maximizing satisfaction ................. minimizing surprises

by Anne Nugent Guignon, RDH, MPH

If a new ultrasonic scaler has been in your dreams for ages and your employer has finally given you the green light to search for the perfect new machine, do you know how to get the best possible piece of equipment for your practice?

Purchasing equipment is a big deal. It is important to make a good decision. After all, if what you select does not perform to your expectations, you may have to live with that choice for years to come. If you are in most hygienists' shoes, you are stuck. Would your thoughts be any different if you were buying the scaler yourself?

Selecting and buying new equipment can be exciting and frustrating, whether you're spending your dollars or your doctor's. There's so much in the marketplace these days. So where do you begin?

Over the past decade, I've purchased my own ergonomic chair, several pairs of loupes, a manually tuned magnetostrictive ultrasonic scaler, hand instruments, ultrasonic scaling inserts, and a fiber-optic headlight system that is attached to my loupes. Every time I spent my hard-earned dollars, I wondered if I was making a wise decision. For sure I wasn't making any more money than any other hygienist on the planet, but purchasing my own equipment has made me an expert in the eyes of many hygienists.

In addition, many companies have given me equipment to work with and evaluate. My list now includes cordless polishing handpieces, a piezoelectric scaler, an automatically tuned scaler, a portable halogen headlight, two other fiber-optic headlights, five more pairs of loupes, four different types of polishing handpieces, a diagnostic periodontal probe, a laser caries-detection device, four cordless curing lights, and an automatic sharpening device for hand instruments. This doesn't include numerous hand instruments and various other disposable commodities.

It is fascinating to see what is out there and to be able to compare one product to another. Perhaps my equipment collection sounds a bit bizarre, but it is amazing what you learn when you try different products side by side in a controlled clinical setting. Believe me, they're not all the same.

I've learned a lot about manufacturing, quality control, marketing, and customer service. In many cases, price is one of the least important things to consider. Quite honestly, it is great fun to be involved with early product design and development, and it's also fascinating to see the marketing side from a manufacturer's point of view. So let me share some thoughts with you about things you may want to consider before you or your doctor sign on the dotted line.

You're getting ready to spend some money. Before you get your heart set on one particular product, it is a good idea to learn as much as you can about the potential purchase. A thorough investigation is impressive to an employer and demonstrates that you're approaching this decision in a businesslike manner. If you're spending your own hard-earned dollars, knowing as much as you can in advance will make you feel more comfortable about your decision.

What should you consider? Are there different products or technologies that claim to accomplish the same thing? For example, in the world of ultrasonic scaling, are you considering a magnetostrictive or piezoelectric unit? Do you know a lot about these two different technologies? There are certain similarities and definite differences between them. A similar question could be applied if you are purchasing magnification loupes. Do you know the pluses and minuses for a fixed through-the-lens system vs. a flip-up model?

Will the new equipment allow you to administer better treatment or do a different type of procedure? If it is a new procedure, will there be an increase in dental hygiene production? Doctors love this type of information. If you supply this new equipment, will you receive some type of financial reward?

Will the new equipment allow you to practice more safely from an ergonomic standpoint? Does the equipment fit your body type? Will more than one clinician share the product with you? For example, it would probably be very difficult for a clinician who is 5 feet tall to share the same operator chair with one who is 5 feet 11 inches, but often no one thinks about things like this until it's too late. If the doctor gets a new ergonomic operator chair for both of you to share, what is the problem? Do I have to explain the math?

Will the equipment fit in your treatment room, much less your hands? Over the years, I've seen doctors purchase equipment without asking what would work in the hands of those who are expected to use it. Some doctors go to conventions and come home with "surprises" for their hygienists. Unfortunately, they are dismayed and annoyed when their hygienists are not overjoyed with their product selection.

In other cases, treatment rooms just don't have the right setup, forcing the clinician to turn and twist constantly just to use the new equipment. Sometimes treatment rooms can be reconfigured, but don't count on this. Measure your working space before you make a commitment.

Another thing to consider is how much counterspace the new device will require. If the device is corded, are there enough outlets, or will you need another power strip just to plug it in? If the device has a foot switch, is there room to park it on the floor? Some modern treatment rooms are becoming as crowded as a shopping center parking lot two days before Christmas.

Cordless devices are a plus in the portability department, but their chargers still need to be plugged in. To ease treatment room congestion, find out if the device can be charged in another location. Speaking of portability, can your new equipment be used in alternative practice settings or be taken from one treatment room or office to another? It doesn't take a demography wizard to understand that more and more patients over the next five years will be treated outside the traditional dental office setting. So if you are thinking about a polisher, you might want to consider a cordless one.

