Medical Dealer - November 2014 by MD Publishing

MEDICAL EQUIPMENT, PARTS & SERVICE

OCTOBER 2014 | WWW.MEDICALDEALER.COM

INSIDE THE WORLD OF A RADIOLOGY DEPARTMENT DIRECTOR

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Upgrade with confidence from the leader in healthcare technology. The high quality, easy to use upgrade — from Bayer HealthCare Multi Vendor Service. Now you can afford to upgrade your suite to digital, with the Acuity HD™ 1417 Wireless detector. This cassette-sized detector features cutting-edge DR wireless technology to easily transform a conventional x-ray room into an efficient, digital radiography suite. Upgrade in a few short hours— and get fast high-resolution digital images. And, because the Acuity HD™ 1417 is lightweight and wireless, you can capture images more easily and efficiently, taking advantage of its design to increase patient throughput. To learn more about this amazing new detector, simply contact your Bayer HealthCare Multi Vendor Service Representative. Bayer and the Bayer Cross are trademarks of the Bayer group of companies. Acuity HD™ is a trademark of RadmediX and is used with permission. BUS-RAD-14-06800 September 2014

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MEDICALDEALER | OCTOBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

“With over 40 years of combined industry experience, we have built long-lasting and close relationships with our customers and vendors all

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CONTENTS_Features 54 MOBILIZED

Radiology directors come from a variety of backgrounds, earn various levels of education and have a variety of directives to reconcile in their positions. We asked three professionals to share the demands of their positions.

64 CORPORATE PROFILE

Metropolis International LLC has an honest desire to provide excellent customer service, world-class support and an extremely talented pool of employees.

Medical Dealer (Vol. 18, Issue #11) November 2014 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 302691530. POSTMASTER: Send address changes to Medical Dealer at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. For subscription information visit www.medicaldealer.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2014

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MEDICALDEALER 11

INDUSTRY UPDATE MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 (800) 906-3373 Fax: (770) 632-9090

16 News & Notes 22 MD Expo Re-cap 27 OEM Updates 32 Block Imaging

Publisher

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editor

John Wallace jwallace@mdpublishing.com

Art Department Jonathan Riley Jessica Laurain

Account Executives Sharon Farley Warren Kaufman Jayme McKelvey Andrew Parker

Contributors

Jim Fedele Myron Hartman Matthew N. Skoufalos Dan Bobinski

MARKET ANALYSIS Radiology: Nuclear Medicine 37 Market Analysis 38 Product Showroom 40 Preferred Listings Med/Surg: Ventilators 45 Market Analysis 46 Product Showroom 51 Preferred Listings

SLICE OF LIFE 70 The Other Side 74 Pay It Forward 78 Success Story 83 Dan Bobinski

Accounting Sue Cinq-Mars

Circulation

Bethany Williams bethany@mdpublishing.com

92 Categorical Index 94 Alphabetical Index

Web Department Betsy Popinga Taylor Martin

Proud supporters of Like us on Facebook! www.facebook.com/MedicalDealer

12 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

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INDUSTRY UPDATE_News and Notes

Staff Reports

TRI-IMAGING SOLUTIONS ANNOUNCES MERGER WITH JET IMAGING Tri-Imaging Solutions, an imaging parts and support company, has merged with JET Imaging. The deal provides Tri-Imaging with unprecedented experience and resources to offer more robust products and services to the industry, including an enhanced training facility. It also creates a highly competitive growth platform for future expansion across imaging modalities. “We are thrilled to combine our industry-leading imaging solutions with JET Imaging. It made more sense to combine personnel and services which will offer unmatched opportunities for the imaging community. It was much better for our industry to combine resources rather than compete,” said Eric Wright, president and partner of Tri-Imaging Solutions. JET Imaging’s John Drew added, “We believe that joining forces will accelerate our growth and increase quality in services provided including a state-of-the-art training facility, increased options for imaging equip-

ment parts and sales, as well as offer broader service options.” “Tri-Imaging is recognized for high standards in imaging parts and support services,” said Wanda Legate, Partner JET Imaging. “Specifically, their depth in providing imaging parts and technical support across a wide variety of OEMs and modalities, in combination with JET Imaging’s ability to offer on demand service – as needed, and training, serves as our strategy to ‘Empower the Engineer.’” “Our new mission statement is ‘Empowering the Engineer,’ and the unification of our two great companies will offer a tremendous model for the imaging service professional,” Wright added. To assist in their new mission of “Empowering the Engineer,” Tri-Imaging has contracted MD Publishing for all of its strategic marketing efforts. • FOR MORE INFORMATION, visit www.triimaging.com

STATES DECLARE DYSTONIA AWARENESS MONTH InterMed Nuclear Medicine Owner, President and CEO Rick Staab met with Georgia Gov. Nathan Deal in September. Staab, the founder of Tyler’s Hope for a Dystonia Cure, was at the Capitol in Atlanta as Georgia became one of several states to recognize September as Dystonia Awareness Month. “It was a great meeting,” Staab said about his visit with Gov. Deal and the first lady. “He went out of his way to spend extra time with us. He and his wife were both asking us about dystonia.” Gov. Deal signed a proclamation declaring September as Dystonia Awareness Month. He invited Staab and his team from Tyler’s Hope to return for a day-long event at the Capitol to raise awareness about the neurological movement disorder. “I think they are really interested in helping,” Staab said. “It was great!” Orange is the official color of Dystonia Awareness Month and people all over the country donned orange clothing or purchased and wore special orange bracelets in support of the cause to find a cure. More information about the disorder and how to impact a change can be found at the American Dystonia Society’s website at dystoniasociety.org. Donations for finding a cure can be made online at www.TylersHope. org. Staab said the organization is structured so that 96 to 98 percent of all donations go toward research and not to administrative costs. •

16 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

_News and Notes

SCANMED INTRODUCES THE WORLD’S FIRST WEARABLE PROSTATE COIL

ScanMed of Resonance Innovations LLC is proud to introduce the PROCURE coil. The latest product in ScanMed’s coil line is the the PROCURE coil (prostate, rectum, ovaries, cervix, uterus, reproductive). The PROCURE features a first-of-a-kind, lightweight SemiFlex design that facilitates effortless and accurate positioning. Similar to wearing a diaper, this dedicated MRI coil positions the multiple antenna elements as close as possible to the target anatomies regardless of patient size. The enclosure for the antenna set is made of flexible liquid impermeable, biocompatible materials. Accompanying the product are disposable liners that can be changed between patients. This phased array coil can be configured to operate with an endorectal probe and also accommodates popular biopsy systems. ScanMed’s design offers

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improved SNR and uniformity that is needed for more aggressive protocols. “There is an increase of the use of multi-parametric prostate MRI, as more and more urologists realize its significant value for early diagnosis,” states Dr. Jelle Barentsz, Professor of Radiology at the Radboud Prostate MR-Reference Center. “The prostate, however, is an organ that is located deep in the pelvis. Its distance to the surface is posteriorly, anteriorly and caudally significant. Therefore a special coil needs to be developed for optimal signal reception. The PROCURE has elements that also receive signal from the caudal part of the prostate. Its design therefore is unique. Initial results show an increased SNR compared to standard coils. Thus this coil potentially can visualize the prostate with improved resolution at same imaging time.” •

CONSENSYS IMAGING SERVICE, ONCOLOGY SERVICES INTERNATIONAL ANNOUNCE ALLIANCE Oncology Services International and Consensys Imaging Service Inc. have announced a strategic alliance to better serve radiation oncology facilities. OSI, an independent service organization for radiation therapy equipment, will utilize Consensys, an alternative to OEM diagnostic imaging field service, to offer CT service solutions nationally. “We realized that many of our linear accelerator service customers are looking for similarly improved service on their CT simulator equipment,” said Richard J. Hall, President and CEO of OSI. “Partnering with Consensys, a national leader in CT service and repair, allows us to expand our service options to radiation therapy facilities.” “With Consensys, we will fill those needs with a recognized and trusted leader in the CT service arena and bring further value to our customers faced with increasing challenges to maximize quality services while minimizing costs,” Hall concluded. The strategic alliance will also allow Consensys to cross-sell linear accelerator services, thus expanding both organizations’ customer solutions. “We are excited to work with OSI, the clear leader among independent service organizations in radiation oncology,” commented Jim Spearman, President and CEO of Consensys. “Their experience and commitment to service is exceptional and mirrors our company culture of service excellence. As a result, we’re very pleased to offer OSI’s service capabilities to our existing customer base. In addition to Consensys being a true alternative to OEM service contracts, we’re a national distributor of OEM alternative CT tubes, giving OSI a highly capable partner with a full range of CT service offerings for its customers.” •

MEDICALDEALER 17

INDUSTRY UPDATE_News and Notes

RADCAL CORP., RIGEL MEDICAL PARTNERSHIP BEGINS AT MD EXPO Radcal Corp. has announced a mutual relationship with Rigel Medical. The partnership between Rigel Medical and Radcal Corp. began at the MD Expo in Orlando, Fla. Both companies will promote each other’s products within the USA and Canada. The companies are known for delivering high-quality products to the service and biomedical/clinical engineering markets. Under the partnership, the companies will seek to deliver more value and broader solutions to their customers by jointly promoting the complementary products and support from each manufacturer. “This new partnership gives our sales channels the opportunity to promote the best products available,” states Jack Barrett of Rigel Medical. “Both companies have established themselves as leaders in their respective test disciplines and share many of the same customers,” says Pat Pyers with Radcal Corp. “We look forward to working together with Rigel Medical to solidify this partnership.” Radcal is an industry leader in the design and manufacture of affordable radiation measuring systems for dose and non-invasive kV. Radcal is synonymous with user-friendly and reliable instruments to measure and diagnose all X-ray machines. Radcal instruments are used and represented worldwide in over 50 countries by medical physicists, biomedical engineers, governments and OEMs. Radcal products are manufactured and serviced in Monrovia, Calif. Users from around the globe depend upon the quality and service of Radcal and its products. Rigel Medical is part of Seward Group USA – a global market leader in biomedical test and measurement solutions. The company’s established reputation for product innovation and technical expertise reflects its knowledge and understanding of the market. Rigel Medical is one of the longest established brand names in the industry with its origin dating back to the 1970s when, in conjunction with the Liverpool Hospital University, the world’s first IEC 601 electrical safety analyzer was launched. Today, Rigel Medical manufactures a comprehensive range of advanced technology biomedical test equipment. The company’s sales, inventory and calibration services are located in Tampa, Fla. •

18 MEDICALDEALER | NOVEMBER 2014

Staff Reports

PARTSSOURCE LAUNCHES HEALTHCARE’S FIRST ONLINE SERVICE PARTS MARKETPLACE PartsSource has launched healthcare’s first aggregated online parts catalog. Spanning multiple modalities, 1,000 OEMs and 6,000 trusted secondary suppliers, the company’s exclusive catalog creates a comprehensive online source for medical device repair parts. PartsSource – with its online catalog – is the first to successfully automate the medical industry’s highly complex, labor-intensive parts procurement process. Plagued by manual, backand-forth, price quotation systems with multiple OEMs/suppliers that have previously been ignored by traditional healthcare supply chain operations; clinical engineers and technicians can now enjoy real-time pricing, comprehensive OEM and supplier selection, ecommerce ordering and online shipment tracking from a single parts marketplace. Designed with feature flexibility for experienced and novice users alike, parts decision-makers can filter searches based on OEM, model or category while viewing photos, exploded illustrations and related parts for increased order accuracy. Moreover, using the company’s patented technology, users enjoy on-demand custom pricing – including personalized OEM discounts – for all part options including OEM direct, replacement and refurbished parts. PartsSource’s online catalog can afford hospital systems condensed workflow, increased productivity, improved equipment uptime and hard dollar savings of 15 to 50 percent in parts spend. TO SEE THE CATALOG IN ACTION, visit partssource.com/catalog.

