How do I buy an ultrasound?

Buying an ultrasound is an expensive and difficult task for the first-time buyer. My goal is to help the person who wants to buy an ultrasound and help them make the right decision. With 15 years in the ultrasound industry, I’m going to share with you how you would choose a product and a company as a pain reliever.

Ultrasound economics

Is Ultrasound the Right Business Decision for You? You first need to identify the types of procedures in which you plan to use them. All peripheral nerves, SI joints, knees, shoulder, hip, trigger points (chest area), facets, pragnency, piriformis, star nodes, caudal epidurals, pump refills, and many other procedures are clinically validated areas where ultrasound is as good or as good. better than fluorine. In addition, these are areas where you will be reimbursed.

For example, let’s say your cost is $ 35,000 and you fund it with a monthly payment of $ 700. They rate your uses at around 15 uses per week and get an average of $ 200 per use.

Gross Income = $ 12,000 / month or $ 144,000 per year

Acquisition cost = $ 700 / month

Net Income = $ 11,300 / month or $ 135,600 per year

Equilibrium point = approx. 3 injections / month

The economics of ultrasound are pretty good. Now, let’s get down to the really important things to make sure the numbers you draw on paper end up in your bank account. How and what you buy has a direct impact on the success of ultrasound in your practice. So let’s move on to the purchase of ultrasound.

Common mistakes

The first place to start is to understand how others have made mistakes and not to repeat them yourself. Buying mistakes are made by people who are afraid of making a mistake and are afraid. So let me put you at ease if you are one of those people. At this point, you may not be the first person in pain management to buy an ultrasound. In fact, you are likely to be surrounded by others who use it successfully. Otherwise, you have a great marketing opportunity. Also, many pain management executives will tell you, “Ultrasound is here to stay so you can get it now, before the discount goes down, or later if it doesn’t.” profitable”.

So let’s take a look at the two most common failed buy conditions:

1. I have to learn it before I buy it.

Ultrasound is a handy tool that, when used regularly with expert guidance, can be easily learned and learned. The person who delves into this concept of learning before buying it often spends thousands of wasted tuition and days using salespeople to “demonstrate” the machine for several tries, only to believe it isn’t. the case. not ready to buy because she still does not understand what to see or how to view the needle.

Unless they realize that all they have to do is buy it to learn, they will continue down this path for years to come. They love to laugh, but I see it happens every day to people who dip their toes in water and don’t want to engage. The water is hot, jump!

2. I want to buy the cheapest I can find to start.

In today’s environment, reselling is a dangerous idea. Medicare explains, “After the audit, the documentation must demonstrate clinical relevance.” Of course, not all of us want to spend nothing and make a lot of money. The reality is that with a cheap system, you get what you pay for. And 95% of the time you get a system that even an expert like me can’t tell what I’m seeing with these types of ultrasound devices. If you can’t see your target, the ultrasound is nothing more than a gimmick. If you perform the “gadget” ultrasound on your patients, insurance companies will likely claim their money back after the test.

You don’t need the $ 200,000 system the radiologist is buying or the $ 20,000 or less system.
System selection

Now that we’ve done that, you are able to start shopping on the right foot. If you have never used ultrasound for chronic pain before, two of them are essential for a successful implementation:

1. Diagnostic quality system
2. Progressive on-site training by experts
3. Offsite CME Courses for Continuing Education

Choosing a diagnostic quality system can be difficult because there is no “specification” in a system that you can research or evaluate to determine its quality. All you have to do is see the system and the quality for yourself. But if you can’t tell a bad image from a good one, stick with well-known companies and don’t try to make that decision.

