Equipment and consumable supplies are part of the cost of doing business in any practice and will definitely have an impact on your bottom line. Are you paying too much or perhaps purchasing unneeded supplies? Here are some tips to help you keep those costs under control.

Buy Generics
When shopping for supplies, you can often find "generic" products at substantial discounts -- sometimes even as much as 50% less than the cost that you might get at a medical or specialty supply house. For example, I priced paper supplies such as toilet paper and paper towels at a medical supply catalog and found them for substantially less at Costco.  We also find excellent prices for our copy paper and other supplies. My suggestion is to definitely shop around. You never know where you will find items.

Try eBay
I have found many clinically related items on eBay. For example I purchased my otoscope and ophthalmoscope on eBay for about half the price that I found from a supplier. They were brand-name (Welch Allyn) items and in excellent condition. In addition, I often get urine analysis tests and probes for my ear thermometer at about 50% less than I can get them at my favorite medical supply house. I always check for expiration dates, as well as the feedback on that particular seller. When you find sellers that you like and trust, you'll want to use them again.

Find It Locally on Craigslist
Craigslist is rather interesting because often you can find items locally. I have found practices closing and selling off equipment. However, you have to be quick in order to get good buys (I wasn't). I've heard from plenty of other providers who have used Craigslist to outfit their office.

Buy From Closing Office
If your community is a larger community, you may find that there are offices closing either through retirement and other causes. Those offices just may be thrilled to sell off their equipment and supplies. This not only helps you, it helps out your fellow providers as well.

Buy Secondhand
You may find that hospital or local practices may be upgrading their equipment and looking for ways to liquidate their current equipment. It wouldn't hurt to call your local hospital and just make sure that they know what you're looking for. Indeed, they may have a storeroom of supplies that they'd be happy to part with for a substantial discount.

Medical Supply Liquidators
When shopping at medical supply liquidators, you'll want to be particularly careful of the equipment that you're getting. Often it is sold "as is" with no guarantees. You'll want to make sure that the item is in good working order, and that the price is something that makes sense. However, you don't want to shop just on price. For example I nearly purchased two used exam tables when I first opened from one of these liquidators. But when I compared them to new tables, I found I would only save about $200 per table (before the shipping cost). Instead, I purchased new, upgraded tables better suited to my patient population. These new tables included free delivery, setup and a warranty.

State Surplus
Many of our office furnishings came from our state surplus program. We found excellent waiting room chairs for about a quarter of the price I would have paid for each had I purchased them new. We also found plenty of filing cabinets, break room chairs, bookcases and much more. At the surplus store, many of the items were not in the best shape. It may take several visits and careful evaluation to find the gems, but they are there.

Computer Equipment
When it came to our computers, I purchased a mix of new and refurbished. Because we do peer-to-peer networking in the office, we don't have a separate server. My desktop computer that sits on my desk, acts as the practice server. That computer, along with the front desk computer, were purchased new. The laptops that are in the exam rooms, as well as the laptop for our clinical assistant, were all purchased refurbished on eBay. We've not had any problems with our machines.

Computer Software
We've been able to keep our software requirements to a minimum by using open-source software. For example in place of Microsoft's Office, we use OpenOffice. OpenOffice can read any Microsoft office document, spreadsheet or PowerPoint file. In addition to OpenOffice, Google now has its own alternative -- Google Docs. We also were able to set up an office e-mail system using Google's Gmail. The only other software that we were really required to purchase was an a health information/electronic medical records system. We use Amazing Charts, which meets our needs just fine.

eSurg
As far as consumable medical supplies, there are several vendors more than willing to assist you. My favorite, particularly for the small office is eSurg. I can often buy supplies in very small quantities, which avoids us having excess costs and waste.

Medications
One of the things you'll need to keep in mind, especially for medications, is their expiration dates. When ordering medications from a supply house, you'll really want to pay attention to those expiration dates. This is especially true for vaccines. Once you know the volume and the needs of your practice, you'll be able to judge this more closely. As an aside, something to keep in mind especially with refrigerated medications and supplies, is power outages. Our first year we were hit with two major power outages and lost all of our vaccines. The second year, we were more prepared, and only lost about 10 flu vaccines. Even your best backup system may fail depending on what's happening in your community.

Final Tips
It's highly important to keep track of the supplies that you are using and the ones that you don't use so often. Don't forget to get feedback from your staff as far as what's working and what's not. Keep an ample supply of batteries and replacement lights on hand, as you never know when you'll need them.

One last thing: If you have to purchase or lease equipment, check with your accountant for the latest updates regarding Section 179 of the tax code. Under sec179 you will be able to fully deduct the price of your equipment (within limits) from you annual taxes in the year of purchase as opposed to depreciation credits over several years.

Having the proper equipment and supplies, purchased responsibly, will assist us with our practices bottom line, as well as help us do what we do best: provide excellent care.

Barbara Phillips is a family and gerontologic nurse practitioner who owns Aberdeen Primary Care in Aberdeen, Wash. She also works with NPs who wish to fulfill their own dreams of business ownership. Reach her through her Web site www.NPBusiness.org.