Five table industry experts talk candidly about purchasing the most important equipment in your office

There are few professions that do not depend on a specific tool to enhance the quality of work. In chiropractic, this partnership comes in the form of doctor and table. Given the evolution of chiropractic tables, it might prove difficult to narrow down the selection—especially when bombarded with information from competing companies. The good news is, the more variety, the easier it will be for you to find a perfect fit.

To help us wade through the array of table choices, Chiropractic Products invited several professionals in the industry to discuss the ins and outs of selecting the right table for your practice. In our panel of table experts:

• Leander Eckard, DC, has been in the chiropractic industry for nearly 40 years. He is the founder of the Leander Co and has created a number of tables now used regularly in chiropractic offices.

• Gary Huddleston, DC, is owner and CEO of Eurotech Table & Mfg, located in Osage Beach, Mo. He has been a practicing chiropractor and table manufacturer for more than 21 years. Eurotech Tables is a major supplier in the professional sports field.

• J. Michael Hunter is general manager of Lloyd Table Co in Lisbon, Iowa. He has 17 years of experience in the industry.

• Thomas J. Kenny is the owner and president of Williams Healthcare Systems LLC and US Table LLC in Elgin, Ill. Kenny has 26 years of experience in the areas of lean manufacturing, integrated product development, sales and operational planning, and strategic management.

• Mark Reiter is the senior vice president of LSI International Inc, Overland Park, Kan. He is a regular guest lecturer at Cleveland Chiropractic College and has more than 10 years of experience in the chiropractic field.

What are the three most important features to look for when purchasing a table?
“I foresee the need for a smart table that would measure the strength and resistance of the patient by using strain gauges at various positions on the table.”–Leander Eckard, DC

Eckard: First, does it support the doctor’s technique? Second, is it comfortable to the patient? And third, is it made to last 20 years?

Huddleston: Make sure the table fits your individual lifestyle and is versatile enough to use your personal techniques and methods of treatment. Note the quality of construction, workmanship, and standard features. Shop around and make sure the table you want is priced fairly. High price does not always equate the best product, nor does low price always equal the best bargain in the long run.

Hunter: It really depends on the doctor’s adjusting technique. But for general purposes, the speed of tilting and or elevating must be considered, as well as the weight lifting capacity and stability of the table.

Kenny: One, the product must be appropriate and capable to consistently perform within the range of treatment protocols required by doctors, with patient comfort in mind. Two, the underlying design, construction, and quality should offer doctor consistency-of-use along with a level of durability adequate to meet the demands of the busiest practice. Doctors should expect this capital investment to provide a suitable return over a life cycle of at least 7 years. This leads us to my third point—get the comparative facts. Don’t buy on price alone.

Reiter: First, look at durability. It might look good on the showroom floor, but how is it going to look and function 5 years from today? Also, consider warranty. Third, look at price versus quality. Compare features needed, the warranty and service options, along with the price.

What should DCs expect in terms of customer service and equipment repair support from their table company?
Eckard: The Food and Drug Administration (FDA) requires manufacturers to record equipment failures and resolutions. How good is their warranty? What is the company history in the market place? What trade shows do they attend? Do they support the profession?

Huddleston: A good company will address the problem immediately and schedule repair as soon as possible. The repair personnel should be courteous, knowledgeable, and able to fix the problem quickly and efficiently. When completed, the company should have doctors check the repair in all aspects of use and sign a completion of repair work order. Doctors should also be able to speak with someone who knows the product line well.

“The number one pro for buying a new table is that you have a more reliable product with a manufacturer’s guarantee. New tables also have updates and ergonomically advanced features. ” –J. Michael Hunter

Hunter: If a service problem arises, the table manufacturer must be committed to getting the problem resolved in the shortest time possible.

Reiter: Most distributors are responsible for servicing the tables they sell. The manufacturer will send parts to the distributor at no charge during the warranty period, which is usually 12 months. The distributor should be willing to provide labor at no charge during that warranty period.

