Focusing on the Patient Key to Practice's Centennial Celebration


With changes coming in radiology faster than a 40-slice CT scanner delivers images, it's hard to comprehend how one practice has been able to adapt enough to celebrate a remarkable milestone—100 years of continuous imaging services to patients. Yet, that is the professional high point recently commemorated by Radiology Associates of Richmond.

The private practice that Daniel Talley Jr, MD, established during radiology's infancy has grown into a 49-member practice with specialists in every subspecialty who provide imaging services for 6 hospitals in the Virginia capital and read more than 750,000 images each year. Then there are the 100 support staff and 2 outpatient clinics with plans for 2 more clinics as a joint venture with HCA Inc.

However, ACR Fellow Howard F. Faunce III, DO, the practice's current president and 28-year staffer, says that while the last 100 years has seen innumerable technological advancements in radiology, the practice's focus has never wavered from its dedication to its patients. That, he insists, is the basis for its longevity.

"We want to do the right things for the right reason; it's as simple as that," Faunce maintains. "Taking care of our patients is our fundamental goal."

While Faunce concedes that any number of developments can qualify as the most important "event" in radiology during the last century, he opts for technological advancements as the top occurrence.

"Technology is easily at the top of the list," Faunce says. "Today we have CT, MRI, ultrasound, interventional radiology, and PACS (Picture Archiving and Computer Storage) which makes it more efficient to review."

Another significant evolutionary change—today's radiologists have to be more than just a medical specialist.

"This is the biggest challenge for many of us since we had to learn the business of medicine while on the job," he admits. "We were not prepared to be businessmen. But we still have to rely on good medicine even while being more cognizant of business issues."

To help lessen these business issues, several years ago the practice established Radiology Associates Services to manage all the business affairs and the complex paperwork and coding issues involved with Medicare and third-party payers.

The Benefit of PACS

Faunce credits PACS as one of the most innovative tools for Radiology Associates, and the firm was among the first in the country to use the system that allows radiologists to share and review images in nearly any location.

"We are a firm believer in PACS," Faunce says enthusiastically. "There is no more sophisticated way to handle and review images. It allows us greater access and easier assessment of images and this is important when you're dealing with sophisticated areas such as musculoskeletal or neuroradiology."

With so many radiologists in several locations and affiliations with several hospitals, PACS has become essential. To ensure that a radiologist is available around the clock to review images, Faunce says the firm does not employ overseas reading services; instead, each partner takes a week of night coverage on a rotating basis, being available from 9 pm until 7 am. Not only has PACS become a requisite tool for the practice, it also has translated into annual savings of about $1 million as a result of not using old-fashioned films.

Yet, he quickly adds, the motivating factor remains the same: "doing the right thing for the right reason."

Watching the Competition

So far, Faunce says that Radiology Associates has not been affected by the increase in "turf wars" and encroachments on their imaging services. That doesn't mean, however, that he and his partners are not aware of this professional storm cloud.

"It's a result of the times we live in," states Faunce.

Nevertheless, he maintains that they are watchful of what is going on, both locally and nationally, and pay close attention to the growing number of procedures such as MR and CT being performed by non-radiologists. Faunce says Radiology Associates has reached out to non-radiologists in an attempt to cooperate on patient care issues with the attitude that the radiologist should be the final interpreter of diagnostic images.

"We like to talk to other physicians and try to help them realize that it behooves them to work with us since, ultimately, it is best for the patient," he says. "We feel that it is important that these readings be up to par."

The firm works closely with HCA Inc when it comes to reading images from the hospitals and has built a strong relationship with the company. He points out that HCA has been supportive of the practice and its needs to stay up-to-date on the latest in radiologic advancements to ensure quality patient care. In fact, the company often asks for the practice's input on such issues.

"We've never given them advice that is self-serving," Faunce says. "They know we'll give them the best advice and they listen."

Still, Faunce looks for the lack of opportunities to work as closely with other medical specialists.

"While it is important to focus on the business aspects of radiology, we must not lose sight of the profession we have chosen," he asserts.

Looking Toward the Future

So, what is Radiology Associates doing to ensure that it will be having another milestone celebration 100 years from now?

"We are trying to run faster than everyone else," Faunce contends, adding that the practice continually looks to position itself in the health care spectrum to ensure that it remains strong. "Staying current with technological advancements will continue to be Radiology Associate's biggest challenge," insisting that the practice will remain diligent to ensure that the looming threat of "turf battles" are dealt with in the correct fashion.

Still, Faunce remains confident that the practice will continue the tradition Talley established 100 years ago and continued by his successor, Daniel Talley III, MD, and others who have served as president.

"We have built this practice with the right contracts, the right relationships, and the right people," he says. "We've gained a lot of wisdom over the last 100 years from those who have not only maintained, but made many contributions, to the legacy we now enjoy. I'm sure that will help keep us around."


While much about how radiology is practiced has changed since Radiology Associates of Richmond first opened its doors 100 years ago, technology remains the key driving force for the specialty. However, notes Radiology Associates President Howard F. Faunce III, DO, the practice's focus remains on providing the highest levels of patient care. (Photo courtesy of Radiology Associates of Richmond.)