Maggie Adams, RN, CSN, the director of the Plaza Surgery Center in Bala Cynwyd, Pa., says she's never regretted buying refurbished equipment. She saved $2,000 to $3,000 on an OR monitor and she'll receive a free loaner if the refurbished equipment happens to break down. Ms. Adams continues to have positive experiences in buying refurnished equipment. Read on to ensure you do the same.

Beyond the savings
So, just how much can you save off the retail sticker when you buy refurbished? Anywhere from 40 to 60 percent, according to the companies we called. A new Amsco 3085 SP surgical table, for instance, sells for between $32,000 and $34,000 and ACE Medical Equipment sells a refurbished one for $18,500. Retail price for a Skytron 6500HD Hercules table can range anywhere from $40,000 to $50,000. Medrecon, Inc., says it will rebuild and sell an old one for $13,000. A new endoscope model PCF160AL would cost between $24,000 and $25,000. HMB Endoscopy Products sells it refurbished for $14,000.

These savings are the obvious benefits of buying used equipment, but you also have to balance safety and performance with bottom-line concerns. Here are some tips to guarantee the equipment you buy is the only thing that gets used.

• Understand the extras. In addition to lower prices, many refurbished equipment companies offer incentives like extended warranties, technical support, on-site service and free loaners. Harry Bauxman of HMB Endoscopy Products in Holly-wood, Fla., says his company offers a free 90-day upgrade policy. Facilities have up to three months to return equipment for full credit toward a higher-end system.

Mr. Bauxman, however, advises that you ask specific questions about the offered warranty. HMB, for instance, provides a two-year extended warranty, but won't continue the warranty for the second year unless you ship the equipment to the company after 12 months of use so technicians can inspect it.

Some warrantees cover all parts, but don't cover necessary labor for repairs. You want a warranty that covers both, say experts.

• Get personal. Ms. Adams recommends you find a dependable contact at a reliable company. "I think it's a good idea to have one person you can go to and rely on to save you the most money," she says. "Someone who will be familiar with the equipment you have purchased in the past, and will therefore be able to give you recommendations for other pieces that fit your needs."
• Make a visit. "Find out where it's being refurbished and go to the site, if it's possible, to see where the work is being done," says Brad Stetler, RN, the administrative director of Atlantic Surgery Center in Pompano Beach, Fla. "I would also request as much information about the people who are doing the work. For example, ask how long employees have been working on certain types of equipment. Then I would ask for customer references - that's where you will get the best idea of who you're dealing with and what you're going to get."
• Be specific. Companies that focus on specific fields of equipment are often your best option, say experts. "You need to go to someone who's specialized in the field you're buying in," says Mr. Bauxman. "If you need a heart transplant, you're going to want to go to a heart specialist, not someone who does a little bit of everything."

Similarly, he advises you to use a company that specializes in one product - not one that dabbles in many. "Companies that focus on one specialty have more knowledge and expertise dealing with that specific piece of equipment than one who attempts to do it all," says Mr. Bauxman.

• Demand help fast. Reaching an expert voice when equipment breaks down should be quick and easy, says Wende Sitcer, accounts coordinator for Medrecon, Inc., in Garwood, N.J. She remembers receiving a call from a customer regarding an OR table stuck in the upright position. The situation was easily resolved with a push of the table's "reset" button, a solution relayed to the center during a brief phone conversation. Instead of a potentially devastating delay and an expensive on-site visit by a trained technician, the table was quickly fixed because help was readily available. "The company you work with should make themselves available, and the person who can help work through technical issues should be available to talk immediately," says Ms. Sitcer.
• Shop for quotes. Contact two or three vendors. Then research the equipment they offer before comparing vendor costs and warranties with the original manufacturer. Company Web sites are also an excellent investigative tool, says Ms. Sitcer. You should be able to view available products online, learn about the company's refurbishing process and get information on the technicians' credentials. A good rule of thumb, according to Ms. Sitcer: The company's reliability is often in proportion to the amount of detail on its Web site.

Buyer beware
Refurbishing companies provided some red flags to look for when choosing equipment. "Pricing that's so low, it's out of line with all other competitors," says Tom Yore, a spokesman for ACE Medical Products in Clearwater, Fla. "Also, look at the turnaround time. For example, we take 50 to 60 hours to refurbish an operating table. It takes a week alone to strip it down, sand it and paint it. If someone tells you he can rebuild a table in a few days, then he's not rebuilding it."

What about equipment dealers, those remarketers of new and used medical equipment? Are they nothing more, as some allege, than equipment finders who lack the ability to rebuild or repair the products they sell? Or are they reputable links in the supply chain that resell used equipment to refurbishing companies and directly to end-users?

"There are a few bad dealers in the business but to lump all of us together in one category is just a result of fear of competition," says John Mendez, founder of Med-Lab Exess, Inc. (formerly Junk-N-Treasures), in Lynchburg, Va. Mr. Mendez says 70 percent of his equipment has a 30-day warranty and customers have a seven-day right of return. If the equipment breaks down, he usually sends it to bio-technicians to fix. Mr. Mendez notes that he tries to avoid selling directly to surgery centers or physicians.

Be aware of buying used equipment in auction-based (eBay) style. "All equipment is sold 'as is, where is' and, once sold, equipment has been known to show up missing boards and other key components," one consultant told us.

Make sure you know the difference between used and rebuilt equipment. Used equipment has essentially been dusted off before the reselling, while rebuilt equipment has been restored both cosmetically and functionally, adding value to it. Ask specific questions about the work that has been done on the used equipment that you're thinking of buying. Refurbished equipment will have replacement batteries, rebuilt boards, replaced components - like buttons and monitors - and new front panels, says Mr. Yore.

Finally, don't be afraid to inquire about the technicians' credentials. You want to buy rebuilt equipment from individuals who have served as biomedical engineers in hospitals or have other medical equipment experience.

Smart shopping
When done right, buying refurbished is an effective means for trimming the fat off equipment budgets. But even though refurbished equipment might seem like a smart savings route, you must be careful and research the companies before making purchases. Look for sources with a solid reputation and customer-service mentality because investing in the wrong equipment or company will cost your facility in the long run.