Sticker shock

Oct. 1, 2001
Since the August issue of Dental Economics hit the stands, I have had several inquiries about setup configurations.

by Paul Feuerstein, DMD

Since the August issue of Dental Economics hit the stands, I have had several inquiries about setup configurations. The questions were similar: Where to purchase the computers, and who will do the best installation. Dr. Ken Whelan, a GP in Irvine, CA, has given me permission to use his "journey" as an example. He was hoping to set up four computers now, with wiring for future expansion. He figured he could purchase the computers for about $6,000. His practice-management company directed him to a local installer for a quote. This company was to build, setup, and install the computers; set up the practice-management software; and also help set up the digital radiography.

Imagine his sticker shock when the quote came in at $18,000! As we shall see, this is a realistic number. I hope to accumulate several of these proposals, dissect them in great detail, and report in a future article. (Please email your stories to me.)

Connecting the computers
Someone has to plan and install network wires and outlets to all of the computer stations. In addition, you still have to configure the network by purchasing and installing software such as Windows 2000, set up a network hub or switch, and make sure the practice-management software can operate within this system. The cost — which can vary greatly— in this example was about $2,000.

Ken didn't give much thought to printers. The installers (and I) recommend two — a black and white laser, and a color inkjet. The laser is for everyday work — statements, insurance, etc. It is faster, crisper, and less expensive per copy than the inkjets.

This introduces another setup issue. Although you can "address" the printers from the computers, a print server is desirable. This will of course mean additional purchase and configuration costs. I have also found that having an "all-in-one" laser printer at the front desk is a real advantage. Not only will you have a plain paper fax, but the copy function also allows for quick single copies. Some printers have a multi-feeder; others have scanning capability — a good feature if your goal is a "paperless" office. The total amount for printers added about $1,500 to our quote.

The "el-cheapo" computers come with 15-inch monitors. Anything smaller than 17 inches is inefficient today. LCD monitors are smaller, lighter, and are now affordable. Fifteen-inch and 17-inch models average $400 and $900 respectively; they could be even less by the time you read this. Putting in an assortment of four will be about $2,000.

Installation, setup, and testing
Typically, the practice-management company will install its own software, but the network and basic backbone of the system must be up and running. In addition, there must be a backup system. This means purchasing a backup component — a tape drive and tapes, a removable disk drive or CDRW drive — and setting up the protocol. A UPS battery backup must also be installed. Many people think you only need these on the server. However, if you have just captured some radiographs and/or images and the power goes out before you hit "save," you have to do them all over again.

Ken also wanted to use his intraoral camera to capture directly into the computer, which meant substituting a video capture card for the standard video card. These items and services conservatively add another $1,200-$3,000.

Unless you have a great deal of experience, this is a job best left to the professionals. I enjoy tearing apart computers, crawling around, and pulling wires through the little holes behind cabinets. This is my idea of fun, rather than, say, hitting balls on the golf course. Although I am saving money by doing this myself, my time is really costing me money. Remember — when the computer installer breaks a cusp, he doesn't try to fix it. himself.

Dr. Paul Feuerstein installed one of dentistry's first computers when he placed a system in his office in 1978, and he has been fascinated by the technology ever since. For more than 20 years, he has taught courses on technology throughout the country. He is a mainstay at technology sessions in New England, including annual appearances at the Yankee Dental Congress, and has been a part of the ADA's Technology Day since its inception. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site ( and can be reached by email at [email protected]

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