Outfitting Your New Office (Part II)

Autoclave

Last week we guided you through the crucial challenge of furnishing an office. However tastefully designed and furnished, though, the office is worthless without the medical gear and provisions that are essential to the main purpose of the office: to diagnose and treat medical conditions. Now that your office is set up with cabinetry, filing systems, desks, and other fittings, you can begin filling it with the supplies and equipment required to get it running.

Medical Equipment/Diagnostics

The quality and functionality of a doctor’s office is directly dependent upon its working parts. Without proper, high-quality equipment, the physician’s diagnoses can be skewed, resulting in dangerous or even fatal errors and the demise of the practice.

Every office needs basic equipment to function properly. Doctors of all specialties will require a physician’s scale, stethoscope, and thermometer. Most regularly use a blood pressure monitor and diagnostic tools such as illuminators and scopes, often combined in sets or wall systems. Every physician will also want specialized diagnostic equipment to correspond to his or her specialty, such as cardiology, pulmonology, otolaryngology, ophthalmology, endoscopy, obstetrics/gynecology, or dermatology; we will be focusing on the basic equipment necessary in family practices as well as specialists’ offices.

Scales 

Scale

Many medical conditions are linked to weight, and a person’s weight is considered an important indicator of overall health. Virtually every doctor’s office has a scale of some sort to assist the physician in obtaining a full health report on his or her patient. A wide range of scale types and designs ensure that every practitioner will find one to suit his or her individual requirements and tastes. Pediatricians and family practitioners need baby scales, wet-diaper scales, and standard scales to help every patient get off to a healthy start in life. One may opt for a standard weigh-beam (mechanical) scale or a sophisticated digital scale with EMR connectivity and other features. A space-constrained office will benefit from a low-profile floor scale, while practices with wheelchair-bound or mobility-challenged patients may wish to have a chair or lift scale. Every style of scale is replete with options, from the most simple to the advanced, in various sizes, heights, designs, and functions, and with a plethora of accessories – such as bags, printers, counterweights, ramps, and replacement parts – to enhance its use. 

Thermometry 

Body temperature is another factor used to gauge patient health. As part of a typical physical exam, temperature monitoring must be performed accurately and reliably. Physicians may choose from infrared thermometers, ear thermometers, touch (surface or forehead) thermometers, digital stick and electronic thermometers (for oral, rectal, and axillary [under-arm] use), and a full line of accessories – such as probes, covers, and calibrators – for each kind of thermometer. Ear and infrared thermometers are recommended for pediatric use as they obtain temperature readings quickly and minimally invasively, ideal for small, squirmy patients. Many thermometers may be mounted to a wall or mobile stand for added convenience.

Stethoscopes 

A top-quality stethoscope is vital in most doctors’ exams. Many are satisfied with standard stethoscopes, but specialized stethoscopes are preferred by numerous physicians, particularly specialists. A Sprague stethoscope, for example, features interchangeable diaphragms and bells for pediatric and adult use, perfect for a family practice. Teaching stethoscopes, with dual binaurals and earpieces, are used in medical schools and teaching hospitals; sophisticated electronic stethoscopes improve sound quality; disposable stethoscopes are recommended for use in highly infectious settings; cardiologists, pediatricians, and veterinarians will likely choose dedicated stethoscopes for their purposes.

Illuminators/Diagnostic Heads

Equipment for the standard diagnostic exam, consisting of an ear and eye check, throat and mouth exam, and blood pressure, temperature, and pulse oximetry measurement, may be purchased separately or incorporated into an integrated wall system for convenience. Those who regularly perform more complete ear exams will need a hearing screener, or audiometer, for routine hearing tests in both pediatric and adult patients, while a simple ear wash system may provide an instant solution for clogged ears and affected hearing.

Welch Allyn Diagnostic Set

A diagnostic set, consisting of the main basic diagnostic tools for eye and ear exams, is suggested for offices administering routine physical exams numerous times daily due to their portability and convenience. Sets are available in several configurations – otoscope only, ophthalmoscope only, otoscope/ophthalmoscope, complete sets with illuminators, compact sets, pocket sets, desk sets – and include at least one diagnostic head (otoscope and/or ophthalmoscope), a handle, and accessories such as ear specula, extra lamps and batteries, and/or insufflators bulbs in a convenient, portable case. A pediatrician who performs countless ear exams for the common ear infection, for example, may opt for an otoscope-only set in a pocket or compact size for easy portability and access. An optometrist will likely choose a high-quality ophthalmoscope with multiple lenses and/or filters over a standard ophthalmoscope for more precise exams.

Some physicians may wish to keep the tools in the exam room rather than carry them around; for those, a desk set with a charger provides a more permanent location for the scopes. Doctors who regularly perform full exams – eye, ear, throat, and nose – will benefit from complete sets with illuminators and accessories, while those watching their budget or space limitations may select single-handle sets with interchangeable heads, pocket-sized sets, or compact sets with all components in one Swiss Army-style foldaway unit. Most sets include a choice of several otoscope and ophthalmoscope heads, handle types, cases, and accessories. Generally, ADC’s 2.5-volt sets are lower-cost without forfeiting quality and are available in a variety of configurations; Welch Allyn offers more sophisticated 2.5- and 3.5-volt sets with advanced diagnostic head options such as coaxial ophthalmoscopes and pneumatic otoscopes, battery choices, and customizability.

