A few years ago, while interviewing candidates for an opening on my staff, I almost let the best person for the job slip through my fingers. He was a very bright young guy, fresh out of college, with lots of enthusiasm for his first professional position. I offered him the job, and he took it. But later he told me that he almost didn’t. Not because the position didn’t appeal to him—it was because of the huge old-fashioned CRT computer monitor sitting on my desk during the interview, and the message it conveyed about our company.

This was just after flat-screen computer monitors had become the norm. Sure, my trusty old monitor was big and bulky, but it still worked just fine, so I didn’t see any reason to waste good money replacing it. As a co-owner of a small business, where cash is always tight, I was being financially prudent. But to the job candidate, we looked behind the times. We looked like cheapskates. It didn’t create a very positive first impression of the company we were asking him to join.

Looking over the results of this month’s annual technology survey, I wondered if some practices might be in danger of creating the same sense of unease—in staff members and also patients. Especially patients.

The majority of survey respondents (54%) tell us they’re going to spend $20,000 or less next year on new equipment, and in fact 35% will spend zero to $10,000. Practice sizes vary wildly, of course, but according to our most recent income survey (October 2011), the average gross revenue of a self-employed O.D. practice was about $500,000. That means over a third of respondents will invest only 2% or less of their gross revenue in new equipment. (Apologies to the statistics sticklers who noticed that I combined two different datasets just now.)

It’s never easy to spend freely in a tight economy, so sometimes you have to make sacrifices—we’ve all been there. But that fiscal prudence didn’t jibe with another finding in the survey: 83% of respondents said that their latest technology investment increased their profitability (“somewhat” for 74% and “dramatically” for 9% of respondents). If you can make at least some money from an investment—and it’ll help improve patient care at the same time and it’ll boost your image as a contempory, cutting-edge practice—why wouldn’t you?

Still, I know that the “if it ain’t broke, don’t fix (or replace) it” impulse is strong. Speaking with an equipment manufacturer at the Vision Expo West meeting earlier this month, I asked if he had any data on how often optometrists replace their fundus cameras. Indeed he did. He said their data showed the replacement cycle was 89 months on average. That’s a product life of about seven and a half years, for a product that evolves pretty rapidly. Are you using the same computer you had in April 2005? How about cell phone? I sure hope not.

There’s certainly nothing wrong with using equipment that has served you well and has long since been paid off. (The equipment vendor also said that it takes about 24 months for a practice to recoup the instrument cost via billings.) But one of the exciting things about being in a technology-driven field like optometry is the opportunity to periodically reinvent and refine your craft, using the latest gizmos. Your job gets easier and, frankly, more fun. Sometimes that alone can overcome the sticker shock.

And the cachet value of using the very latest technology cannot be denied. When the original iPad came out in 2010, I bought one that first month—and headed down to the ARVO conference the next day. In meeting after meeting with doctors and industry representatives, all anyone wanted to talk about was the iPad. In fact, for a whole year that was still the first topic of conversation at all my meetings. I’m sure it left a positive impression with people. (Yes, I’ve come a long way since my “vintage” CRT monitor days.)

But none of this means you should go easy on the equipment vendors. Times are tough, so they need to be explicit with you about how their fancy new device will: (a) improve patient care and (b) pay for itself. You, your patients and your practice won’t gain anything if it’s just a white elephant.

Jack Persico
Editor-in-Chief