Is Private Practice Radiology as Important as an Amusement Park?

Once upon a time, as a college student certain of my future as a psychiatrist, I thought it would be helpful to major in psychology. Subsequent work in psychiatric clinics and my time in med school disabused/ me of that notion and, of course, we know what specialty I went for instead.

Still, I liked the subject material and enjoyed knowledge tends to stick in the mind even if one never really uses it. One of the better classes I took focused on theories of personality development, showcasing various schemes of life stages based on what one tends to go through in each age range. A toddler might be focused on becoming less dependent on parents, for instance, while an oldster might look back on his or her accomplishments to weigh the worthiness of his or her life.

I found myself dwelling on that staged examination of life when recently noodling about heading to a major amusement park in my region. I had been there a few times during childhood and more as a teen and twenty-something. I could see a psychological staging system based on one’s attitude toward such parks.

A super young kiddo, for instance, would just be overwhelmed by the place. It would be too massive to comprehend, dazzling the senses. Add a few years of age and it would be a paradise with infinite rides, games, and treats. Some more aging, and an adolescent might yearn to freely explore without the burden of chaperones.

After that, joyfulness might give way to jadedness. The lines are too long, they are starting to charge way too much for what you get, and boy, how many of these rides can you go on before you start to feel a headache coming on?

Such thoughts might have kept me from ever going back. I had done it enough and wasn’t eager to drive five-plus hours for the round trip. Plus, it is just a kick in the teeth to get to this park in the middle of nowhere and have them suck an extra $45 out of you just to park your car.

Still, my lady had never been there and that was worthy of correction. Plus, it was the first weekend of their Halloween attractions for the year, and she loves that stuff. Typing this the day after, I can happily report that it was entirely worthwhile.

Even some of the stuff that one might regard as price-gouging struck me as good moves. I mentioned the deterrent of lengthy lines to go on rides. Long ago, the place instituted ways (at extra cost) to reduce your wait or eliminate it entirely. When they first did that, a lot of us thought it was in poor taste. We’re already paying the park handsomely to be there, and now other folks can throw more money at the situation to leapfrog us?

Now I am not so offended. This is partially because I have more scratch than I did as a kid, and I can do some leapfrogging myself if I like. Additionally, I had been around another couple of decades and see that this is how the rest of the world works. People pay to get shorter lines at security in airports, priority boarding, nicer seats. Is it fair? No, but precious little is fair.

Another reason I am more accepting is that the park’s systems have gained sophistication. Getting an all-day, unlimited-use line skipping pass costs enough that you have to use it a bunch of times before it is worth the time you have saved. Meanwhile, the park has added single use passes at each ride with each price based on the current wait time. Want to go on a coaster in five minutes rather than 120? That will cost more than if you reduced a 10-minute wait to two.

In other words, more a la carte options are around now than there used to be, and you can pick/choose what you wish. Someone like me might take advantage of a few of them but scoff at pricier, all-or-nothing deals. It gives more of the people what they want, and gives the park more cash for profitability, or to bankroll newer and better attractions. This indirectly continues to give more people what they want.

As we enjoyed the place, the notion hit me more than a few times. Why can’t this be done in radiology?

As massive as the amusement-park-going population is, folks utilize health care in even greater numbers, most with greater frequency. Are amusement parks, airlines, etc., somehow more important and trustworthy? Society can allow them such leeway to do what is good for their business, but you had best not try to do the same as a physician.

Suppose, for instance, a patient was inclined to pay out of pocket for a dedicated hour of sit-down time with a radiologist who had read a bunch of his imaging. Alternately, knowing that there is a two-month wait for imaging procedure X, a patient wanted to pay more, a la skipping the line at the amusement park or going through TSA’s “trusted traveler” queue for better speed and convenience.

Our perpetually cash-strapped health-care system, you might imagine, would gratefully allow such moves. Sure, doc, we are paying you a fraction of your operating costs to read an X-ray. Make up the difference any way you reasonably can. If you are gouging, patients will find their way to other docs who offer similar services without your price tag.

Instead, our system does everything it can to stand in the way. Sorry, doc, the services you propose to offer at an added fee are considered to be “bundled,” baked into the reimbursement you already receive.

Make a move that even appears to be asking for an extra cent, and you will be scrutinized by the full weight of the government. They won’t just be looking into the issue at hand. Now that you are in the crosshairs, everything you have done in years within the statute of limitations is subject to dissection and retrospective condemnation.