We Kept Buying Stim Devices. The Problem Was Never the Devices.

There's a drawer in our supply closet with 11 stim devices in it

Nine of them power on. Four still have the original packaging. I counted them in March during our annual asset reconciliation, and I could not get a straight answer out of anyone about why they weren't being used.

I'm the office administrator for a 140-person practice group — three outpatient rehab clinics, one hand therapy room, and a small corporate wellness arm that runs on-site programs for our business clients. I manage roughly $180,000 in annual ordering across eleven vendors, and I report to both operations and finance. Which means I'm the person who buys the nerve stimulator machines, the wireless electronic muscle stimulators, the hand physiotherapy equipment, the EMS foot massagers for the wellness room, and the period cramp relief devices we stock on the retail shelf at the front desk.

And for about three years, I was also the person quietly moving unused devices into that drawer.

When clinic managers complained, the complaint was always the same: the device doesn't work, the patients don't like it, the foot massager hurts. So we bought replacements. Cheaper ones, usually, because if the last one didn't work, why pay more?

That went on until our CFO asked me a question I didn't have a good answer for: why are we buying the same category of equipment four times a year?

What we got wrong (it was never the brand)

The obvious assumption is that we bought junk. That some units are just badly made and you get what you pay for. There's something to that — but it is not the reason eleven units were sitting in a closet.

Here's what was actually happening. Every device in that drawer had been bought by a different person, for a different reason, with a different definition of good.

• The EMS foot massager was bought as a staff perk for the wellness room.
• The clinical TENS units were bought as treatment equipment for the PT floor.
• The wireless EMS units were bought for mobile visits — the idea being therapists could carry them into client offices.
• The hand physiotherapy tools were bought because a new hand therapist had used a particular brand at her last clinic.
• The period cramp relief devices were bought as a front-desk retail item, mostly on a hunch.

Five different use cases. Five different definitions of acceptable. And one shared purchase order process that treated all of them as equipment — a box with a price on it — rather than as what they are: a system with consumables, training, a service path, and a disposal path.

Most buyers focus on the unit price and completely miss the electrode supply chain. I know, because I was that buyer. I compared $89 to $340 and asked why the second one cost so much. The answer, which took me two years to understand, was that they weren't really in the same product category.

Our clinical units sit in FDA Class II territory — 21 CFR 882.5890 covers transcutaneous electrical nerve stimulators for pain relief, and 21 CFR 890.5850 covers powered muscle stimulators. Many of them are 510(k)-exempt, which is not the same as unregulated: labeling requirements, general controls, and manufacturing standards still apply. The clinical units also carry an IEC 60601-2-10 mark for nerve and muscle stimulator safety. The marketplace foot massager did not. I'm not saying you can't buy consumer devices for a wellness room — I'm saying they aren't interchangeable, and our purchasing process treated them as if they were. If you're ever unsure, check the FDA device database rather than trusting a marketplace listing.

There's a second layer here that took me even longer to see. If you're writing copy for your retail shelf or your website — describing a period cramp relief device as offering ‘drug-free relief,’ for example — those claims fall under FTC advertising standards. Claims have to be truthful, substantiated, and not misleading. I found that out the boring way, during an internal review of our wellness program materials.

People think cheap units fail because they're cheap. That's backwards.

The assumption is that a device ends up unused because it broke. For us, that was true for maybe two of the eleven. The rest were in the drawer because of things that had nothing to do with build quality:

• Nobody owned the electrodes. We had four different unit models across three clinics, which meant four different electrode SKUs. Staff would grab the wrong connector, the unit would read as faulty, and it would go in the drawer. The unit was fine.
• Nobody owned the training. We turned over five therapists in eighteen months. Every new hire got about ten minutes of equipment orientation. Two of them never used the EMS units at all, because they weren't sure which setting was appropriate for which patient population — and they weren't going to guess.
• Nobody owned the chargers. The wireless units used proprietary charging docks. When a dock went missing, the unit became a paperweight. Replacement docks cost $60 each (which, honestly, felt excessive for a piece of plastic) and took about three weeks to arrive — or rather, closer to four once you count the approval cycle. By then, people had stopped reaching for the unit.

It isn't that unreliable devices get abandoned. It's that devices without an owner get abandoned — and then they look unreliable.

What this actually cost us

I pulled the numbers in 2024 during our vendor consolidation project. The picture was worse than I expected.

Eleven idle units at roughly $3,400 in original purchase cost. Maybe $3,900 if you count the electrodes we bought for models we'd already stopped using. That's capital sitting in a closet.

Electrode replacement ran about $1,100 a year across the three clinics. Roughly a third of that was waste — wrong connectors, adhesive that had dried out, or packs opened for a unit nobody used. Not a huge number on its own. But it was a number we had never once looked at, because electrodes weren't in the equipment budget. They were in supplies. Different line item, different person, nobody adding it up.

Then there's staff time. I'd estimate fifteen to twenty minutes per shift, across three clinics, spent hunting for chargers, matching electrodes, or explaining to a patient why the unit wasn't charged. Call it forty hours a year we were never getting back.

And there's the part that cost me personally. In 2022 I found a great price on wireless electronic muscle stimulators — about 40% under what our distributor was quoting. I ordered twelve. The vendor sent a handwritten receipt and nothing else. Finance rejected the expense report, and I ate $480 out of the department budget to make it go away. Now I verify invoicing capability before placing any order, regardless of the price. That's a lesson I paid for.

None of this shows up as a line item called ‘bad purchasing.’ It shows up as a slightly higher supplies budget, slightly more staff frustration, and a drawer nobody wants to open.

What I'd ask before the next purchase order

We eventually got this under control. Not through a big system — through five questions that now go on every requisition for anything that plugs in and touches a patient.

1. What is this device for — clinical treatment, front-desk retail, or staff wellness? Those are three different purchase decisions with three different standards. A wellness-room massager and a treatment-floor stim unit should not sit on the same requisition form.
2. What is the accessory SKU, and will it exist in three years? Electrodes, pads, charging docks, lead wires. If you can't name the part number, you don't have a supply plan.
3. Who trains new staff, and where does the documentation live? If the answer is ‘whoever's on shift,’ you'll be re-buying this in eighteen months.
4. What's the service path — repair, replace, or disposable? Some units have a repair depot. Some are designed to be thrown out. Both are valid. Not knowing which one you bought is not.
5. What's the regulatory status, and does it match the setting? Class II TENS and powered muscle stimulators, IEC 60601-2-10 where applicable, 510(k) status if relevant. Verify it rather than assuming.

We also cut down to two unit models across all three clinics. That alone eliminated most of the electrode confusion. Our distributor's rep — Henry Schein, in our case — put together an electrode compatibility sheet for the two remaining models, which is now laminated inside the supply closet door. It's not a sophisticated fix. It's just the first time anyone had written it down.

There's something satisfying about finally emptying that drawer. We redeployed seven units, sold four, and closed out the year with a supplies budget about $900 lower — without anyone actively trying to cut it.

The devices were never really the problem. The way we were buying them was. And that part, at least, was ours to fix.