Using the same methodology previously developed for evaluating maintenance strategies and inspection frequencies, a comparison was made between hospitals that developed and used their own, internal scheduled inspection procedures and others that followed procedures recommended by equipment manufacturers. The results show little, if any, difference in the maintenance outcomes, suggesting that using internal procedures is not undermining patient safety. If all hospitals are mandated to adhere strictly to manufacturer-recommended procedures, the additional cost has been estimated to be around $5 billion annually. Furthermore, it is foreseeable that this could result in more patient incidents. Clinical engineering professionals will be forced to curtail their support of clinical users, reduce participation in the integration of medical equipment data into the electronic health records, and withdraw assistance in the planning and acquisition of capital equipment, accessories, and supplies. The combination of higher costs, questionable benefits, and lower safety suggests this requirement should be carefully reconsidered by regulatory authorities.