There are a number of challenges surgery centers face; here are our top four:
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Collaboration: Because hospitals are also feeling the squeeze many hospitals and surgery centers have chosen the tenuous road of autonomous partnership. Because the hospitals and the surgery centers are coming together this is creating a ripple effect in the marketplace and many of the smaller surgery centers who opt out of the partnership could be eliminated. As well the larger, more bloated hospitals will also be forced to potentially shut down unless they embrace the opportunity with this collaboration and employ it.
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Patient Information: Like it or loath it; people come equipped to their interactions with retailers now more than ever. Even though you may be a surgery center; that doesn’t make you any different from an electrosurgery accessories dealer, dentist, car salesman, or toy teddy bear maker. You need to engage your customers and persuade them why they should be doing business with you. Surgery centers who do this will continue to survive and thrive.
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Regulation: It’s no surprise that the increased regulation which many doctors, surgery centers, and others are facing is creating a real squeeze in the actual marketplace. While the absent surgery centers may just sit on their laurels and wait to get caught doing things the old way, newer, nimbler, ready-to-survive surgery centers will implement these new guidelines and make sure to follow every rule, fill out every form, and dot every “i.” For their survival there really is no other way.
Of course there are other challenges facing surgery centers but these are four of the bigger ones. We'd like to know what you think:
Feel free to contact us or leave your comments below!
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Electrosurgery is a vital part of medical care today, making it possible to move many procedures to an outpatient facility for the convenience of the patient and the medical care provider. The primary purposes of these tools include precise surgical cutting and coagulation at the incision, making them a valuable part of minor cosmetic procedures and intricate surgical procedures alike. It is important to take care when choosing electrosurgery accessories for the unit since choosing the right ones can help keep procedures efficient and not only minimize associated risks, but improve the patients outcome.
There are two modes of operation, the first of which is monopolar electrosurgery. In this type of surgery, energy completes a circuit beginning at the electrosurgical generator, going through the handpiece and the appropriate electrode, through the patient and exiting at the grounding pad and returning safely to the ESU. A variety of accessories may be useful in different procedures and situations for an optiumu outcome. The basic accessories include a blade, ball, needle or loop electrode. While typically a blade electrode is standard on most disposable pencils (handpiece), depending on the procedure, other electrodes may be more advantageous. In the case of a precise incision, surgeons frequently rely on a needle electrode since it can be operated at a lower power level while producing a very fine incision. Monopolar electrosurgery is the best and fastest mode for a cut procedure.
Bipolar electrosurgery is the other standard mode of operation. In this mode, power goes from the ESU to the forceps that restrict electrosurgical energy to a small area within the end of the device. There is no grounding pad required in this case, since one tip of the forceps acts as the active electrode and the other tip acts as the return electrode. Bipolar is considered by many to be the safer form of electrosurgery. However, it is more useful for coagulation than for a cut procedure.
Today's modern electrosurgical generator which has a pad sensing technology inside, and when used in conjunction with a split grounding pad, offers a very high level of safety for the patient, surgeon and staff. When properly placed and used, the ESU can determine if all of the energy is not being returned to the unit and immediately disabling it.
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While today's generation of electrosurgery generators has seen vast improvement since the first electrosurgical device was used successfully in 1926, the principle remains the same. Electrosurgery enables doctors to make precise cuts during surgical procedures while simultaneously helping in the prevention of blood loss during operations of all types. Electrosurgical equipment is now routinely used in a variety of medical areas, including:
While there is no question regarding the efficacy of employing electrosurgery in a wide range of medical procedures, there are also several potential safety hazards associated with its use. While today's modern electrosurgical generators have built-in safety features that offer many safety features, the possibility of a fire or explosion happening is a safety hazard that can only be eliminated by adhering to certain safety precautions when one is operating this type of equipment. Some simple fire-safety guidelines include:
Because the sparks produced when using electrosurgical generators are an obvious potential source of ignition, proper fire-safety precautions must be observed at all times. If you are involved in the use of this type of equipment, ongoing education is essential to ensure its safe and proper operation. Additionally, employment of an effective smoke evacuation or ventilation system should be considered to prevent the inhalation of noxious smoke and vapors produced during electrosurgical operations.
