Reinventing the Radiology Practice

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Radiology practices must be nimble enough to reinvent themselves if they are to thrive, according to Fred Gaschen, MBA, CHE. Gaschen, executive vice president of Radiological Associates of Sacramento, Calif, presented "Reinventing Your Radiology Practice" on October 24, 2008, at the Economics of Diagnostic Imaging 2008 National Symposium in Arlington, Va. Radiology, he says, is changing rapidly, and practices that are capable of changing along with the industry will be much more likely than their more hidebound competitors to survive.

Fred Gaschen, MBA, CHE.

In 10 to 15 years, Gaschen adds, methods of radiology practice will be nearly unrecognizable, by today’s standards. Because the money, time, and staff needed to respond to the coming changes will be limited in nearly every case, it is necessary to plan the practice’s response to those changes now. By setting priorities in the present, the practice that plans ensures that it will have the necessary resources to reinvent itself as needed in the future.

Strategic Planning

Before undertaking change, Gaschen notes, practices must use strategic planning to determine the direction that change should take. In practices that do not conduct frequent planning sessions, it may first be necessary to determine whether the group already has a strategic plan in place, as well as whether it was developed with or without the help of an external consultant. If a plan is present, it may need to be updated to reflect changes in the practice, in its market, in radiology and its technologies, and in health care regulation and reimbursement.

Gaschen recommends the use of planning retreats to improve the focus of strategic planning, adding that it may be helpful to bring in outside experts who will speak to the group and will help the attending radiologists and practice executives make their communication and planning efforts more effective.

A comprehensive strategic plan covers the practice’s mission, vision, values, goals, and objectives, and it includes an assessment of the practice environment. Based on all of these, it then outlines the core strategies that will be used to position the practice for the most successful future possible.

Women’s Health

In planning for a market that he characterizes as showing slowed (but still strong) growth, Gaschen recommends placing emphasis on comprehensive women’s health services within the radiology practice. While mammograms are not particularly profitable, the follow-up procedures that they generate usually are. Since the percentage of screening mammograms that will call for follow-up imaging and/or biopsy is relatively high, Gaschen notes, the initial mammogram serves as a type of loss leader that prompts many patients to return, if they were favorably impressed by the facility and by the level of customer service that they received there.

The women’s imaging center must offer all applicable services, Gaschen says, if it is to gain a substantial share of the market; his own practice includes radiation oncology in addition to all women’s diagnostic procedures. This sector also calls for the most pleasant environment that the practice can create, including attractive waiting and changing spaces.

The goal of Radiological Associates of Sacramento, Gaschen explains, is to maintain practice spaces that look so wonderful that patients, on arrival, nearly always react by saying, “Wow.” If a space is no longer getting this reaction, employees are asked to report this to management. The practice then updates and upgrades the space until the wow reaction returns, and it spares no reasonable expense in obtaining this effect.

Turnaround Times

Referring physicians almost universally want more rapid access to radiology reports. Reinventing the practice to suit today’s (and tomorrow’s) requirements will call for serious, sustained attention to turnaround times; this will include every step of imaging provision, from the patient’s arrival through delivery of the report.

In many practices, it may take some investigation to determine the causes of routine delays, which may be multiple. Clerical staff, technologists, transcriptionists, and radiologists may all be responsible for some types of slowdowns, but so may poor spatial layouts, obsolete patient-throughput methods, aging imaging equipment, or outdated information systems.

Once the operational and personnel-based bottlenecks have been addressed, the practice can consider improving its