Are you familiar with research that supports the manufacturer's product claims? Is the manufacturer willing to discuss this with you, or do the representatives just point to glitzy ads and speak marketing mumbo-jumbo? Reliable companies want educated consumers. This prevents a lot of headaches on their end and will help you focus on whether not the product is the right one for you.

Have you taken time to find out how other clinicians feel about the product? Are your friends using it? What are their thoughts? One word of caution here. Your friends may love or hate what they are using, but they may never have given their equipment any thought. So take their gushes or gripes with a grain of salt.

Now that you have a good handle on the technology, there are some other things to think about. Is the device as easy to use as a point-and-shoot camera? There are times when things appear to be easy to use at first glance, but turn out to be a lot more complicated once they are in your treatment room. If the device requires pushing more than one button, make sure the user manual is easy to decipher. If the equipment is more complex, is special training necessary or desirable?

Are demos or trial units available? Sometimes this is possible, but don't be disappointed if companies tell you no. Some types of equipment are easily damaged if used by untrained consumers. Other companies are not in the position to send out demos, but they do offer reasonable return policies. Keep in mind that manufacturers still have to run profitable businesses and that sometimes our expectations may not be realistic.

Does the company provide training, or can they recommend a resource? Computers are perfect example. Most of us can fumble round with our PCs or Macs until we get something that might be barely satisfactory. Investing a few hours in some basic or even advanced training can make our time at the keyboard much more efficient and much less frustrating.

Some companies offer excellent tech support. Others only provide a manual. At times, you may have to rely on the supply company's rep or be faced with contacting the company directly. It is important to know the level of support with which you are comfortable.

What if the technology changes six months after you purchase the new equipment? Can it be updated or upgraded? If the answer is no, you might feel like wringing the manufacturer's neck every time a new product is introduced.

Certain devices have parts that are considered consumable, such as inserts or tips for ultrasonic scalers. What is the cost of replacing these items over a period of time, like a year? This becomes a real issue when the initial piece of equipment is relatively inexpensive but costs a lot to use over time. In contrast, a product that appears to be very expensive initially can actually be much cheaper for the practice to operate in the long run.

It is also important to know if the equipment will only work with the original manufacturer's consumables. Would this limit the types and numbers of applications that can be derived from your new device? Do other manufacturer's consumable parts work as well? Of course, the manufacturer wants you to continue using his products — that only makes sense from his point of view, but you need to know this information. Sometimes it is difficult to get a straight answer on this issue.

Now, we come to the subject of the manufacturer. Is a larger, well-known company always the best choice? There are lots of small- to medium-sized companies that make outstanding products, so get to know who is out there. Sometimes the most sophisticated or reliable equipment comes from sources you've never heard of. This is not an automatic red flag. Also, many products are manufactured by well-known companies but are marketed under a private-label name.

In today's competitive business world, a small company that is surviving generally has something worthwhile to offer, and customer service may also be more responsive. If you have a problem, smaller companies have fewer organizational layers to go through. You might think that price is a key consideration in your purchase, but it has been my experience that customer service is far more important in the long run.

An example of the importance of good customer service can be found with the purchase of magnification loupes. Loupes must be fitted properly. If they're not, it's nearly impossible to enjoy the benefits. Occasionally, the measurements taken at a dental convention may not match what you need in your treatment room. If this happens to you, it will be hard to get used to wearing loupes. Does the company you are considering buying magnification from have a customer support system in place that will help you resolve any concerns?

It is important to know if the company will stand behind the product and correct any discrepancies. Find out the period of time the manufacturer allows for product changes. How long do you have to adjust to the loupes? Some practitioners take to magnification like a duck to water; others need several weeks or even a month to get used to wearing them. What is the return policy? Who pays for the shipping?

For any piece of equipment, it is important to understand the terms of the warranty. Can repairs be made on-site at your dental office, or do you have to send the equipment to another location? If that is the case, what is the typical turnaround time? If you purchase an extended warranty, what does that really mean? No one wants to be stuck with a piece of equipment that will be out of service for weeks at a time.

And finally, are there any financing options available? Dental hygienists are becoming an important segment of market share in dentistry. More and more companies realize that dental hygienists are purchasing their own equipment, and they are interested in having dental hygienists as customers. They realize our income stream is much less than that of a dentist; consequently, more companies offer payment options or special pricing for hygienists. Again, this may not be the norm yet, but there is a definite trend toward recognizing that we can be the primary purchasers of our own equipment.

Did you notice that price is the last thing to consider? Take a lesson from the Maytag® folks. Their washers and dryers are not cheap, but they last for years without a lot of repairs. My mom swears by them. She raised seven kids and did a zillion loads of laundry.

When it comes to purchasing dental equipment, do your homework, evaluate your needs, consider your budget, and understand that you generally get what you pay for. This is not advanced economics, but, rather, a lesson in real life.

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing-education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at anne@ergosonics. com.