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Crest of a Wave


For radiology practices, paying attention to – and offering to meet – industry needs can help differentiate you from the pack.

I’ll start by saying that I have never so much as touched a surfboard. Haven’t even felt inclined to try standing on one of those super-broad/stable SUP things.

Nevertheless, I’ve got a lifelong appreciation of waves…greatly antedating my physics lectures in radiology residency and pre-med curriculum. Living near beaches and frequenting them every summer, I had plenty of exposure to waves of all shapes and sizes.

The crest of a wave holds my interest the most, and I’m surely far from alone in this. A wave’s got plenty going on elsewhere, but eyes are drawn to the peak. How high will it get? Has it overextended itself; is it about to collapse? Sooner or later it will, of course, as with most things we mortals encounter.

From certain perspectives, however, a wave lasts as long as it needs to (or longer). For instance, during those trips to the beach, I spent plenty of time bodysurfing. Depending on how well I negotiated the crest, I might ride all the way to the sand, the wave might get away and leave me behind to watch it go…or, sometimes, I’d get a little too far forward on the wave, pulled underneath it, and chaotically spun/churned.

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No surprise that such a background has predisposed me to regard various ventures as being akin to seeking out, perhaps riding, the crest of a wave.

Case in point: Recently selling my vehicle. Purchased at the end of 2005 and still serviceable but increasingly crying out for replacement, it had surprisingly good retained value according to sources like the Kelley Blue Book (KBB). I knew I didn’t want to just trade it in at the dealership where I was getting my new ride; that’s easiest but also gets you the least. KBB helpfully gives you a range of prices depending on whether you do that, sell to a used-car entity, or (best but requires the most work) sell to another private party.

I decided to go with the middle option. Outfits with names like “CarCash” varied in their offerings, but generally matched what KBB predicted. One stood out with a quote that was solidly in the better, private-party price range.

Too good to be true? Maybe. But I did some digging and confirmed for myself that the outfit was not only legit, it had strong ratings from both previous customers and professional reviewers. Moreover, they were one of the few that would do just about the entire process online, only coming to pick up your vehicle at the end of the transaction.

In other words, they were the crest of the sell-your-car wave, offering the best in terms of both pricing and convenience. I pulled the trigger and successfully completed the transaction within a few weeks. No unpleasant surprises.

How could they do this? Maybe they won’t be able to for long; maybe paying out that much more than their competitors will prove to be a non-viable business model, and their wave will collapse. Or maybe they’ve figured out something that others did not, and they’ll capture a whole lot of market-share…their wave might, thus, crest even higher and more impressive. Whichever: For my purposes, it did exactly what it needed to.

I have a similar story about a computer I bought for myself before my current machine: I identified an outfit that was doing what others were not (offering a website where you used drop-down menus to assemble, piece by piece, various hardware components that would be compatible with one another, with competitive prices for each item you chose, and, then, they’d assemble it). I wound up with a rig that had exactly what I wanted rather than a cookie-cutter Dell or the like.

This doesn’t always work out so wonderfully: Years later, seeking my current computer, the original outfit’s wave had continued to swell mightily, to the point they could demand higher prices and were no longer a bargain. So I tried a relative newcomer to the biz who was doing similar things with a lower price-tag…would up with mediocre results.

A similar approach has served me well in my radiology career, for instance when changing jobs. When I started writing this column, I was making a move from a traditional onsite private-practice group to vRad (vR). Considering the bad job-market at the time, vR’s wave was cresting nicely: They had just become the biggest player in the field. They arguably offered the best suite of hardware, software, and support-personnel to boost their rads’ efficiency and productivity, and that translated to the best professional livelihood I could expect without uprooting my life and relocating.

I leave it to others more recently-familiar with vR (are they ever going to just call themselves RadPartners?) to opine about whether that wave has gone on to further crest or collapse. When it stopped cresting for me, personally, I sought a replacement which would crest in ways vR was not…and am now in my third year with the group that I found.

Rads seek out things like compensation, schedule, reasonable expectations of productivity, etc., and groups do what they can to appeal to such interests. Some groups “reach” further, by claiming to offer what others cannot. If they can deliver and continue to thrive, those groups’ waves crest higher. If they can’t, they risk varying degrees of collapse.

But, there are other ways to crest more impressively than the competition, especially offering things that nobody else has. Sure, it’s nice to boast that you’re paying $2 more per RVU than the next guy…but if you can provide a reliable track to real partnership in an area (like telerad) where others aren’t? Or allow some rads to literally log on and read whenever they like, rather than adhere to a schedule? That’ll make you stand out.

Let others watch and wait to see if you overextended. If you did your homework and formed your plan carefully, by the time they figure out that they need to do what you’ve done, and follow in your footsteps, your wave can already be cresting higher with even newer initiatives.

Follow Editorial Board member Eric Postal, M.D., on Twitter, @EricPostal_MD

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