A Half Dozen Tips for Your
Radiology Practice
Lawrence R. Muroff, M.D., FACR
Principal, Partners in the Imaging Enterprise
--CEO & President, Imaging Consultants, Inc.
--Clinical Professor of Radiology
University of Florida & University of South Florida
Colleges of Medicine
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Objectives:
Attendees should, at the conclusion of this
presentation, be able to:
1. Implement procedures that facilitate
strategic planning
2. Develop a mission statement and a business
plan that will promote effective decisionmaking
3. Discuss the rationale for evaluating all
practice members
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To take your practice to the next
level, you must have an effective
governance structure and a strong
business infrastructure …but there
are so many other nuances to
consider.
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Developing a great practice- a half
dozen differentiators to consider
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Characteristics of a Great Practice
1) Great practices make decisions based on
a group developed and approved mission
statement and business plan
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Mission Statement/Business Plan
1. Statement- Defines who you are, what
you want to do, and where you want to
do it
2. Plan- Lists specific goals that fit with
stated aims, and provides timelines for
completion
3. Group- Periodically measures progress
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Mission Statement/Business Plan
4. Group- Rejects business that doesn’t
fit with plan
5. Group- Reviews Statement and Plan at
appropriate intervals (yearly)
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The importance of the mission
statement and business plan
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The Mission Statement and the
Business Plan provide focus. They
define who the group is and what it
needs to accomplish, and they provide
leaders with a blueprint (including
timelines) for action.
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Most groups fail through
inaction, and it is the lack of a
mission statement and a business
plan that is most often to blame.
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Decisions, if made at all, are
frequently re-visited, often overturned, and the end result is a
paralysis of action.
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Action taken after the window of
opportunity has passed is
worthless and may even be
counter-productive
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Characteristics of a Great Practice
2) Great practices pursue strategic
planning, then adopt strategic thinking.
They employ scenario planning so that
they can confront problems in a proactive
manner.
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Strategic Planning
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Strategic planning provides group
mandated direction! Scenario
planning provides a mechanism to
proactively address potential
issues/opportunities.
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Why Bother With Strategic
Planning?
1. Radiology practices are “pathologically
addicted to democracy”
2. Decision-making often based on
insufficient information or emotion
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Why Bother With Strategic
Planning?
3. Financial and personnel implications
may not be considered prospectively
4. Interests of individuals may impede
progress of group (tyranny of the
minority)
5. Innate mistrust of partners/associates
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Why Bother With Strategic
Planning?
6. The most important reason is that there are
aggressive entities that are capable of
replacing you, and these entities are
contacting (cold-calling) hospitals across the
country.
These companies are well funded, competent,
provide 24/7 sub-specialty and call coverage,
and are responsive to hospital needs.
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How Do You Start/ Implement
Strategic Planning?
1. Partners and senior partner-track physicians
(or, if academic, faculty) should discuss the
practice’s projects and priorities (based on
the statement and the plan) at a group
retreat
2. Hire a facilitator/ consultant to moderate the
session
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Remember the concept of subspecialization. It works with
consultants/facilitators, as well as
with your radiology group. Pick the
consultant best suited to deal with
the issues facing the practice.
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How Do You Start/ Implement
Strategic Planning?
3. Make absolutely sure the facilitator is
knowledgeable about radiology practices and
the culture of radiology
4. Every partner (or if academic-faculty
member) should agree to the plan, the
projects, and the priorities (or at least have
all objections thoroughly discussed)
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Once decisions have been made,
the group must stand behind the
decisions and present a united
front.
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Adhering to the Company Line
One of the crucial elements in taking a
company from good-to-great is somewhat
paradoxical. You need executives, on the one
hand, who argue and debate-sometimes
violently- in pursuit of the best answers, yet
on the other hand, who unite fully behind a
decision, regardless of parochial interests
…Jim Collins, Good to Great
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SWOT analyses can be helpful, but
often don’t get to the real issues that
will face the practice. Think aheadscenario plan; confront possibilities.
Understand the trends that will be
impacting your practice and decide
how you will deal with those trends.
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Characteristics of a Great Practice
3. Great groups demand that everyone in the
practice contribute to practice-building
activities that, by necessity, occur after
routine working hours. They realize that a “95 mentality” is for shift workers, not owners
of the business.
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Fostering a Culture of
Participation and Mutual
Expectation
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Group Expectations
Every member of a practice who is either a
partner or a partner-track physician must
contribute to practice building in addition
to reading films and performing
procedures.
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The most destructive situation
occurring in most radiology
practices today is that 90% of the
practice-building is done by 10% of
the practice members.
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There is a name for a radiologist
that believes that he/she doesn’t
have to participate in the practicebuilding activities of the group…
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Non-shareholder Employee!
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70+% of practices have fired a
partner or an associate (or
forced a radiologist to resign) in
the past 5 years. Is that a lot or
is it not enough?