While the above-mentioned hazards exist and are inherent in the use of electrosurgery generators, they are also controllable through proper use and care. Education is critical, as the best safety system is a knowledgeable user. At Bovie Medical Corporation, the first name in electrosurgery, we offer a free eBook containing electrosurgery generator safety guidelines that can be downloaded from our website. We've got you covered.
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Today there are two major players in the high frequency desiccator market, Bovie Medical Corporation with their Aaron 940 and Conmed Corporation with their Hyfrecator 2000. These products are mainly used in dermatology and unlike an electrosurgical unit (ESU) they do not have the ability to cut tissue. Clinically the Aaron 940 and the Hyfrecator do the exact same thing. They desiccate, fulgurate or coagulate tissue and mainly deal with small skin lesions, skin tags and the like.
So if they are clinically the same, what is the functional difference?
The quick answer is that the Aaron 940 from Bovie is much more user friendly. But since the blog headline is the "Top 3 Attributes of High Frequency Desiccators", let's look a little deeper.
The first thing that stands out is that since the Aaron 940 is a digital system, there are no extra or cumbersome steps required to go from low power to high if you need to. This typically happens when a physician hits a small bleeder and needs coagulation. On the 940 you simply push the up button on the handpiece or use the rotary dial, so one step is all that is required. The competing unit actually requires four steps instead of one to accomplish the same thing. To make it worse, if you need to go back and finish the procedure, then the four steps must be repeated. The user friendly way with the Aaron 940 is once again only one easy step.
The second user friendly attribute with the Aaron 940 is when you want to add the optional foot switch. You simply plug it in to the face of the unit. If you are unfortunate enough to have that other machine, then you are facing a six step process which is also a more expensive proposition. Not only is it more expensive, you actually get less features on the Conmed unit, because you need to buy a different handpiece too, which has no up down buttons.
The first two attributes actually require you to plug and unplug their handpiece...consequently it faces much more physical abuse. We have had many doctors ask us how our handpiece lasts SO MUCH LONGER than their old Hyfrecator handpiece? In truth, other than the collet we use to tightly hold the electrode in place, which is WAY BETTER that theirs, both hand pieces are made to similar standards. But because they are plugged in and out more, they seem to wear out faster. While ours lasts and lasts and lasts. So attribute 3 is our handpiece doesn't break. Or at least compared to theirs.
The Aaron 940 is the logical choice for a high frequency desiccator when you want ease of use combined with reliability. There are several other attributes, and if you want to know more contact Bovie and we'd be happy to tell you more.
J. Robert Saron, President
Bovie Medical Corporation
*Aaron and Bovie are registered trademarks of Bovie Medical Corporation and Conmed and Hyfrecator are registered trademarks of Conmed Corporation.
Electrosurgery has been around since 1926, when William T. Bovie, a Harvard PhD first introduced the technique to a colleague who had previously been unsuccessful in removing a tumor from a patient's head due to excessive bleeding. Dr. Bovie assisted Dr. Harvey W. Cushing with the use of electrosurgery to remove the mass with very little bleeding, and the operation was a resounding success.
86 years have passed since that initial use of electrosurgery, and it has has become a mainstay in operating rooms, with over 80% of all surgeries involving the practice. Dr. Bovie's name has become synonymous with his invention: surgeons refer to their equipment as their "Bovie", and bovie cautery (both of these are misused by the way) is the catchphrase for electrosurgery. However, if a surgeon or nurse refers to an ESU (electrosurgicl unit) as their Bovie, it needs to say Bovie® on the face of the unit. Bovie is a registered trademark of Bovie Medical Corporation. While we are flattered that Bovie is synonoymus with electrosurgery, to prevent the misuse of a registered trademark of the United States Patent and Trademark office, it really needs to say Bovie® on the product.