What are some aspects of table companies of which DCs should be wary?
Huddleston: Many companies think they can build chiropractic tables quickly and cheaply. Look for companies that have been in business for many years. They usually have a long history of research, development, improvement, and dedication to the chiropractic profession. Be leery of companies that say they never have repair problems. All good companies will have proper 510K documentation from the FDA, as well as product liability insurance. Run—don’t walk—from manufacturers who do not spend the time, money, and resources to cover their products as well as doctors’ liability.

Hunter: Doctors should be wary of companies that display little in the way of customer service. For instance, do you get a real person who answers your phone call and, if so, does he take a genuine interest in your inquiry or complaint? Also, look at the manufacturer’s guarantee. A minimum of 1-year parts and labor should be provided.

“The product must be appropriate and capable to consistently perform within the range of treatment protocols required by doctors, with patient comfort in mind.” –Thomas J. Kenny

Kenny: Carefully look at the experience, longevity, and reputation of the manufacturer. Does the table company have its products operating in high-volume clinics and academic facilities throughout the world? How well has the product held up in those environments? Does the table company carry product liability insurance and maintain FDA medical device registration on its products? What are the terms of the warranty offered?

Reiter: Some companies only honor their labor warranty if you can get the table back to them at your cost. With many tables weighing 300 lbs to 400 lbs, this is usually not possible, and you may be stuck with an expensive repair bill, even though the table was under warranty. Also beware of stated delivery times. Table manufacturers know that long delivery times can mean lost sales and sometimes they exaggerate their delivery times. Armed with this knowledge, you can demand to know what their average ship times have been over the past several months.

What are the pros and cons of purchasing a new versus a used table?
Eckard: If you can buy a table used, there is a good reason why it is on the market. And you don’t want to find out the hard way. Buy new!

Huddleston: With new products, there is a better warranty, more choices in table features, and the satisfaction of knowing that the table was designed and built especially for you. The flip side of the coin means the new table could cost more money. It could also take substantially longer to get than a used table. But the used table could also harbor problems that caused it to be traded in or sold in the first place. Remember, many used tables are sold “as is” with no warranty either expressed or implied.

Hunter: The number one pro for buying a new table is that you have a more reliable product with a manufacturer’s guarantee. New tables also have updates and ergonomically advanced features. However, if economics dictate buying a used table, be sure to purchase from a reputable table rebuilder. Whenever possible, get the serial number of the used table and call the manufacturer for a repair history.

Kenny: A used table can offer what appears to be the immediate advantage of a lower up front acquisition cost based on a sticker price comparison with a new table. But be careful—acquisition cost is only one element that goes into the cost of ownership equation for the table. Doctors must also consider the estimated resale value at the end of the use period; how much warranty, if any, will be provided; what organization will honor the warranty after the purchase; the age and service history of the table; and what if OEM parts have been used throughout the service history or if poorly manufactured after-market parts were used. Doctors should know that many lending and leasing institutions will not offer financing terms on used tables. When these cost elements are taken together, the resulting cost of ownership for a used table will, in many cases, exceed the cost of buying a comparable new table.

Which adjusting and nonadjusting tables are popular with DCs?
Eckard: In recent years, the profession has started buying and using multipurpose tables with motorized flexion and elevation and specific drop sections—one table that does it all.

Huddleston: At this point, manual and motorized flexion tables are enjoying tremendous appeal. Originally, the flexion table was more of a specialty table. Now, these are built with drop pieces, hinge-down abdominal features, and are versatile enough to be used as the primary adjusting table in any clinic. The hi-lo is still popular, but may be experiencing a slight decline simply because of price and the versatility of new tables coming into the marketplace. Elevation is another new feature that has shown huge growth. This allows the table to rise from a lower height of 21 in to 35 in by stepping on a pedal. There are fewer flat benches and portable tables used in the clinic to adjust on. These are often uncomfortable, very limited in versatility, and do not really lend themselves to a wide variety of techniques.

Hunter: Without a doubt, elevating tables with automatic or manual drop pieces are the most popular. Also popular are elevating flexion-distraction tables.