MEDICAL EQUIPMENT, PARTS & SERVICE

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MEDICALDEALER 19

PartsSource Introduces Healthcare’s

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MEDICALDEALER 21

INDUSTRY UPDATE_MD Expo

Staff Reports

MD EXPO ORLANDO SHATTERS ATTENDANCE RECORDS

Awards Gala honors industry leaders

This year’s MD Expo Orlando was phenomenal with record-setting attendance, outstanding educational sessions and abundant networking activity throughout the three-day event. The records were shattered before the show even began with 355 pre-registered attendees. The numbers continued to climb throughout the show with another 113 walk-up attendees. The MD Expo sold out early with 118 companies that exhibited with 309 exhibitor personnel also in attendance for the annual fall show. MD Expo’s partnership with the Florida Biomedical Society was a key reason for the show’s success. Golfers teed off Wednesday morning at the prestigious Waldorf Astoria Golf Club course. DirectMed Parts spon-

sored the golf tournament with prizes and a delicious awards buffet lunch. Networking continued that evening with the Welcome Reception sponsored by AllParts Medical. The first full day of the MD Expo kicked off with educational sessions. Attendance was high as HTM professionals from 34 states earned CE credits. The exhibit hall opened at noon with a grand opening sponsored by Block Imaging. Exhibitors reported consistent traffic flow and high-quality interactions with attendees. An attendee/ven-

dor happy hour sponsored by Advanced Ultrasound Electronics (AUE) served as an ideal forum for great interaction and networking as the exhibit hall closed for the day. The Manager’s Breakfast with keynote speaker John Maurer from The Joint Commission had a packed room Friday morning. Extra tables had to be brought in to accommodate the Health Tech Talent Management-sponsored event. Attendees and vendors alike learned the latest news and updates from TJC. The MD Expo Awards Gala and After Party, sponsored by AIV, capped off the amazing three-day event. Leaders in the industry were recognized for their hard work and accomplishments with the TechNation Department of the Year, TechNation Professional of the Year, Medical Dealer Humanitarian of the Year and Medical Dealer Lifetime Achievement awards. A state-of-the-art video about each winner was shown as the awards were presented.

PROHEALTH CARE BIOMEDICAL ENGINEERING DEPARTMENT TECHNATION DEPARTMENT OF THE YEAR The ProHealth Care Biomedical Engineering Department manages about 15,000 pieces of medical equipment. Also, the team has developed a capital planning process for projecting the replacement of certain medical devices. The hospital staff from the nurses and doctors all the way to the highest levels of the C-suite value the members of the biomedical engineering department. The group of experts has developed a complete in-house program that covers all modalities of imaging and biomed. The process developed by the shop even includes a parts procurement specialist.

22 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

_OEM Updates

FRANK MAGNARELLI MEDICAL DEALER LIFETIME ACHIEVEMENT Frank Magnarelli is a legend in in the industry for his accomplishments, readiness to help others and years of educating the next generation of HTM professionals. He is a founding father of the Florida Biomedical Society that continues to serve biomeds throughout the state via its various chapters. He has shaped careers and impacted the industry in countless ways. Despite his retirement, he continues to have a strong presence in the industry as a speaker, presenter and valuable go-to expert on a variety of topics.

ROBERT PRESTON

LYNDA A. HAMMOND

TECHNATION PROFESSIONAL OF THE YEAR

MEDICAL DEALER HUMANITARIAN OF THE YEAR

Robert Preston, CBET, of St. Anthony Hospital, is a leader and dedicated HTM professional. He has donated time to visit Vietnam where he trained biomeds and set up donated equipment. He has excelled in the workplace advancing at a steady rate to his current position as Account Manager II. He has also worked tirelessly with the Colorado Association of Biomedical Equipment Technicians (CABMET) having served as vice president and is always involved in coordinating the group’s annual symposium.

President and CEO of ATS laboratories Inc. Lynda A. Hammond is a successful businesswoman. She is known throughout the industry for her company’s products and her ethical business practices. She is also well known for giving her time and resources to help others. She is a longtime supporter of the Rotary Club, but her desire to help extends beyond her local community. She has been involved in the International Children’s Heart Foundation for over a decade and has been instrumental in the procurement of equipment and funding grants. She is also instrumental in the success of the St. Martin de Porres Academy in New Haven, Conn. The school uses the Nativity Model to reach disadvantaged youth and provide them with a quality education and an environment of support.

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MEDICALDEALER 23

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INDUSTRY UPDATE_OEM Updates

Staff Reports

PHILIPS MORPHS INTO TWO COMPANIES At a meeting with investors and analysts in London, Royal Philips announced its next strategic step to capitalize on fundamental market changes is to create two companies focused on HealthTech and Lighting Solutions opportunities. “I do appreciate the magnitude of the decision we are taking, but the time is right to take the next strategic step for Philips, as we continue on our transformation,” said Frans van Houten, Chief Executive Officer of Royal Philips. “To become the global leader in HealthTech and shape the future of the industry, we will combine our vibrant Healthcare and Consumer Lifestyle businesses into one company. “At the same time, giving independence to our Lighting Solutions business will better enable it to expand its global leadership position and venture into adjacent market opportunities,” he added. “Both companies will be able to make the appropriate investments to boost growth and drive profitability, ultimately generating significantly more value for our customers, employees and shareholders.” Royal Philips will capture new HealthTech opportunities by combining Philips’ existing Healthcare and Consumer Lifestyle businesses. Building on this foundation, Philips will be able to capitalize on the convergence of professional healthcare and consumer end-markets across the health continuum, from healthy living and prevention, to diagnosis, treatment, recovery and home care. According to the company, the HealthTech businesses already have leading positions in, for example, oral healthcare, healthcare informatics, ultrasound diagnostics, cardiac care and home healthcare, and serve a total addressable market estimated to exceed $100 billion. “Philips is uniquely positioned to help reshape and optimize population health management by leveraging big data and delivering care across the health continuum, from healthy living and prevention to diagnosis, minimally invasive treatment, recovery and home care,” continued Frans van Houten. “The combination of our Healthcare and Consumer Lifestyle portfolios and the integration of the data from the connected products on Philips’ cloud-based digital health platform illustrate our opportunity to capture growth in an increasingly connected world, where societies are looking for more effective and lower cost health solutions.” The Lighting solutions business will be better positioned to capitalize on the fundamental changes taking place in the lighting industry, in which the value is shifting from individual products to systems and services, according to a news release. •

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ESAOTE RECEIVES FDA CLEARANCE FOR PORTABLE ULTRASOUND SYSTEM

Esaote North America announced that its new MyLab Gamma ultrasound system has received 510(k) clearance from the U.S. Food and Drug Administration and is now available for sale in the United States. MyLab Gamma is a laptop-sized ultrasound system with lightweight portability and feature-rich applications that facilitate its use in a wide variety of clinical environments, from shared service to dedicated clinics and point-ofcare. “Today’s practices are under increasing pressure to deliver quality healthcare at an affordable cost,” said Larry Dentice, president and general manager of Esaote North America. “The portability and affordability of MyLab Gamma helps providers deliver excellent care wherever and whenever it’s needed." MyLab Gamma incorporates advanced clinical technologies to support comprehensive cardiac and vascular exams, including TEE, strain, stress echo and other quantitative studies. With 3D/4D capability and a wide range of available probes, the system is also well suited to women’s health, general imaging, and non-traditional point-of-care applications. Ergonomically designed to be easy to use and reduce sonographer stress, MyLab Gamma can operate on battery power with fast boot times and rapid resume modes so it’s easy to transport and ready to use within seconds. The two onboard probe connectors can be expanded to four, with the optional cart, giving MyLab Gamma users access to a wide range of clinical utility and flexibility. MyLab Gamma, with its wireless connectivity, remote service capabilities, and three-year warranty, is another innovative clinical solution from prevention to therapy available from Esaote for medical practitioners across the U.S. •

MEDICALDEALER 27

INDUSTRY UPDATE_OEM Updates

Staff Reports

FUJIFILM SONOSITE UPGRADES NEW MEDICAL APP FUJIFILM SonoSite Inc. has unveiled version 2.0 of the SonoAccess educational app, a free mobile device application that provides the healthcare community with access to the largest multimedia library of ultrasound resources including instructional videos, clinical image galleries and a variety of case studies. FUJIFILM SonoSite redesigned the app from the ground-up based on collaboration from existing users, added more features and workflow improvements, and extended its reach to include all Apple and Android phones and tablets. “A textbook or a colleague with more experience is not always available, but an app can be with you while on-the-go,” said Diku Mandavia, MD, FACEP FRCPC, Chief Medical Officer and Senior Vice President, FUJIFILM SonoSite Inc. “SonoAccess 2.0 is a result of our commitment to serving the needs of our customers. Multimedia educational resources are in high demand and we want to serve our customers better by providing them access to resources quickly and easily whenever, wherever.” Within the SonoAccess version 2.0, users can customize a profile to generate a recommended list of content, download any content item for offline access, view the “What’s New” feed to browse through all of the content on the app, and use the search functionality to find the content quickly. Additional features include the ability to: • Watch ultrasound “How To” videos organized by specialty and product to pick up helpful tips from expert ultrasound users; • Watch video case studies for more detailed information on clinical applications of ultrasound; • Watch specially created 3D animation videos which correlate ultrasound findings with anatomy; • Access the clinical image gallery to reference and compare to the images you scan; • Find reimbursement information and Quick Start user guides for SonoSite systems; • Share the app via several social media outlets; and • Contact FUJIFILM SonoSite from the app to get questions answered. •

28 MEDICALDEALER | NOVEMBER 2014

GE HEALTHCARE ANNOUNCES 510(K) CLEARANCE OF DISCOVERY IQ GE Healthcare has announced U.S. FDA 510(k) clearance of its Discovery IQ PET/CT system. Physicians not only want the ability to detect smaller lesions, but also the ability to determine whether the patient is responding to current treatment. Discovery IQ delivers the highest NEMA (National Electrical Manufacturers Association) sensitivity (up to 22 cps/kBq) and the largest axial field-of-view (up to 26 cm) compared to other market leading PET/CT equipment. This system can image with both half the PET dose and half the scan time. Discovery IQ with Q.Clear is designed to provide more accurate quantitation (SUVmean) with excellent image quality (SNR) for small lesion detection, fast and efficient reading, and a confident diagnosis. “By 2020, it’s estimated that 50 percent of people will develop cancer at some point in their lives and we also know that currently, approximately 70 percent of cancer patients do not respond to their initial chemotherapy treatment,” said Wei Shen, general manager of GE Healthcare PET/CT. “I’m excited about the recent FDA clearance of Discovery IQ, which will help physicians achieve their primary mission of delivering the best possible patient outcomes. And, by making Discovery IQ mobile-ready, we engineered it to be accessible to more patients in more places, allowing for high-performance PET/CT clinical care to whoever needs it.” GE Healthcare’s new Q.Clear technology is a critical component of Discovery IQ. It delivers, for the first time, no trade-off between image quality and quantitative SUV measurements. By providing two times improvement in both quantitative accuracy (SUVmean) and image quality (SNR) in PET/CT imaging, this new tool provides benefits to physicians across the cancer care continuum from diagnosis and staging to treatment planning and assessment. •

MEDICAL EQUIPMENT, PARTS & SERVICE

_OEM Updates

CARESTREAM, UBMD ORTHOPAEDICS & SPORTS MEDICINE COLLABORATING ON MEDICAL IMAGING RESEARCH Carestream and UBMD Orthopaedics & Sports Medicine have announced a research agreement to collaborate on development of a new three-dimensional medical imaging system for capturing orthopaedic images of patient extremities. Physicians from UBMD Orthopaedics & Sports Medicine will work with Carestream researchers to conduct clinical studies initially focused on the advantages of using cone beam CT (CBCT) technology in the diagnosis and treatment of knee injuries. Imaging systems based on CBCT technology for use in treating orthopaedic conditions — including traumatic injuries, joint replacements, arthritis and osteoporosis — can be designed to be lower in cost and use less radiation than full body CT systems. This new digital technology is designed to provide the ability to capture otherwise unavailable weight-bearing images of knees, legs and feet, which are of particular interest to orthopaedic and sports medicine physicians. “Bringing three-dimensional imaging to the point where patient care is provided — whether on the playing field or at the physician's office — has many benefits. In simple terms, three-dimensional imaging provides additional information over two-dimensional imaging technology in treating patients, but it is too expensive to be used in most medical offices. The CBCT technology we are exploring can be optimized for specific use in sports medicine and orthopaedics, and at a significantly lower cost,” said Dr. John Marzo, a physician with UBMD Orthopaedics & Sports Medicine, Associate Professor of Clinical Orthopaedics, School of Medicine & Biomedical Sciences, University at Buffalo and Medical Director, Buffalo Bills. “Because CBCT systems are smaller in size and more affordable, they can be installed at urgent care facilities, athletic training facilities, and physicians’ and specialists’ offices. This could make it easier for patients to obtain diagnostic exams immediately following an injury and help improve evaluation and treatment,” he added. The two organizations plan to broaden their collaboration at a later date to study the advantages of digital medical imaging in treating other patient extremity problems. This joint research project may be further expanded to focus on developing a CBCT system with image quality that is suitable for assessing and treating traumatic brain injuries.

