The decision to purchase or lease a laser is an important one for any practice, and it requires thoughtful research. Some key considerations are obvious: Is there interest on the part of the dermatologist? Has he or she acquired the necessary training and skill? Is there demand or need among patients? Can laser therapy be profitable? Sometimes, practices are lured into purchasing a laser based on the perceived cache of offering a hot, new procedure or a high-profile device. However, the most successful laser practices are those that make key decisions based on fact-based analysis rather than excited optimism.
At this year's Annual Meeting of the American Academy of Dermatology, Brad Renton, PhD, Vice President of Aesthetics at Iridex Corp., which serves the aesthetic market place with a range of lasers, including the 532nm KTP, 532nm with 1064nm Nd:YAG, and 532nm with 940nm Diode systems, urged laser purchasers to recognize an often-overlooked but crucial purchase consideration: the company a practice will buy or lease their laser from. “Before investing in a laser, we suggest physicians research systems that are time-tested, with technology strong enough and long-lived enough to achieve good results of the most common indications, such as vascular and pigmented lesions,” Dr. Renton said.
the aesthetic market, Dr. Renton observed, but he warned that there are also less reputable sources of laser products and supplies. ”We want physicians to know that when they invest in a laser they are also investing in the value of the company,” Dr. Renton commented. “It is important to partner with organizations that stand by their product and their customers.” To help dermatologists make informed decisions about a laser lease or purchase, we asked cosmetic dermatologists to share tips from their experience.
Dermatologists who wish to maximize the utility of a laser in their practice should focus on identifying a need. “Assess your patient population to determine the most requested need(s) or your source of referrals to other laser physicians in your area,” suggests Cheryl M. Burgess, MD, Medical Director of the Center for Dermatology and Dermatologic Surgery in Washington, DC. “Assess whether the goal or desired treatment can be accomplished with less expensive means or devices available other than lasers,” she adds.
Once you decide on a laser procedure and begin to evaluate companies, Dr. Burgess reminds, “Your relationship needs to extend beyond the sale.” Therefore, physicians should research a laser company's maintenance service record.
Girish “Gilly” Munavalli, MD, MHS, Medical Director at Dermatology, Laser, and Vein Specialists of the Carolinas, PLLC in Charlotte, NC also emphasizes the relationship one develops with a company. Among, “Company attributes that I personally look for include whether the company is publically or privately held and if it is established or not (greater than 10 years).” He also assesses a company's reputation among peers for sales, servicing, and support. “I look for a track record of innovation and to some minor extent if the technology is ‘hot' and trendy, but obviously it must be efficacious.”
Seek Good Advice
Advice from experienced peers can be helpful for a clinician investigating lasers. Dr. Munavalli recalls three important pieces of advice he received from trusted sources: “One, never rely solely on the company's word and data. Do your due diligence and talk to colleagues other than the references they give you, if possible; Review any published literature on the laser before purchase.
“Two, know your patient population (skin type, common conditions, etc.) and the most common uses for which you could potentially integrate a new laser.
“Three, fire the laser on yourself to test it, so you know what it feels like and what the healing would entail.”
According to Dr. Burgess, the best advice she received was related to maintenance contracts. “The need for a service maintenance contract is not as important on pulsed dye laser devices. The lasers are work horses that rarely malfunction that operate with dye kits. The cost for the service maintenance generally costs one-third more than hiring the laser technician to replace the dye kit without the service maintenance agreement,” she explains. She advises buyers to prioritize costs and assess a maintenance contrac based on the specific device.
Any decision regarding a service and maintencance contract should be made on a case by case basis upon review of all the facts. Consider costs for service, repairs, and replacement parts, as well as any guarantees on timely service and other potential perks.
Beware Bad Advice
Of course, not all advice is good advice. Dr. Burgess says that, despite the realities of pulsed dye laser maintenance described above, many peers gave her the blanket admonition that every laser needs a service maintenance agreement.
Dr. Munavalli says he received bad advice about nonablative rejuvenation. “That was a trend about seven or eight years ago, with infrared lasers for treating wrinkling, scars, and tightening. That didn't quite pan out like we thought it would in terms of efficacy,” he says. “This highlights the need to understand the ebb and flow of laser technology and position yourself in the middle. First adopters can do well, but can also get burned—figuratively speaking of course!” Weigh all decisions carefully he warns, “There can be significant financial risk.”
Another piece of bad advice Dr. Munavalli received? “‘Don't worry about the ROI…it will work itself out'! Big mistake,” he says.
Seek Healthy Partnerships
Practices that purchase a laser hope a company will stand behind their product, ensure its quality, and support them through the integration process, but companies can do much more. “It is good to have a healthy relationship with industry,” Dr. Munavalli suggests. “They can really help make your practice grow.” Ultimately, no matter how good the company or its products, the device in question must be a good fit. “One must evaluate for themselves whether a particular laser will work in their office,” Dr. Munavalli says. “Just because it ‘works' doesn't mean it will work for you and your bottom line.”
The decision to purchase or lease a laser is an important one for any practice, and it requires a good deal of thoughtful research. The most successful laser practices are those that make key decisions based on fact-based analysis rather than excited optimism. Prospective laser purchasers can acquire good—and bad—advice from peers. Of note, practices that purchase a laser should expect a company will stand behind their product, ensure its quality, and support them through the integration process.
Company Assessment Checklist
According to Dr. Renton, laser buyers/leasers can spot a quality
company based on their performance or the level of service they
offer in each of these areas:
- Company Reputation
- Product Longevity
- Product Applications
- Product/Laser History
- Service Support
- Clinical Training
- Practice Marketing