How Does A Plastic Surgeon Incorporate Lasers Into A Primarily Surgical Practice?

One of the most common questions that other physicians ask me is “how do I incorporate lasers into my surgical practice?”

I am often called by a plastic surgeon, specializing in cosmetic surgery, who wants to know how he or she can begin to use lasers in their practice. It can seem exciting yet daunting to bring in a new procedure because of the level of knowledge and training required to properly treat patients and produce excellent results. And many times, physicians have limited time for further training once a busy practice has been established. In addition, lasers are expensive and most surgeons are not used to having to purchase expensive equipment beyond the initial investment in supplies to start a surgical practice. That being said, the laser procedures can help surgeons offer a much wider range of treatments that will benefit both the patient who has had surgery and the one who is not yet ready for surgery. I tell physicians and patients that laser procedures can be “insurance for your surgical procedure” in many ways. Laser procedures can help add to the result of surgical tightening by treating dyschromia, discoloration, texture, pore size, vascular lesions, and providing overall better skin health and appearance. One can pull the skin tighter with surgery, but the skin often needs surface treatment with laser procedures. Don’t just focus on achieving tighter skin, focus on overall better looking skin also. This may sound like a sales pitch, but you will hear me often say, “don’t put cheap tires on a Rolls Royce!” Surgical results will greatly benefit from maintenance laser procedures and good medical skincare. Finally, a laser procedure can often help a plastic surgeon treat a patient who does not really need surgery yet, so that the patient does not have to be referred elsewhere.

My advice always starts with telling fellow surgeons that

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Planning Ahead For Equipment Failures

It's inevitable. At some point your cosmetic laser or IPL will go on the fritz. Then what?

About half of the people I speak to every day are medical spa owners. The nature of my job pretty much implies that most people calling me are in some type of situation they would consider an emergency. Most have just one cosmetic laser or IPL, a schedule full of customers, and no time. A week of searching for a repair company or technician can put a medical spa in a very bad situation. Unexpected service expenses are not so... they should be expected, but they are ignored.

How does one prepare for such unforeseen expenses as the need for a laser cavity rebuild, a power supply repair, or laser rod resurface- all repairs that can result in at least a week of downtime? This problem can best be remedied at the time of purchase, but most of you are far beyond this point. There are few options, but there are options.

The very best option in contingency planning for unexpected repairs is to warranty your devices. This is best done when purchasing your new or used laser- new lasers should come with a minimum 12 month warranty, and you should never purchase a used laser from a company that cannot offer at least a 6 month warranty after purchase. Many dealers and third party service companies now offer warranties on a wide variety of laser makes and models, but to know who offers what you may have to ask around. Some of these third party warranties offer more for the money than the original equipment manufacturer warranty, but come with the caveat that there are parts that may not be readily available at all times.

Another option to consider, even if you have a warranty, is a backup unit or rental. If you can only afford one laser, teaming up with local colleagues is one way to alleviate this problem. If you have a Cutera Xeo, for example, you can seek out colleagues in your area who also use the Cutera Xeo and together purchase a standby unit that is only used in case of emergencies. You might also ask your warranty company if they are capable of providing loaner units while yours is in repair.

The third option to consider is leasing your unit. Under a lease, you are not directly responsible for all the maintenance. In case of emergency, the leasing company should be able to provide a loaner or temporary unit. I am not referring to a lease as in taking out a loan from a bank to pay for what will be your laser- I mean leasing the laser from an owner who will handle all the maintenance should anything go wrong. These kinds of arrangements do include clauses where you may be responsible for negligence, equipment abuse, and misuse, but most lasers fail because of normal wear and tear.

Of course, none of these options will alleviate every emergency situation. The best course of action may be a combination of these options, or all three. Even though there is no catch all, HAVING a plan, or at least being aware of the possibility of an unforeseen expense is more than ignoring the possibility in it's entirety.

Have a question? Please leave a comment.

Every Day Maintenance Of Your Cosmetic Lasers & IPLs

Your cosmetic lasers and IPLs need some basic care and maintenance. What should you be doing?

Many people ask me if there is anything they can do to prevent their laser from breaking down without having to call in a technician every time. While there is not much you can do for normal wear and tear breakdowns, there are a few things you can do that will ensure your unit is in top condition between maintenance checks. This is in no way intended to replace any manufacturer's recommended periodic operator maintenance procedures, nor is this intended to replace periodic maintenance in any way. I still recommend that every laser used on patients should be checked every six months by a trained professional.

Basic checks on your laser can be broken down into modules. To make certain practices a habit, most people need to know why they are performing a task. I will first break down basic laser systems into the 5 modules that make up every laser, and then the basic things you can do to maintain these modules:

Power Supply / Exciter

Stimulated emission of radiation occurs when a lasing medium is excited, and forced to release it's own photons in a wavelength specific to that lasing medium. CO2 lasers, for example, use either an RF exciter, or a DC exciter. Yag lasers use a high powered flashlamp- it is not the flashlamp light that is collimated and amplified, rather the flashlamp excites the Yag crystal and forces it to release photons in wavelegnth specific to the crystal, ie. 1064nm. An exciter can also be a chemical reaction, as with Excimer lasers (excited dimer). A bad power supply will result in some obvious errors like the laser not powering on, but it can also result in intermittent issues or problems more difficult to find like peak power settings not being selectable, or certain pulsewidths not being available.

What can you do to maintain your power supply? Power supplies are mostly affected by wall outlet power. Ensure you are using medical grade power outlets, and a dedicated line. A medical grade outlet will be indicated by a green dot on most 110VAC outlets, but 220VAC outlets will not have this dot. For 220VAC systems, make sure you are getting "healthy" power... that is anywhere between 218VAC and 237VAC for most systems. I don't know of any systems rated for higher than 240VAC, but I have seen power as high as 247VAC at some facilities. This is not acceptable, and power should be maintained in the safe zone for your laser. This info is available in your operator's or service manual.