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INDUSTRY UPDATE_Block Imaging

By Simeon Lowe

HOW TO CHOOSE THE BEST IMAGING EQUIPMENT SERVICE PROVIDER

icking the right service provider to maintain your imaging equipment is a highly subjective decision. What may be a significant service feature for one facility may fall further down the list of importance for another. The goal of this article is to help you ask questions that will qualify which service organization will best serve your needs. Uptime Guarantee Uptime guarantees have become increasingly common for service providers to offer in full-service contracts. Essentially, the service provider guarantees that your system will be functional X amount of days (commonly between 95 to 97 percent) over the contract period. If the percentage is less than the agreed amount, the service provider typically offers some sort of extension or discount on the contract. This can be a bargaining chip to ensure that the level of service sold is the level of service received. To some, especially high-volume facilities, this is essential. To others, an uptime guarantee does not impact the decision to use a specific service vendor. If you have a longstanding relationship with your service provider, the trust you’ve built with them can be more important. Does having an uptime guarantee give you the peace of mind needed to sign a service contract or are you 32 MEDICALDEALER | NOVEMBER 2014

Simeon Lowe

satisfied with the trust you’ve built in an existing organization? Response Time Coming to a mutual understanding on engineer response time is crucial. Service buyers should be wary of contract language that defines response time

as the amount of hours it takes for an engineer to call the site, not physically have hands on the equipment. Some sites demand a 4-6 hour response time to have an engineer onsite while others have engineers that they prefer, and are willing to wait for. Preferences in this area are often determined by patient volume. A specific response time is especially difficult to promise in rural or low-population areas. It’s advisable to consider your geographic location when negotiating response time with your service vendor. Whether your imaging equipment is in Aberdeen, S.D., or Chicago both the customer and the service provider need to have reasonable expectations of response times. What is your response time expectation and has your service provider agreed to meet it? Technical Support Not every service call requires a hands-on repair from a field service engineer. Many times a phone call from a trained expert can be all that is needed to find and correct minor problems or applications issues. This is especially true when a system has been recently installed and the staff is MEDICAL EQUIPMENT, PARTS & SERVICE

_Block Imaging

still adjusting to use on that specific model. If phone support is needed, you’ll want to be sure that any provider you’re considering can get a qualified engineer on the phone with your staff in a time frame that you find reasonable. How important is technical support to your service plan? There are certainly other areas that need to be taken into consideration when pairing your facility with the proper service organization, but these are the ones that we discuss most often with our potential customers. We encourage you to explore your options by asking the questions above and any others that are important to your individual equipment ownership experience. The more questions you ask and leg work you do, the more likely you are to find the service plan that meets the needs of not only your imaging equipment, but also your patients.

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MEDICAL EQUIPMENT, PARTS & SERVICE

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PRODUCT FOCUS_Radiology_Market Analysis

Staff Reports

NUCLEAR MEDICINE

he nuclear medicine market is expected to experience growth over the next decade and beyond. The forecasted growth, however, will come amid some factors that are limiting the global radiopharmaceutical market. “The North American market for nuclear medicine is estimated to be $2.2 billion in 2014, and is poised to reach $3.85 billion by 2019, with an estimated Compound Annual Growth Rate of 11.84 percent,” according to a report by Mordor Intelligence. The report indicates that the market is set to be mostly driven by therapeutic radiopharmaceuticals, markets that are expected to increase annually by 30 percent between 2013 and 2030. Other factors expected to fuel the nuclear medicine market include an aging population and an increase in the number of heart disease cases. Newer technologies and reimbursements will dictate shifts in the U.S. market. Danny Hamm, Vice President of Sales for InterMed Nuclear Medicine, says heart disease will continue to steer the nuclear medicine market. He said the number of heart disease patients will continue to increase as baby boomers age. WWW.MEDICALDEALER.COM

“More tests are being ordered just because more people are in the age bracket where heart disease is a concern,” Hamm said. He said SPECT will continue to be a staple of the nuclear medicine market. “I don’t think it’s going anywhere,” Hamm says. “The diagnostic value of it is very high with certain studies with cardiology being the main one. I don’t see heart disease or heart studies decreasing anytime soon.” “There is really not anything else that gives you the same diagnostic value,” Hamm adds. “It’s not going away because it would cost more to do the same study with PET.” However, Hamm said PET will continue to be a big part of the nuclear medicine market. “Nuclear medicine hasn’t changed a lot with the exception of PET,” Hamm says. “I would say the introduction of PET has become significantly more popular because of higher reimbursements.” The report by Mordor Intelligence also predicts cardiac disease as a reason for continued growth. “Increasing incidences of cancer and cardiac ailments, increasing awareness of people for radiopharmaceuticals and ready availability of radiopharmaceuti-

cals are the major driving factors for the market. PET and SPECT increasing usage also propels the market to grow,” according to the report. “However, short half life of isotopes and stringent regulations are the factors that are hindering the growth of radiopharmaceuticals worldwide.” “This era opens new opportunities in the nuclear medicine landscape,” the report continues. “The opportunities have been identified not only in the radio diagnostic area but also in therapeutic radiopharmaceuticals, with the first products scheduled to reach the market before the end of 2020. Opportunities exist for larger groups or investors to finance such development, to merge with some partners and/or to acquire companies.” The global nuclear medicine market will increase to $24 billion by 2030, according to a market research report by MEDraysintell. The report indicates the importance of the therapeutic radiopharmaceutical market and the diagnostic radiopharmaceutical market in regards to the nuclear medicine market.

MEDICALDEALER 37

PRODUCT FOCUS_Radiology_Product Showroom

Staff Reports

NOVEMBER PRODUCTS : This month, Medical Dealer explores Nuclear Medicine.

SIEMENS SYMBIA INTEVO

he first-ever xSPECT system, the Symbia Intevo fully integrates single-photon emission computed tomography (SPECT) and CT during image reconstruction, combining SPECT’s high sensitivity with the high specificity of CT and completely integrating data from the two modalities to generate high resolution and, for the first time, quantitative images. The Symbia Intevo xSPECT system reconstructs both the SPECT and CT portions of the image into a much higher frame of reference than previous systems for precise, accurate alignment of SPECT and CT that facilitates the extraction and deep integration of medically relevant information. This ability is also the basis for differentiating tissue boundaries in bone imaging. With xSPECT Bone, physicians can potentially provide additional support for detecting – and distinguishing between – cancerous lesions and degenerative disorders. • WWW.MEDICALDEALER.COM 38 MEDICALDEALER | NOVEMBER 2014

MEDICALDEALER 38 MEDICAL EQUIPMENT, PARTS & SERVICE

Radiology_Product Showroom

TOSHIBA CELESTEION PET/CT SYSTEM

o advance the care clinicians provide, Toshiba’s Celesteion PET/CT system delivers a more comfortable patient experience with the industry’s largest bore, widest field-of-view, dose reduction technology and fastest imaging. The versatile system combines high-performance PET and CT for all radiation and oncology imaging needs, including tumor detection, treatment evaluation and CT simulation. As healthcare reform puts a greater emphasis on patient satisfaction, the Celesteion’s numerous patient-friendly features are designed for this new landscape. •

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MEDICALDEALER 39

PRODUCT FOCUS_Radiology_Preferred Vendors

Staff Reports

PREFERRED VENDORS

NUCLEAR MEDICINE ALCO Sales & Service SEE OUR AD ON 6851 High Grove Blvd. PAGE 25 Burr Ridge, IL 60527 Phone: 800.323.4282 Fax: 800.950.1167 Email: info@alcosales.com Website: www.alcosales.com Since 1952, our family has been providing quality medical equipment and replacement parts to the healthcare industry. We provide our customers with multiple ordering options. Our four “full line” catalogs and various “product specific” catalogs compliment our new online ordering web site that offers over 70,000 products for your facility.

Intermed 13351 Progress Blvd. SEE OUR Alachua, FL 32615 AD ON PAGE 41 Phone: 800-768-8622 Fax: 386-462-5330 Email: sales@intermed1.com Website: www.intermed1.com Your Medical Equipment Sales and Service Experts: • Multi-Vendor Repair Services, All Levels of Coverage • 24/7 availability • National Ultrasound: Service, Sales & Training • East Coast Nuclear Medicine: Sales, Service & Training • Southeast Biomedical Services: Comprehensive Programs & Equipment Repairs • Jump teams available

Universal Medical Resources, Inc. 207 Lange Drive Washington, MO 63090 Toll-Free: 888-239-3510 SEE OUR Phone: 636-239-3510 AD ON PAGE 41 Fax: 636-239-6221 Email: umrinc@uni-med.com Website: www.uni-med.com Universal Medical Resources, Inc. has nurtured a business philosophy founded on offering comprehensive nuclear medicine equipment services at a reduced price. UMRi products and services include, NEW and refurbished nuclear imaging systems, quality parts, excellent equipment service, training courses for clinical engineers, camera system moves, technical and clinical support, flexible financing options, and more.

SEE OUR AD ON PAGE 29

Hilditch Group - Medical Auctioneers Gloucester Road Trading Estate Malmesbury, Wiltshire, SN16 9JT United Kingdom Phone: 0044-01666-822-577 Website: www.hilditchgroup.co.uk Specialist medical equipment auctioneers, leading the European market. Buyers from around the world buy from our sales, in person or on our website. Medical engineering department offers condition reports, repairs, servicing.

40 MEDICALDEALER | NOVEMBER 2014

TROFF Medical 2 Stoney Nob Dr. SEE OUR Hendersonville, NC 28792 AD ON PAGE 43 Phone: 828-697-1086 Fax: 828-698-4391 Email: mike.helms@troffmedical.com Website: www.troffmedical.com Imaging parts supplier for multivendor OEMs, Independent Service Organizations, and Clinical Engineering departments. Equipment purchasing, room moves and removals, and repairs.

MEDICAL EQUIPMENT, PARTS & SERVICE

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MEDICALDEALER 41

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42 MEDICALDEALER | NOVEMBER 2014

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PRODUCT FOCUS_Med/Surg_Market Analysis

Staff Reports

VENTILATORS

echnological advances seem to happen faster and faster. A brand new computer purchased online can feel outdated before it is delivered to your home. The same is true with smartphones, digital cameras and just about any other consumer product.

