June 09, 2020

RLI-RFS Webinar Series: Examining Trends in Corporatization, Part 2

Casey Cable, MD, is an IR resident at Vanderbilt University Medical Center in Nashville, Tennessee.

Graphic Image of People WorkingThe ACR’s Radiology Leadership Institute® (RLI) and RFS have teamed up to create a two-part webinar series entitled “Trends in Corporatization.” Part one of the series took place on April 14 and featured ACR BOC Chair Howard B. Fleishon, MD, MMM, FACR, and RLI Chief Medical Officer Frank J. Lexa, MD, MBA, FACR. During this webinar, attendees were provided with historical perspective of what has led to increasing corporatization in radiology, followed by a discussion of strategies to navigate the current and future job market amidst increasing buyouts.

On May 26, part two of the series took place, featuring talks by Lawrence R. Muroff, MD, FACR, CEO and president of Imaging Consultants, Inc., and Daniel Ortiz, MD, a radiologist at Summit Radiology Services, PC, in rural northwest Georgia. This webinar built upon the knowledge gained in part 1, and focused on the differences between independent private practices and national corporate entities, specifically how these differences disproportionately affect early career radiologists.

Large corporate entities have found success infiltrating the radiology landscape by touting a long list of benefits centered around “economies of scale.” The theory is that through larger scale operations, practices will have improved negotiating power with hospitals and third-party payers, financial benefits related to improved business expertise (including back office support such as revenue cycle management), improved HR and billing services, and pension/profit sharing opportunities. Although many of these sound like enticing benefits on the surface, in many cases these imagined benefits are not realized. Ortiz directly addressed several of these perceived “benefits of scale” and discussed how his rural radiology practice is able to provide many of the same benefits for its patients and providers without losing control of business operations. Organizations like the ACR and RLI have many resources available to help develop the skills necessary to successfully manage the business side of your practice. Additionally, many of the back office support needs of a group can be contracted out, providing a higher level of professional services for the group while maintaining control of governance — ensuring the group can cut ties with the contractor and find a better fit, if necessary.

Another big point made by the presenters was that, “If you have seen one corporate-backed practice, you have seen one corporate-backed practice.” Every group is different and the details of the corporate structure can be difficult to ascertain when applying for jobs, unless you take the initiative to investigate prior to signing a contract. These can be difficult questions to ask on the interview trail, but the coronavirus outbreak has provided an easy stepping stone into these conversations. By discussing how the group responded to the pandemic, you can learn a lot about the governance and business operations of the practice.

At the end of the day, there is no perfect business model for practicing radiology. Whether it’s an academic practice, a physician-owned private practice, or a national corporate entity, each has the potential to be an excellent personal fit for you or a complete disaster based on the individual specifics of each group. It is up to you, as the physician, to educate yourself on the topic, because only by understanding the differences in the intricacies of each type of practice can you make an informed decision about where you want to work.