Laser Cavity / Resonator / Laser Head

This is the heart of your laser. This consists of your lasing medium (crystal, dye, or gas), a highly reflective surface or HR mirror, and an output coupler or partially reflective surface. Oftentimes the flashlamp will be in the laser cavity itself as with Yag and Alex lasers. Many issues with other system modules will cause problems in the laser cavity. The worst enemies of your laser cavity are heat, and of course, time. An old, worn, or dirty laser cavity will overwork your power supply which is working extra hard to excite your medium because the internal test results are low. This may result in power output errors, detector mismatch errors, flashlamp ignition errors, etc.

What can you do to maintain your laser cavity? The best way to maintain your laser cavity is to monitor your power output over time. Have your laser checked every six months by a trained professional, and at least once a year, have them inspect the internal condition of your cavity. Though you may get an unexpected expense at a random six month interval it is much better to catch problems during these inspections rather than having your unit shut down during a case, and resulting in canceled appointments. Maintaining your other subsystems also extends the life of your resonator.

Optics Train / Beam Path Optics

These are the optics between your laser cavity, and your delivery optics. Some laser don't have anything more than a fiber focus lens between the output coupler and fiber. The Cynosure Apogee Elite, for example, on the Alex side, has nothing more than a surface output coupler (a partially reflective surface on the output side of the Alexandrite crystal), and from there the beam goes into a fiber focus lens, and directly into the fiber. A Cutera Xeo's crystal is different- it requires an external output coupler, and a rear HR mirror. The beam bath also takes two turns before it reaches the fiber focus lens. CO2 lasers, and some Erbium lasers use an arm. Every knuckle in the arm has a mirror that can be adjusted and may require cleaning over time.

What can you do to maintain your cosmetc lasers optics? Best advice- keep your room lint and dust free. I can't emphasize this enough: KEEP YOUR PROCEDURE ROOM FREE OF DUST AND LINT. Clean up as much as possible. Wipe down your system as often as possible. Change any filters that can be changed, and clean others (this includes office HVAC system filters). To preserve alignment, take care when transporting the laser, and the best thing you can do is not transport it at all.

Delivery Optics

This may consist solely of your handpiece, but in some cases (as with an arm) it may consist of a train of mirrors. The fiber focus lens is also part of the delivery optics. Problems with the beam path and delivery optics will result in calibration errors where a handpiece calibration is required, or diminished output not readily noticeable to the operator in some cases. In other cases, a bad alignment may cause heat, burning in the handpiece, and other issues noticeable to the operator.

Besides the same advice I can give for the beam path optics, take care not to drop your hand piece! If you have a laser with an arm, PARK THE ARM before moving your laser around. Stow the arm safely when not in use. Clean your hand pieces after every patient. Replace blast shield windows periodically. Replace distance gauges more often than you think necessary- it is better to replace distance gauges than it is to replace hand piece optics. And FYI- any dirty optic will have an effect on the entire laser train.

Cooling System

The cooling system in most lasers consists of a water reservoir, a heat exchanger, a water pump, a water level detector, a water pressure detector, DI and/or particle filters, and tubing throughout the system. Some cooling systems include a heating element as well to maintain a specific temperature (as with Alex systems). Distilled water is normally used to fill these systems, but some manufacturers may require a coolant additive as well. The cooling system is often used to cool the laser cavity, handpiece (in some lasers), and power supply (in some lasers).

To maintain your cooling system, the best thing you can do is use reagent grade deionized water. When that is not realistic, use NOTHING less than distilled water. Again, replace any replaceable filters, and clean any that are not. Clean your heat exchanger/ratiator as often as possible, and never let a blanket of dust form on your radiator. Another thing you can do is grab a voltmeter, set it to read Ohms, stick your leads in the water reservoir about an inch apart from each other and read your resistance. The ideal resistance for Deionized water is 2MOhms. If it is lower than 1MOhm, I would recommend replacing the DI filter and possibly the particle filter as well (if there is one).

I know none of these things are actually going to prevent a catastrophic/emergency failure, but they may help you avert one, or at least be aware when one is looming. Heat, time, dust and movement is what will eventually take out your laser. These are just ways to avoid letting these things run your laser down prematurely.

Questions about any of this? Please leave a comment.

The New Medical Spa Physician Report

The New Medical Spa MD Physician Report is (finally) out!

download

And we thought that our first medical spa report was huge...

We've had to juggle a huge number of launches in the last month and, unfortunately, the launch date for the report got pushed back a little. We're sorry that we weren't on time, but once you take a look at the report we think you'll find it work the wait.

We integrated a lot of your feedback from the first report in this one, cutting back on the 'situational' questions (although we still have some) and moving in to areas that we know you want answers about.

Here are some of the questions that are answered in this report:

  • What percentage of your clinic's revenue is spent on marketing and advertising?
  • How is your clinic staff compensated?
  • What do you think of paying commission for medical treatments?
  • What is the total income of your clinic or medical spa per month?
  • What percentage of your clinic's revenue is spent on payroll?
  • If you pay commission, how is it structured?
  • What are your patients requesting most that you don't currently offer?
  • How much is a new patient worth you you as a clinic in the first month?
  • How many new patients does an average client refer to you in a year?
  • What do you consider to be the most important way to generate sales for your clinic?
  • What is your most effective marketing tactic?
  • What marketing have you tried that you would never recommend?
  • If you could add one cosmetic medical technology by manufacturer and model, what would it be?
  • Which treatments generate the most revenue for your clinic?
  • What generates the most profit?
  • Which technology manufacturer do you think has the best reputation for efficacy among physicians?
  • Who has the best reputation for customer service? Who has the worst?

Whew.... and that's just a partial list of what we cover. There is also a great interview with plastic surgeon Dr. Enrique Etxeberria from Spain and some great info about waiting room marketing videos from this reports business sponsor, Frontdesk.

Download the report here.

 

Thank You To All Of The Contributing Physicians & Clinics

The following is a partial list of the physicians and clinics that contributed to this report and gave us permission to identify and link to them. Sign up to contribute to the next report here.

Note: We do not identify individual physicians or clinics with specific answers to make sure that all respondents can be completely candid in their answers. (Our surveys are done through our online software and provide confidentiality and anonymity and they take about 10 minutes to complete.)

