Thoughtful tactics can lead to great group practices

Most radiology practices are governed haphazardly, act unpredictably, and tend to succeed in spite of what they do rather than because of it. This evocative statement by Dr. Lawrence R. Muroff touches off an instructive new paper in the September issue of the Journal of the American College of Radiology titled Taking your radiology practice to the next level.Radiology groups have benefited over the last decade from favorable market conditions that made it difficult to fail, said Muroff, CEO and president of Tampa-based Imaging Consultants. But the gravy train is over."Things are cyclical," he said. "One only has to turn to the mid-90s to see when radiology was not so fortunate and there were concerns about the future of the job market, for example."The federal Deficit Reduction Act and down economy are among the forces foreshadowing hard times for procedural specialties. Commoditization of radiology services, a burgeoning teleradiology industry, and increasingly fractious contract negotiations with hospitals are also seen as harbingers.Radiologists will need to manage their affairs more diligently, Muroff said."Practice members are going to be expected to spend time after hours practice-building and in other ways protecting their radiology group," said Muroff, who is also a clinical professor of radiology at both the University of Florida and University of South Florida.

The major difference between great practices and the rest is that the great practices have effective governance structures and strong business infrastructures. He offers a dozen differentiators for readers to ponder. For example, great practices:

• Have effective governance structures based on group-developed mission statements and business plans.
• Involve their members in decision making and strategic planning.
• Understand that they also are businesses that require expertise and involvement by practice members to ensure that opportunities will be brought to fruition successfully.
• Are not afraid to deal with their problematic partners and associates.
• Demand that all radiologists in their practices contribute to practice-building activities that, by necessity, occur after routine working hours.

"These groups realize that a 9-to-5 mentality is for shift workers, not the owners of a business," the article said.

But Muroff's list is not meant to be taken as gospel. What he wants is to get radiologists to think about their livelihood in a serious way. For example, teleradiology has had a profound impact on the specialty, but there is salvation in being hands-on."Nothing replaces relationships and service if a group is willing to make an effort to provide that," he said. "Otherwise, I like to say the future for radiology is extraordinarily bright, but the future of radiologists is very uncertain."For more information from the Diagnostic Imaging archives:

Legal uncertainties linger as teleradiology expands

Medicare fee schedule proposal could force nonrads to close office-based imaging services

Columnist explores impact of healthcare reform on your practice