Advances in technology also impact the rapidly growing number of healthcare devices. New technology is changing everything from medical imaging to hospital beds. Ventilators are among the devices becoming more advanced and these updates are changing the market. Healthcare reform is affecting the market of almost every type of medical device used in the United States. An aging U.S. and global population is also impacting healthcare markets, regardless of the type of equipment in question. The global ventilators market was valued at just over $765 million in 2013 and will exceed $1 billion by 2020, representing a Compound Annual Growth Rate (CAGR) of 5 percent, according to a GBI Research report. The report states that while the increasing prevalence of Chronic Obstructive Pulmonary Disease (COPD) will continue to be the primary driver of market growth, new technologies will also make a crucial contribution. WWW.MEDICALDEALER.COM

“The already-high prevalence of COPD will be exacerbated by the aging population, leading to more critical care admissions, where the use of mechanical ventilation is common,” says Srikanth Venkataraman, Senior Analyst for GBI Research. The GBI report states that new technologies are a strong growth factor. “Companies are focusing on developing multimodal ventilators, which act as a one-stop solution for critical care physicians handling a wide range of ICU procedures,” says Venkataraman. GBI Research states that attention is turning increasingly toward improved technologies that prevent lung injury, reduce the time that patients have to spend on mechanical ventilation, and improve the synchrony between the patient and ventilator. “Compared to older methods, these technologies also help to reduce the risk of lung injury from high inspiratory pressure and are more customized to patients with varying levels of complications. They can also promote speaking ability

and improve patient comfort during mechanical ventilation,” he adds. In the global market, an increase in the number of quality healthcare facilities is expected to spur the growth of the ventilator market. “In emerging economies, such as China and India, a rise in new hospitals has led to a surge in the number of Intensive Care Unit (ICU) beds equipped with ventilators,” according to GBI. The increasing preference for non-invasive ventilation in the developed world will be another significant trend over the forecast period, with Europe currently leading the U.S. in the adoption of these systems. GBI Research attributes the low penetration of non-invasive ventilation in the U.S. to the lack of efforts toward increasing respiratory therapy and nursing time. Furthermore, there is an inaccurate perception that additional time is required to implement this treatment method, according to the GBI report. Some leaders in the ventilator market include Draeger Medical GmbH, Maquet GmbH & Co. KG, Philips Respironics Inc., Smiths Medical and Covidien PLC.

MEDICALDEALER 45

PRODUCT FOCUS_Med/Surg_Product Showroom

Staff Reports

NOVEMBER PRODUCTS : This month, Medical Dealer explores current trends in Ventilators.

CAREFUSION AVEA VENTILATOR

he AVEA® ventilator provides comprehensive critical care ventilation for the smallest patients in the NICU to children and adults with complex respiratory diseases. As an integral part of the CareFusion ventilation system solution, the AVEA ventilator not only meets your most demanding clinical needs with features, such as invasive and noninvasive ventilation for all patients types, Volumetric Capnography and Transpulmonary Pressure Monitoring, but also has the capability to bring clinicians and hospital management actionable information to help better address clinical and operational challenges in patient care. The exclusive BiCore™ technology integrated into the AVEA ventilator connects clinicians to their patients like no other ventilator can. •

46 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

Med/Surg_Product Showroom

COVIDIEN PURITAN BENNETT™ 980

he new Puritan Bennett™ 980 ventilator helps enable patients to breathe more naturally through the most innovative breath delivery technology available. The simple, safe and smart design provides more natural ventilation that may help clinicians improve patient comfort.1 • (1) Grasso S, Puntillo F, Mascia L, et al. Compensation for increase in respiratory workload during mechanical ventilation. Pressure-support versus proportional-assist ventilation. Am J Respir Crit Care Med. 2000;161(3 Pt 1):819-26.

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MEDICALDEALER 47

PRODUCT FOCUS_Med/Surg_Product Showroom

Staff Reports

DRÄGER EVITA INFINITY V500

The Evita Infinity V500 is a critical care ventilator that is suitable for all patient ranges– neonatal, pediatric and adult. It offers new concepts in ventilation such as APRV with auto-release, configurable SmartCare/PS, and variable PS. It’s standardized nomenclature and customizable interface improves workflow and gives clinicians the information they want at a glance. The V500’s ability to provide invasive, noninvasive, and 02 therapy provides a comprehensive array of therapy to adapt to the patient’s changing requirements. For more information, visit www.draeger.com •

48 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

Med/Surg_Product Showroom

IMPACT INSTRUMENTATION INC. EAGLE II

he Eagle II critical care portable ventilator is the ideal solution for ICUs, emergency departments and intra-hospital transports of infant, pediatric and adult patients. Weighing less than 10 pounds, it features pressure and volume ventilation modes, CPAP/BiPAP with automatic leak compensation and pressure support, an internal compressor, air/oxygen mixer and PEEP control. It also incorporates Masimo SpO2 to monitor pulse rate and blood oxygenation. It is also available in an MRI configuration allowing you to ventilate patients in an MRI suite. Eagle II is proudly made in the USA by Impact Instrumentation Inc. of West Caldwell, N.J. â&#x20AC;˘

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MEDICALDEALER 49

PRODUCT FOCUS_Med/Surg_Product Showroom

Staff Reports

PHILIPS RESPIRONICS TRILOGY

hronic obstructive pulmonary disease (COPD) has been added to the list of diagnoses subject to penalty by CMS if 30-day readmission rates are higher than expected. Philips Respironics’ end-to-end solutions can help to reduce hospital readmissions and the subsequent healthcare dollars spent on COPD management. Across the continuum of care, the treatment solutions and value-add programs are designed to provide comfortable and effective treatment as well as transition and treat patients at home. Philips Respironics Trilogy ventilators incorporate AVAPS-AE (Average Volume Assured Pressure Support with Auto-EPAP). AVAPS-AE automatically titrates EPAP and regulates pressure support to a physician-defined tidal volume (based on ideal body weight), maximizes expiratory time to help avoid breath-stacking and adjusts the back-up rate based on the patient’s spontaneous rate. •

50 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

PRODUCT FOCUS_Med/Surg_Preferred Vendors

PREFERRED VENDORS

VENTILATORS

SEE OUR AD ON PAGE 29

Government Liquidation SEE OUR AD ON 15051 N. Kierland Blvd. #300 PAGE 44 Scottsdale, AZ 85254 Phone: 480-367-1300 Email: info@govliquidation.com Website: www.govliquidation.com Government Liquidation (GL) is your direct source for U.S. Government surplus. Sales are conducted via our online auction platform through internet auctions. GL invites you to purchase medical, dental and test equipment in a convenient environment at: www. govliquidation.com. Search our inventory as new items are added daily.

Hans Rudolph, Inc. 8325 Cole Parkway Shawnee, KS 66227 Toll-Free: 800-456-6695 Email: hri@rudolphkc.com Website: www.rudolphkc.com

SEE OUR AD ON PAGE 82

Designers & Manufacturers since 1938 of Respiratory Valves, Pulmonary Function/Exercise Testing Masks & Valves, Pneumotachs, Flow Measurement Instrumentation, Volume Calibration Syringes & Syringe Validators, Lung Simulators, Flow Resistance Standards, Mouthpieces, Nose Clips, Oxygen Conserver Testers, Reusable & Disposable CPAP/BiLevel and NIV Masks for Hospital and Homecare. Dealer & OEM relationships are welcome.

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SEE OUR ReMed Equipment AD ON PAGE 53 Phone: 800-735-8078 Fax: 800-790-8364 Email: sales@remedequipment.com Website: www.remedequipment.com

ReMed Equipment is a dynamic company with over 10 years of industry experience. We provide quality new and refurbished medical equipment. We have a broad range of equipment to meet your specific needs and budget. ReMed Equipment sells refurbished medical equipment from top manufacturers such as Datascope and Philips. Contact us for all of your used equipment needs.

Rieter Medical Services 735 Landers Rd. SEE OUR Spartanburg, SC 29303 AD ON PAGE 42 Phone: 800-800-5402 Fax: 864-699-5359 Email: federicobeltran@rieter.com Website: www.rietermedical.com Rieter Medical Services, an ISO9001:2008 certified organization, provides support services for most medical equipment. Our electronic repairs consist of component-level repair, including difficult surface mount components and multi-layer boards.

MEDICALDEALER 51

It’s Here...

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MEDICALDEALER 53

RADIOLOGY DEPARTMENT DIRECTOR

54 MEDICALDEALER | NOVEMBER 2014

MEDICAL EQUIPMENT, PARTS & SERVICE

INSIDE THE WORLD OF A RADIOLOGY DEPARTMENT DIRECTOR

By Matthew N. Skoufalos

or all the importance placed on the imaging suite in a clinical, research, or distributed setting, thereâ&#x20AC;&#x2122;s really no set way to get to the top.

Radiology directors come from a variety of specialty backgrounds, earn various levels of graduate education and vocational certifications, and have a variety of directives to reconcile in their positions. We asked three profession-

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als to compare notes on the demands of their positions, and discovered that, whatever the setting, being a radiology director demands a degree of leadership that is dictated by the pace and objectives of their individual institutions.

MEDICALDEALER 55

RADIOLOGY DEPARTMENT DIRECTOR

PRIVATE PRACTICE

In private practice, said Larry Weber, Chief Operating Officer for Desert Radiologists of Las Vegas, Nev., radiology directors not only must balance the technological and human resources management aspects of the position, but also interpret those demands through the lens of constantly decreasing revenues, as technical and professional reimbursements continue to decline. “Human resources leadership is very gray,” Weber said. “Technical leadership is very black and white. Leading the technology; that’s very simple. You know that you want to be able to perform certain studies, [so] you go out there and find the technology that will allow you to do that, you then implement the technology, and then hire people to perform the technical studies. You have a certain budget to stay within, you try to maximize the impact that budget will have.

that bottom-line impact. If devices need to be operating at 90 percent capacity 100 percent of the time in order to hit certain financial metrics, Weber said, it’s incumbent upon directors to bring their subordinates into the fold from a philosophical perspective. By giving staff an opportunity to be engaged in the process, directors can drive results along the metrics that most relate to their performance needs. “We do employee engagement surveys,” Weber said. “We understand what our employees are thinking. We allow them to give us feedback. We develop focus groups on areas that we want to develop as a company. It’s a very formal structure that allows them to be a part of identifying the problem, identifying the solution and implementing the solution.” By way of example, Weber described how focus groups led employees at Desert Radiologists —

“The people that are successful are the people that can take those numbers and transform them into ideas and concepts.” – Larry Weber,

Chief Operating Officer for Desert Radiologists of Las Vegas, Nev.

“The people that are successful are the people that can take those numbers and transform them into ideas and concepts,” he said. “[They] get engaged in trying to resolve the numbers and help find solutions that engage them in their work.” The challenge for radiology directors is engaging with technical staff to recognize their role in mitigating 56 MEDICALDEALER | NOVEMBER 2014

which comprises six, wholly owned outpatient imaging facilities, 16 multi-specialty partner affiliates, and a staff of 400 — to refine the performance management system at the company. The survey results led leadership to conduct a number of focus group meetings, which revealed a number of redundancies in its management evaluation strategy. MEDICAL EQUIPMENT, PARTS & SERVICE

“We had 13 sections that didn’t necessarily hit home,” Weber said. “We also revised the management evaluation and tied in what they felt the managers’ responsibilities were, and it gives them the authority to impact change.” Including staff in the decision-making and execution process is only part of the responsibility of effective leadership that comes with a director title, Weber said. Engaged employee teams come from engaged leaders, he said, and that requires “own[ing] the direction of the organization.” “If the organization recognizes the engagement of the employees as its most basic, fundamental need, as a director, you have to embrace it,” he said. “You have to understand it, create passion in yourself for it, and then impact it. They’ll see through the smoke if you’re trying to use smoke and mirrors. “No matter who your audience is, you have to be able to speak to the audience to give them the information they need to make the decision that you know they need to make,” he said. WWW.MEDICALDEALER.COM

Along with that responsibility comes the need to distinguish among those factors that a director can control and those which are beyond the scope of the position, Weber said. Data that drive those decisions become the key performance metrics for the practice. “Who we do business with, I can control; how much they pay us, I can’t, with Medicare,” he said. “I can be aware of any changes, analyze the impact to our organization, and then use that as the impetus to create support for any additional change. My job is to constantly evaluate and analyze.” Functionally, Weber said, imaging is “a cost center for all or most hospitals,” which will require practices like his to evolve beyond purely volume-based metrics to drive profitability. Until reimbursements are dictated by “adding value as opposed to adding volume,” medical imaging will exist “in a transient state,” as far as revenues are concerned. “Long-term, our role in the healthcare continuum is going to be making sure we do exactly what’s right the first time and never do an unnecessary examination,” Weber said.