Clinica Etxeberria

BCLaserAndSkinCare.com

ForeverYoungMedspa.us

WinchesterLaserCosmetic.com

RenovoMD.com

Reveal.com

VisageMedArt.com

ScienceMedispa.com

OmniHealthPro.com

Clinica-Luxury.ro

Our contributing physician list is growing fast. Thank you to the physicians and clinics who have contributed to this report. If you're a physician and would like to contribute to the next report, please let us know by entering you information in the form below.

 

Become a Contributing Physician Member

Complete this form to contribute to the next report.

Licensed Clinicians Only: If you're a licensed clinician practicing cosmetic medicine and would like to be included as a Contributing Member in the next report, please fill out this form. You will then be added to our Contributing Members and receive a monthly questionnaire that only takes about 10 minutes to complete. (If you're a business that would like to sponsor a report, please contact us.)

Purchasing Used Cosmetic Lasers

used cosmetic laser

Looking for a used cosmetic laser or IPL?

By Mickey A. Couvertier, CBET, CLRT

Starting or expanding a private medical or cosmetic practice can be a complicated experience. Location is of the utmost importance, followed by branding, and marketing. Staffing, clinical needs, pricing, advertising- all of these things can be an added headache to the whole process… not to mention acquiring quality equipment, and the follow up service.

While all the other parameters mentioned can be worked, and reworked, the one aspect that can make or break your entire practice is purchasing and servicing used medical lasers. There are hundreds of wholesalers, distributors, and other second source vendors offering as wide a variety of aftermarket options as there are options for new equipment, and even more. OEM’s are also in the market, and while basic supply and demand dictates that so many options should be a benefit to the consumer, the process of choosing which devices to purchase is amongst the most discussed, asked about, debated, and argued about amongst clinicians, salesmen, and repair companies alike. I have written this short guide with the hopes of assisting anyone in the market for a used medical laser in making the right decision.

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Time Is Running Out: Section 179 Tax Deduction For New Equipment Purchases Installed This Year

Just a reminder for our Members, you have a chance this year to deduct the full purchase price of a new laser or pulsed light platform — saving up to 35% of the purchase cost.

The 2011 Section 179 federal tax deduction for new equipment purchases provides you an opportunity to writed off a new IPL or laser purchase. (Systems installed before December 31, 2011 may qualify for the 2011 deduction.)

*Please contact your own advisors for specific guidance regarding the impact of Section 179 for your practice.

How to Buy a New Medical Laser – What the Laser Manufacturers Don’t Want You To Know

The goal of negotiating for a new medical laser is to try to get the largest possible discount off the laser manufacture’s “List price.” The list price is what a manufacturer, such as Alma Lasers or Palomar Medical, posts as the selling price. You’ll see the manufacturer’s suggested list price in many of the trade magazines such as the Aesthetic Buyers Guide or at Aesthetic Trade Shows.  This is a price that is not commonly paid by most doctors, however there are many physicians who don’t like to negotiate and accept the list price as the final price.  Unfortunately, they end up losing thousands of dollars in the process and even more money down the road when they try to resell it. I’ll get to how this happens a little later.

Obviously, before you even start negotiating, you need to decide which medical laser(s) you want to buy. So take the time to investigate what you’re looking for, request the manufacturers to demo their equipment in your clinic.  Attend the various laser conferences and do your own research.  Ask your more experienced colleagues what laser systems they have used and which ones they recommend.  If you’re not part of some of the laser societies, I would strongly recommend that you join some of these organizations.  A great one that I like is the American Society for Laser Medicine and Surgery (ASLMS.org).  The networking aspect is tremendous and you will get invaluable user feedback on all of the major laser systems out there.  Walk the floor of the trade booths and don’t be afraid to ask questions.

Try to become as knowledgeable as possible regarding laser biophysics so that you don’t get “bamboozled” by the slick “laser-techno-babble” of the sales reps.  During this initial demo phase inside your clinic, never promise anything to a salesperson, never give a deposit, and never sign any type of contract. Don’t feel pressured either — if you do, inform the salesperson that you never buy any equipment on the first visit to your office.

You need to be sure that your sales reps know that you are looking at many different laser manufacturers.  If they get the slightest idea that you really only want their equipment (even if you do), you have lost considerable leverage when it comes time to negotiate.  You should also get comparative price quotes of each model you are testing.  You can use this pricing to your advantage by having each sales rep bidding against each other on price.

You have to think outside of the box to get a good discount. The worst thing you can do is negotiate a price without having any information on the TRUE sales price.  So, how do you get the true sales price?  Ask for references from the sales rep in your area of other doctors he has sold to.  Once you have this information, it is important that you call these doctors and ask them about their level of satisfaction with the equipment as well as how much they paid for their system.  This may seem a little crass to ask for this type of information from a total stranger, however it’s your money and you could be saving thousands of dollars by doing so.

You may also know other associates who own this equipment.  If you’re able to get accurate sales price information, you can use this as leverage when you are presented with an offer.  The sad reality is this, whatever you pay for a new system, all new medical lasers typically depreciate by at least 40 to 50% as soon as they are sold.  Even if you buy a new medical laser and never use it, it still loses at least 40% of its original value.

Why does this happen?  It doesn’t really seem possible or fair does it?  There are critical reasons for this and it is not by accident.  One of the main reasons is that most laser manufacturers do not allow the original one year warranty to be transferred to another buyer.   If you want to sell a laser you just purchased, the original warranty is voided because it is typically non-transferrable.  Most doctors who are buying their first laser do not know this, and they naively sign the purchase agreement with these clauses contained in the agreement. In addition, the new buyer will need to pay a “recertification fee” to the manufacturer in order to get the laser serviced by the manufacturer.

As if that’s not painful enough, the “recertification fee” doesn’t include the warranty.  The new buyer has to also purchase an entirely NEW warranty if they want the laser serviced by the manufacturer because the last warranty was just voided due to the transfer of ownership!  What a racket huh?  Whether these practices by the manufacturers are truly legal is highly questionable, however the sad reality is this is the standard practice inside the medical laser industry.  All of this gets very expensive very quickly!  In some cases, the recertification fee is in upwards of $25,000 plus a new warranty of around $10,000 = $35,000 TOTAL – just because the laser changed ownership. These extra fees charged by the manufacturer cause the value of the equipment to plummet!