Amazingly, the technique and principals have changed very little over the decades; the significant changes are in safety, electronic technology and the advancements in electrosurgical accessories. When someone uses the term Bovie Cautery and is referring to an ESU they are once again mistaken. A Bovie cautery should refer to Bovie's line of battery operated cauteries. Bovie is the worlds largest producer of battery operated cauteries. They do their work with heat...fairly high heat at that. A high termperature cautery operaties in the vicinity of 2200 degrees fahrenheit. That is NOT how a Bovie ESU works. In fact heat has virtually nothing to do with it. An ESU does it's magic by blowing apart the cells to cut and by dehydrating the cells to coagulate (stop bleeding).
Battery powered cauteries today are available in high and low temperatures, the low temperature ones are mainly used in ophthalmology, offering "pinpoint precision". High temperature cauteries offer great versatility and are commonly used in a wide range of procedures such as relief of a subungual hematoma, vasectomies, sculpting woven grafts and for what they were originally used for, to stop small bleeders. For situations where reusability is desired, the Bovie cautery lineup offers the Change-A-Tip; a replaceable battery and tip cautery that offers both high and low temperature, depending on the model, and is most often used in the doctors office where cost savings is important and in veterinary medicine. Hospitals nearly 100% of the time use the one time use, sterile disposable cauteries.
A Bovie electrosurgical unit or battery operated cautery, enables surgeons to select the optimal instrument for a specific procedure, providing the greatest potential for a successful outcome.
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The cost of healthcare continues to rise at a rate that outpaces the United States GDP, and the industry is tasked with developing strategies that will stem the tide. Medical Equipment companies seek to trim their costs by increasing efficiency, reducing waste, and with technical innovation. Another approach is to form a collaborative partnership with medical distribution.
Medical distributors can provide two significant advantages to medical equipment companies: economies of scale and entree into new markets. Economies of scale can significantly reduce the cost of doing business; the medical equipment company will save money on the sales and delivery process while concentrating on what it does best, manufacture quality equipment and the accessories that go along with them. The distributor also provides access into new markets, enabling the medical equipment company to gain market share, increase revenue and strengthen their position within the industry.
Selecting the right distributor for your products is vital to a successful partnership. The company must have a strong reputation for selling only the highest quality medical products and providing superior customer service; they are representing you and are the face of your company in the field, and will influence customer opinion of you and your medical equipment. When your business is electrosurgical equipment and accessories, your medical distributor needs to possess the requisite knowledge of electrosurgery, its equipment and accessories in order to accurately and confidently explain the benefits of your products. If a representative needs help they have several options. If it is base education or a refresher course, they can log onto EOL (education on line) at MDSI.org, go to our website at boviemed.com, call one of our region managers or our 50 independent representatives.
Electrosurgery is now performed in over 80% of all operations. Its benefits have proven to be significant: electrosurgery uses cauterization and fulguration to cause instant coagulation or evaporation of fluids at the surgical site and is a good way to minimizing blood loss. A blended cut is an underused mode of cut which does an excellent job at minimizing blood loss.
Visit boviemed.com to learn more about electrosurgery. With the surgery moving out of the traditional operating room and into ASC's and physician's offices, the demand for electrosurgical equipment and accessories is increasing.
To gain the maximum benefits from the collaborative partnership, your medical distributor must possess a large customer network and sufficient resources to put your electrosurgical equipment into the hands of healthcare professionals with speed and efficiency. As a medical equipment manufacturer, you are committed to helping medical professionals provide high quality healthcare to their patients. Your distributor can be invaluable in facilitating that objective; providing an expanded customer base, lowered sales costs, and increased revenue opportunities for both the distributor and you. Bovie Medical Corporation has a registered trademark of Dedicated to Distribution®, it is how we have built our business.
Feel free to contact us or leave a comment below.
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When electrosurgery is used during operations there is always a risk of fire, and with over 80% of all surgical procedures today involving electrosurgery, the risk is frequently present in the operating theater. This article addresses some common concerns and questions regarding OR fires and offers some strategies for reducing their occurrence.
