Breast radiologist and the Practice President for RP Georgia, a 11-radiologist practice based in Columbus, Georgia.

Andrea Nicole Cole, MD

The COVID-19 global pandemic has profoundly impacted healthcare services in the United States, and radiology is no exception. As leaders of our local practices, we have seen firsthand how the pandemic has exacerbated challenges radiology was already facing – financial and otherwise. We represent practices of various sizes, serving different and diverse areas of the country. Each of our groups is part of 

 (RP). As a national organization, we have been able to develop thoughtful solutions and creative approaches to many newly posed challenges.

Like politics, healthcare is local. This means a one-size-fits-all approach simply won’t work for many aspects of a practice. Local radiology leaders know their referring physicians, client partners, and patient population. That is why RP operates under its “one practice, locally led” (OPLL) principle. OPLL means that RP comprises a single community of radiologists with a shared mission to transform the specialty, 

 local RP practices have autonomous decision-making authority over how their group is managed. When dealing with the challenges presented by COVID-19, we didn’t go it alone.

We are never told how to manage our group, even during a global crisis. We are charged with making decisions in the best interest of patients, referring physicians and client partners. RP provided tools, analytics and resources to ensure our decisions were well-informed. For example, we were provided detailed reports to help us predict volumes and dedicated human resources representatives who helped advise our decisions about staffing that were ultimately right for us locally.

This allowed radiologists nationwide to be re-deployed from practices with lower volumes to those who experienced less decline. Especially for smaller practices, the ability to gain the level of insights needed to make optimal and rapid decisions from our own data was impossible. These analytic capabilities have been critical and may prove to be even more important going forward. Through RP’s robust resources, organizational structure and collaborative culture, we were able to react to COVID-19 swiftly, decisively, and fairly. Now, with the benefit of hindsight, we see that such timely action was—and continues to be—crucial.

Like many other practices, we had to pivot quickly to offer teleradiology. The ability to rapidly shift our work offsite without sacrificing quality was made possible by national resources. This allowed us to continue serving our hospital partners without interruption. This transition also limited exposure of many of our physicians, particularly those most vulnerable. Through collective IT support and deployment of hardware and equipment, we were we able to rapidly adapt to the new work environment. This shift has also given us the flexibility and structure to manage the volume as patients return for care. In fact, given our expertise and adaptability, RP is still growing, having secured agreements with 19 clients since March 1, 2020, representing more than 1.2 million annual exams.

One of the benefits of scale is administrative support and that has been highlighted by the current challenges. For example, many practices now find a need for radiologists to be credentialed in multiple locations, sometimes in different states. With dedicated teammates handling the licensing and credentialing for radiologists, our local practices are less burdened and able to focus on patient care. While our physicians have been providing care to our communities, our support team colleagues were able to understand the financial complexities on our behalf, including governmental assistance programs, which requires a unique knowledge base and thorough understanding. These aspects played key roles during the height of the pandemic and will provide lasting benefits in our ongoing work.

Through our COVID-19 Taskforce and Clinical Value Team, comprised of radiologists and support team leaders from across the country, we were able to quickly develop and share best practices, new processes and procedures during the early onset of COVID-19. There was a flood of new medical literature, and our multidisciplinary resources allowed us to quickly review and communicate in focused practice updates. Through organization-wide clinical best practice sharing, we learned from each other about how to best manage the additional requirements for cleaning and sterilization and effective scheduling with more time in between visits. With the lean volumes we had and rapidly emerging, unique risk management issues, there was little margin for error. Additionally, the challenging nature of the times has allowed new leaders to emerge, applying the leadership principles they were taught through the various RP professional development programs, like RP University.

Communication with our local and national colleagues has never been more important. Practice leaders from across the country met weekly to share experiences and best practices. To ensure all physicians and support teammates remained informed, RP hosted internal webinars to discuss the response to the pandemic. Locally, teams met face-to-face via virtual tools. And, our COVID-19 Taskforce produced email newsletters, COVID education and wellness and resiliency resources to ensure teams remained informed, connected and cared for during the most critical points of the pandemic.

Across the country, radiology volumes were down 50 percent-to-70 percent (or more) at the height of the pandemic. This created difficult situations, not just for radiologists, but also for our support teammates. We were fortunate that RP created RP One, a teammate assistance fund to help alleviate some of the financial burden for those who were impacted. Physicians and support teammates donated money as well as paid time-off. RP made an initial contribution of $1 million on the first $100,000 of teammate contributions and continues to match teammate contributions dollar-for-dollar. To-date, our teams have raised nearly $2 million.

This has been an emotional and stressful time, and RP continues to ensure that wellness and resiliency resources are available to all teammates and physicians. In addition to our robust employee assistance program, RP offers weekly coaching sessions as a safe space to connect with colleagues across the country and reflect on our emotions. And, we continue to emphasize the importance of ongoing mental and physical health through key provisions such as regular internal articles and resources provided by our COVID-19 Taskforce, Culture and Leadership Development team and Wellness Committee.

COVID-19 has presented an abundance of challenges to radiology. Nonetheless, our focus remains the same: high-quality, patient-centric care, local practice autonomy and support for our colleagues. The challenges we have faced have come with opportunities to strengthen our commitment to these goals. Although we come from different regions and lead local groups of different sizes, we are one practice with a singular vision. We share the belief that a strong practice culture, a locally led model and the benefits of scale will only be more beneficial in the future, and that together, we can transform radiology.

Dr. Frank Castellano is a neuroradiologist and the Practice President for Columbus Radiology Corporation (CRC), a 120 radiologist practice based in Columbus, Ohio. Dr. Andrea Nicole Cole is a breast radiologist and the Practice President for RP Georgia, a 11-radiologist practice based in Columbus, Georgia.

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