Imaging in the Global Marketplace: A Conversation With Stephen Pomeranz, MD
Stephen PomeranzAs radiology practices continue to grow in size via mergers, partnerships, and other forms of consolidation, the model of the nationwide practice is beginning to appeal to many. ProScan Imaging (Cincinnati, Ohio) owns 24 freestanding imaging centers in the United States, and it offers teleradiology services both nationally and internationally. ImagingBiz spoke with Stephen Pomeranz, MD, ProScan’s founder and CEO, about the practice’s business model and how it reflects a changing radiology marketplace. ImagingBiz: ProScan has a wide national and international reach. Can you characterize the company’s business model? Pomeranz: The foundation of our business model is the quality of our people, including internal staff, business partners and customers. Everything is focused on making physicians—especially radiologists—successful, so we focus on using quality education and service to raise the bar of care for people, regardless of country or nationality. We train all members of our customer service and radiology teams to function at the highest level. What we do externally, we also do internally, which is treat our employees and customers with the utmost respect and work hard at raising their level of expertise, and many of them stay for that very reason. We create our own internal culture of excellence. ImagingBiz: The radiology market has seen a trend toward larger and larger practices in recent years. What economic forces have influenced this trend? How have they shaped ProScan’s path? Pomeranz: I think the trend is driven by concern over the current world economy and the current national economy—in any business, there’s always the feeling that there’s safety in numbers. More and more physicians are selling their practices to hospitals; that’s happening at an accelerated rate, with the hospitals’ goal being to control the flow of health-care dollars by controlling the clinicians’ behavior. In reaction to that, radiology practices have felt there would be safety in numbers (in a community and even across communities) that would enable them to maintain an important presence in the health-care arena and to maintain some autonomy. Physicians are independent people by their very nature; that’s one of the reasons that they’re good at what they do. Losing independence for certain decision-making processes is a scary thing for physicians. ProScan is probably the most experienced provider of what I would call noncommodity services—services where a high level of expertise is necessary. We see well over 1,000 complex MRI exams a day. We provide a real, valued service, and we do it with board-certified, fellowship-trained, and sub-specialty-focused imagers. We integrate that training with clinical medicine, so we’re not just readers; we’re consultants. As the economics of health care change, what is going to happen is that physicians are going to be given a fixed amount of money to take care of a fixed population. What would you rather do, pay $500 for an MRI exam of the knee interpreted by world-renowned experts or pay $1,500 for an interpretation from a hospital? An organization with a high level of quality and service and a lower cost is an invaluable strategic partner. ImagingBiz: What are the advantages of contracting with a nationwide radiology business and of working with one? Pomeranz: We know what’s happening in different parts of the country; we understand some of the nuances between different parts of the United States and the world, and that helps us make strategic decisions. We see what has played out in countries like Australia, Germany, the United Kingdom, and Switzerland. Another valuable thing is that all of our radiologists are trained here, but sometimes they choose to go home to where they were born, and that could be in Asia. They’re US-trained and ProScan–fellowship-trained physicians, but they read when we’re asleep. We’re able to offer a 24/7 high-level service all over the world, every day of the year. As an international radiology business, we get to help people globally, which is rewarding. Our radiologists get to see the world’s greatest pathology; they get to focus on very high-end, complex, intellectually challenging, and satisfying exams. When they leave their training at ProScan to read for us remotely, we often have double and triple reading for the first two years to raise the bar even further, and that makes them very comfortable. Our executive and administrative teams are very dedicated to our radiologists and to our referring physicians and their patients. They’ll do anything they have to do to get the right answer to the right place. ImagingBiz: ProScan also offers imaging and interpretations to support clinical trials. Why is this important? Pomeranz: It’s important for a number of reasons. Most pharmaceutical companies don’t have a deep bench in terms of imaging expertise, so when they’re designing trials and figuring out how to use imaging, they often need to turn to outside expertise. There aren’t that many high-level organizations that have the necessary experience—clinical trials are culturally different, the medical approach is different, and the datakeeping is dramatically different. We live in both worlds, and our datakeeping is impeccable. It’s also extremely interesting to be involved in a clinical trial. It’s very stimulating for our physicians. ImagingBiz: Speaking of datakeeping, national radiology practices are known for their tech savvy. How can this expertise be leveraged across the health-care continuum? Pomeranz: ProScan has always been dedicated to being on the forefront of technology, and we’ve shown strong commitment to that through spending and staffing. It's challenging and costly in these changing times to keep up with the pace of technology, including interfacing disparate systems, optimizing workflow, and maximizing productivity. Those who have a technology advantage can use that as differentiation leverage among competitors, can provide better information to the ordering clinician, and can improve the quality of patient care and understanding—which is something that is in our DNA and to which we are firmly committed. I think the future of imaging technology in health care is very bright. It’s going to become an even more important part of the decision-making process in which patients are triaged based on information from imaging. In my opinion, there will be more imaging that’s appropriately done, and that will play a big role in reducing costs. Cat Vasko is editor of and associate editor of Radiology Business Journal.