Unfortunately, most doctors don’t realize this until after they’ve already bought their laser and it comes time to sell their equipment.  How do you avoid this?  First of all, I would highly recommend that you have your attorney review any purchase agreement you are being asked to sign before you sign it.  He or she will be able to detect any clauses that are oppressive or unfair and will give you recommendations on what clauses should be revised or deleted.

This is probably the most important paragraph I am placing in this article.  Please read and re-read this paragraph because it is so critically important and can save you thousands of dollars.  You need to enter the purchase negotiations for a new medical laser with the goal of accomplishing these four objectives:  (1) Revise the purchase agreement to allow the warranty to be transferred to a new buyer without penalties or fees of any kind, (2) Request that the warranty be extended beyond the standard one year to two or three years, (3) Eliminate any language in the agreement regarding a “recertification fee” should the laser be sold beyond the warranty period, and (4) require that the warranty include a Laser Depot service to be sure you have no downtime in your clinic.  A laser depot service is when the manufacturer ships you a replacement laser should your laser break down during the warranty period.  It is a critical service to have when you have just purchased a new laser.  Be sure this is always included.  If you can, request that the Depot service is extended through the entire life of the warranty, whether it be one year or up to three years.  If you are able to accomplish these four objectives, you will be way ahead of the game.

Changing the purchase contract so that the warranty can be transferred without penalty will dramatically help you sell your laser down the road, should you choose to do so.  It will also help increase the laser’s resale value and how much money ends up in your pocket.  Requesting that the warranty be extended beyond a standard one year is another key strategy to help you maintain your laser and ensures that you don’t incur expensive repairs after the first year of use.

Most medical laser malfunctions and breakdowns occur after the first year of ownership, so extending the warranty to two or three years will ensure you don’t incur expensive repairs during this period.  Recertification fees are the manufacturers way of leveling the playing field when competing against their own used medical lasers in the used marketplace.  By having a “recertification fee” of $10,000 to $25,000, it closes the gap between the cost of a new laser versus a new one.  Quite frankly they are ridiculous fees and I don’t believe they are legal, but no one has challenged the manufacturers in this area to my knowledge.  What if an automobile manufacturer were to charge such bogus fees?  The public would revolt!  I’m not sure why it’s tolerated in the medical community.

Keep in mind that you have the greatest leverage in the negotiation process before you buy.  You can never get what you don’t ask for, so ask for it!  You will be surprised with the sales rep says yes to.  If you are a qualified buyer, there aren’t many of you around, especially for new medical lasers!  You need to exploit this fact to your greatest advantage.  The strongest arrow in your quiver is your ability to “walk away” from any deal.  The sales reps don’t want this to happen and they will do anything in their power to avoid this!  If you do walk away, you can typically buy the exact same system on the used market for much, much less – up to 60 to 70% off!  In most cases, all of this equipment can be serviced by third party repair companies without going through the manufacturer, so who needs em!  If you are reading this, you obviously have access to the Internet.

Take advantage of that and inform yourself by surfing the Web. One of the most important steps you can take is to see what your laser is selling for on the used market.  A good place to start is www.Dotmed.com.  This is a very large Internet Portal connecting buyers and sellers of all used medical equipment.

Key word:  DEMO UNIT.  Often times you can secure a very good price on a “new” medical laser by asking if they have any “demo” units available.  A “Demo Unit” is often times a new piece of equipment, however by calling it a “demo” unit it allows the manufacturer to “save face” and dramatically drop their sales price below the acceptable range.  Most of the time if the laser is actually used, it has been used very lightly and the manufacturer still carriers at least a six month to one year warranty on the unit.

Once you’ve tested a medical laser inside your clinic, there is no need for the sales rep to return except to sign a contract.  Try to maintain negotiations on the phone or by email — you will be less intimidated and less likely to falter to pressure.  Some sales reps/manufacturers refuse to give you a price on the phone. Inform them that you are serious about buying and will do so quickly if offered a good price.

Make sure the final price is the final price: Compare apples with apples. Have all taxes and fees included in the final quote.  Ask them, “If I were to buy this medical laser outright, and had to get a certified check, what would the amount on the check say?”

Remember that in the end, you end up with a new medical laser at a lower cost. Saving money is never a wasted effort. In addition, when it comes time to sell your medical laser, your equipment will have a higher resell value if your contract allows a transfer of the warranty and no “recertification fees!”

3 Comments

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

How to Negotiate the Purchase of a Used Medical Laser

Successful negotiation for a used medical laser comes from having solid information. This is particularly true when buying a used medical laser.  Before beginning negotiations you should conduct online research on the availability and price of the lasers you are looking for. An excellent resource for the value of used laser equipment is Dotmed. If a certain kind medical laser is for sale, it is normally available on Dotmed.  You should be able to get an average asking price for the laser you are looking to purchase.  You can use this information as a basis for negotiating the price if it appears that the broker’s asking price is too high.  Knowledge is power, and this is especially true in the used laser market.

If brokers justify a higher price because the laser is in good condition, it has a low pulse count, or it has been recently “refurbished” or serviced, then you need to ask them to provide documentation or proof of such claims.  In many cases, brokers will often raise their prices slightly to allow discounts when a buyer asks for one.  Keep in mind that the critical issue is not to just get a discount for discount’s sake, but rather to buy the laser at or below the prevailing market value.  Follow these guidelines when negotiating:

  • Only enter into negotiations with a broker with whom you feel comfortable and who may have been recommended by a fellow physician.
  • Make an opening offer that is low, but in the ballpark.
  • Decide ahead of time how high you will go and back away when your limit’s reached.

In addition to negotiating the price, you should also be aware of what standard accessories should come with the laser.  You need to require that the broker is very clear what is included in the price.  Common accessories are:  Keys, Operators Manuals, Treatment Parameters Guide, Operator Eyewear, Patient Eyewear, Footswitch, Cryogen, Treatment Tips, Light Guides, and Hand pieces, Additional Fibers, Water Refill Kits.