TEACHING HOSPITALS

Laura Findeiss, who chairs the Department of Radiology at the University of Tennessee Medical Center in Knoxville, Tenn., agreed with Weber that one of the most important qualifications of being a radiology director is being able to relate to a variety of individuals at a number of levels. “It’s a complex, multi-consumer specialty,” Findeiss said. “You’re responding constantly to demands from every corner of the institution. “I don’t know that there’s anything that can really prepare you for the broad range of responsibilities in this position,” she said. “Most physician leaders traditionally end up falling into it rather than being trained for it. You tend to excel at whatever are you’re excelling at in your clinical arena, but you don’t necessarily get trained in leadership really formally.” As an interventional radiologist, Findeiss said she learned how to manage patients by managing teams of technologists, nurses, and physicians, which helped her understand more about how to motivate MEDICALDEALER 57

RADIOLOGY DEPARTMENT DIRECTOR

“Most physician leaders traditionally end up falling into it rather than being trained for it. You tend to excel at whatever are you’re excelling at in your clinical arena, but you don’t necessarily get trained in leadership really formally.” –Laura Findeiss,

Chairs the Department of Radiology at the University of Tennessee Medical Center in Knoxville, Tenn.

58 MEDICALDEALER | NOVEMBER 2014

and construct professional teams. Continuing to maintain her clinical practice independently of her directorship also helps her to understand how her department functions from the perspective of the radiologists who interact with it on a daily basis. “I get to engage with my department as a customer as well as a radiologist,” she said. “It helps me see where we’re falling down a little bit. It helps me understand what the needs of the referring physicians are.” Findeiss believes that the survival of radiology as a physician specialty is contingent upon radiologists embracing a team treatment model around patient care — a direction in which hospital staff have long been trending. For a profession in which “it’s not been part of the culture to do a lot of interacting with referring physicians so much,” Findeiss said, she predicts that the personalities of people who enter the field in the future will be more interactive, more consultative, and therefore “more primed for leadership.” “The way hospitals tend to be structured, the physician leader is in sort of a parallel track relative to the operation,” she said, with “sort of a tenuous oversight.” “We don’t actually, from a structural standpoint, employ and manage the people that make the equipment run,” Findeiss said. “We need to have really good relationships with the administrative component of the department in order to facilitate and improve throughput, with sort of a partnership and not a direct line of sight management.” Given such a structure, she said, leadership in a hospital role then becomes a matter of “surrounding yourself with brilliant

people.” As department chairs are ever more specialty trained and modality-based, they are less likely to have a broad knowledge base, which makes it ever more critical to align their training with the needs and directives of the institution. Whereas such specialists may be better utilized in providing guidance around technological improvement, they can’t ignore more basic technologies that are nonetheless critical to operations, Findeiss said. “For this position, it’s going to depend on what environment you’re in,” she said. “I think what will be down the road in my kind of position will be different from what you see at the Mayo Clinic. It’s going to be very individualized. “I do think we’re seeing more movement away from the purely academic-oriented chairman who’s selected on the ability to promote the research site, get grant funding, academic CVs, and more towards people that are operationally minded and enterprise-alignment oriented.”

STRIKING A BALANCE

Jeff McGough, Operations Director for Ambulatory Radiology at the University of Alabama-Birmingham’s Kirklin Clinic, is one such individual, having started his career as a CT technologist. After 23 years on the job, he rose through the ranks to become the director of the center’s outpatient facility. It wasn’t a transition that came without a learning curve. “I’ve been siloed in the CT world for maybe close to 20 years,” McGough said. “I had to learn every modality and how their operations work. Everybody’s got a different schedule or way of handling the patients. Understanding how that MEDICAL EQUIPMENT, PARTS & SERVICE

affects their access capabilities on a day-to-day basis, that’s still an ongoing process.” In the meantime, McGough is furthering his advanced education by pursuing his MPA. As he continues to grow into his role, his approach is one of a coach rather than an overseer, he said. “I let them run their departments how they see fit, and I provide support to them based on what I see from patient volume to patient satisfaction,” McGough said. “I try to be out and about as much as possible because I think it’s important to know what’s going on in the areas, but I don’t want to micro-manage. A lot of my role is seeing if there are issues on their end, trying to address them from a department standpoint.” McGough’s way of keeping his finger on the pulse of the department is to hold “a radiology town hall meeting” twice a year. The 109 employees of the department gather in a conference room, and staff inter-mingle in four or five sessions throughout the day. The setup helps leadership communicate its expectations, and gives the department a chance to bring to light any concerns that might otherwise have slipped through the cracks. “We just had our last one in the middle of September,” McGough said. “When we put initiatives out and ask them to do certain things, they can have a better understanding of what we’re trying to achieve.” Those aims are a bit of a mixed bag: at Kirklin, McGough has some of the challenges of an outpatient clinic, and some of the challenges of a teaching hospital. Even as McGough is trying to help navigate more patients through the WWW.MEDICALDEALER.COM

“ I let them run their departments how they see fit, and I provide support to them based on what I see from patient volume to patient satisfaction.” – Jeff McGough,

Operations Director for Ambulatory Radiology at the University of Alabama-Birmingham’s Kirklin Clinic

system, the academics on staff are working to push new protocols and expand the technology at their disposal as much as possible, he said. Sometimes there are conflicts, but brokering a peace between the technical and the physician sides requires clear communication of the goals of both the clinic and the health system as a whole.

For example, McGough describes a nearby imaging center “that has over time been able to capture some of our MRI volume that we’re not able to accommodate.” In response, Kirklin has restructured its schedule, opening Monday and Tuesday night clinics to provide additional options for patients, and installing a fifth MR unit on a separate schedule for sameday appointments. “But it’s been a change in culture to tell [physicians and patients] that we have this service now,” McGough said. “As we’re trying to evolve as a department, we still have challenges because our protocols are so long. Being an academic center, sometimes that’s a challenge: we still have to see patients and meet the demands of our referring clinics.” Being a teaching institution also affects capital planning, McGough said, and even with a five-year academic budget, dollars can be consumed on the latest and greatest equipment rather quickly. Diminishing returns mean that those dollars have been held off somewhat, as departments evaluate equipment based on its patient safety features above all else. “In the past we’ve been on a fiveor seven-year replacement plan,” McGough said. “They’re saying, ‘Hey can you push it to 10 years?’ Being a high-volume institution, they do wear out.” At the same time, he said, the dual-energy CT scanners at Kirklin have helped the center become the highest volume producer of dual-energy imaging in the country. “That’s back to that research component,” McGough said. “Our physicians think that they’ll be able to develop protocols based on that. It’s exciting.” MEDICALDEALER 59

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MEDICAL EQUIPMENT, PARTS & SERVICE

CORPORATE PROFILE

METROPOLIS

INTERNATIONAL LLC

en years is a significant milestone and Metropolis International LLC has every reason to celebrate as

the company approaches the decade mark. The company was formed by forward-thinking Leon A. Gugel in 2005 when he saw an unmet need. A need for quality pre-owned diagnostic imaging equipment and, more importantly to Gugel, a need healthcare facilities had for a dependable and trustworthy partner.

“Metropolis was started in 2005, in direct need of an honest, no-nonsense, stocking dealer in New York City proper that does sales as well as service on the best refurbished systems in the industry,” Gugel explains. “I have been in the industry since late 1998. In that time, I have built a reputation of trust, knowledge and competence that is second to none. So, when I started Metropolis, I was looking to make the market grow bigger and better.” “And now, nine years later, we are doing better than ever,” he adds. “We are growing and our team and products are on par, or better, 64 MEDICALDEALER | NOVEMBER 2014

than most other dealers from around the country.” An experienced team of professionals powers the growth and success of Metropolis. “With over 40 years of combined industry experience, we have built long-lasting and close relationships with our customers and vendors all over the United States and in many other countries around the world,” according to the company’s website. “We believe that this is the only way to succeed in business. Because we strive for repeat business, you can be assured that all of your needs will be taken care of in finding

and providing the right equipment for your medical needs.” Gugel explains that a yearning to stay educated and up to date on imaging equipment combined with a fierce dedication to customer service and relationship building is a part of the culture at Metropolis. “The advantages that Metropolis has over the competition is that we learn all the time. The first aspect is that we learn about the market we are in, what systems we sell and work with. We learn about what makes them tick and their respective histories,” he says. “Second, we provide extremely good customer service. After all, what is a customer and a product we want to sell them if we don’t provide support, help, logistics and service? Much like any human interaction and relationship, it works the same way with the staff of Metropolis as well as with myself.” Another huge bonus of dealing with Metropolis is the company’s strict adherence to FDA regulations. “The biggest advantage I believe we have is that the FDA mandated that ‘all entities that sell, service and propagate radiological emitting devices MEDICAL EQUIPMENT, PARTS & SERVICE

SPECIAL ADVERTISING SECTION

The members of the Metropolis International team are (back row from left) Will Cadet, Alex Kalish, Henry Dorr, Mike Osiashvili, Leon Gugel, (front row) Katherinne Jurado-Hernandez, Andrew Kramer and Lita Perl.

must be registered with the FDA.’ This is something that most folks in our industry do not know of, or simply don’t care about, or take for granted. But this is the law, even if one does nothing but broker equipment,” Gugel explains. “We are FDA registered and keep all proper records of everything we do. And, the most reassuring part for the customer as well as our vendors, is that because we are FDA registered we keep proper validation forms of all systems we sell to prove that they are working.” Gugel is the founder and leader at Metropolis, but he is quick to applaud the entire team. He isn’t shy when it comes to describing what makes them special. “And another advantage we have is that our service manager, Alex Kalish, is the best engineer that I have ever seen,” Gugel says. “I have been doing this for over 16 years now, and I have seen engineers, but never someone with the skill-set and competence that he has. Under his leadership, we WWW.MEDICALDEALER.COM

“With over 40 years of combined industry experience, we have built long-lasting and close relationships with our customers and vendors all over the United States and in many other countries around the world.” – Leon Gugel are able to easily fix any system that comes in that is broken from 3. ultrasound to mammography, to C-arm even CT and MRI, as well as X-ray and nuclear medicine.” “As a result, we have picked up numerous service contracts from old and new customers who are amazed at his technical capabilities,” Gugel adds. “He also helps train and focus the rest of the service members here.” Gugel and Kalish are not the only stars at Metropolis. “We have added another service engineer to our roster as well as William Cadet as head of retail sales. Otherwise, we have a staff that has been here for many years which gives us

the stability that every business strives for,” Gugel points out. “We have many good employees, Katherine has been a part of Metropolis for more than six years now, and Andrew has been here for more than four,” he says. “And, as I mentioned before, our engineer is a genius. Alex is able to fix anything, not just mechanically, but also solve electrical and critical software issues that the systems may have. This software capability is what makes Metropolis second to none! We have the capability to fix any system, any modality from any manufacturer.” Healthcare in the United States is undergoing lots of change and the economic strugMEDICALDEALER 65

CORPORATE PROFILE SPECIAL ADVERTISING SECTION

Imaging equipment is seen in the warehouse at Metropolis International in New York.

gles of the past continue to have an impact on the medical imaging market. Despite these obstacles, Metropolis has performed very well and Gugel looks forward to the next 10 years. “The challenges that Metropolis faced were, I think, the same as what many others faced. The economy, regardless of the faux numbers the government reports, is still not what it was in 2009 or before,” Gugel says. “In conjunction with reimbursement cuts, and with doctors and hospitals afraid to pull the trigger on upgrades or purchases of new systems, the medical environment has become very tight. There are fewer spending dollars and even those that are being spent are done so with more scrutiny. Metropolis simply refocused their efforts both individually and 66 MEDICALDEALER | NOVEMBER 2014

collectively in reaching out to old and new customers and vendors in an effort to generate more business.” “Metropolis is truly a unique company among many. It was founded on the principal of better service and systems and being able to adapt to the changing market environment that we are all in,” he says. “We are looking at continued growth and stability for Metropolis in garnering not just more sales, but more service as well. We are actively adding unique and qualified service techs to our team.” As the company prepares to reach the 10-year mark, Gugel sees a promising future on the horizon. “What excites me about Metropolis and its prospects at the moment are the phenomenal upgrades we do on older ultrasounds, C-arms and portables

that have been saving hospitals and private doctors lots of money. And, in turn, it generates more business for Metropolis,” Gugel adds. “And, we are in negotiations to become a primary refurbishment company for a large OEM.” The company’s 10-year anniversary is close, and Metropolis has proven that an honest desire to provide excellent customer service, world-class support and an extremely talented pool of employees have the company on the right track for the next decade and beyond. TO LEARN MORE ABOUT METROPOLIS please visit www.metropolismedical.com. MEDICAL EQUIPMENT, PARTS & SERVICE

