Professional Courtesy: Loyalty by Design by Dr. Thomas Giacobbi, DDS, FAGD

The other week, one of my hygienists informed me that the digital panorex machine was "making a groaning sound" and the head had stopped moving when she tried to reset the machine.

When I had a moment I took a look at the machine and the error code on the display. A couple of calls later, and I had a diagnosis—one of the three motors that controlled the head needed to be replaced.

I was happy to have an answer so I could save my equipment technician a visit to the office and go straight to ordering the part. My next call was to my supply representative to order the part and find out when we could schedule the installation. When he called back, my plans changed: The part was $1,100 plus installation. I had already seen the motor inside the machine and I thought he had made a mistake.

A Google search revealed that the motor inside my machine was worth about $45. I found the part for my panorex on eBay for $350. The differences between the $45 version and $350 version is a set of gears attached to the back of the motor and the fact that the guy on eBay knows that the supply companies charge $1,100 for this part. I bought the part from the local eBay vendor and with the office closed Friday, I decided to swap the motor myself.

This repair became more than an opportunity to save $1,000-plus; it was a reflection of the relationship between manufacturer and customer and a study in the way design can influence a long-term relationship.

Dentists frequently face the cost-versus-quality dilemma when we buy equipment. When I started my practice, I bought operatory chairs that would be described as "value." They served me well for 10 years but the repairs were frequent and they were sometimes difficult to fix. When I was in a position to make a change, I purchased one of the most expensive chair brands in the market because repair guys find them easy to work on and they're well-designed and built to last.

Back to the panorex. With the machine unplugged and the cover removed, I began the tedious process of swapping out this motor. I went through several stages of frustration:

First, I felt sorry for the repair techs, who must be frustrated trying to extract the motor from its tight quarters. (The high cost of labor for this task would certainly soothe some of that frustration.) Next, I was angry with the engineers who designed the machine. The motor is essentially the only moving part inside the head of this machine—wouldn't it make sense to design it in such a way that replacing the motor would be a bit less impossible?

My final thought was about the manufacturer and its long-term relationship with customers. If you want to make a product that dentists would buy again and recommend to their colleagues, make sure it performs well through every part of its life cycle.

My panorex machine is now 10 years old and it has performed very well. If a critical component fails in the next few years, the first thing that will come to mind is the difficulty encountered in replacing that motor. The second thought will be the fact that a motor worth roughly $100 would cost more than $1,500 to replace. Do you think I'll rush to buy that brand without question, or will that experience be enough for me to consider other brands? I will pay close attention to repair and parts costs, because we know that is a reality of ownership.

Another example of design that ignores the end user: Any small rechargeable item that has the battery soldered to the inside. There is no reason for this except the company likely wants you to send the unit in for costly "service" instead of just replacing the $12 battery yourself.

Dentistry has been blessed with healthy profit margins in every aspect of the business: equipment sales, consumable supplies, repairs, laboratory services and patient care. There are many developments in the marketplace that are going to disrupt the status quo. If you didn't know that already, now you do!