To be safe, some lasers should be installed by a laser service technician after it is delivered to your practice.  Ask your broker if this service can be offered with your laser purchase.  This usually costs extra, however it can be very worthwhile to ensure that the unit is set up properly and that no accidental misuse occurs.  If you have never operated the laser you intend to purchase, this is especially important.  You should also make arrangements for training if you have never operated this laser.  The laser broker can often arrange for training and you can ask that he build the cost of training into the purchase price of the laser.

Once an agreement has been made, you need to make sure the broker provides you with a detailed invoice that includes all items you will be receiving along with any guarantees that are being provided.  If the laser includes a warranty, be sure the warranty is clearly spelled out regarding exactly what it covers and the time period.  Once this is complete, it is time to prepare for shipping the laser to your clinic.  Be sure to verify that shipping insurance is provided on the laser during transit for the full purchase price.  Your worst nightmare would be the laser is damaged during shipment and you cannot get your money back from the broker. Having insurance allows for reimbursement in the event an accident happens during transit.

Buying a used laser, but thinking of replacing it with another used cosmetic laser? Advertise it with us here.

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Used Medical Laser Financing

Once you have found the used medical laser you want to buy, you have three ways to pay for it:

  1. Cash.  Need we say more?  Money talks, you know-what walks.  If you can close quickly on a laser purchase you can normally negotiate a larger discount.  Cash is the fastest way to close on anything and can save you significant dollars if you have it available to buy a laser.  If you have the liquidity, you can bring down the price by promising to pay same day or next day.  The ability to buy quickly from the seller always gets their attention and is an excellent way to save money.
  2. Credit Card / PayPal.  Not all laser brokers accept credit cards, but if they do, this is the safest way to go because you can dispute a charge if you’re having trouble with the laser or it isn’t what you were promised.  Always ask the laser broker if you can pay by credit card.  If you can’t pay the entire amount, perhaps you can pay some percentage of the payment with a credit card, sometimes up to 25 – 50%.   In my opinion any reputable used medical laser broker should accept credit cards for all medical laser purchases.  It is one of the key ways of showing they are reputable and that they stand behind the lasers they sell.
  3. Third Party Leasing.  You will typically pay a higher rate of interest if you choose to finance a used laser, in upwards of 12 to 18%.  You need to personally guarantee most laser leases, which isn’t fun, and you normally can’t pay off the lease early without a prepayment penalty.  You need to carefully review any type of lease agreement, especially for pay-off terms.  Ideally you would like to have a lease that is similar to a loan in which you can pay it offer early without any interest penalties.

It can be difficult to secure a lease, especially with the tightening credit markets.  Capital equipment makers, who had seen aggressive growth and comfortable margins before the economic slowdown, were hit hard when tight credit left few physicians available to buy big-ticket items.

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Stay Away From Medical Lasers That Are Not FDA Approved

There are several manufacturers from China who are now promoting their aesthetic devices on the internet and Ebay.  While it is tempting to try these devices out and buy them due to their inexpensive price tag, the vast majority of this equipment is not FDA approved.   Section 510(k) of the Federal Food, Drug, and Cosmetic Act requires that all medical device manufacturers must register to notify FDA, at least 90 days in advance, of their intent to market a medical device.  Most foreign manufacturers have not done this.  Is is therefore illegal to use these devices in the United States.

It is extremely risky to be using any equipment that is not FDA approved.  It is very important to use only FDA approved devices and substances.  If anything were to go wrong during the treatment, the fact that a patient was given an FDA approved treatment limits your clinic’s liability dramatically.  In addition, you could be prosecuted by the FDA which is something don’t want to have happen.

As long as you follow the guidelines for use with those FDA approved aesthetic devices, you are on very safe ground.  A large portion of the liability is shared by the manufacturer, and most plaintiff’s go after the entities with the deepest pockets, which are typically the manufacturers.  If you are using a medical device that does not have FDA approval, you are on very shaky ground and if trouble arises, you could be the one left “holding the bag.”

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Stay Away From Used Medical Laser Equipment That is “Too Old”

It may be tempting to buy older medical laser equipment because of the great price, however you must be extremely cautious about this.  The newer equipment on the market has become more user-friendly and safer to use.  Using older technology can be much more “expertise” driven and in the wrong hands, can have disastrous results.  Some of the problems with older technology is inadequate cooling on the skin, a lack of ongoing calibration and maintenance, and a poor user-friendly interface that helps ensure the operator provides a safe treatment.  While newer equipment can never replace someone who has been properly trained in the safe user of lasers, it goes a long way to help prevent adverse reactions from occurring in the first place.

Ideally, you want to buy a laser that has seen little use that is no greater than 3 or 4 years old.  If you go too far beyond this point, you can run into a lack of third party support for the laser and a lack of people who can repair it or find replacement parts.  It can also be too outdated and more dangerous to use.  That said, some technology has not changed dramatically over the past 8 or 9 years and it may still be worth a look, laser hair removal being a prime example  If you find a laser with a low pulse count that is an older model unit (Candela Gentlelase for example), find out if the same unit is still manufactured today.  If it is, then obsolescence may not be a problem and you can potentially get a really great deal on a very effective and reliable laser.

Used will never mean old in our book, and so should you. Get your next used aesthetic laser right here.

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Do Your Own Research on the Best Used Medical Lasers & Manufacturers

Most laser reps/brokers know very little about the equipment they are selling, aside from the one-day crash course of single-sided “facts” about their equipment that they could simply get from a datasheet.  What is really bothersome is that so many doctors will believe what the reps/brokers say but not do the diligence and research it. Going off of marketing brochures really does not iterate the actual equipment or the workings of the equipment.
 

Get a technical explanation, if they can do it, of how the laser works.  If they can’t, then you should really question their ability to know what the laser can do and why.  Cost alone should not and should never be a deciding factor in buying a laser.  Quality, longevity, repairs / replacements, efficacy and the light delivery methods are far more important than the cost.  All too often I see doctors take the cheaper route and end up getting less of a laser that ultimately costs more in the long run, also costing them patients referrals, trust and more replacement parts to keep the laser operating it (thus keeping them in the pocket of the laser maker).

