By Evan Leepson, MBA
The following article is the first in a series that will examine quality improvement issues at two fictional, and distinctly different, radiology practices. Each article in the series will examine a different clinical or socio-economic issue, and will show how each practice solved the problem. Hopefully, their examples will provide lessons that real-world radiology practices can use to improve the way they deliver medical imaging services.
"It was the best of times, it was the worst of times."
Charles Dickens, 1859
Our series will examine Proactive Imaging Associates, PC (PIA) and Reactive X-Ray Partners, PC (Re-X). By way of introduction, meet the folks from PIA. There are ten partners. They work in two small hospitals in a suburban East Coast community, and own a freestanding imaging center and a billing company. PIA subspecializes in neuro and interventional radiology. The partners employ a full-time practice administrator, and one radiologist serves as the managing partner.
Re-X has nine partners and employs two part-timers. They consider themselves generalists. They read for a private freestanding imaging center in a mid-sized city in the Midwest. They have had privileges at the local community hospital for 20 years. The practice has a business manager, and one radiologist serves as the practice's president.
Talk to any of the radiologists at Re-X and you'll hear the standard litany of complaints about the practice of radiology and the hospital they serve. You’ve heard this laundry list before--accepting low-reimbursement managed care contracts, watching an eroding referral base, dealing with a hospital administration that holds back on important imaging equipment purchases, taking brutal on-call and night schedules, and reading more and getting paid less.
PIA's approach
While Re-X complains about life, PIA works with hospital administrators to project the future need for diagnostic imaging services. Instead of fighting the administration, PIA and the hospital jointly funded a study to look at diagnostic imaging needs in the surrounding community.
Their assessment consisted of:
- Analyzing demographics;
- Assessing the competition for diagnostic imaging;
- Looking at utilization rates (both for managed care and indemnity plans); and
- Surveying referring physicians.
PIA ascertained the current and future demand for diagnostic imaging services in the community -- and planned accordingly. PIA now has the data sets needed to make informed planning decisions.
With their data in hand, PIA's radiologists developed three possible scenarios for future market share (base case, worst case and best case). Each case had corresponding workload projections.
What was Re-X doing while PIA was building relationships and gaining valuable information? They were reading films.
This is good and bad. Good: income stream is maintained. Bad: they were perpetuating their bunker mentality.
PIA does not have a crystal ball to predict the future, but they understand the need to predict future trends in the practice of radiology. They have the ability to translate trends into action strategies for future growth. PIA is focused on the needs of their referral sources, the latest changes in managed care, and other socio-political issues. Meanwhile, the Re-X doctors keep to themselves in the reading room.
"You gotta read film," says a senior radiologist at Re-X. Agreed, preferably in a dark room. But that is where the analogy stops.
Next time: His wife is what?
Evan Leepson, MBA, is a former director of marketing at the American College of Radiology. He has extensive consulting experience, focusing on the strategic planning aspects of radiology, and is a well-known author and speaker at national radiology meetings. He can be reached at [email protected]
February 4, 2000Copyright © 2000 AuntMinnie.com
