Radiology’s Gut Check

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Curtis KauffmanYou know things are bad when virtually all of the luminaries and thought leaders in a profession agree on certain negative indicators and a most likely scenario that will be the result of a confluence of “perfect storm” issues. That’s how it is with radiology these days. Lots of influential people in this space agree that change is here to stay, that it is mostly going to hurt, and that it is long overdue.

Economists agree that the growth curve of health care spending continues to spiral out of control, with imaging a key cost driver. Payers agree that something drastic needs to be done to control imaging over-utilization. Health executives agree that they don’t understand why radiology has not found better solutions to the lack of leadership on some of the most important institutional issues of the day. Even most radiologists agree that theirs is a system fraught with misaligned incentives and an RVU driven environment that dictates behavior and priorities.

It’s time for a gut check. The bubble that is fee-for-service radiology is going to burst sooner rather than later. The smart and facile among us who have been planning for this sea change will survive and flourish because they have for some time embraced change, re-structured to take advantage of its new dimensions, and have aligned their respective practices around a strategy that anticipates and plans for the inevitable. It is said that imaging reimbursements are likely to decline anywhere from 15% to 30% in the not too distant future. Can you take that kind of hit and still survive? You can if you get everyone in the organization on the same page regarding productivity, efficiency, service, efficacy, and marketing.

My recommendation is to not be caught by surprise and be the last practice to understand and plan for such an event. In an era in which the most recent data reveals that radiologists remain in the top three medical specialties in terms of annual compensation with the bottom three specialties compensated at less than half of those at the top, those who allocate the diminishing national resources to pay for this take notice and act to fix an obvious inequity.

Population health management, new types of capitated payment systems, risk sharing, and other forms of business models are emerging as practical solutions to the problem of how best to deal with what is largely believed to be a 30% waste in medical imaging.

After 30 years in the field of radiology studying what makes our profession both amazing and challenging I have re-committed myself to helping organizations find better methods, strategies, and solutions to the problem of how best to succeed in what has become a very dynamic and fast-changing specialty. Helping practices, hospitals, and vendors to better align themselves around their purpose, vision, core values, and value proposition is an exciting and rewarding way that I will continue to coach and guide those that I work with through what I believe to be the most intellectually interesting time in our profession. How you differentiate your business and remain a key player in a profession undergoing profound change will be the difference between success and failure as we move forward through these troubled waters.

If you are interested in talking more about survival strategies I would love to chat with you and discuss some of the seminars and courses that I have developed over the years such as strategic planning, leadership training, communications coaching, team alignment, message and value proposition development, and others. Feel free to contact me directly at: Perhaps just a good conversation on these topics will get you pointed in a better direction—or give you a much needed gut check.