Anyone looking to buy a laser needs to pick up the phone, call around and get technical info on everything you want to consider.  I recommend the following company that does an EXCELLENT job in providing laser technical information:  Medical Insight.  This company has some aesthetic laser charts that provide across the board comparisons of every laser that’s out there for every type of aesthetic modality.

Take your time, be patient, stay in control of your decisions and simply tell the broker exactly what you want.  Don’t let them guide you into anything else, just make them give you the stats, the facts and their technical support case of why. If they cannot give you these answers on the spot or in a timely manner, say goodbye and move on to a broker and a company who will support you in this expensive and long-term decision.

There are some excellent resources for finding out which lasers are the favorites among physicians.  One such resource can be found online at:  www.MedicalSpaMD.com.  This is a blog of aesthetic physicians who discuss very openly their experiences with all of the various manufacturers and equipment that is on the market today.  Once you begin reading this information, it will become very clear which manufacturers and which equipment you should stay away from and which equipment is a favorite among the physicians in the group.

I also highly recommend that you sign up for the free webinars that are offered by almost all of the laser manufacturers.  These are free, you don’t have to travel, and it allows you to get a solid idea of the benefits of the laser technology available.  Attending trade shows can also be another great way to learn of the technologies that are in favor with the industry.  Two shows that I recommend you attend are the American Society for Laser Medicine and Surgery and The Aesthetic Show sponsored by Medical Insight.

Test-driving a used car helps you decide if it is the right car for you and also if this particular car is in good condition.  It may not hurt to rent a laser from the manufacturer before you decide to buy so that you can give it a good “test drive.”  Find out if this option is available to you.  They may be able to provide you with a demo unit they can rent out to you.  This will allow you to find out if the laser is a good fit for your practice.

Look no further! Find your new aesthetic laser here with us.

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Choosing the Right Used Medical Lasers for Your Practice

At the beginning of the laser-buying process, many people already know the laser they want. But it’s a good idea to stop right now and test your decision with this question: Will this laser fit into my practice and my monthly budget?  Buying a laser at the right price is an important first step.  Developing a realistic pro forma of the revenue you anticipate generating from this laser is critical.  The key word here being realistic.  It is important to be sure your revenue numbers are very conservative so you won’t have problems getting a solid ROI on your new device.  If your revenue numbers can easily support the price you are paying for this unit, then it may be the right laser and the right price.

  • Patient Population.  What kind of population are you serving? gender, age range, ethnic types (Fitzpatrick Skin Types I thru VI), your surrounding competition?  There is no true all-purpose laser platform.  Make your determination FIRST based on your practice profile, then decide on specific platforms.  It is imperative that you objectively identify your market first before making decision on laser machines. This will minimize risks of side effects or poor clinical outcomes or buying the wrong laser platform for your targeted client base.
  • Wavelength.  If you have a patient population of darker skin types and you wish to do laser hair removal, you will need to be sure to have a laser that can treat darker skin, such as a 1064 Nd Yag.  On the same token, if you have a patient population of lighter skin types you want a hair removal laser that best treats this patient base, such as an Alexandrite.  If you have a mix of all skin types, then perhaps a diode laser with a long pulse width would be the best fit for you.
  • Profitability.  If you want your practice to be profitable, you must focus on HIGH DOLLAR / HIGH MARGIN treatments.  In general, the most worthwhile investment to focus on is skin resurfacing, skin tightening and body shaping (laser lipolysis, Radio Frequency).  People are willing to spend big dollars to rejuvenate and tighten their face and sculpt their body.  Selling larger packages typically means combination therapy which results in happier clients.  It is important that you understand that your goal of increased revenue is aligned with the client wanting the best results possible  Small packages or single treatments typically do not yield good results and the client walks away dissatisfied – never to return!
  • Spot size.   The spot size of a laser determines how much skin area can be covered per laser pulse.  Lasers with larger spot sizes can cover more area much more quickly. For example, a laser hair removal treatment of the back or full legs could take as long as 2 hours with older lasers. Today, these areas can be completely treated in less than 20 minutes.  The spot size not only determines the speed and comfort of the treatment, but the efficacy as well.
  • Hertz.  The hertz, or pulses per second, tells you how fast the laser emits each pulse.  Some lasers can go as fast as 3 pulses per second, which allows you to cover more surface area faster.  This is an important feature, especially for laser hair removal lasers.
  • Consumables.  Some aesthetic devices are very expensive to operate, however it may still be worth your while IF you are able to charge higher prices with these same medical devices.  Some examples of consumables include:  Single use treatment tips, Cryogen Canisters, Coupling Fluid, Lightguides, Handpieces with a certain pulse life, Filters, Fibers, etc.  You need to factor in the cost of these consumables as you create your pro forma revenue to determine your break even costs and profits.

Understanding the Technology:  3 Key Improvements to the Face:  The 3 Ts.

a) Tone (Even Color). The goals of even color are to eliminate pigmentation and redness (facial veins)

b) Texture (Smooth Skin). The goals of texture are to smooth rough skin and reduce fine lines and wrinkles

c) Tighten (Skin Tightness & Fullness). The goal of tightening is to reduce skin laxity caused by solar elastosis, aging and other skin oxidants.

The following chart diagrams the available aesthetic procedures and their role assisting in one of the three areas of Tone, Texture or Tighten. On a scale of 1 to 3, a 1 is considered the most effective treatment for the designated area of Tone, Texture, or Tighten while a 3 is considered the least effective treatment. 2 is considered middle of the road and not as effective.