To do this, go for the big 3. There are many other companies, but in general, if you are new and want to make the least risky aftermarket purchase without surprises or going wrong by buying something that you do not have. So it’s safer to stay in the box and not try to be the expert and go off with a stranger. The 3 main companies involved in this field are:

1. Consultant physician
2. GE
3. Sonosite

Unless you want to do some serious spinal surgery right away, I’ll stick with a lead setup that includes a lead. The best broadband probe is a linear probe with selectable frequencies between 5 and 10 MHz. It offers both resolution for shallow structures and penetration for deeper structures. In the future, you can choose to buy a convex probe with lower frequencies between 2-5 MHz, but you can always buy it later so I don’t see much of the need to spend $ 10,000. . more from the beginning.

The best way to structure your purchase is to have the company guarantee you a price for this additional probe for a period of 6 months after purchase. This way you lock in your price and can delay the decision until you have more information about your limitation or not by absence.

Stay stupid (KISS). You probably don’t want to be an ultrasound technician who presses a million keys while scanning to optimize the image. Find procedure preferences that you can adjust to the system so you can enter, insert the lead, run the procedure, and move on to the next patient. Pressing the buttons and running the system will slow you down and speed up your learning curve.

Training … you plan to use it, right?

Pay close attention to this section because not all training courses are created equal. The best training for you to learn ultrasound very quickly in real patients is with an expert at your side who will help you know the angle, the position, the point of entry of the needle and a lot of advice. ‘other keys to facilitate ultrasound. And then repeat the next day alone and the next day until it becomes as natural as fluoride-guided procedures. It is the fastest way to learn fast.

Then after 30-45 days, take a course where you can study from live models and / or corpses to improve your skills in faculties that have been doing this for years and teach you how to learn more difficult procedures. Since on-site training is the first and most important step, you need to ensure that the company is willing and able to:

1. Learn how to run the system (patient name, save image, etc.)
2. Learn how to perform ultrasound-guided surgery!

Notice to Buyers: Most companies offer on-site training by an ultrasound technician. Ultrasound technologies originate from traditional ultrasound settings, including scanning the thoracic, vascular, abdominal, cardiac, and other areas without MSK or chronic pain. That means they can teach you how to use the ultrasound machine, but they can’t show you anything about the procedure ultrasound for chronic pain just because, like you, they don’t know the sonoanatomy of the surrounding structures, the goal, or where to insert the best needle. . Also, many companies are run by lawyers and this is a directive “not to show the doctor how to do the procedures, but simply to run and optimize the system.”

– This means that learning the procedural ultrasound is on your shoulders. Now all of a sudden you’re stuck, uncomfortable with the system you bought for patients, and it’s there like a very expensive dust collector. Also, the return on investment you got when you made the purchase decision no longer matters.

The only way to get the numbers printed on your bank account is to use them. Be absolutely clear on this and get it in writing from the seller if possible.

Once you’ve improved your local process and established a clear path to get started, take the next step. What CME courses will you take in the future to ensure you expand your experience and get the most out of the ultrasound system in your practice?

I recommend AAPMU (American Association for Ultrasound Pain Management, www.aapmu.org). offers 3 levels of courses depending on experience and will offer the first and only procedural ultrasound certification in 2014. It may be possible to negotiate with your provider to ask you to reimburse you for the cost of tuition for these courses.

Price range and financing

I have a lot of questions about the price range I want to try to stay in. The answer is simple and is shared by most other experts. It is between $ 30,000 and $ 60,000. If you’re just doing basic ultrasound injections, go for a high-end portable device with a goal of around $ 30-40,000. If you intend to use it for spine diagnostic and / or serious purposes. You should consider looking for more power than a cart device can deliver. It also means that you may need to spend more on the higher end of $ 50-60,000.

Why not finance it? Financing is an excellent option to improve cash flow. Consider the following when your seller offers the offer:

1. Deferred payment from 3 to 9 months.
2. 2. No prepayment penalty.
3. 60-month dollar purchase loan (eligible for IRS section 179 withholding).

This gives you time to get refunds before the device costs you money. Then, when you’ve earned enough in a few months. You can simply pay off the loan without penalty and own it immediately. What he has structured is a way to fully charge for ultrasound without affecting his cash flow.