Imaging vendors receive an earful of tactical scanner sales advice

Companies told to ride the health-care paradigm shift

Medical imagingvendors have been quick to jump on the cost-effectiveness bandwagonheaded toward managed health care. Even mega-ticket technologieslike PET are now touted as potential cost-savers. However, scannersuppliers must do more than pay lip-service to cost-effectivenessif they expect to be one of the companies left standing when thehealth-care reform smoke clears.

Vendors must supply customers with hard data to back up theircost claims. They must prove that their equipment can save usersmoney compared to a competing technology, according to a panelof experts dispensing advice on equipment marketing at a conferencelast month sponsored by Diagnostic Imaging.

Entitled Opportunities for the Imaging Industry: Prospectsand Challenges in the `90s, the conference brought together imagingvendors, radiologists, hospital purchasing experts, financiersand consultants in an effort to develop strategies for dealingwith medical imaging's changing environment.

A major issue discussed at the conference was how vendors canadapt their marketing strategies to changes in equipment purchasing.The influence of radiologists on the scanner purchasing processhas declined significantly over the last half decade. Althougheach hospital purchasing system is unique, the days when radiologistswielded almost total control over what imaging equipment to purchaseare fast disappearing.

Hospitals are now developing more scientific methods to replacethe radiologist-centered purchasing model. Technology assessment,purchasing committees and other techniques are being used withgreater frequency to take the guesswork out of buying.

But the new techniques require vast amounts of statisticaldata about cost-effectiveness, outcomes, equipment use and personnelproductivity. This information is in short supply. Vendors musthelp purchasers acquire and use operational data if they wantto successfully compete in the managed-care arena, according topanelist David Berkowitz, vice president of the nonprofit consultingagency ECRI of Plymouth Meeting, PA.

"As manufacturers, teach us how to do technology assessment,"Berkowitz said. "Show us technology that will improve outcome,quality and value. Show cost-effectiveness and collect informationthat will allow us to prove it to payors."

Vendors must tailor their research to account for the paradigmshift taking place in radiology, according to Dr. Derace Schaffer,chair of the department of radiology at The Genesee Hospital inRochester, NY. Schaffer is also president of Ide Radiology Group.

For example, promoting equipment as having high patient throughput,long a favored marketing tack for many vendors, will have littlevalue in a capitated environment, Schaffer said. Instead, vendorsshould sponsor studies that will enable clinicians to use theirequipment more wisely.

"We are going to be capitated," Schaffer said. "Insteadof trying to do as much (imaging) as we can, we are going to bein a position of having to decide what (managed-care) businessto bid on, and (how) to control our patient volume. You can beof great assistance by helping the people who are managing radiologydepartments measure their productivity and get a better handleon the numbers in their practices."

Other marketing strategies include:

** Setting the ground rules for equipment bidding ahead oftime. Schaffer's hospital conducts only one round of bidding,and asks vendors to make their first bid their lowest bid. Thisavoids endless negotiations that waste both the buyer's and theseller's time;

** Marketing to the master center of a radiology or hospitalnetwork. These networks are building significant buying powerthat can be easily accessed;

** Making agreements with users that spread the risk of equipmentacquisition, such as fee-per-scan arrangements;

** Getting community hospitals and radiology groups involvedin clinical studies. Collecting research data outside the universityhospital setting will give vendors a more accurate picture asto what the average user is doing;

** Using knowledgeable sales staff to market equipment. Thelarger radiology groups become, the more they are able to specialize,Schaffer said. Vendors must make sure that the sales staff visitingthose groups are equally specialized; and

** Selling the right equipment for the right job. Vendors sometimessell too much equipment to pump up sales volume, or don't sellenough, trimming features in an effort to win a bid. Both practicescan alienate customers.

The panel also discussed the growing use of medical imagingequipment by nonradiologists. In one of the liveliest discussionsof the conference, they debated the wisdom of marketing to nonradiologists.

Nonradiologists are a market that cannot be ignored, due tothe large numbers of clinicians in other specialties buying andusing imaging equipment, according to Schaffer. Laws that banphysician self-referral -- but allow physicians to conduct imagingprocedures in their own offices -- have exacerbated the situation.

"Because of the fact that you have Stark-like (self-referral)legislation throughout the country now, orthopedic surgeons, neurologistsand neurosurgeons who were satisfied to have a piece of the localimaging center will no longer be able to have that," Schaffersaid. "Since they control patients, they are going to windup doing more imaging on their own."

Others on the panel stated that radiologists will continueto be the primary market for imaging technology and should remainthe focus of vendor marketing efforts. While nonradiologists whoare trained in imaging can do a good job, they are not as committedto the discipline as radiologists, according to Dr. Ross Golding,radiology department chair at St. Mary's Regional Medical Centerin Reno.

"Radiologists are interested in imaging from more thanan economic basis," Golding said. "It's our life, it'swhat we have spent many years training to do, and we do it betterthan non-imagers. Radiologists are more important, and that isthe direction (in which) you need to focus your sales."