by Mark T. Agerton, Northeast Georgia Health System

"It is unwise to pay too much, but is is worse to pay too little. The common law of business balance prohibits paying a little and getting a lot. . . . it can't be done. When you deal with the lowest bidder, it is wise to add something for the risk you run, and if you do that you will have enough to pay for something better!"- John Ruskin (1819-1900)

This simple, but astute observation was written in the late 19th century, however it is as true today as it was then. The surgical equipment repair industry is full of companies who claim to offer discount or flat rate service, when in reality their "discounts" can add up to big trouble and even bigger expenditures.

Picture this unfortunate, but not uncommon, true story.

A pneumatic wire driver breaks down and you send it to a reputable repair service who gives you a repair estimate of $600.00. Having done business with them in the past, you ordinarily would approve the repair. But just recently, a new repair company salesman promised they could fix all your power equipment for a flat rate of $375.00, no matter what the damage.

Sounds good, right? So you send it off to the new company who calls you after a few days to tell you the wire driver is "non­repairable!" That's puzzling, since the first repair company had already told you it could be repaired for $600.

You need the wire driver back in service and so you return it to the original repair company and approve the original quote.

Now the plot thickens. When the first repair company reopens the driver, it is discovered that five major parts are now missing from the unit! Because they had opened and evaluated it originally, they know that all the parts had been intact. Since Company #2 never knew that the driver had been previously examined, they assumed the hospital would just accept their word that it couldn't be repaired, and buy a new unit. Instead, they got caught red-handed stealing parts!

The question becomes then, why would a repair company steal parts instead of simply performing their repair to make a profit?

The answer is as simple as it is unbelievable. They never had any new replacement parts to begin with, so by scavenging five perfectly good parts from this driver, it enables them to complete five other repairs on five other drivers for five other customers! No wonder they can offer great, but unrealistic flat-rates!

As unbelievable as it sounds, it's happening everyday and not just with power equipment, but with scopes and other instrumentation as well. And it's not just one company who's doing it and getting away with it. There are literally dozens of under-capitalized, fly-by-night, so-called repair companies who are running this or similar scams, trying to make a fast buck at our expense. At least one of them is in your back yard.

And it's costing us big-time! The updated quote to repair that driver was $1800.00!

This is only one example of cons and incompetents that plague the industry. Lew Tracey, National Repair Center Supervisor for Mobile Instrument Service and Repair says, "We encounter situations such as these virtually every day." Endoscopes being cannibalized of their expensive lenses; fiber optic scopes being sealed with tub and tile caulk; we recently spent a week at a Texas hospital that had decided to 'give a new van repair guy a chance because he was so inexpensive.' He had done so much damage to their entire inventory of instruments that we couldn't salvage all of them, and many had to be replaced! It cost the hospital much, much more in the long run."

The surgical equipment repair industry has become a muddied marketplace and so, it's Buyer Beware! You could be being ripped off by illegitimate "vendors" who offer abnormally low-cost or "flat rate" repair prices. It is critical that you know the reputation and the history of the company to whom you trust your hospital's expensive equipment!

These are all questions you would demand a response to on any bid equipment that would cost you as much as $20,000. Look at your repair expenses over the last 2 years and ask yourself if you can continue to ignore these expenses.

Don't be a victim. You've already made an enormous investment in the inventory that is entrusted to your care. One would be penny-wise and pound-foolish to believe that any John Doe who decides to set up shop can repair sophisticated equipment such as this.

It takes investment capital and technical expertise to operate a legitimate repair business. Unfortunately, even reputable repair companies can be tarred with the same brush, because these "fly-by-nighters" give everyone a bad name. But don't be fooled by the charming "Mom & Pop" exterior of a startup company. Your assets are simply not worth the risk.

Caveat emptor! Buyers beware! Protect your valuable surgical equipment from these opportunists who will not only give you poor quality repairs, but could render it useless if they're incompetent or if the equipment happens to contain parts they can cannibalize.

