalinsurancecoversaccidentdamagefor

yourultrasoundmachine.• The120-poundRottweilerknockingthemachineoverinto

dysfunctionisaneverydayriskweallrun.• Yourhospitalinsurancemaycoverthatormayrequireaminor

increaseinyourpolicytocoveritwhichismorecosteffectivethanaservicecontract.

• Considergettingausedutilitymachinejustforback-up.• Youhavetohaveaviableprobeanddriveronthefloorforevery

houryourfacilityisopen.Thisbackupsafetynetutilitymachineensuresworkflowviabilityandprofitability.

• Rememberhowimportantwork-flowandeconomiclossesareeverydaythattheprobeisnotmovingoverananimalnottomentionthelossindiagnosticefficiencyforyourpatients.

HELPFULREMINDERS

Buywhatyoureyelikes.Everyeyeisdifferentinpreferencesothereisinherentpersonalpreferenceontheimagetypeofeverymachineoutthere.

– EricLindquist,DMV,DABVP,Cert.IVUSS““

Dr.EricLindquist,DMV,DABVP,Cert.IVUSShasprovidedhigh-volumemobileveterinaryclinicalsonographyasaspecialistinNewJerseysince2001.HeboardedABVP(Canine&Feline)in2003andre-certifiedin2015.

FoundingSonoPath.comin2008,LindquistleadsateamofboardedspecialistswhoprovideEducationalTeleconsultation™Services.Healsoownsandmanagestwomobileultrasoundcompanies.

Asthethree-timepresidentofInternationalVeterinaryUltrasoundSociety(IVUSS),Dr.LindquisthasapassionforultrasoundandhascreatedtheSDEP™Protocol.TheSonoPathDiagnosticEfficiencyProtocol™isaninnovativeinstructionalultrasoundtechniqueusedforfullandefficientscanning.

ABOUTTHEAUTHOR

WHATELSEDOYOUNEEDTOKNOWABOUTBUYINGANULTRASOUNDMACHINE?

•Learnhowtoevaluateandgradeyoursalesrepresentative•Caveatsonmovingimagesetsaroundtheinternetandin-housewithrespecttodifferentmachinesandteleconsultationcompanies•Getasummaryoverviewonthecapitalequipmentsalesprocessfortheinsideout