Tag: practice management

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Working From Home: A Difficult Dilemma For Radiology Practices

from home

Since Covid began, almost all practices have established a teleradiology presence from home. But, it is a work in progress. Some radiologists still need to man the forts, especially in hospital and imaging center-based practices. Contrast issues, treatments, complex studies such as cardiac CTAs, and on-site ultrasounds still involve a radiologist on-site. And many practices have been struggling to figure out the right mix. This dilemma leads to problems with structuring rotations, compensation, and making the staff happy. Therefore, I will discuss the most significant issues practices face and potential solutions to the most critical problems. I will divide these into rotations, compensation, and personal staff issues,

Rotation Problems Caused By Working From Home

Setting rotations to staff the practice from home versus in-house adequately can be daunting. Some radiologists typically have expertise in areas more conducive to work at home. Others need to be in the department more often. These lead to inherent problems of inequity and jealousy. So, setting up appropriate rotations to equalize home rotations can be very difficult. In addition, technologists and nurses need to be in contact for occasional events like contrast reactions and when to do so. If you create new rules, you must ensure the staff understands who to get and when.

To create equity, you have to recognize the following facts. First, only some people can work from home all the time in a non-teleradiology practice. And then, some specialties allow radiologists more freedom to work at home. Once we recognize these inherent problems with total equity and fairness, we can create rotations to equalize some of these issues. For instance, the practice can make some of the in-house rotations “easier” to compensate for inequities within the practice partially. Or, you can make some rotations on-call rotations. These are just simple ways to relieve some of the problems of unfairness among the staff.

Compensation 

Should employees and partners receive the same compensation if they can do more at home? Is there an upcharge or premium for having to come in more often? These potential inequities in the fairness of compensation also lead to other problems. Some procedures you can read at home pay more per unit worked (MRI) than others involving in-house work (IR). How do you account for that when you compensate your radiologists for their work?

Well, there are a few simple models. First, you can make all work equal with the philosophy that all work is valuable to the practice regardless of the reimbursement. It would help if you had the low RVU fluoroscopers as much as the high revenue MRI readers because they all provide a helpful service. This philosophy works much better in a partnership. In addition, you can provide more revenue and moonlighting opportunities to increase income for radiologists who are more interested in making some extra money. These opportunities help out a bit.

You can also decrease pay for radiologists who only work by teleradiology since they do not provide the same on-site services, such as management of contrast reactions, consults, and procedures. A practice can adjust the rate depending on the time worked outside the office compared to an “average” practice radiologist.

Either way, these models provide some equity for the practice.

Personal Staff Issues

Finally, you have issues such as radiologists who have extenuating circumstances. You may have new mothers or radiologists who temporarily need to move far from the practice, and so on. Sometimes, you need to make accommodations for individual radiologists so they can continue to work. Again, compensation needs to reflect the amount of time that these radiologists work outside the office and the need for the radiologist once they return. 

Working From Home: Not All A Bed Of Roses

On an individual basis, working from home can be a godsend. What’s better than being present at home with kids, dogs, spouses, contractors, and more? On the other hand, from a practice perspective, working from home introduces many additional problems. Fairness/equity of rotations, compensation issues, and individual staff issues are just some of the problems that group leaders need to contend with. Practices can work out most of these kinks. But getting the right mix takes a bit of effort and creativity. Having all radiologists working from home is more complex than it seems!

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Presumptions About Our Radiology Colleagues Can Sow The Seeds Of Destruction!

presumptions

First and foremost, radiologists are people. And, people make presumptions about others, whether it is colleagues, leaders, or friends. It’s just human nature. However, it is also one of the biggest mistakes that one can make in business, particularly in private radiology practice. We all think that we know what kind of job our colleagues do. And, we base many of these stereotypes on miscommunication and pure conjecture. All this can lead to bad blood and, even worse, lousy practice outcomes. So, let’s go through the main reasons why presuming to know our fellow radiologist’s job is so dangerous to the practice and business of radiology?

Ways That Presumptions Damage A Practice

You Do Less Than Me!

If you like toxicity, this unfounded statement can spread the most venom to the rest of your colleagues. And, most of the time, it is not valid. Everyone does work a bit differently. So, work can be hard to quantify.

Moreover, this statement decreases everyone’s incentive to work. Who wants to work when everyone else does less? Of course, maybe there is one outlier in your practice that does a lot less. But, if you are always going to worry about everyone else, what is the incentive for you to work?

The Work They Do At The Other Practice Down The Street Isn’t Hard.

You can never tell for sure how hard work that some other practice is doing is difficult or not. Indeed, it is even worse to make that presumption. Has your practice ever tried starting a thriving vein center? It’s effortless to create one for yourself. Well, there is probably a lot more to the process than you think. Without doing the research, this assumption is a surefire way to lose a lot of money and time, not being prepared for the work you will need to succeed!

Presumptions That Administrative And Teaching Roles Are Not Real Work

This one is a real doozie. Almost every program director throughout the country has been the brunt of this presumption at one time or another. Yes, we are not constantly pumping out RVUs. But instead, we are teaching, fielding all the requests and complaints, and completing all the paperwork. A residency can fall apart without these services. It is not the same as reading films, but yes, it is real work!

MR, IR, Nuclear Medicine, Mammo, Etc. Are Easy

One way to get into trouble, presume that other radiologist’s area of expertise is simple. You don’t know until you work in the field. Think mammo is easy? Wait until your first lawsuit? And, MRI is not complex, right? Just wait until you miss your first subtle neural tumor. Every field has its challenges. And, each needs a lot of practice to become good at it!

It Doesn’t Matter That He Has The Ear Of The Referrer; I Work Harder

It’s not always just about the amount of work that you do. It is also about the perceived quality of your work. That radiologist that always gets phone calls to consult with referrers? There is probably a reason for that! Maybe he’s just friendly. But maybe, just maybe, he knows a lot. And perhaps he knows a lot more than you! You lose his expertise, and you start losing patients from your practice. It doesn’t matter how hard you work!

Presumptions About Our Radiology Colleagues: Sowing The Seeds Of Destruction!

Yes, presuming to know what your friends down the hall do on a day-to-day basis is fraught with danger. And, you probably know less than you think you do about your colleague’s issues. So, if you want to take this path, be very wary of the dangers above. It’s a surefire way to add to a toxic workplace!