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Personnel Decisions
1. When in doubt, don’t hire-keep looking.
2. You will not likely be able to rehabilitate a
problematic potential hire.
3. It is rare to be able to hit personnel needs just
right. You are either a bit too fat or too thin. The
group has significantly more flexibility if it runs a
little fat.
4. When you need to make a people change, act.
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Characteristics of a Great Practice
4. Great practices evaluate all of their members
periodically (usually annually) so that members
know what is expected of them and where they
stand in the eyes of their colleagues.
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It is not enough to evaluate a
practice member. If there are
problematic issues, then the
practice must be prepared to deal
with them.
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Practice Policies
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Practice Policies
1. Leave
a) Family
b) Medical
c) sabbaticals
2. Impairment
a) substance abuse
b) Psychological
c) eroded skill sets
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Practice Policies
3. Behavioral issues
a) rudeness
b) absence/habitual tardiness
c) acting contrary to interests of group
4. Sexual harassment/creation of a
hostile work environment
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Practice Policies
5. Fraternization/nepotism
6. Productivity expectations
7. Practice-building expectations
8. Disability
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It is best if policies are in place
before they are needed, otherwise
the group responds to the person,
not the problem. In those instances
the consequences are either too
permissive or too punitive.
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Breach of a policy should have a
consequence of significance.
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The primary reason for evaluations
of practice members is not to
blame or intimidate, but rather to
educate, re-invigorate, and/or
rehabilitate the radiologist in
question.
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Blame
Assessing blame and wallowing in misfortune
are counter-productive. Learning from mistakes
and not repeating them is what separates great
groups from the rest.
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Characteristics of a Great Practice
5. Great practices want to optimize their
financial position, but they realize that
if they are to be successful, money
cannot be the prime motivator of
group members. You can’t pay the
wrong people to do the right things.
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Radiology is a service specialty; if you
are unwilling to accommodate
reasonable service needs of patients
and referring physicians, you are in the
wrong specialty. Provide the service
and the money will be there!
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Do not delude yourself into
believing that your contract is
untouchable. You can be replaced.
Service and involvement are keys to
tenure.
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Why Are “They” Doing This To Us?
1. They are tired of hearing complaints from
the referring physicians (service issues)
2. They don’t like us competing with them
3. They want more control (hours, #’s, etc.)
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Why Are “They” Doing This To Us?
4. They want our turf to attract referring
physicians
5. They want to own our practice-integrated
service model
6. Because they don’t like us (personality
clashes), or they don’t think that we have
the necessary leadership capability
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Why Are “They” Doing This To Us?
7. Because they believe that you are too small
to provide the 24/7 sub-specialty and call
coverage that national entrepreneurial
companies promise to offer.
8. Because they believe that the group lacks the
leadership skills necessary to move forward
in the new health care dynamic
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Characteristics of a Great Practice
6. Great practices have an understanding
of marketing and the importance it has
on the growth and success of a
practice. In these groups, a marketing
plan is in place, a budget has been
developed, and appropriate practice
members participate in the marketing
activities.
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Who is the Target?
1.
2.
3.
4.
5.
Referring physicians
Managed care companies
Large corporations
Other radiology practices (specialty reads,
night coverage services)
The media (establishing your practice
members as the experts)
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Who is the Target?
6. Hospitals with service contracts to grant
7. Your current hospital (validate your presence)
8. Patients
a) self-directed radiology (screening)
b) the secondary impact on the referring physician
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A Physician Member Is the Best
“Marketer” for a Radiology Practice
1. Activea) Educate
b) Solicit
c) Entertain
2. Passivea) Skill sets (or lack thereof)
b) Attitude and demeanor
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Basic Marketing Tools for Your
Practice
1. Radiologists willing to educate referral
sources
2. Marketing rep./trouble shooter
3. Web site (essential)
4. Descriptive brochure (separate pages)
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Basic Marketing Tools for Your
Practice
5. Order forms/prep sheets (map of offices)
6. Marketing software
7. CME opportunities for referring
physicians
8. Practice branding (color, design, etc.)
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The Message and the Product
1. You can spiff up a bad product with
sophisticated marketing, but this is rarely
sustainable.
2. If the product is bad, fix it first, then
market the improved version.
3. Radiology practices are not an exception to
these rules.
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An excellent way to build your
practice is to explore needs that are
ignored by others.
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“Non-traditional” Markets
1.
2.
3.
4.
5.
Patient Support Groups
Chiropractors
Podiatrists
Oral Surgeons, Dentists
Sports Administrators, Coaches, Team
Trainers
6. Personal Trainers, Massage Therapists
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Characteristics of a Great Practice
PARTING ADVICEGreat practices have challenges that are
similar to those facing all of the other
practices; they are just better positioned to
cope with them- avoiding the problems
and taking advantage of the opportunities.
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