Early-Career Radiologists' Perceptions of National Corporations in Radiology.

Purpose: Radiology, like many medical specialties, has experienced an increase in nationalized corporatization. The most vulnerable cohorts affected by this trend are early-career radiologists (ECRs), including trainees and recent graduates, particularly those entering or who have recently entered private practice. The aims of this study were to examine the awareness and perspectives of ECRs regarding this trend and to share salient examples of the impact of corporatization.

Speed Versus Interpretation Accuracy: Current Thoughts and Literature Review.

Whether there is a precise relationship between reading speed and diagnostic accuracy has been an elusive and much debated issue. We discuss the literature and include practical considerations and relevant experience. To our knowledge, no credible relationship has been established between the speed of diagnostic image interpretation and accuracy.

Change Management for Radiologists.

Change management refers to the research, science, and tools that prepare, equip, and enable individuals to adopt transformation successfully. Implementation of this discipline involves familiarity with an organization's culture, people, and structure. Several frameworks exist within which radiologists can successfully apply these concepts.

Forecasting the Effect of the Change in Timing of the ABR Diagnostic Radiology Examinations: Results of the ACR Survey of Practice Leaders.

The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function.

Culture shift: an imperative for future survival.

Radiologists have experienced unprecedented prosperity for the past 3 decades. Technology has continually evolved, providing exciting opportunities for earlier diagnoses and improved patient care. The financial rewards enjoyed by radiologists have been impressive, and the quality of life has been difficult to beat.

National entrepreneurial radiology initiatives: what are they, and what can they do to and for you?

National entrepreneurial radiology companies have evolved over the past 3 decades. In the 1990s, a few initiatives were established to implement business principles and reward shareholders with gains derived from management expertise, practice efficiencies, and economies of scale. The next decade saw the emergence of night call coverage and "specialty read" companies.

ACR white paper: New practice models--hospital employment of radiologists: a report from the ACR Future Trends Committee.

In response to the current era of rapid evolution of health care delivery and financing, radiologists are increasingly considering, as well as confronting, new practice models. Hospital employment is one such opportunity. Within this report to the ACR membership, the potential advantages and risks for radiologists considering hospital employment are examined.

Measuring and managing radiologist productivity, part 2: beyond the clinical numbers.

Radiology practices endeavoring to measure physician productivity, identify and motivate performance outliers, and develop equitable management strategies and policies often encounter numerous challenges. Nonetheless, such efforts are often necessary, in both private and academic settings, for a variety of professional, financial, and personnel reasons. Part 1 of this series detailed metrics for evaluating radiologist productivity and reviewed published benchmarks, focusing on clinical work.

Measuring and managing radiologist productivity, part 1: clinical metrics and benchmarks.

Physician productivity disparities are not uncommonly debated within radiology groups, sometimes in a contentious manner. Attempts to measure productivity, identify and motivate outliers, and develop equitable management policies can present challenges to private and academic practices alike but are often necessary for a variety of professional, financial, and personnel reasons. This is the first of a two-part series that will detail metrics for evaluating radiologist productivity and review published benchmarks, focusing primarily on clinical work.

ACR task force report: relations between radiologists and hospitals and other health care organizations.

The vast majority of US radiologists are affiliated with hospital-based group practices, making professional relationships between radiologists and hospitals one of the most crucial factors for a successful practice. However, tensions between radiology groups and hospitals have been increasing and have led to some well-publicized breakdowns. The ACR Task Force on Relationships Between Radiology Groups and Hospitals and Other Healthcare Organizations was charged to identify key factors affecting these relationships and to make recommendations and propose positive steps that could improve relationships and benefit radiologists, hospitals, and patients.

Why radiologists lose their hospital contracts: is your contract secure?

Previously, a hospital contract meant tenure for the incumbent group of radiologists; however, those days are long gone. Exclusive contracts have morphed into exclusive contracts with carve-outs. Turf erosion has become a fact of life for radiology practices.

Challenges facing the mature radiologist: a guide.

Radiologists who are chronologically advanced (or mature, as the authors prefer to call them) are faced with many special issues, obstacles, and opportunities. These are in many ways unique and different from the circumstances involving those who are recently out of training or in midcareer. The authors discuss some of these circumstances.

Taking your radiology practice to the next level.

The majority of radiology practices are governed haphazardly and act unpredictably, and if they are successful, it is in spite of what they do, not because of it. A few exceptional practices ensure their success with good governance, a proactive approach to problems, and a clear sense of direction provided by group-developed and group-approved mission statements and business plans. This paper describes what great practices do to differentiate themselves from the vast majority of radiology groups.

Dealing with the problematic partner or associate.

Problematic physicians can sap the morale of practice members and rend the very fabric of the group. When problems are ignored, the physicians who cause them become emboldened; their bad behavior persists, and the entire practice suffers. An appropriate employment contract must be structured; this provides a mechanism for the group to take action against a practice member.

Buy-sell options for radiology: what works and why.

Buy-sell agreements for shareholders entering and leaving a radiology practice are different from those commonly used in other business endeavors. This paper explores the reasons for these differences, focusing on the culture of radiology and its unique influence on the buy-sell process. Buy-sell methodologies commonly used in most business transactions are described, and basic principles that influence these methodologies are discussed.

The anatomy of an outstanding CME meeting.

Organizing a continuing medical education (CME) meeting should not be a casual undertaking. It requires experience, staff support, and adequate funding. The sponsoring entity should have a thorough grounding in the Accreditation Council for Continuing Medical Education mind-set, and the course should be within the mission of the organization.

Contracts in radiology practices: breaches and remedies.

Contracts between radiology groups and their physician members are often ambiguous. Key clauses may not be precise as to the intent of the contracting parties. For example, the requirements for a group member to achieve shareholder status may be discussed but not reduced to a written form.

Contracts in radiology practices: contract types and key provisions.

A contract between a radiology group and its physician member(s) provides the foundation for the professional relationships in a group practice. The parties are not in positions of parity; contract provisions are structured to maintain the primacy of the group over the individual members. An integration clause should be included to preclude reliance on communications that are not memorialized by the language of the contract.

Implementing an effective organization and governance structure for a radiology practice.

Radiology practices that are well organized and effectively governed have a competitive advantage. Decisions are made rapidly, actions are taken decisively and in accordance with established policy, and each group member has a responsibility for practice building. Such groups are perceived by their peers, hospital administration, and community business leaders to be both formidable and effective.