3 Key Areas of Improvement to the Face
1 = Best Treatment, 2 = Helpful Treatment, 3 = Least Effective Treatment

Procedure

Tone

Texture

Tighten

Advantages Disadvantages
Portrait Plasma

3

1

1

Single treatment 5-7 days of downtime
CO2 Fractional

3

1

1

Great results 3-5 days of downtime
RF Fractional

3

1

2

Little to No downtime Series of treatments
Erbium Fractional Resurfacing

2

1

3

Little to No downtime Series of treatments
Thermage & Accent RF

2

1

No downtime, “permanent” Variable results
Permanent Fillers

2

1

Immediate Results Potential side events
Temporary Fillers

1

2

Immediate Results Temporary results
IPL

1

2

No downtime Series of treatments
Botox™

1

Quick, predictable results Temporary results / repeat necessary

In general, for fine wrinkle (crow’s feet) you can go with fractional skin resurfacing.  For moderate to deeper ones, this is more difficult. You can go with Portrait Rhytec, CO2, Thermage, Velashape or Alma Accent.  With Thermage or Accent, you get the added “lifting” effect which work better on the sagging wrinkles/skin as in the jowls or the droopy upper eyelids though a strong full ablative CO2 as in Luminis Active FX can do such for the eyelids.

Sometimes, wrinkles can also be corrected with fillers such as Radiesse, Perlane or Restylane as those on forehead or glabellar. Wrinkles can also result from tissue atrophy in the mid and lower face. In these instances, an AUGMENTATIVE volumizing injection (with Perlane or Radiesse) will stretch out the loose skin thus not only fading out the wrinkles and folds but also giving the lifting effects.

Be sure to ask your broker his opinion of the laser her or she recommends and why.  This will help you to determine how knowledgeable the broker is regarding the laser technology they are selling you.  Often the broker may have hands-on experience working with the laser in question.  If so, that is a plus because it shows the broker has some hands-on laser operations experience.

Stop making bad decisions, and start making great ones by checking out our line of used cosmetic lasers for your clinic.

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Beware of Buying Used Medical Lasers From Brokers

Here are some things you need to know about the used laser market.

First of all, some of the people in it are very shady. Second, it is not standardized like the used car industry. There is not a “blue-book” value for used laser equipment. Prices and quality vary widely across the board. You usually don’t get a chance to check out (or test drive) the equipment you are purchasing. There is no lemon law with used lasers. When you buy it, it’s yours. It may be difficult getting your money back if it doesn’t perform. Most of these used dealers are not real companies. They are some guy who probably doesn’t even have the laser, but is instead brokering it. There are no real warranties with the equipment. The following are things you should look for in a laser broker and ask:

  • Does the laser broker actually have the laser in his/her possession or is it a consignment sale? If it is a consignment sale, you need to do your own due diligence on what condition the laser is in because you can’t always rely on the broker giving you accurate information. Since the broker may have never actually physically seen the device, he/she may not know if there are any flaws with the device. He or she is relying solely on the doctor who owns the device to give him accurate information.
  • Has this broker been certified by third parties and received a seal of reliability and ethics? Below are a few of the certifications that can be helpful in your assessment:
  • Dotmed. An online website that certifies laser brokers is Dotmed (found on the internet http://www.Dotmed.com). Find out if your laser broker is Dotmed Certified.
  • Ebay.  Every Ebay seller should have a seller’s rating. Find out if your broker has sold on the internet and what his satisfaction rating is. You want to see as close to 100% satisfaction as possible.

These certifications mean a lot to laser dealers and brokers because it validates their good reputation. Brokers and dealers who plan on selling medical lasers for many years to come do not want anything to happen to these ratings because they realize how important they are in selling equipment.

  • Has the broker had the equipment inspected by someone qualified to repair the laser prior to shipping? Even used lasers cost a lot of money, so it behooves you to make sure the laser that you’re buying has been properly inspected prior to purchasing. This should be done by a technician who knows the laser and should be done before you put any money down. Would you buy a used car from a fly by night dealer without having your mechanic look at it? Once it’s been purchased, all bets are off. Apply leverage to the broker when you have leverage, and that is prior to purchasing.

Many brokers tout that their laser equipment has been “refurbished.” This statement means absolutely nothing if the laser broker cannot provide documentation of the laser’s refurbishment. If they claim it has been refurbished, they should be able to send you a checklist of items that have been done to the laser in a matter of minutes via email or fax. If they cannot provide this to you in relatively short order, then nothing has been truly done to this unit.

If you have any doubt as to the laser’s condition, you can also ask the broker to shoot a video of the laser in operation, showing the following:

1. The laser being fired
2. The pulse count on the screen
3. The user adjusting the treatment parameters on the screen
4. The serial number of the unit.
5. Any material defects the laser may have that need to be disclosed

The bottom line is this: You want to make sure the laser is in good, operating condition. You need to make sure it is actually functioning. Shooting video these days is extremely easy. You can buy a Flip HD video camcorder for less than $200 and shoot high resolution video that can be uploaded directly to YouTube in a matter of minutes. Don’t let this process intimidate you. You are about to make a very large investment. Asking these items of your broker shouldn’t be seen as excessive.

4.   The Importance of a Laser Inspection Checklist

How do you know if a laser has been inspected or “refurbished”? Ask for a laser inspection checklist that has been completed by someone qualified to perform the inspection. Below is a basic laser checklist THAT SHOULD BE PERFORMED ON ANY LASER PRIOR TO BEING SOLD TO ANOTHER PARTY:

Laser Inspection and Maintenance Checklist

Inspection / Maintenance Item Date Completed Tech Initials
1. Check coolant level and add deionized water.
2. Inspect electrical connections.
3. Perform power meter calibration check.
4. If more than 250,000 shots replace deionizer cartridge and DI water.
5. Inspect and clean internal optics (if applicable)
6. Replace Xenon flash lamp if power is low and more 250,000 shots.
7. Inspect footswitch for proper operation.
8. Verify laser has no leaks after replacing any filters or connections.
9. Check High Voltage Power Supply.
10. Verify operation at all power settings.
Signed:_____________________________________Date:_________________________
Laser Repair Company:____________________________ Phone:___________________

In most cases, the inspection checklist will not have been performed prior to the broker listing the item, however you should make it a condition of the sale that the laser be properly inspected. If you do not require this, you will be buying at your own risk.

  • Can the broker provide you with a service report on the laser while it was under the manufacturers warranty?  In addition to the laser inspection checklist, you should also request any and all laser service reports that documents any maintenance that has been done on the laser since it was purchased new.  Sometimes the selling doctor may no longer have a record of this, however this should also be available from the laser manufacturer.  Manufacturers have a responsibility to document all repair and maintenance work that has been done to the laser as part of any warranty they have provided for the laser when it was purchased new.