As educated consumers, we should know by now that if it sounds too good to be true, it probably is, yet we continue to fall into that "bargain-hunter's" trap. We must be as diligent with the selection process for repairs as we are in selecting the instruments themselves.

Dealing with an honest, reputable repair company is a decision one never has to defend.*

Make Prospective Vendors Pass This Test for Integrity and Capability:

• What is their background in the repair business? Where did they get their training? Is it a reputable training source? Were they fired from a reputable repair company for poor performance? How long have they been in business? If they don't represent a major company, you don't want them practicing on your equipment, so look for at least five, if not more, years of experience.
• Is their repair center in their garage or in a professional facility? Ask to visit it. A reputable repair company proudly offers tours of their facility as routine operating procedure.
• What is their warranty? If it's not at least as good as the manufacturer's then it's a risk. Do you have it in writing?
• Do they have completed product liability insurance? Don't take their word for it. Ask for a copy of the certificate for your files. The insurance is very expensive, so if they don't carry it, it's an immediate tip-off to their instability, and never use a vendor who can't provide it.
• Do they use new parts and materials? Where do they get them? Do these parts meet or exceed original factory specifications? Do they carry a sufficient inventory to address repairs immediately, or must they be ordered in upon demand, consequently delaying your repair? Ability to stock parts is an indicator of fiscal soundness, but are the parts of sufficient quality?
• Do they seem to be practicing what is known as "breakdown maintenance" where items they repair have a history of breaking down over and over, but the subsequent repairs aren't warranted because it's a "different" problem each time? It could be an indicator that they're either fixing only enough to render an item serviceable while ignoring other pending problems, or they could be setting up one of its other components for future malfunction. Whichever the case, they're ready and waiting to cash in on the misfortune.
• Do they have a business license? Ask to see it. Are they registered with the Secretary of State as a legitimate business? Can you find them in the phone book?
• Have they filed for bankruptcy and/or reorganized under another name? Is their bankruptcy protection placing a financial burden on their own supply vendors, who must ultimately charge more to the other repair companies they sell parts to, in order to pay their own bills?
• Are they currently financially solvent? Expensive hospital equipment has often "disappeared" when the discount or flat rate repairs service they sent it to went out of business or filed for bankruptcy. Check their Dun and Bradstreet rating and ask to know who the principals are.
• Are they simply a middleman? A business card and the ability to pick up instruments does not a repair company make. If they're just out-sourcing repairs to a variety of companies, then you've really lost control of your equipment because you can't even question the skills and practices of the actual repair source. No one should simply trust a salesman to that extent.
• Evaluate their promotional materials. If all they can provide is a computer-generated leaflet and price list they took to the copy store for duplication, then you might just as well give your $20,000 scope to the handyman who put a flyer in your mailbox looking for odd jobs. If they can't make an investment in professional literature, can they really afford the necessary equipment and parts to address extensive repairs?
• Make them justify their ability to offer such low prices. Will they reject the repair if it costs them more than their flat rate quote? What is their percentage of "non-repairables?" Are their repairs only cosmetic? Does their price include the replacement of damaged parts with new parts or are they extra?
• Is the flat rate really too much? If the actual cost of a repair is only $50.00 or $100.00, then these "flat rates" are not a good deal, and it's important to note that many repairs are minor. Common sense dictates that they couldn't offer that price unless they intended to come out ahead on it.
• Are they really who they say they are? Some locally independent van repairmen have often tried to pass themselves off as representatives of the nationally-known service(s). It's easy to use generic words in conversation and hope you associate them with bigger organizations. They have been successful in many cases.
• Ask for references and check them. They may have performed some work at those facilities on their list, however that doesn't always mean that the hospital continues to use them.
• Quiz them about their professional insight. How familiar are they with the cutting edge and shearing action of various surgical instruments? Are they educated about appropriate instrument finishes and instrument pacifications? Do they know what each instrument is used for and how it's actually manipulated so they can determine how best to sharpen or align it? Self-taught and/or inept repair people can actually shorten the life of your instruments by not knowing how to properly grind them.

*Reprinted with permission of Georgia Scroll Magazine, July 1998