Dr. Muroff: "Good is a Given"

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Lawrence Muroff, MD, continued his presentation on the characteristics of a great radiology practice by discussing evaluation of members. Great practices evaluate all of their members periodically so that members know what is expected of them and where they stand in the eyes of their colleagues. These evaluations should be both clinical and non-clinical, he said, and should apply to partners as well as newer staff members. “And it’s not enough to merely evaluate,” he added. “If there are problematic issues, the practice has to be prepared to deal with them—and the ultimate way of dealing with people is termination.”

Oh, Dr. M—I knew I could count on you for some straight talk. He went on to say that two-thirds of practices have fired a partner or associate in the past five years, which he said is not enough. “We don’t do a good enough job dealing with our problems,” he said. “Bad behavior not only can, but has caused many groups to lose their hospital contracts. The group knew the person involved was a problem, and yet the group did nothing.” He added that “good is a given”: a radiologist being good is not a sufficient reason to keep the person on staff.

So how can groups make better personnel decisions? Muroff had a few ideas:

--When in doubt, don’t hire. You are not likely to be able to rehabilitate a problematic potential hire.
--It’s rare to perfectly fulfill your personnel needs—you’ll always be a bit too fat or too thin, and “you have a lot more flexibility if you’re a little fat,” Muroff said.
--When you need to make a change, act decisively and immediately.

As a final note on the subject, Muroff said, “Assessing blame and wallowing in misfortune are counterproductive. Everybody makes mistakes, but the good groups don’t repeat them.”

Great practices want to optimize their financial position, but they realize that money can’t be their prime motivator. “Radiology is a service specialty,” Muroff said. “If your radiologists are unwilling to accommodate the service needs of patients and referring physicians, they’re in the wrong specialty. If they provide the service, the money will be there. Don’t provide the service, and someone else will.”

Muroff said hospitals get rid of their radiology groups for several key reasons: they’re tired of hearing complaints from their referring physicians, they don’t like radiology groups competing with them, they want more control, or they don’t think radiologists have the necessary leadership capability. “The ACR is talking about establishing a radiology leadership institute just to help educate key members of practices,” he noted. “Hospitals actually respect practices that bring in consultants. They understand that they’re trying to better themselves.”

Great practices understand marketing and the importance it has to the growth and success of a business. “People don’t understand what we do,” Muroff said. “Most of it wasn’t even there when our referring physicians went through training. Marketing is the way to educate them.” Other major marketing targets include hospitals and patients. “If a patient feels good about a visit to your practice, so will the referring physician,” Muroff noted.

Basic marketing tools for a practice include:

--Radiologists willing to educate referral sources
--Marketing reps
--A great website
--Order forms and prep sheets with maps
--Sophisticated marketing software
--CME opportunities for referring physicians
--An eye-catching practice logo

“Having said that, you can spiff up a bad product with sophisticated marketing, but you can’t sustain it,” Muroff noted. “If your product is bad, fix it first, then market the improved version.”

As some final food for thought, Muroff mentioned a few non-traditional, emerging markets for radiology, including patient support groups, podiatrists, oral surgeons, sports coaches/team trainers, and personal trainers/massage therapists. “Great practices have challenges that are similar to those facing all other practices,” Muroff concluded. “They’re just better equipped to deal with them.”