ACR Bulletin

Covering topics relevant to the practice of radiology

Running Lean and Strong

Practices push forward to bolster their financial position post-COVID.
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To mitigate our losses, we are really trying to focus on positive growth as opposed to ways to negatively reduce costs.

—Mahmud Mossa-Basha, MD
June 04, 2020

Lost revenue from the cancellation of elective procedures and screening — coupled with scaled back staff and salary cuts — may plague radiologists and other healthcare professionals long after the worst of COVID-19 subsides. During a recent Radiology Leadership Institute® (RLI) virtual session, Leadership Town Hall: Leading in Times of Crisis, radiology leaders shared what their institutions are doing now to mitigate downstream losses and re-evaluate pre-pandemic operations.

“Obviously there are going to be financial consequences,” says Dana H. Smetherman, MD, MPH, FACR, chair of the department of radiology and associate medical director for medical specialties at Ochsner Medical Center in New Orleans. “There are already financial consequences for all health systems. For now, we have been told [here at Ochsner] that everyone’s salary is guaranteed through June, and all 2019 bonuses are being paid.”

To do that, Smetherman says, everyone was asked (required) to take 15 vacation days or the equivalent hours — depending on your position — between March 9 and July 3 to “reduce that liability on the balance sheets.” And like many other healthcare systems, she says, they are trying to secure financial assistance from the federal government. “A lot of it is wait and see,” she says. “For now, the whole institution locking arms and moving together is very important.”

Other groups are planning short-term cuts to save. “We’re being very proactive,” says Mahmud Mossa-Basha, MD, medical director of MRI and associate professor and vice chair of clinical operations at University of Washington School of Medicine. “I think that really helps our standing with the hospital and within the institution — things like deferring incentive pay,” he says. “We’ve looked at deferring 75% of our incentive bonuses to a later date.”

The UW dean has been communicating with the chairs, speaking to the reality of estimated losses, Mossa-Basha says. “Part of the message is about the radiology bottom line and trying to meet financial commitments, but also to help in supporting staff and faculty radiologists through this crisis,” he says.

There is a six-month hiring freeze, he says, “but people who already have an offer letter or have signed an offer letter will still be employed by us.” Unfilled positions have been deferred to a later date, Mossa-Basha notes.

“We’ve also focused on eliminating TPS payments — temporary supplemental pay for extra shifts — and we're working toward consolidating those into our regular call structure and into our regular daytime coverage.” Everyone will be working harder, he says, “but the goal is to maintain their pay while we’re doing that.”

In addition, Mossa-Basha says, they are accelerating some programs that might increase revenue. “We’re looking at increased efficiency in MR and shortening CT block times.” The group is also looking to population health metrics and health and wellness efforts as ways to improve its bottom line. “To mitigate our losses, we are really trying to focus on positive growth as opposed to ways to negatively reduce costs,” he says.

Perspective is everything, and putting lessons learned during the pandemic into practice could benefit radiologists and patients alike, Smetherman believes. “I think social distancing, for instance, will have a positive economic impact,” she says. “You really won't have to invest in the infrastructure.”

Throughout the challenges of COVID — and in looking forward to evaluate the economic toll the pandemic leaves in its wake — strong leadership has never been more important. “When you lead a team, it’s important that you be clear in your communication, organized, and strategic,” says Judy Yee, MD, FACR, chair of the ACR Colon Cancer Committee and professor and chair of the department of radiology at Montefiore Medical Center in Bronx, NY. Yee has effectively communicated to her team that while there are no salary cuts at Montefiore, there will be no ability to support additional moonlighting. As a team, the radiologists were requested to front-load vacation and academic time so that when patients return for imaging later in the year there will be adequate staffing.

“Stay positive,” Yee says. “When everyone looks to you as the leader, your uncertainty and stress trickles down. They need to trust that you're doing your best to support them.”

This article is the third of a five-part series in which the Bulletin will delve into key topics covered during RLI’s Leadership Town Hall: Leading in Times of Crisis. To access the full recording of the webinar, visit

Author Chad Hudnall,  senior writer, ACR Press