A First-to-market Approach in Charleston

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Imaging Specialists of Charleston opened its doors at a time when most imaging centers were looking for ways to cut costs-and the South Carolina center took an aggressive first-to-market approach, investing in some of the most advanced imaging technology available, including digital mammography and the country's second open 3T MRI scanner. When the imaging center opened in January 2008, it was the first facility in the region to offer a full range of imaging services, from radiography and ultrasound to CT and MRI.

The center is owned by an LLC formed by the partners in Charleston Radiologists, PA, which provides professional services. Michael Garovich, MD, president of Imaging Specialists, spearheaded the center's strategy: to win market share by offering comprehensive, top-of-the-line service to referring physicians and patients alike. He spoke with ImagingBiz.com on the risks-and the potential pay-off-of the first-to-market approach.

ImagingBiz.com: In the post-DRA era, most radiology groups are watching their technology investments closely. How did you determine that this approach would sustain you?

Garovich: The strategy was to offer the most advanced equipment in a patient-friendly environment. We wanted to be very respectful of the patients’ time, get them in and out, and provide a high level of service to our referring doctors by having a turnaround time in minutes, rather than hours or days. At the hospital, they’re trying to cut FTEs, and that affects the level of service they can offer. Since we can control all the steps, we can provide superior service. For instance, the expense of more transcription hours is worth it, because by providing that extra level of service, we get more business.

In this time, when most people are circling the wagons and don’t want to buy equipment, we went out and bought a 3T open MRI. It’s great for the patients. It’s faster, it’s higher resolution, and the bore is so open that the patient’s comfort is incredible. If you’re claustrophobic, it’s great. I can’t tell you how many patients who used to need IV sedation can come here now and zip through the scanner. They’re not paying any more for it, and we’re not getting reimbursed more for it, but we believe that if we’re doing a great job, we’ll get more volume.

ImagingBiz.com: Is a first-to-market approach important across all modalities, or is it more viable when it comes to advanced imaging technologies?

Garovich: We thought it was most important in MRI because it’s a real differentiator for both sophisticated patients and for physicians. Orthopedic surgeons or neurosurgeons really appreciate image quality, but even with other doctors, you can get the message across that if it’s faster, that’s good. You don’t have to understand the physics of MRI to understand that twice as powerful makes a difference.

The other critical area was digital mammography. There were only two facilities in town that had digital mammography at the time that we purchased ours. We weren’t first to market, but since we got it, all our competitors switched, and we didn’t stop with that. We have computer-aided detection on both digital mammography and breast MRI. If I were a woman getting a mammogram, I would want every advantage possible. Some people will just go where their doctors say, but others are discriminating, and we want to give them the best that we can.

ImagingBiz.com: What high-tech modalities does Imaging Specialists have, and how does your portfolio compare to what’s in the Charleston market?

Garovich: We have DR and high-end ultrasound. When we got our open 3T, the Medical University of South Carolina did have an older 3T magnet, but it was one of the first 3T magnets in clinical use, and it was mostly used as a research tool. When we applied for a certificate of need, we didn’t have any problems getting it because our MRI was going to be strictly for clinical use. Since that time, the Medical University has installed a new 3T magnet. As far as digital mammography goes, when we designed the center, there were only two other facilities in town that had it.

We have 16-slice CT; most facilities in the area have 4- or 16-slice CT, though there are a couple that have 64-slice CT. The reason we didn’t make that leap to 64-slice was we found that the big utilization for that is detection of coronary-artery disease, and we don’t do too many coronary CT angiography (CCTA) cases. The physicians have not embraced that use of the technology.