Welch Allyn Connex® 84MTVEC-B Integrated Wall System

A more sophisticated alternative to the diagnostic set is an integrated wall system. The wall system is installed on the exam room wall, providing a permanent “dock” for various diagnostic tools used in the standard physical exam. Wall systems are replete with options to serve virtually every office well. In their most basic form, they consist of a wall board and transformer to power and hold at least two diagnostic heads and handles. The systems are customizable and modular, meaning that physicians may purchase the basic model and add on to it whenever it becomes necessary and/or affordable. Fully-equipped systems may include any combination of other diagnostic tools such as a thermometer, blood pressure device, pulse oximeter, and vital signs monitor; they will also typically incorporate storage for small accessories such as ear specula. The two major types of wall systems, both by Welch Allyn, are the 777 Green Series (successor to the 767 Series and the more cost-effective and environmentally-friendly line, due to LED lamps and automatic on/off switches), and the Connex® system (featuring virtually every conceivable diagnostic instrument and accessory plus an advanced vital systems monitor and sophisticated EMR connectivity).

Vital Signs Monitoring

Vital signs monitoring has become a – pun intended – vital component of routine physical exams, diagnostics, and treatment plans. The term “vital signs” generally refers to the measurement of blood pressure, oxygen saturation (pulse oximetry), and temperature. A vital signs monitor features any combination of the three in one handy device for straightforward, uncomplicated monitoring, reducing the need for extra equipment. Many vital signs monitors are modular, like the wall systems, for customization and cost-effectiveness; their special functions may also include EMR connectivity, touch screens, integrated printers, and/or portability for even further ease of use. 

ADC ADview

ADC’s ADview® 9000™, for example, is a budget-friendly but full-featured vital signs monitor. It consists of three snap-together modules: a main blood pressure module and supplementary temperature and pulse oximetry modules that snap on and off effortlessly, with no tools required. This allows users to purchase any configuration of the monitor or the main monitor alone with the capability to upgrade easily at any time to keep up with the ever-changing demands and finances of a practice. It may also be configured with wireless EMR connectivity and several mounting options for flexibility and incorporation into any office. Other higher-priced but feature-rich monitors include Welch Allyn’s Connex® vital signs monitor, which features a touch screen display and is designed for straightforward integration into EMR systems; the Spot® Vital Signs line, which have become the products of choice for frontline caregivers world-wide due to their versatility, temperature options, and advanced vitals monitoring; and the 300 Series, Welch Allyn’s low-cost monitor, with push-button operation, customizable features, and optional printer.


A doctor may wish to have each individual component of vital signs monitors in addition to or in place of an all-inclusive monitor. Blood pressure monitors are essential in healthcare and are available in a staggering array of types and functions: aneroid (standard analog clock-style) sphygmomanometers, mercury sphygmomanometers (check your state’s mercury laws), digital aneroids (which eliminate the delicate components of mechanical units without compromising on quality or accuracy), pocket and palm aneroids (for portability), and integrated aneroids (for one-piece operation). To ensure smooth, accurate readings, myriad accessories are necessary as well: reusable or disposable cuffs, bladders, bulbs, valves, hoses, replacement gauges or crystals, stands and mounts, connectors, and batteries, among others.

Fingertip Pulse Oximeter

A separate pulse oximeter may be required as well. Most oximeters provide both oxygen saturation and pulse rate readings. The devices – in a compact, fingertip or wristwatch style or larger handheld or tabletop design – feature clear readouts on various types of screens and innovative options such as memory, software compatibility, wireless connectivity, and/or customizable alarms. Accessories such as disposable or reusable sensors of all sorts, cables, software, and chargers are crucial to the monitoring process.

AEDs

While not a diagnostic tool, an AED should be a permanent fixture in every medical office. With an automated external defibrillator nearby, a patient or staff member – even the doctor him or herself! – may be saved from certain death or irreparable damage when sudden cardiac arrest strikes. The AED and its essential components and accessories – electrodes, cables, batteries, and storage cases or mounts – should be installed and maintained from the very first day of office operation.

Lab Equipment

Centrifuge

Many offices maintain their own labs for in-office testing, eliminating the need to send patients to offsite labs. Lab technicians will need a centrifuge to spin samples for segregation and in-depth analysis of specimen substances. An autoclave for sterilization of equipment and supplies is indispensable in keeping the lab hygienic and safe.  Specialized equipment for examination of certain tests – a glucose analyzer, hematology and cholesterol testers, urinometer – may also be necessary in addition to the standard microscope and incubator for specimen assessment.


Aside from the diagnostic and lab equipment, lab, infection control, cleaning, wound care, and various disposable supplies are crucial in any and every doctor’s office. Check in with us next week for in-depth coverage of the assorted supplies that you will need to complete your office setup and get it ready for your patients!