CHICAGO—With the spate of recent breakups between hospitals and radiology groups, Vijay Madan Rao, MD, chair of radiology at Thomas Jefferson University Hospital in Philadelphia, explored the causes behind these breakups and offered strategies for radiology groups to communicate their value to hospitals during a session on Dec. 1 at the 97th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

Rao also put a figure on the radiologists’ value and said radiology departments contribute 37 percent to outpatient profits, far more than any other specialty.

Hospital-based radiology groups face competition from two primary sources: teleradiology companies and nonradiologist specialists who read images. Rao summarized the appeal of each.

There are multiple reasons why a hospital might want to replace its onsite group with a teleradiology provider, Rao said. These include:

• Radiologists compete with the hospital through ownership in an outpatient imaging center.

• The radiology practice does not provide the necessary subspecialty expertise.

• Radiologists aren’t responsive to the service needs or complaints from referring physicians.

• Radiologists don’t make themselves available for hospital committee service.

• The hospital wants to give away imaging turf to attract other specialists.

• The hospital wants to put radiologists on salary, bill globally and profit on professional fees.

Similarly, there are three reasons why a hospital might want to grant imaging privileges to nonradiologist physicians. These are:

• Credentialing nonradiologist physicians in imaging can help recruit physicians who bring new admissions with them.
• Radiologists may not have expertise for certain specialized procedures.
• The hospital or other physicians may resent the radiology group.

However, Rao said, “A unified cohesive onsite radiology group adds many values to a hospital. These are often overlooked or taken for granted and would be lost if the radiology department was fragmented by other specialists or teleradiology companies.”

Rao divided the values radiology groups bring into six categories: patient safety, quality of exams, quality of interpretation, image expertise, timely service and cost containment.

As the experts in imaging, radiologists can help reduce the risks of radiation exposure, high magnetic fields and contrast injection and also provide advice on the most appropriate imaging study. She said onsite availability within the department is key to patient safety, and neither teleradiology companies nor nonradiologist physicians can provide this.

Radiologists also ensure quality through optimized protocols, practice guidelines and technologist education as well as provide advice on equipment purchases.

In addition, radiologists interpret the entire image, not just a single organ, and integrate images from multiple modalities. Another plus, said Rao, is that radiologists are available to consult with referring physicians on outside cases for second reads, which helps build the hospital’s business.

“Radiologists are not just image readers,” said Rao. “We do a lot more at the front and back end of the imaging process. To truly add value, we have to do all this and not just read images.”

And it doesn’t hurt to tout that 37 percent contribution to the bottom line.