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I'm a radiologist and writing helps me make sense of the world.

"My method is to take the utmost trouble to find the right thing to say, and then to say it with the utmost levity" -George Bernard Shaw

Tuesday 14 January 2014

How to buy a scanner

Scanners and radiologists exist in an uneasy symbiosis; one cannot function without the other. Scanners and radiologists are expensive; both need to be chosen carefully. Scanners and radiologists can malfunction; an engineer with the right spanner can usually sort one of them out. Scanners and radiologists eventually wear out; both are needlessly difficult to replace.

In an ideal world, if the old scanner was any good you’d simply ring up the company and order exactly the same, but more modern. Like the family that buys the same brand of car each time. There is a lot to be said for this approach. You know what you are getting, you develop a close relationship with the local dealers and you generally get a good price. It generally works well.

Better the devil you know?
However, it won’t do in the modern NHS. Acquisition of new kit has to be transparent, fair and completely above board. Choosing between different manufacturers has to be for better reasons than “we always buy one of those”, “we liked the colour” or “the MD is a family friend”. And to be honest, if you are responsible for spending several hundred thousand pounds of taxpayers’ money then it is only right and fair that we procure diligently.

In recent years, my hospital has bought more than its fair share of scanners. We have a new hospital building than opens in a few months that is equipped with entirely new scanners. And, yes, I admit that there is an element of joy in getting new kit. The inner geek admires its scanning prowess, the inner aesthete admires its sleek construction and the inner child revels in having new toys.

But the procurement of new scanner isn’t all cakes and ale: it is like pregnancy. It is a months long process (and feels much longer), you can feel physically sick at times, you worry about the new baby and are never quite relaxed until it is delivered. Only to find it is a lot more complicated than you expected.

So here are a few hints and tips to help you through this difficult time:
  • Set a realistic timescale. Allow plenty of time to evaluate and chose your new scanner. On no account rush this because of extrinsic factors. Just because the money has to be “spent by the end of the financial year” is irrelevant. 
  • Construct an objective rating scale. This may match the features of the preferred scanner but it is wise not to produce a facsimile of it’s operating spec. 
  • Don’t believe the brochure. Of course they’ll show the best images produced by that scanner. You have to go and see it in action.
  • Watch out for flattery and bribery. The more the beautiful rep laughs at your jokes and the more expensive the meal you are treated to, the less you should buy their scanner. A good scanner should sell itself.
  • Avoid technological innovation. It is very tempting to look at a new feature as inherently better. Innovation is a value-laden term: ‘early adopters’ are groovy and cutting-edge. Or at least that is what the scanner sales team wants you to believe. Be a “late adopter”; stick to proven and mature technology.
  • Beware bells and whistles. The assumption is that the more features a scanner has, the better it will work. In reality, 95% of scanner use is pressing no more than 5 different buttons. Complex stuff gets ignored or often just doesn’t work.
At the end this long process of visits and evaluations, the manufacturers will make formal offers which is when it gets quite exciting. After this lengthy period of techo-lusting, the decision point is nigh. At which point, your manager secretly throws all the evaluation out of the window and buys the cheapest scanner.

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