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SLICE OF LIFE_The Other Side

By Jim Fedele

SAVING MONEY SHOULD NOT BE SCARY

veryone wants to save money, as long as it is doesn’t really affect him or her. One of our primary duties is to help our customer drive costs out of their operations; it is a key initiative in our organization. However, it is remarkable how that agenda changes when saving money will affect those same people. Biomedical engineering departments know how to save their facility’s money. Nevertheless, when it comes down to doing it some people do not want to cooperate. To make matters worse, OEMs use tactics to scare customers into keeping service contracts. We need to do some preparation to thwart these tactics and show people it can be done. In today’s economic market, all of healthcare is trying to drive out expenses to reduce costs. However, when it comes to making the sacrifices or taking the risks that always accompany the beginning of a real cost-saving program people are too apprehensive to implement them. One part of my job as the biomedical engineering manager is to save money by eliminating ser70 MEDICALDEALER | NOVEMBER 2014

vice contracts. The promise I make is to provide better service than the OEM at lesser cost and in every case we have been able to deliver on that promise. Still, every time I make a pitch to eliminate a service contract I never know how it is going to turn out. The challenge in convincing my customers to not sign a service agreement is counteracting the OEM’s scare tactics. Let me give you an example of how one particular OEM used these tactics to keep their service contract. We have a nuclear medicine system that is comprised of two cameras, a computer system and various imagers and printers. The cost for the biomedical first pass service agreement sold by the OEM is $85,678. Annually, I have tracked service events that were encountered on this system. I then evaluated the value (parts costs and hours logged to fix problems) of the contract based on those service events. I noticed that in a three-year period we could save a consider amount of money by dropping the service contract. We would continue to do first response

and any problems beyond our capability would be handled by the OEM or a third-party repair company. I estimated, conservatively, that we could save about $40,000 a year based on my analysis of the past history of the equipment. Armed with this information I presented it to the department manager and staff. Assuming “everyone” wants to save money, I was surprised by the ensuing barrage of negative statements and disagreements that were shot at me. I was very naive to think that everyone would see the amazing amount of money we could save and just join the cause. I underestimated how hard the OEM would fight to keep the contract. The biggest mistake I made was informing the staff of my intentions before I presented the numbers. While I was gathering data, I questioned the staff about the service history of the units because I wanted to be sure I was including everything. The staff told the local service representative what I was planning to do. The service representative visited us one week later and he brought his ammunition. MEDICAL EQUIPMENT, PARTS & SERVICE

_The Other Side

In today’s economic market, all of healthcare is trying to drive out expenses to reduce costs. However, when it comes to making the sacrifices or taking the risks that always accompany the beginning of a real cost-saving program people are too apprehensive to implement them.

He told a story about a site similar to ours that had just paid a whopping $36,000 service charge. He told them that under a time and material relationship the free software upgrades would cost them $10,000-$15,000. He told them phone support would no longer be available. Finally, he told them we would be put on a lower priority for any repairs we needed him to come in to do. What would I have done differently? Alternatively, maybe what I should say is “This is what I do differently now.” I try to anticipate these scare tactics. Every OEM uses similar ones in one form or another. First, I handle the concern that is most dear to the customer’s heart, technical support. It is amazing that when you call an OEM and ask them how much a technical support only contract is few offer it. Usually this is a bluff by the OEM and I try to expose it as such. If this is the biggest issue and there is not a tech support contract available we just give them a blanket purchase order from my department to cover any charges for techniWWW.MEDICALDEALER.COM

cal support. You can collaborate with an ISO to deal with this concern. The software upgrades can be tricky, operational fixes for bugs should be included regardless of the contract status. Enhancements that add functionality are usually what the end user is promised by having a service contract, however I rarely see these types of updates occurring without additional costs for hardware. As for the $36,000 service bill, I tell them first that I am taking full financial responsibility for the equipment. Then, I show them three years of service history with associated costs. You can have a few $36,000 service bills when you look at what you are spending in three years. Finally, I have never experienced an OEM that wasn’t willing to respond promptly to a time and material call. Let’s face it, who is going to turn down business and possibly damage their relationship with a facility? The key to this entire process is that you have to sell it. You have to make sure that you are genuine in your concern for the equipment. You need to allow

them to voice their concerns and then work on each one. Because if you go over their heads and get your program approved by a vice president and mandated, they will never be satisfied with the service and you will be setting yourself up for certain failure. We are disadvantaged sometimes. OEMs are very prepared and they have a sales force that deals with these kinds of issues on a regular basis. We do have options. You can contract an ISO and let them do the selling and servicing. The bottom line is that in order to save money, people need to change their way of thinking and sometimes make temporary sacrifices. JIM FEDELE, CBET, has been with Medical Dealer magazine for more than 12 years. He is currently the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments by email at info@mdpublishing.com.

MEDICALDEALER 71

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SLICE OF LIFE_Pay It Forward

By Matthew N. Skoufalos

HALYARD HEALTH RECOGNIZED FOR ECO-FRIENDLY APPROACH

ules governing the handling of manufacturing waste and the byproducts of industry differ so greatly from country to country that for any business looking to operate internationally, aligning its procedures is a vast undertaking. “Globally, regulation is so different,” said Jane Hart, Global Sustainability Leader for Halyard Health, formerly Kimberly-Clark Health Care; “everything from waste to how you handle the chemicals that go into it. “The landscape is so vast across the world, but our products are everywhere,” she said. “We’re not usually manufacturing for one place. We’re manufacturing for all places if we can.” For the second year in a row, however, Halyard Health, has been recognized by the Practice Greenhealth organization for its waste management and sustainability practices. Practice Greenhealth is a nonprofit organization that works to drive systemic environmental change by bringing healthcare companies to focus on green issues. “We’ve had goals for years, and we’re just now reaching our 2015 milestone point,” Hart said. “We’ve been doing a sustainability report for quite some time, and we’ve been part of the GRI ratings system for some time. “We’ve lived it,” Hart said. “We know that you start small and you get big.” The company is “99.91 percent landfill-free in our manufacturing process,” Hart said, and “aiming for 74 MEDICALDEALER | NOVEMBER 2014

100 percent.” That mentality is what inspired the Blue Renew program, which helps hospitals recycle their sterilization wrap through local plastics processors. About 143 hospitals actively participate in the program, and another 257 hospitals are “engaged and pending start-up,” Hart said. “We can help it get to another useful source,” she said. “Regulations won’t let that [wrap] get back into a Class I medical device, but there are plenty of other uses for it. We help train hospitals so they have the discipline to separate that [and] remove it from the OR before it gets in the room.” Manufacturing waste has been a metric Halyard Health has tracked for quite some time. “We measure our energy, our water,” Hart said. “We were paying to make sure we avoided landfills before people were really tracking the waste as close as we want it. We’re thinking about the footprint of it.” The level of impact that a huge, multinational corporation can have simply by looking for ways to drive internal efficiencies is staggering, Hart said. For example, she said, the corporation sells its annual manufacturing scrap materials to the tune of $60 million. That’s enough money to call it an entirely separate business, she said, “but we have a group of people who look at secondary materials usage, and that’s their job, and they’re phenomenal at it.” In some cases, the waste team has helped to create new industries that

“We learn from our customers and we want to teach them what we know as well so we can be better together.” – Jane Hart didn’t exist before, Hart said. Even within the Blue Renew program, the leftovers from the manufacture of medical equipment aren’t necessarily going to recyclers, she said — they go to manufacturers. “Whether it’s car parts, motorcycle parts, plastic bins, people are realizing that they can take the raw material that we have and turn it into what they need in the same way that pre-consumer waste gets remanufactured in a mill,” Hart said. “Just by virtue of the fact that we’re doing that program, people are coming out of the woodwork,” she said. “[Right now we’re] working with a textile company to see if we can mix cotton with polypropylene to make scrubs. I get excited because I know that there’s a value for business, a value for society, and a value for the environment.” Another aspect of the Halyard Health environmental push involves its work with the Healthcare Plastics Recycling Council (HPRC). The company created an educational iniMEDICAL EQUIPMENT, PARTS & SERVICE

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tiative called the HospiCycle toolbox that helps maximize hospital recycling efforts from the ground up. The toolbox takes a step-by-step approach to guide facilities and staff from initial planning to effective roll-out of such a system, with instructions for everyone from decision-makers to nurses and professional staff members. “The HPRC team works with several hospitals to develop case studies of recycling measurements and opportunities,” Hart said. “We work together WWW.MEDICALDEALER.COM

for new ways to help explore these studies as to how to most effectively recycle, reuse, or even send materials or goods to a group like MedShare. “We learn from our customers and we want to teach them what we know as well so we can be better together,” she said. “It’s a big puzzle; it’s not just one thing.” Through its partnership with MedShare, Halyard Health has pledged $1.7 million in donated supplies — about 55 45-foot containers’ worth — to

South American hospitals. MedShare’s distributed infrastructure in those countries is solid, which helps guarantee that the shipments will reach their intended destinations. “We have to be careful because it could get confiscated and sold on the black market, and we don’t want that,” Hart said. “We ensure that it gets there just as much as everybody else.” The donations achieve two objectives. First, they help provide the means to treat sick patients in needy countries. Second, they find viable recipients for goods that Halyard Health would otherwise not necessarily be able to retail in the United States. “If the outer case is damaged, but not the goods inside, we can provide them to people,” Hart said. “It was a way to continue to get rid of waste from a landfill and put it to better use. They’re not just randomly shipped, they’re ordered by people around the world. It’s these hospitals on the cusp of being able to take care of their own. Sometimes they order a shipment and sometimes one is sent.” Next up on the horizon for Halyard Health is finding ways to conserve energy throughout its operations, Hart said. The healthcare division is running on 78 percent renewable energy, she said, but greater conservation will come not from improving the system itself alone, but how people interact with it to create efficiencies. “We’re reporting to people who are investing in us, so all of those things become important factors in making decisions,” she said. “Supporting efficiency is much better than supporting inefficiency.” MEDICALDEALER 75

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SLICE OF LIFE_Success Story

By Matthew N. Skoufalos

LAKE CARDIOVASCULAR DIAGNOSTIC CENTER

fter a decade of managing equipment purchases for private practice diagnostic centers, Mike Ganus has fielded a number of sales pitches from medical equipment vendors hungry to earn his business. And Ganus, a Critical Care Paramedic/CVT who also manages the cath lab at Lake Cardiovascular Diagnostic Center of Lady Lake, Fla., has a sharp eye for bargains.

But he also has learned that what separates a good deal from one that makes long-term financial sense for the institution is often more than a matter of bottom-line pricing. Lady Lake is a small town, the largest, closest neighbor of which is Ocala. It’s a retirement area, Ganus said, with a population that trends senior in its demographic makeup. As such, Lake Cardiovascular primarily sees older patients suffering from heart disease. The sickest patients are referred to the local hospital, he said, but those who require peripheral angiography and interventions or heart catheterizations for cardiovascular diseases are among those treated there. With the bulk of the revenues generated at the two-year-old center coming from procedures that require high-end, specialty technologies, every dollar that can be conserved in equipment costs is a dollar that can be reinvested in its operations. So when Ganus has the opportunity to save money, he seizes on it. Finding a trusted partner to provide high-quality pre-owned medical equipment 78 MEDICALDEALER | NOVEMBER 2014

“When I buy something, I look at the new price and the remanufactured [price] Some of the preowned, remanufactured stuff is half-price from [the cost of] new [equipment].” — Mike Ganus

is one of the surest ways to win on price without compromising on functionality. “When I buy something, I look at the new price and the remanufactured [price],” Ganus said. “Some of the pre-owned, remanufactured stuff is half-price from [the cost of ] new [equipment].” As an independent center with no hospital affiliation, Lake Cardiovascular relies on cost savings to remain competitive in a crowded healthcare market. Without competitive equipment vendors, “you wouldn’t be able to get the doors open, especially in this economy,” said Ganus, who also offers his services as a consultant for other doctors opening independent catheterization laboratories.

