Model Practice

Radiologists take on the evolving health care paradigm with inspiration from the corporate world.


Professionals in business and medicine make difficult decisions on a daily basis, prioritizing the customer’s (or patient’s) needs through exceptional service. So it’s no surprise that radiologists are seeking advice from successful entrepreneurs.

Success in both arenas calls for great evolution and innovation in order to reduce costs, keep up with technological advancements, and avoid commoditization. Many physicians, including radiologists, pursue formal business degrees to enhance their strategic thinking and leadership skills. Currently, more than 1,700 radiologists are participating in the Radiology Leadership Institute® (RLI), which prepares imaging professionals to advance their career and shape the specialty’s future — especially considering the many pressures on the U.S. health care system today. Alexander S. Misono, MD, MBA, radiology resident at Massachusetts General Hospital in Boston and a former management consultant, believes, “In any field or industry where things are likely to change and there’s tumult, confusion, or uncertainty about the future, it’s good to be equipped to handle that situation. Coming at [those changes] from a business angle can often provide valuable insights.” Here are several tips gleaned from corporate case studies to help you avoid pitfalls and ensure the specialty’s longevity.

Prioritize Quality

It’s the ACR motto: “Quality is our image.” And examples from the business world only further confirm the importance of quality. Recently in the JACR®, Anand M. Prabhakar, MD, cardiovascular radiologist at Massachusetts General Hospital in Boston, highlighted the links between challenges to interventional radiology (IR) and Starbucks, a company whose “invincibility was challenged,” during the 2007 economic crisis.1 Briefly, customers laughed at the idea of paying $4 for a cup of coffee. Now, Starbucks is one of the largest coffee chains in the world. What did the company do right? Prabhakar says that when Howard Schultz, the founder of Starbucks, was brought back in 2008 as CEO to turn the company around, he made quality a high priority. He focused on training employees to make the perfect espresso manually rather than relying solely on the automated espresso machinery intended to maximize efficiency. Schultz also purchased individually brewed, unique blends and redesigned the storefront setup, thus improving the customer experience. Switching gears, from coffee to patient care, interventional radiology faces similar challenges, including commoditization — with numerous non-IR clinicians performing procedures. Prabhakar and his coauthors suggest becoming more visible to patients, volunteering objective quality data, and ensuring the appropriate utilization of services to demonstrate value.

Keep Innovating

Some of the most successful companies are those that know how to innovate. The same goes for such successful and innovative leaders as Steve Jobs, late CEO of Apple, or Bill Gates, former CEO of Microsoft. These companies are constantly creating new products and evolving to meet customer demands.

However, not all companies have applied this policy of innovation victoriously. Geraldine B. McGinty, MD, MBA, FACR, chair of the ACR Commission on Economics, believes a lack of innovation caused one well-known organization —Kodak — to go under. “They were such a great American company,” McGinty says, “but they didn’t really adapt. They didn’t find a way to be a part of the future of imaging in a successful way.” A recent article in the New England Journal of Medicine discussed Kodak’s surprising 2012 bankruptcy: “Kodak was late to recognize that it was not in the film and camera business: it was in the imaging business. With the advent of digital imaging, Kodak was outpaced by other companies that could better meet our consumers’ needs.”2 McGinty believes the same challenges apply to radiology. “We will not be recognized and compensated for our value unless that value is obvious to our customers,” she says. “We need to respond to what patients want.” The ACR’s Imaging 3.0™ case study series provides many examples of radiology practices already innovating to demonstrate their value. McGinty encourages ACR members to “really understand and familiarize themselves with the Imaging 3.0 concept and look critically at their practice. Be informed about what’s happening in the wider world of health policy. Make the difficult step to get off the treadmill of focusing on quantity, not quality. Look closely at your community and find the opportunities to demonstrate value.”

Serve Others

The case of Starbucks provides another piece of insight for radiologists — one that benefits both the specialty and the community. In 2008 after Hurricane Katrina, Schultz asked 10,000 Starbucks managers to provide 50,000 hours of community service during their annual leadership meeting. The result was the largest volunteer effort in the history of New Orleans. Many other companies are also committed to playing a positive role in the community through service and volunteering. One great example of this is the Microsoft Employee Giving campaign, a program that encourages employee donations and corporate matches, allowing the company to raise more than $1 billion since 1983. Furthermore, contributing to the community can help raise the profile and local opinion of a business. Prabhakar says that radiologists can improve their perception among patients and the medical community by participating in community health fairs and awareness campaigns.

Meet Customer Needs

But what is perhaps the most critical correlation between business and health care? The need to listen to your customers (or patients). McGinty says radiologists should “find out what will make a patient’s experiences more positive, and provide it better than anyone else. Look where we can provide value. If our opening hours are not geared toward patients but to our own schedules, or if it’s difficult to schedule appointments online, we need to better respond to what patients want.” RSNA’s Radiology Cares® campaign has many resources to help radiologists build patient-centered competencies. One example Misono provides is the new venture startup company Uber. The mobile phone app connects passengers with hired vehicles with the tap of a finger. In doing so, Uber is providing a niche service that takes away the annoyances related to taxis: calling and being put on hold, not knowing when the cab will arrive, paying in cash. The Uber app is linked to your credit card information to avoid those hassles and provides a real-time map so you know exactly when your ride will arrive. “It’s a really efficient, easy, no friction way for someone to get a driver and go somewhere,” says Misono.

According to Misono, radiology practices and departments can similarly work to provide seamless ways for patients to schedule imaging and access their results. Misono, who formerly worked in the management consulting industry, emphasizes that radiologists are truly in the consulting business. Part of that business is appeasing the customer, which includes both patients and referring clinicians. “We need to continue to reinvent ourselves from a technology standpoint so that we can improve the way we treat patients,” Misono explains. He looks to IBM as another great example of this reinvention: the company used to focus exclusively on selling hardware and software. Over time, IBM has transformed itself into a service-focused company. Similarly, radiologists need to continue to evolve and innovate their services, prioritizing quality and patient care to keep up with the times — just like the most successful and smart 21st century business leaders.

By Alyssa C. Martino, freelance writer.

1. Prabhakar A, et al. What’s brewing: how interventional radiologists can learn from the reinvention of starbucks. JACR 2013;10(8):559–61.
2. Asch D, et al. What business are we in? The emergence of health as the business of health care. NEJM 2012;367:888–89.

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