What is the most common cause of operating room fires? Three factors must be present for a fire to happen:
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A source of fuel (prepping agents containing alcohol, surgical drapes, etc. Even the patient's hair, blankets, fiberoptic cable coverings can be a source of fuel.)
Fuel source can be minimized by letting prepping agents dry thoroughly before surgery begins; even a small amount of alcohol can be very dangerous. Careful preparation of the OR, eliminating unnecessary materials and ensuring that all equipment is in perfect working order is essential for a safe working environment.
Supplemental oxygen delivered through a nasal cannula can be extremely dangerous: oxygen delivery via this method is fairly routine during a surgical procedure. Problems arise when oxygen builds up in the cannula or accumulates under surgical drapes positioned to establish the sterile field. Use of compressed air or intermittent use of supplemental oxygen decreases the amount of oxygen in the operating room, and reduces the potential for build-up.
Today electrosurgery is used in most surgical procedures, making ignition sources ubiquitous to most operating rooms. Electrosurgery is considered extremely safe if performed by a trained medical professional and carries many benefits to traditional surgical methods.
Electrosurgery accessories minimize the invasive nature of surgery by increasing the surgeon's precision and reducing bleeding. Procedures are shorter, resulting in improved outcomes.The risk of fire comes from the electrosurgery accessories being in proximity to : for example, a blade, ball, needle or loop, which may spark and therefore must be carefully monitored.
Electrosurgery, when properly used, nearly alwas give the doctor and the patient the results they desire. Unfortunately, since there is so rarely a problem, complacency can set in. Always be vigilant and pay particular attention to your ignition source when combined with a source of fuel and/or increased oxygen levels.
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On November 21, 2011 Bovie Medical Corporation announced that it had been awarded a patent for a "Method to Generate a Plasma Stream for Performing Electrosurgery" (boviemed.com, 2012), naming the procedure J-Plasma.
J-Plasma is created by passing an inert gas i.e., Helium, over a sharp conductive point that is maintained at a high voltage and high frequency. The individual atoms contain particles that are electrically neutral, but when subjected to high voltage and high frequency at the sharp point they are temporarily broken apart creating freed charged particles called ions (boviemed.com, 2012). The gas ionizes and now will conduct electricity like a traditional wire. To describe it in the most basic of laymen's terms, think of Luke Skywalker's Light Saber- although this beam is only a few inches long, as opposed to over a meter in length!
J-Plasma represents a potential breakthrough in electrosurgery; the method uses electricity flowing to the surgical site for a brief time, and then reverses to flow back out. The effect is one of cold plasma, which minimizes damage to surrounding tissue; additionally, without a net flow of electricity around the body a return electrode is not needed.
This new technology takes electrosurgery to a new levels of performance; traditional methods, while very effective, carried some inherent risks to the patient due to the challenges of harnessing electricity, and to the surgical team due to the exposure to potentially harmful fumes and smoke which are by-products of the cauterization process. Using a cold plasma, the j-plasma procedure offers increased precision and stability of the plasma stream, which minimizes the extent of the invasive nature of the surgical procedure. A smaller surgical site should result in faster, easier recuperative times for patients, with theoretically less risk of infection and/or other complications.
J-plasma follows the current industry trend of minimizing invasiveness with surgical procedures whenever possible, and carries on the tradition began by Dr. William Bovie back in October, 1926, when he employed electrosurgical techniques for the first time.
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I have been debating how to approach this subject, and after much procrastination, I guess I will just jump in. There are many challenges that medical manufacturing organization leaders face on a daily basis. However, the most frustrating part for me is the regulatory and legal red tape that exists in the process today. While I understand that regulations and legal issues are designed to protect the public (myself included) I often feel that much of what is happening today is not beneficial to the public and in actuality detrimental to our economic well being. The first challenge on every leaders list in the medical manufacturing arena is the Food and Drug Administration and the additional burden of much longer approval times for new products. At different trade shows we casually talk with friends in the industry, and a common topic is the pain felt in dealing with the FDA today. I personally rate the first subject so high on my list that I think number two is actually number three on the list.