Brokers can be hesitant to provide you with a serial number of the laser because they do not own the laser.  With a serial number you can call the manufacturer and find out where the laser is and sometimes who actually owns the laser.  This makes brokers nervous because it means that you can potentially go around them and buy directly from the owner of the laser unit. Such behavior is completely unethical, however it does sometimes happen which is why laser brokers are very careful about providing such information to you.

  • Can the broker provide you with at least 5 references within the past 3 months of doctors he has sold to?  Not every transaction will always run smoothly every time with a broker, however does the broker adjust to problems and ensure that things get back on track to keep the buyer happy?  Calling references of recent transactions will allow you to find out from buyer’s their level of satisfaction with the broker and whether they would do business with him or her again.

We have special offers on the lasers on our classifieds section, and all of them are in GOOD condition. So come and check it out until supplies last.

Comment

Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.

Medical Lasers: Buying New Versus Used

When a new piece of equipment hits the aesthetic market, there is often a race to buy this technology quickly and sell treatments to consumers while there isn’t as much competition. Consumers in the aesthetic industry tend to be early adopters, jumping on the latest and greatest technology, believing that it will finally be the answer they are looking for. This often happens even when there is very little clinic research to support the claims made by the laser manufacturer regarding the equipment.

Those clinics that buy the latest technology typically must buy it from the manufacturer at top dollar. Sadly, most NEW aesthetic equipment becomes obsolete 2 or 3 years after the initial purchase, however most leases on that same equipment last for 5 or 6 years. Any leasing company will require a personal guarantee., which means that when you “lease” you are really “buying”.

In the world of aesthetics, technology is evolving at a rapid pace. This evolution also means that laser equipment does not remain useful for very long. It’s a hard pill to swallow when you continue to make monthly lease payments on equipment that has become a “doorstop” inside your practice. If you’ve paid top dollar for that equipment, it just makes that pill you’re swallowing even the more bitter.

If the technology fails to deliver results, this practice now has a piece of equipment that is only worth a small fraction of what you originally paid for it. A practice that plays this strategy for very long will continue to accumulate additional leases and have equipment that delivers very little ROI two or three years into the lease. It doesn’t take too many years of doing this until the liabilities on your company balance sheet are consuming your net worth and eating up all of your positive cash flow!

Another key issue is keeping your lease costs down so that you remain competitive. If your practice buys a new medical laser and your competitor buys the same laser pre-owned at a 70% discount, your competitor has a large competitive advantage over you. His fixed costs on capital equipment are 70% less than yours which means higher profit margins for him. He also has the ability to offer lower treatment prices and potentially put you out of business. You also have the option to match his lower prices, but you will need to compensate for the higher costs you are paying on that equipment by having a higher treatment volume. If you choose to keep your prices higher, then you will need to somehow differentiate your practice from the competition by offering other “value-added” benefits that justify your higher prices. This could be “Board Certified Dermatologist” or “Onsite Physician” etc.

The Best Strategy for Buying Medical Lasers

The best solution to keep up with advancing technology is to wait 18-24 months after a new device is introduced before you purchase anything. When you do buy, never buy NEW. Always buy used. This will allow the following benefits:

1. You will let someone else take the hit on depreciation (It will allow you to save 70-80%)
2. It allows you to monitor the reception of this technology in the aesthetic industry and go beyond the hype to find out the level of satisfaction of those doctors who have been using the device for the past 18-24 months and review clinical data. A good way to monitor this is to attend meeting such as the ASLMS and discuss items with other physicians who have the technology at trade shows.
3. If the device appears to be living up to expectations, then this could potentially be a technology to invest in and you will be much better off than the practices who jumped in early and have lost significant money by overpaying for aesthetic equipment.
If you’ve decided to buy a used medical laser, you’ve already made a smart decision. You can get a medical laser that’s just as good as a brand-new one without paying for the depreciation that wallops new laser buyers as soon as they fire their first pulse. Even lasers that are less than a year old are 40-50% percent cheaper than brand-new lasers.

Get better investment at half the price with the used cosmetic lasers we have on stock. We have limited availability, get them while you can!

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Vin Wells

Vin Wells, MHSA,  is the President and Founder of RockBottomLasers.com and has over 11 years experience in the aesthetic laser industry. Mr. Wells started his own chain of aesthetic clinics under the brand name Skinovative and opened his first medical spa in Boise, Idaho in February 2001. Mr. Wells continued to grow and operate aesthetic clinics for over 8 years.  Since 2008, Mr. Wells has focused on selling used aesthetic equipment to physicians and medical spas.

Mr. Wells received a masters degree in Health Services Administration from Arizona State University (1995) and has extensive practice management experience, working with a number of different hospital and outpatient care systems.

Mr. Wells has developed a number of business operations systems that help aesthetic clinics to maximize their profitability, including: Aesthetic Consultation Training, Medspa Management Training, Medspa Business Plans, Medspa Operations Manuals, and Front Desk Operations Training.  These products can be found at: SkinSalesTools.com

Mr. Wells completed received his bachelors of Science degree at Brigham Young University in 1991 and continued his education at Arizona State University, in Tempe, Arizona, receiving a Masters in Health Services Administration in 1994.  He has worked for a number of different health care organizations including as a Program Director for group of primary care clinics (Arizona Association of Community Health Centers), a Health Care Manager for a hospital network group (Arizona Healthcare Federation), and as Associate Director for the Arizona Council for Graduate Medical Education.

Mr. Wells has devoted considerable time in research the latest cosmetic trends and treatment modalities. He stays current on the cutting edge of such research and uses this information to make strategic decisions for the company.  He has a broad understanding of lasers and has been certified in laser biophysics and theory.

Mr. Wells was successful in developing a Laser Certification Program that was approved by the Arizona Radiation Regulatory Agency, the agency that oversees the use of medical lasers in Arizona. The program involves 40 hours of laser didactic curriculum as well as hands-on laser training.