“It’s less expensive for start-up costs [to buy pre-owned],” he said, but many independent physicians are either intimidated by the process or uncertain of the quality of the equipment. “A lot of doctors do well with their patients, but they sometimes don’t know how to run a company and what the cost of stuff should be,” Ganus said. “A lot of them are used to working in the hospital where the X-ray costs $20 — but it really doesn’t. People whose [product] reps come to them and say, ‘We want to put our products in here for $10,000,’ but don’t realize you can get [the same thing] for $2,300. That goes for devices, stents, balloons, stretchers, monitors – everything. MEDICAL EQUIPMENT, PARTS & SERVICE

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Their job is to get the premium [price] because [it’s] more profit they get for their shareholders.” Companies who are looking to compete in the pre-owned equipment space often thrive on recommendations, and for Ganus, those companies that earn his recommendation do so from a handful of perspectives: honesty, price point, and service after the sale. In such an environment, Ganus said, it’s important for providers to have the support of a trusted partner with which to do business. He said that’s why he relies on Venture Medical of Tampa, Fla. The company provides new and pre-owned equipment to ambulatory surgery centers, hospitals and medical offices. Venture also provides equipment support and service locally for its Florida customers. With a 44,000-square-foot warehouse and a separate quality assurance department, the company provides consumer confidence that its equipment is reliable, durable and well-maintained. “I only use Venture Medical, and I use them on every project that I do buying hard equipment,” Ganus said, including stretchers, tables, monitors, EKG machines, blanket warmers, wheelchairs and IV poles. “It’s less expensive for start-up and operational costs,” he said. Beyond price, Ganus said, he enjoys a high degree of confidence in the reputation of Venture Medical, not only in standing behind the WWW.MEDICALDEALER.COM

products they retail from a warranty and support perspective, but in providing an extra bit of assurance that the price they quote will be the price he pays. “Some of these companies you call and then they give you a totally different price,” Ganus said. “It fluctuates. If you know they gave you a price, [the vendor should] stand behind that price.” That honesty and reliability extends even beyond items that are in the current inventory at Venture Medical, Ganus said; when the company does help him source the equipment he needs, they will pass along the savings to him. “They’ve looked for things for me that they don’t have,” he said. “If I need something, they’ll try to research it and give me the best price.” Ganus does his own price-shopping as well, he said. From Internet searches to calls to other vendors, he makes sure that his ducks are in a row before he makes a purchase. But the loyalty that he said he has shown to Venture Medical is returned to him in the form of value for dollar spent and continuity of service. “They repair, maintain, and service the equipment,” Ganus said. “If there’s a problem, I call them up and they repair it. They go above and beyond almost all the time. If I send a part that needs to be repaired, they tell me they’ve got it; they tell me the cost of repair and whether it’s under warranty. [It’s] another bit of peace of mind.” MEDICALDEALER 79 410002 INTERNATIONAL MEDICAL TechNation AD 12312013.indd 12/31/13 1 1:45 PM

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SLICE OF LIFE_

By Dan Bobinski

THE SCIENCE OF BEING ASSERTIVE

icture a graph with the vertical axis representing your ability to stand up for yourself and get your needs met; and the horizontal axis representing your ability to give genuine consideration to other people’s point of view. Within that graph we can establish four basic quadrants: aggressive, assertive, passive, and passive aggressive. Most everyone tends to live predominately in one of those quadrants, but the healthiest place to be is in the assertive quadrant. Too often, people think they’re being assertive when they’re really being aggressive. The mistake is usually accidental, but people trying to assert themselves can easily create problems if they’re not sure of the differences between the two. Therefore, before I continue, allow me to lay out some clearer definitions. Aggressive people score high on their ability to get their views heard and their needs met, but they score low on their ability to genuinely consider other people’s point of view. Quite frankly, they’re going to “win,” and they don’t really care what others want. In some cases people become ultimately aggressive. Not only will they fight to win, they’ll also fight to ensure you lose. Clearly, being aggressive is unhealthy for workplace progress. Passive people are the opposite WWW.MEDICALDEALER.COM

Dan Bobinski Workplace Consultant

of aggressive. They are very adept at considering other people’s perspective and allowing others to get their needs met, but they rarely stand up for what is rightly theirs. And, because they won’t be firm when it comes to getting their own needs met, they can build up a lot of unspoken resentment, or, as it’s also called, tension. As you can imagine, passive behavior in the workplace is also unhealthy. Thirdly, we have people who are passive-aggressive (and frankly, I feel sorry for this group). These are folks who won’t honestly and openly state what they want, nor will they strive to truly consider other people’s point of view. As such, they struggle with

seeing the bigger picture and often see themselves as blameless victims. People in this group are often considered catty and their passive form of hostility always carries plausible deniability. If you’ve been around this type of person, you know it’s an unhealthy position to take and not good for workplace progress. Finally we have assertive people – those who will truly seek another’s point of view, working so the other party gets what they need while also standing up for their own needs and not allowing themselves to be walked on. Assertive people are a refreshing breath of fresh air in the workplace. It seems they are always striving to get things done while working to ensure everyone is rowing together in the same general direction. As mentioned earlier, assertiveness is the healthiest place to be. That said, it usually takes a very conscious choice and a fair amount of practice to be assertive. Aggressive people have to learn empathy while passive people must develop courage and balance it with their existing empathy. Passive-aggressive people will have the most difficulty transitioning to assertiveness. They’ll usually need a lot of personal healing first, because their whole sense of survival is based on their ability to deflect and distort reality. In the Oxford English Dictionary, MEDICALDEALER 83

Essentially, think of assertiveness being based on a mindset that says “I want to win, but I’m not going to walk over you to do it – I’m going to respect what you want and work to help you get your win, too.”

the verb “assert” means “to state an opinion, claim a right, or establish authority.” Obviously, this is to be encouraged as it’s part of the assertiveness equation, but to be assertive includes the former plus the practice of maintaining a high regard for what other people want or need. Best-selling author Stephen Covey would have called this mindset “winwin thinking.” Essentially, think of assertiveness being based on a mindset that says “I want to win, but I’m not going to walk over you to do it – I’m going to respect what you want and work to help you get your win, too.” What Stephen Covey emphasized, but many people struggle with, is our need to be thinking win-win. Way too often I hear people giving lip service to achieving win-win outcomes, but their thinking is still win-lose 84 MEDICALDEALER | NOVEMBER 2014

(aggressiveness). When one’s thinking is not geared toward helping other people get what they want in addition to achieving a win for one’s self, then achieving win-win outcomes pretty much falls to random chance. If you find yourself being either passive or aggressive and want to move into being assertive, Covey’s Habit Five is an excellent process: “Seek first to understand, then be understood.” In this axiom we see the balance: An ability to genuinely consider someone else’s point of view (seek first to understand), and an ability to stand up and get your needs met (then be understood). Unfortunately, too often when passive people have grown tired of their needs not being met and they finally stand up to voice their desires, they’ll jump straight to aggressive-

ness. In other words, they go from acquiescing to the needs of others to totally ignoring the needs of others. This is a common mistake, so it’s important that passive people understand the need for a balance. Personally, I think the order of Covey’s instruction is excellent, because by first seeking to understand someone else’s point of view, you’re establishing the groundwork for an attitude and practice of fairness. In other words, since you took the time to genuinely understand the other person’s point of view, it’s only fair that you be heard and understood as well. The key, in my experience, is to be sure to strive for a balance. Granted, sometimes one has to “be political” and pick one’s battles, but the more balance there is in seeking to understand and seeking to be understood, the healthier your communications – and your workplace – will be. DAN BOBINSKI is a certified behavioral analyst, author of the best-selling “Creating Passion-Driven Teams” and president of Workplace-Excellence.com. He travels internationally helping organizations of all shapes and sizes. Reach him at dan@workplace-excellence.com or 208-375-7606.

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CATEGORICAL INDEX ANESTHESIA Paragon Service…………………………………………… 68 ASSOCIATIONS IAMERS…………………………………………………………… 36 AUCTION/LIQUIDATION Government Liquidation…………………………… 44 Hilditch Group Ltd………………………………………… 29 MedWrench…………………………………………………… 87 BATTERIES Eastern Diagnostic Imaging……………………… 63 Holden Battery Services……………………………… 42 BIOMEDICAL AMX Solutions.……………………………………………… 73 AIV Inc.…………………………………………………………… 35 Bayer Healthcare Services.…………………… 2, 60 BETA Biomed Services, Inc.………………………… 87 Conquest Imaging………………………………………… 13 Crothall………………………………………………………………4 InterMed Biomed………………………………………… 80 Maull Biomedical Training, LLC………………… 72 Medical Specialties Distributors……21, 25, 31 MedWrench…………………………………………………… 87 Trisonics……………………………………………………………7 CABINETS/CARTS Bryton Corporation……………………………………… 34 CARDIOLOGY J & M Trading…………………………………………………… 81 ReMed Equipment………………………………………… 53 CAREER SERVICES Health Tech Talent Management, Inc.……… 86 C-ARMS Eastern Diagnostic Imaging……………………… 63 COMPUTED TOMOGRAPHY East Coast Medical Systems……………………… 81 Ed Sloan & Associates………………………………… 77 Imaging Affiliates………………………………………… 62 Metropolis International……………………… 64-67 MIT/Medical Imaging Technologies…………… 33 Tri-Imaging……………………………………………………… 26 CT A+ Medical Company Inc.…………………………… 72 Asset Management Associates, LLC.………… 42 East Coast Medical Systems……………………… 81 Ed Sloan & Associates………………………………… 77 Imaging Affiliates………………………………………… 62 International Medical Equipment & Service …………………………………… 79 J & M Trading…………………………………………………… 81 KEI Medical Imaging Services…………………… 76 Technical Prospects…………………………………… IBC

88 MEDICALDEALER | NOVEMBER 2014

DIAGNOSTIC IMAGING A+ Medical Company Inc.…………………………… 72 AMX Solutions.……………………………………………… 73 Brandywine Imaging, Inc.…………………………… 73 Eastern Diagnostic Imaging……………………… 63 J & M Trading…………………………………………………… 81 Multi Imager Service……………………………………BC North American MRI Parts………………………… 90 TROFF Medical……………………………………………… 43 Signature MRI, Inc.……………………………………… 33 EMPLOYMENT SERVICES Health Tech Talent Management, Inc.……… 86 ENDOSCOPY Endoscopy Specialists………………………………… 87 HMB Endoscopy Products…………………………… 76 Mobile Instrument Service & Repair………… 14 S.H. Medical Corporation……………………… 21, 31 GENERAL Eastern Diagnostic Imaging……………………… 63 Government Liquidation…………………………… 44 MedWrench…………………………………………………… 87 PartsSource, Inc.…………………………………………… 20 Puma Export, Inc.………………………………………… 69 Remarket Medical………………………………………… 82 IMAGING/PARTS A+ Medical Company Inc.…………………………… 72 Ampronix……………………………………………………………6 AMX Solutions.……………………………………………… 73 Diagnostic Solutions…………………………………… 69 Eastern Diagnostic Imaging……………………… 63 InterMed Ultrasound…………………………………… 62 InterMed NucMed………………………………………… 41 J & M Trading…………………………………………………… 81 PartsSource, Inc.…………………………………………… 20 ReMed Equipment………………………………………… 53 Technical Prospects…………………………………… IBC Tri-Imaging……………………………………………………… 26 TROFF Medical……………………………………………… 43 INFUSION THERAPY AIV Inc.…………………………………………………………… 35 Medical Specialties Distributors……21, 25, 31 INFORMATION TECHNOLOGY Tesseract………………………………………………………… 31 INTERNET RESOURCES MedWrench…………………………………………………… 87 LABORATORY MIT/Medical Imaging Technologies…………… 33 Ozark Biomedical………………………………………… 69 LASER IMAGERS Multi Imager Service……………………………………BC