Number two is the additional testing and new standards being implemented which drive up the cost of either bringing the product to market or keeping it there. If it actually made a better and safer product because of these tests I couldn’t argue with it, but in 99% of the cases it only makes it more expensive, not better in my opinion. I am reminded of elementary school where we played with mercury and were amazed at all of the tiny balls and how it behaved in your bare hand. Today you would evacuate the school and call in a hazmat team.
Next on the list is a tossup between too many lawyers in the USA that can sue anyone for any reason or none at all and international labor costs which are significantly lower than the good old USA. As an addendum to US labor costs are our health insurance costs for our already higher labor costs. Let’s go with too many lawyers for $100 Alex. The legal system serves a purpose, and I know that, but I still think my best long term deal was over an exclusive agreement made on a handshake. We tried over the years to get something in writing, but our mutual attorneys kept making it impossible to do a deal. That handshake deal lasted until the patent ran out and then we sold the registered trademark to them for half a million and all of it was accomplished with nary an attorney in sight. We have had multiple lawsuits over the past year and about all they have accomplished is wasting money, wasting time, and distracting us from what we need to do to make Bovie Medical a better company. Why don’t the politicians help us with this problem? Oh yes, now I remember, they are 90% attorneys too. Heaven forbid that they might do something that is good for the USA and bad for their brethren in the legal system.
Lastly, unless you make highly protected patented product for a special application and can command a premium from them, then labor costs is a problem. In some countries electrical engineers are a third the cost of what we pay here. If we are speaking of basic labor rates, we pay more per hour for the health insurance to cover these workers that our international competitors pay their workers. We then add our hourly rate on top of it and as you can see, Houston we have a problem. I could probably go on, but this kind of reminds me of a book I once lost on a plane, and was glad I did titled “The Death of Common Sense”. Don’t read the book, it will only depress you.
Feel free to contact us or leave a comment below.
J. Robert Saron
President, Bovie Medical Corporation
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As 2012 approaches, the team here at Bovie Medical Corporation is excited about the opportunities ahead of us and no one is more excited than I am. I have watched our company grow over the years and can’t remember a time where I felt this much excitement about what is in front of us. Our best story in 2011 was the Medical Illumination International Agreement and the MI-1000 light. These new products have energized and excited our sales team. We have high expectations for this product line as we enter 2012. In addition, we are excited about the expected launch in early April of the MI-500 – a LED light specific for the physician’s office. It is guaranteed to be a big seller. We expect to release a larger LED Surgery light later in the year. We will be a major source for LED lighting through distribution in 2012.
The electrosurgery arena is also expected to provide us with some exciting new opportunities. Our goal is to release J-Plasma to our beta sites the first quarter of 2012 – of course this is dependent largely on FDA approval (see my soon to be released blog titled – The Challenges of a Medical Manufacturing Organization Leader). Our team worked extensively on our submission and we are confident the result will be positive. We have two new Super Sharp coated needles SS01T and SS02T set for release the first quarter that compete directly with the market leader. In addition, we have a new 4MHz generator that is pending FDA approval for the physician office market and is sure to be a hit with our sales team, distributors, and end-user customers. This is also dependent on the FDA, but once again we are pretty comfortable with the facts as they are. We also expect to introduce a full line of bendable 1/16” electrodes at the same time. We should have a sterile drape A910ST to compete with our competitor in the dermatology market. This product is a direct conversion with surprising volume. Lastly, laparoscopic electrodes in both coated and stainless versions should roll out second quarter as well.
In early January we will be adding a powered mobile surgery table along with anesthesia equipment to our line. Both of these products are bigger ticket items than we have sold in the past and give our sales force more to sell on each call. Our sales team will get to see touch and learn about these products at our sales meetings at the end of January.
In closing, let me say hitting the dates and timelines listed above are dependent on many factors, some of which are simply out of our control. However, our team is dedicated to the success of the organization and doing everything within our power to make it happen.
J. Robert Saron
President, Bovie Medical Corporation
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