Best practices for acquiring diagnostic equipment

When considering a new technology purchase, explore profitability, patient outcomes, and more.

Ophthalmology practices require a bevy of sophisticated and expensive equipment to deliver current and advanced eye care. Some devices are your standard fare in most medical ophthalmology offices, including slit lamps, phoropters, tonometers, digital eye charts, and autorefractors. In addition, many other modern, technologically advanced devices can greatly affect your level of care — and your practice’s budget.

At Northern Virginia Eye Institute, we screen and treat patients for a wide spectrum of eye diseases, including glaucoma, cataracts, dry eye, and refractive errors. For our cataract patients, we offer refractive correction with femtosecond laser and multifocal intraocular lenses (IOLs). These technologies require accurate and meticulous measurements and interpretation by our staff and physician, including detailed biometry and comprehensive topography, not to mention scan of the patient’s eyes to rule out any underlying eye disease. Also, in the last few years, technological advances have changed dramatically how physicians diagnose and treat diseases, such as glaucoma, macular degeneration, corneal dystrophy and diabetic retinopathy.

In light of the pace of advancement in ophthalmology and the desire to provide the best possible outcomes for patients, it can be extremely daunting to make decisions and sift through what technology is best for your practice. Each of these technologies comes with a price tag, and finding products that fit your practice’s needs requires a well-planned decision-making process that balances the following factors.


Any equipment purchased for your practice should be carefully scrutinized for its potential in obtaining positive outcomes for your patients. Just because it is the newest gadget doesn’t necessarily mean the data you get from it will apply or be useful in your practice.

One area where you may want the most detailed, up-to-date data is diagnostic equipment that provides key information to improve your cataract and refractive surgery results, especially when implanting premium lenses. For example, when implanting a toric lens, every degree off axis equals 3% loss of effect. Therefore, a new device that produces accurate astigmatic information for implanting toric lenses would be a must.

While the device should fit into how you practice now and benefits you immediately, you should anticipate future needs for how you will utilize the device. Many machines have a multitude of measuring parameters you will not initially utilize but could benefit you and your patients. In addition, consider that making the best diagnoses may mean a whole set of different data in the future that the device does not currently provide. So, any device that receives software updates to potentially incorporate new data would be a plus.


Many new devices cost tens of thousands of dollars. You must consider if the price of the device can be re-couped in a reasonable amount of time.

Profitability of your new device is dependent on multiple variables. Along with the overall cost, consider any necessary per-case costs, then look at your potential conversion rate and volume of cases to determine your potential return on investment. Also, remember to factor in the “hidden costs” in your purchase. These include the frequent purchase of disposables and maintenance.

You also can utilize certain strategies to save money on equipment purchases. For instance, demo units may be available at a discount price. You also may have the option of trading in an older device for credit toward the purchase of a newer model. Also, to make it easier to purchase your device, ask a company representative to help set up a payment plan.


If the device can produce a detailed amount of information, but your staff has trouble producing that information consistently, it will not help you make precise decisions. I can’t stress enough the importance of detailed training for all staff members on any machine you buy.

Before you buy, ask any sales representative whether they offer extensive training on the device for current and future staff. Within your staff, I’d recommend that you have more than one person in the practice who has the ability to train new staff. This will prevent you from being stuck without a trainer if your only “expert” leaves your practice.


If the device needs constant service or does not perform as sold, it will not be utilized. This usually occurs when you do not conduct enough research upfront. Talking to staff members who have experience with the device at other practices you trust may save you from buyer’s remorse.

Other physicians or staff members can provide anecdotal or personal technical details. For instance, colleagues have warned me against buying something that they had purchased and that we were ready to buy. This caution saved us the cost and humiliation of making a bad decision.

Technological advances occur rapidly in ophthalmology, which can make it difficult to invest in a product or know whether a possible new version is on the horizon. Attending conferences that provide product vendors opportunities to present their equipment is extremely valuable. The space for vendors at these events is usually expansive and allows room to roam from one product to the next easily.

My plan of action often consists of seeking out the companies that manufacture devices we are researching to purchase. I prepare a list of questions to ask prior to attending a vendor event and make every effort to get instant training and hands-on experience with the device.

Just remember, these are controlled environments, not your clinic where staff with varying skill levels will be operating this device.

Utilizing reps

Finding a product representative that you can trust and depend on is essential to making a smart decision on your purchase. They are motivated to make a sale, but a dependable representative will advise you on whether the product does not fit your needs.

Typically, it takes a few years to select the representatives in which you can develop almost a symbiotic relationship. In today’s competitive sales environment, it’s a luxury to have a representative with any longevity. They are relocated or sometimes promoted out of the region of your practice. But, if you find a representative you trust, he can be a conduit for any questions you have and frequently provide demos of desired devices for your staff to evaluate.


Any tools you acquire for your practice should help you provide the very best outcomes for your patients. Keep this in mind — along with the other factors listed above — to make the best decision possible regarding equipment purchases. OP