Aesthetic Devices: How to Assess If It’s a Good Fit (Part 1)

How many conversations do you have a week about whether to purchase a new device? Established physicians want to keep their practices fresh with new offerings. New grads feel overwhelmed by the options and cost. So the question on everyone’s lips: What device should I buy next? I’m not going to answer that question. Instead, what follows are my very practical Heideas on how to be a smarter purchaser, whatever you choose to buy.

After fellowship, I made a grid with the list of diagnoses I wanted to be able to treat on one axis and the category of devices on the other. For example, when I began in the mid-90s, treating port wine stains in adults and children and hemangioma in infants was important. Today there are medical treatments for hemangiomas; babies and young children with port wine stains can be treated at laser centers under anesthesia and few adults weren’t treated as kids.

Who makes up the majority of your patient population? Think about age, race, gender, degree of sun damage, and discretionary income level. These factors will guide the diagnoses, device risk of post-inflammatory hyperpigmentation, and depth of treatments you’ll want to provide. Will you be asked to treat individual telangiectasia and lentigines or just large areas? Will patients be willing to pay out of pocket for acne treatment?

Realistically, how many tattoos will you see? Are more patients getting them than seeking to remove them? Do you see significantly more Fitzpatrick type I – III skin, IV – VI skin, or an even mix?

When I started in practice, I was the only one handling devices. Twenty-five years later, the opposite is true for most of us. It will depend on your comfort level, patient expectations, staffing, and the laws in your state. If it’s you, do you really have time in your schedule? If it’s an extender, can they do it when you are out of the office or only when you are there? How many staff will you train? And, what happens if your trained staff leaves? Will the device sit unused or can someone else jump in to treat patients? (This happens more than you might think!)

How much space do you have for the device and doing the procedure? Some devices are compact; they can be moved easily between rooms. Other devices are bulky and require a specific voltage outlet. Can you move around them to use that room for other things? Given the length of the procedure, would that room be better used for something more profitable? If it’s a multi-functional device, how will you avoid or handle having two patients scheduled for two different purposes using the same device at the same time?

Will the device fulfill an unmet demand in your practice or area? For example, many communities are packed with discount laser hair removal and fat reduction “factories.” Are there enough patients within your practice who would prefer to have the procedure there and can you offer something different to attract new patients? Is it something happy patients can repeat? Are they likely to refer their friends and family? Is the price point necessary to make the device profitable proportional to the results and palatable to patients? Is it worth it just to keep patients within your office walls? Does it allow you to treat something new or provide a significantly better way of treating something you already do? Don’t assume that a new device will be profitable just because it is new or because you have the first on the block.

Even with careful thought, you’ll make mistakes. We all have a very expensive door stop or even a device graveyard somewhere in our offices. But the smart purchases—those profitable devices that pay for themselves in months—make up for them.

Stay tuned for more about device purchases. Part II—Getting a fair deal: it’s not just about the price!