Are you thinking what she’s thinking? Attempt to align before making drastic/dramatic decisions

Most radiologists have fundamentally the same concerns: 

• How do I maintain a good income?

• How do I balance the increasing demands of time/speed with my overall workload?

• Am I increasing my potential clinical risk?

• What is going to change next?

During the last five years, I have been actively engaged in more than 100 radiology board meetings and what I find in the beginning is that the structure of most meetings produces a disproportionate amount of time spent not addressing these concerns. Most of the time is spent on passively reporting financials, clinical protocols, and addressing administrative items such as vacations, taxes, call schedules, dues, etc. The worst meetings produce animosity among partners without resolving the issues that could lead to a bad situation for all (legal disputes, disbanding, high emotions, lack of trust).

The concerns above are true for everyone, and the problems of potentially lower volumes, decreases in reimbursement, increases in compliance, increases in competition, more complexity in billing, and more distractions are similar for all of you. Thus it is imperative, no matter what compensation model you are in (partner, employment, RVU, or some combination), to be aligned so that you not only deliver care collaboratively, but also maximize your income potential. The more time spent focusing as a collaborative team, the greater the probability you will succeed and reach a destination that is best for both the group and its individuals, even if that means certain individuals choose to leave.

Therefore, before you decide, independently or as a group, to make changes in your structure, please work with one another to agree on fundamental goals and share with one another your specific challenges. For example, a 60-year-old radiologist may have different specific concerns (be conservative, produce average income, improve lifestyle, etc.) than one who is 40 (pay off bills, accept uncertainty about what might happen over the next 20 years, fund children’s education, etc.). Try not to judge; rather move to improve your mutual situations.

If you do not make an effort to align, you will not have clarity in making the proper decision for either yourself or your practice, which could lead to financial and personal disruptions. I have spoken with several radiologists who, by their own interpretation, have made the wrong career decision and feel that it will take at least three to five years to fix. They also discuss the associated emotional and legal costs and wish they had moved in a more deliberative way. But if you do make the effort to align, the even in the worst case scenario, you will feel good about your decision to change because you exhausted all of your options internally.

Lastly, I encourage you to work with your partners, hospitals, senior administrators, and physicians to understand what they are most concerned with so you can put together a solution that is less subjective and is focused on serving your partners. In my next report, I will speak about specific suggestions for doing this.


Mr. Jethani is CEO of Medical Imaging Specialists