We all go to the grocery store. We all buy the same things. Milk, bread, orange juice, vegetables, meat, fish and so on. What I find fascinating about grocery stores is that some are just better than others. Some are simply transactional. A place to get the essentials and check-out quickly, with no reason to drive out of your way to get there. Other stores seem to transform the shopping experience. The displays are better, the staff is friendlier and more helpful, and the products seem fresher. It's a pleasure to shop at the transformational store. However, at both stores, the products are pretty much the same.
As radiology providers are confronted with major changes in the way we will deliver our services, it may be important to learn from other industries about transformation. Whether it is in the introduction of new IT infrastructure and PACS, handheld devices, clinical decision support software, accountable care organizations or bundled payments, we all need to be paying attention to transformational ways to deliver the same product—a high quality image with an unequivocal interpretation in a report that is delivered in a timely manner and billed properly.
Many radiology groups and hospital radiology administrators operate in this very transactional phase of existence. Cutting costs seems to be the exercise of the day. Radiology groups are looking for ways to pare down their staffs, benefits, advertising, billing costs and supplies. Hospitals are looking at the same issues. Questions regarding the reduction in services are debated quite frequently. This is a very typical transactional response to threats of reduced reimbursements. Some would call these discussions "bean counting." Within the proper context, they are very good discussions for organizations. For most organizations, they are not discussions that are carried on when there's plenty of pie to go around. It's only when the pie gets smaller that we all get nervous.
How will my piece of pie be affected?
Is Dad cutting the pieces evenly?
With all this transactional talk, we miss the opportunity to become transformational. Right before our industry are new opportunities to embrace conversations around transformation. The proposed payment mechanisms that have been outlined in the healthcare reform debate are being executed by the Center for Medicare & Medicaid Services. Accountable care organizations, shared savings, bundled payments are new terms, but old ideas.
Reforming the U.S. healthcare system in some form has been attempted by every president since Richard Nixon. If you count President Lyndon Johnson and the establishment of Medicare in 1965 that would be nine presidents for those of you who are transactional.
It's time to be transformational. Conversations need to start with "What if…" What if we changed the income models and worked together to make the pie bigger? How can radiology leverage our expertise in PACS and IT to make the pie bigger for all? How can radiology drive shared savings? What if we utilized the informatics within our practices to maximize efficiency? What is holding our practice or radiology department back from providing the right image at the right time? How can radiology transform the imaging experience?
Robert T. Sill is practice manager, Lancaster Radiology Associates, in Lancaster, Pa., and a frequent lecturer on healthcare reform and practice management. He currently serves as president-elect of the Radiology Business Management Association.