We often hear about radiologist practices and radiologists who cannot seem to get along well with the hospitals with which they work. Perhaps, it is the revenge of the grade C student hospital executive? Maybe, it is the lack of capital intensive resources for the radiologists? Or could it be that some hospitals take every opportunity to cheat radiologists of their next dollar?
Sure, these factors may contribute to a bad experience of working with a hospital. But, I believe that these factors are not the leading causes of conflict. Instead, the answer is simple. Our mission differs sharply with the employers with which we work.
So, how exactly does the primary mission of the employed radiologist or the
Mission Statement For The Employed Radiologist
What is it that radiologists want? Well, let me give you some sentiments from radiologists in the form of some familiar complaints.
“Constant phone calls are constantly interrupting my workflow.”
“We don’t have enough technologists to keep the workflow going in interventional radiology.”
“The PACs system went down again, and I can’t dictate any cases.”
And finally, of course, “How many times do I have to tell the technologist to complete the study!”
So, what do these complaints have in common? Basically, they are all saying the same thing. Radiologists want seamless workflow. And, if I had to think of the mission statement for a practicing radiologist, it would be, “let me do my work without interruption!
Mission Statement For The Imaging Center/ Hospitals
What about the hospital or imaging center owners? Well, let me give you some of their sentiments in the form of some statements.
“We need to get the SPECT-CT operational so that we can get new patients into the system.”
“Clinicians are continually complaining that radiologists are not getting the reports out in time!”
“We have several obstructionist radiologists that are refusing studies to clinicians. We need to talk to them!”
“The layout of the department is making it impossible for patients to get their tests promptly.”
So, what do these statements from the guys in the executive suite have in common? They all are about the bottom line of the hospital. Or, “how can we maximize revenue for the organization and decrease costs?”
Misalignment Of Mission Statements
Fortunately, most of the time both owners and radiology employees are on the same page. Hospital executives usually want to create a seamless work environment for the radiologist to improve revenues. Likewise, radiologists aim to bring in the most revenue possible for the organization by improving workflow. However, many times these two mission statements will butt heads.
Occasionally, increasing system revenue may mean impeding the workflow of the radiologist. For instance, the hospital sees that picking up the phone while in the midst of a busy rotation makes their clinicians happy. At the same time, it delays the readings of the radiologist. The hospital continues to allow this to happen.
Likewise, increasing efficiency of the radiologists sometimes costs more to the system than doing nothing. Maybe, the reading room is not ergonomic, and the hospital cannot see how the hospital expense will improve the bottom line.
And, herein lies the crux of the problem. How can we reconcile the two missions?
Solving The Employed Radiologist/Owner Misalignment
Both parties need to have skin in the game to solve the misalignment dilemma. Employed radiologists need to have some ownership stake in the operations of the hospital. And just as importantly, owners/managers performance should be tied to improving the seamless workflow of the radiologist. You can’t expect either an employee or a manager to implement changes actively without incentive or experience. In some institutions, minimal incentives exist for these liaisons. Additionally, some managers have little experience with understanding the radiologist’s workflow.
So, how can we allow hospitals and radiologists to have better relationships? Well, we need to align the fundamental misalignments.
First, radiologists should receive some compensation for increasing the revenues and decreasing departmental costs. Tying rewards based on increasing institutional profits make the radiologist more likely to find favor with less radiologist friendly policy but excellent institutional benefit.
Moreover, hospital/practice management should not hire a random secretary within the building at a lower cost to run the business side of the practice. They should find a seasoned business manager who understands the trials and tribulations of the radiologist. How frustrating can it be to have someone who has no clue about radiologist operations?
Additionally, hospitals should tie the business manager to the efficiency of the radiologist practice. How? They can create a reward system not just based on hospital goals, but instead meeting the efficiency goals of the radiologists as well.
Tying The Knot
You cannot expect two groups to be on the same page when some of the most critical goals of each organization differ so widely from one another. Instead, you need to marry the two organizations mission statements into one. Creating a system to align the priorities of both groups should be a top priority. And, hiring the appropriate individuals is critical. Let’s resolve the differences instead of complaining about what both hospitals and the radiologists do wrong!