LIGHTS Bryton Corporation……………………………………… 34 LUNG SIMULATION & FLOW INTRUMENTATION Hans Rudolph Inc.………………………………………… 82 MAMMOGRAPHY Digitec Medical Service Corp.……………………… 86 MODULE/TELEMETRY Bio-Medical Equipment Service Co.…………… 30 MONITORS/CRTs Advanced Ultrasound Elec./AUE………………… 10 Ampronix……………………………………………………………6 Enment Corp.………………………………………………… 25 Technical Prospects…………………………………… IBC TROFF Medical……………………………………………… 43 MRI Asset Management Associates, LLC.………… 42 Cool Pair Plus………………………………………………… 34 East Coast Medical Systems……………………… 81 Ed Sloan & Associates………………………………… 77 Enment Corp.………………………………………………… 25 KEI Medical Imaging Services…………………… 76 MIT/Medical Imaging Technologies…………… 33 ScanMed………………………………………………………… 82 Signature MRI, Inc.……………………………………… 33 NUCLEAR MEDICINE E.L. Parts………………………………………………………… 73 InterMed NucMed………………………………………… 41 International X-Ray Brokers……………………… 81 J & M Trading…………………………………………………… 81 Universal Medical Resources, Inc.……………… 41 PATIENT MONITORING BETA Biomed Services, Inc.………………………… 87 Bio-Medical Equipment Service Co.…………… 30 Pacific Medical……………………………………………… 52 ReMed Equipment………………………………………… 53 Rieter Medical Services……………………………… 42 Sage Services Group……………………………………… 81 PHANTOMS ATS Laboratories, Inc.…………………………………… 53 PROBES/PROBE REPAIR Conquest Imaging………………………………………… 13 RADIOLOGY A+ Medical Company Inc.…………………………… 72 Carestream Health, Inc.…………………………………3 Eastern Diagnostic Imaging……………………… 63 Enment Corp.………………………………………………… 25 Holden Battery Services……………………………… 42 International X-Ray Brokers……………………… 81 InterMed Ultrasound…………………………………… 62

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Categorical Index InterMed NucMed………………………………………… 41 J & M Trading…………………………………………………… 81 Maull Biomedical Training, LLC………………… 72 Metropolis International……………………… 64-67 Multi Imager Service……………………………………BC QAL Manufacturing……………………………………… 53 Radon Medical……………………………………………… 85 Rayence…………………………………………………………… 61 ScanMed………………………………………………………… 82 Technical Prospects…………………………………… IBC TROFF Medical……………………………………………… 43 Varian Medical Systems…………………………………9 RADIOLOGY PARTS AMX Solutions.……………………………………………… 73 Asset Management Associates, LLC.………… 42 InterMed Ultrasound…………………………………… 62 InterMed NucMed………………………………………… 41 J & M Trading…………………………………………………… 81 TROFF Medical……………………………………………… 43 RECRUITING Adel-Lawrence Associates, Inc.………………… 21 REPAIR/REFURBISH Advanced Ultrasound Elec./AUE………………… 10 AIV Inc.…………………………………………………………… 35 Ampronix……………………………………………………………6 AMX Solutions.……………………………………………… 73 Bio-Medical Equipment Service Co.…………… 30 Bryton Corporation……………………………………… 34 Conquest Imaging………………………………………… 13 Continental Equipment Company…………… 62 Crothall………………………………………………………………4 Digitec Medical Service Corp.……………………… 86 Eastern Diagnostic Imaging……………………… 63 Ed Sloan & Associates………………………………… 77 Endoscopy Specialists………………………………… 87 International Medical Equipment & Service …………………………………… 79 KEI Medical Imaging Services…………………… 76 MedWrench…………………………………………………… 87 MIT/Medical Imaging Technologies…………… 33 Mobile Instrument Service & Repair………… 14 Multi Imager Service……………………………………BC Pacific Medical……………………………………………… 52 QAL Manufacturing……………………………………… 53 Radon Medical……………………………………………… 85 Rieter Medical Services……………………………… 42 Sage Services Group……………………………………… 81 TROFF Medical……………………………………………… 43 REPLACEMENT PARTS A+ Medical Company Inc.…………………………… 72 Advanced Ultrasound Elec./AUE………………… 10 AIV Inc.…………………………………………………………… 35 ALCO Sales and Service………………………………… 25 AllParts Medical…………………………………………… 15 Classic Diagnostic Imaging………………………… 77 Conquest Imaging………………………………………… 13

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Continental Equipment Company…………… 62 Diagnostic Solutions…………………………………… 69 Digitec Medical Service Corp.……………………… 86 E.L. Parts………………………………………………………… 73 Ed Sloan & Associates………………………………… 77 Government Liquidation…………………………… 44 J & M Trading…………………………………………………… 81 International Medical Equipment & Service …………………………………… 79 KEI Medical Imaging Services…………………… 76 MTC/Medical Technologies Co.…………………… 85 Multi Imager Service……………………………………BC MW Imaging…………………………………………………… 24 National Ultrasound…………………………………… 35 North American MRI Parts………………………… 90 Ozark Biomedical………………………………………… 69 PartsSource, Inc.…………………………………………… 20 Radon Medical……………………………………………… 85 Signature MRI, Inc.……………………………………… 33 Technical Prospects…………………………………… IBC TROFF Medical……………………………………………… 43 Varian Medical Systems…………………………………9 RESPIRATORY Enment Corp.………………………………………………… 25 Hans Rudolph Inc.………………………………………… 82 Medical Specialties Distributors……21, 25, 31 SOFTWARE Tesseract………………………………………………………… 31 STERILIZERS Enment Corp.………………………………………………… 25 Continental Equipment Company…………… 62 Government Liquidation…………………………… 44 InterMed Biomed………………………………………… 80 MTC/Medical Technologies Co.…………………… 85 SURGICAL Bryton Corporation……………………………………… 34 Eastern Diagnostic Imaging……………………… 63 Endoscopy Specialists………………………………… 87 International Medical Equipment & Service …………………………………… 79 Mobile Instrument Service & Repair………… 14 S.H. Medical Corporation……………………… 21, 31 SURPLUS MEDICAL Government Liquidation…………………………… 44 Hilditch Group Ltd………………………………………… 29 TABLES Bryton Corporation……………………………………… 34 TRANSFORMERS Bridgeport Magnetics Group Inc.…………………5 TUBES/BULBS AllParts Medical…………………………………………… 15 Imaging Affiliates………………………………………… 62

J & M Trading…………………………………………………… 81 International Medical Equipment & Service …………………………………… 79 Technical Prospects…………………………………… IBC ULTRASOUND Advanced Ultrasound Elec./AUE………………… 10 ATS Laboratories, Inc.…………………………………… 53 Bayer Healthcare Services.…………………… 2, 60 Conquest Imaging………………………………………… 13 Diagnostic Solutions…………………………………… 69 Endoscopy Specialists………………………………… 87 InterMed Ultrasound…………………………………… 62 Medcorp, LLC………………………………………………… 19 Mobile Instrument Service & Repair………… 14 National Ultrasound…………………………………… 35 Trisonics……………………………………………………………7 ULTRASOUND PARTS Advanced Ultrasound Elec./AUE………………… 10 Conquest Imaging………………………………………… 13 InterMed Ultrasound…………………………………… 62 Medcorp, LLC………………………………………………… 19 Mobile Instrument Service & Repair………… 14 MW Imaging…………………………………………………… 24 VCR REPAIR/SERVICES Advanced Ultrasound Elec./AUE………………… 10 Conquest Imaging………………………………………… 13 VENTILATORS Government Liquidation…………………………… 44 VIDEO Endoscopy Specialists………………………………… 87 Multi Imager Service……………………………………BC X-RAY A+ Medical Company Inc.…………………………… 72 Brandywine Imaging, Inc.…………………………… 73 Carestream Health, Inc.…………………………………3 Classic Diagnostic Imaging………………………… 77 Diagnostic Solutions…………………………………… 69 Eastern Diagnostic Imaging……………………… 63 Government Liquidation…………………………… 44 Holden Battery Services……………………………… 42 Imaging Affiliates………………………………………… 62 MIT/Medical Imaging Technologies…………… 33 Rayence…………………………………………………………… 61 RTI Electronics……………………………………………… 85 Tri-Imaging……………………………………………………… 26 X-RAY PARTS AMX Solutions.……………………………………………… 73 Imaging Affiliates………………………………………… 62 J & M Trading…………………………………………………… 81 Technical Prospects…………………………………… IBC TROFF Medical……………………………………………… 43

MEDICALDEALER 89

ALPHABETICAL INDEX

A+ Medical Company Inc. ………………………… 72 Adel-Lawrence Associates, Inc.………………… 21 Advanced Ultrasound Elec./AUE ……………… 10 AIV Inc. ………………………………………………………… 35 ALCO Sales and Service ……………………………… 25 AllParts Medical ………………………………………… 15 Ampronix …………………………………………………………6 AMX Solutions. …………………………………………… 73 Asset Management Associates, LLC. ……… 42 ATS Laboratories, Inc. ………………………………… 53 Bayer Healthcare Services. ………………… 2, 60 BETA Biomed Services, Inc. ……………………… 87 Bio-Medical Equipment Service Co.………… 30 Brandywine Imaging, Inc. ………………………… 73 Bridgeport Magnetics Group Inc. ………………5 Bryton Corporation …………………………………… 34 Carestream Health, Inc. ………………………………3 Classic Diagnostic Imaging ……………………… 77 Conquest Imaging ……………………………………… 13 Continental Equipment Company ………… 62 Cool Pair Plus ……………………………………………… 34 Crothall ……………………………………………………………4 Diagnostic Solutions ………………………………… 69 Digitec Medical Service Corp.…………………… 86 E.L. Parts ……………………………………………………… 73 East Coast Medical Systems …………………… 81 Eastern Diagnostic Imaging …………………… 63 Ed Sloan & Associates ……………………………… 77 Endoscopy Specialists ……………………………… 87 Enment Corp. ……………………………………………… 25 Government Liquidation ………………………… 44 Hans Rudolph Inc. ……………………………………… 82 Health Tech Talent Management, Inc. …… 86 Hilditch Group Ltd ……………………………………… 29 HMB Endoscopy Products ………………………… 76 Holden Battery Services …………………………… 42 IAMERS ………………………………………………………… 36 Imaging Affiliates ……………………………………… 62 InterMed Ultrasound ………………………………… 62 InterMed NucMed ……………………………………… 41 InterMed Biomed ……………………………………… 80 International Medical Equipment & Service ………………………………… 79 International X-Ray Brokers …………………… 81 J & M Trading………………………………………………… 81 KEI Medical Imaging Services ………………… 76 Maull Biomedical Training, LLC ……………… 72 Medcorp, LLC ……………………………………………… 19 Medical Specialties Distributors …21, 25, 31 MedWrench ………………………………………………… 87 90 MEDICALDEALER | NOVEMBER 2014

Metropolis International …………………… 64-67 MIT/Medical Imaging Technologies ………… 33 Mobile Instrument Service & Repair ……… 14 MTC/Medical Technologies Co. ………………… 85 Multi Imager Service …………………………………BC MW Imaging ………………………………………………… 24 National Ultrasound ………………………………… 35 North American MRI Parts ……………………… 90 Ozark Biomedical ……………………………………… 69 Pacific Medical …………………………………………… 52 Paragon Service ………………………………………… 68 PartsSource, Inc. ………………………………………… 20 Puma Export, Inc. ……………………………………… 69 QAL Manufacturing …………………………………… 53 Radon Medical …………………………………………… 85 Rayence ………………………………………………………… 61 Remarket Medical ……………………………………… 82 ReMed Equipment ……………………………………… 53

Rieter Medical Services …………………………… 42 RTI Electronics …………………………………………… 85 S.H. Medical Corporation …………………… 21, 31 Sage Services Group…………………………………… 81 ScanMed ……………………………………………………… 82 Signature MRI, Inc. …………………………………… 33 Soma Technology, Inc. ……………………………… 43 Southwestern Biomedical Electronics, Inc. …………………………………………… 35 Technical Prospects ………………………………… IBC Tesseract ……………………………………………………… 31 Tri-Imaging …………………………………………………… 26 Trisonics …………………………………………………………7 TROFF Medical …………………………………………… 43 Unfors RaySafe, Inc. ………………………………………8 Universal Medical Resources, Inc. …………… 41 Varian Medical Systems ………………………………9

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