Radiologists have long enjoyed an almost symbiotic relationship with their hospitals. The hospitals provided the equipment, technologists and support and the radiologists, the specialized expertise to support the diagnostic consulting needs of the medical staff. Economically it worked for both parties. Then times began to change and in an unprecedented series of events, radiology practices—even very large ones—found their contracts terminated. What the heck happened?
I used to hear from the radiology department manager that the only time radiologists showed up for hospital meetings was at capital budget time—where they proceeded to ask for millions of dollars of new equipment. Not just ask—demand. He laughed when he told me we were getting a new CT and updated interventional room but the cardiologists were turned down for a new treadmill.
And then we get to how radiologists and hospitals define quality. Radiologists look at credentials, including where their colleagues went to school, which fellowships were completed and what subspecialty expertise is added to the practice. The hospital definition of quality frequently involves incurring minimal complaints from the medical staff, participation in marketing efforts and on hospital committees, causing few morale problems among the technologists and department staff, signing reports promptly and willingly adopting new technology such as voice activated dictation. We begin to appreciate the divergence of perspectives.
In terms of behavior, the old style radiology practice still seems to consider its hospital contract an entitlement. The hospital views it as a business and they know they are often the largest single source of revenue for their radiologists. The old style group asks the hospital to pay for nighthawk coverage. The hospital may then actually help bring in the organization that can establish strong ED service levels—and later, an alternative to the group’s perceived negativity and demands.
The perceptive radiology group sees the hospital as a major customer. And strategically they are asking questions. What does that customer feel is important and how do we increase our value as a business partner? How do we work with the administration to develop a strategy to improve radiology services? How do we support internal improvement efforts? How does radiology become a player for the long term?
It is a time of change and challenge—and opportunity. There is much to be gained and lost. Which side will you be on?