Kenny: For adjusting tables, the versatile hi-lo and elevating hi-lo tables are by far the most popular tables on the market today. They accommodate the physically challenged patient to get on and off the table at different heights, while the patient is either seated or standing. These products may also qualify for tax credit under the Americans with Disabilities Act of 1990 (ADA), which dramatically reduces the cost of ownership. Of nonadjusting tables, the intersegmental traction table or treatment bench are must-haves in any practice.

“I have seen many doctors taking a back-to-basics approach when buying a new table. But if the technology makes it simpler and more convenient for doctors, I think it will win them over.” –Mark Reiter

Reiter: Hi-lo tables that can adjust from a horizontal to a full-standing vertical position have lost a lot of their popularity. They used to be considered standard equipment in the chiropractic office. Now, because of expense and time consumption, many doctors opt for simpler benches, usually with at least one drop. However, the most popular choice is electric elevation.

What advice do you have for DCs purchasing their first table?
Eckard: Know who you are. What are your strong points and your weak points? Buy a table that makes you look good to the patient.

Huddleston: The chiropractic adjusting table is the main tool of our trade. Buying a cheap, worn-out, or useless table is an injustice to your patients and our profession. It is ridiculous to spend $100,000 on a chiropractic education, $25,000 getting your office ready, and then spend $250 for your adjusting table, which is the most important piece of equipment you will ever own. A good table will make you money, not cost you money.

Reiter: Whether the table is new or used, it should fit your technique, as well as your budget. Don’t break the bank on a feature-laden, high-dollar table right out of school. You can always trade that first table in for an upgrade when you’ve got a greater patient base.

What can DCs expect to spend when purchasing a table?
Eckard: A motorized flexion table with segmented cushions can be purchased new for $3,500. You can add elevation to that table for an additional $1,700 and drops for about $1,000 more. For around $6,500 you can have a top-of-the-line table, and with the elevation, you get the ADA tax credit.

Hunter: The price for adjusting tables varies greatly depending on their features. A doctor can expect to pay as little as $300 for a stationary table or more than $16,000 for a fully-loaded multifunctional table. There are many different table types and configurations between these two extremes.

Kenny: Just as the racecar driver would not select a Yugo to run in an Indy race, doctors should understand that their ability to perform is greatly enhanced by the product they use in their profession. DCs should choose adjusting instruments commensurate with the level of enhanced performance they need in their practice.
Reiter: Obviously, this can vary widely, but I would say the average adjusting table goes for $2,000 to $5,000.

What technological advances do you see in the near future for the table industry?
Eckard: Third-party participants in the health care industry want to know what they are paying for. I foresee the need for a smart table that would measure the strength and resistance of the patient by using strain gauges at various positions on the table. Also, this new table would measure and record every thrust delivered to the patient, and then automatically transfer data to the patient’s file electronically. The advantage would be the establishment of a database of information, proving the effectiveness of the chiropractic adjustment. The disadvantage would be the individual doctor’s lack of effective adjusting would become apparent.

Huddleston: Quality, durability, and versatility will continue to expand and improve in the table industry to keep up with the growth of the chiropractic profession and health care in general. Doctors may see tables with patient treatment memory or tables that can interface into a national database. However, I feel tables will simply mirror the advances that chiropractors will make to their profession.

Kenny: We will see continued efforts to integrate a wide range of diagnostic and treatment modalities into and through the table platform, leading to highly-diversified treatment platforms. We will see further integration of support services into the chiropractic office via the Internet as well as smart tables/ products that communicate a whole host of patient, product, and business data via the Internet.

Reiter: As air compression systems become smaller and quieter, I think you will see more manufacturers using pneumatics. There will probably also be a greater use of small electronics to control functions that now take human interaction or physical controls. An example might be controlling the functions of an electric flexion table with keypad presets for time and length of stroke. Of course, with many of these advancements comes a greater risk of mechanical failure. I have seen many doctors taking a back-to-basics approach when buying a new table. But if the technology makes it simpler and more convenient for doctors, I think it will win them over. CP

Julie Z. Lee is a contributing writer for Chiropractic Products.