SR enables practices to develop and maintain healthy cultures, maximize professional satisfaction for radiologists and other team members, and avoid the conflicts of interest associated with outside ownership.
In a podcast interview with The Radiology Report host Daniel Arnold, Scott A. Bundy, MD, FACR, Chair and CEO of Strategic Radiology (SR), discussed a wide range of topics, including current challenges facing radiologists, Strategic Radiology, independence, the virtues of having an ownership mentality.
A practicing neuroradiologist with an undergraduate degree in biomedical engineering and one of the founding shareholder members of independent wholly physician owned 250-radiologist private practice, Radiology Associates of North Texas (RANT), Dr. Bundy was elected CEO and Chair of Strategic Radiology in January 2021.
The SR Landscape
Mr. Arnold, co-founder of the clinical development platform MRI Online, began with the basics: What is SR? Dr. Bundy replied: “Strategic Radiology is a coalition of 33, wholly owned, private practice radiology groups, representing more than 1,400 physicians with a national footprint from coast to coast and representation in approximately 26 different states. On a foundation of trust and transparency, SR members collaborate and engage in active, daily discussions related to clinical, operational, and business functions and share best practices and collectively problem solve on our internal network, ‘Collaborate,’ which consists of a number of committees and workgroups.
"We also engage in twice-annual CME educational programs focusing on leadership development, physician onboarding, patient and safety initiatives under the nation’s first imaging specific Patient Safety Organization, and keep our members up-to-date on current trends and developments in radiology, including payment policy, technological advancements, AI, data analytics, as well as introducing our members to various technology platforms such as PACS, VR, and workflow optimization. Then, based on member interest, we invite selected vendors to educate our members on their products and services, giving the vendors face to face access to our decision making physician and administrative leaders.”
When asked about his vision for SR, Dr. Bundy shared the coalition’s mission and vision statements: “Our mission is to improve lives by creating superior value through collaboration and innovation among privately owned independent radiology practices. Our overarching vision is through collaboration, Strategic Radiology member practices will be recognized locally, regionally, and nationally for delivering exemplary imaging and clinical care, service, and value to our patients and clinical partners.”
In essence, he added: “SR empowers member practices to develop and maintain healthy cultures, maximize professional satisfaction for radiologists and other team members, and avoid the conflicts of interest associated with outside ownership.”
SR also has leveraged the coalition’s collective size, scope, and scale to form a group purchasing program. “This is not just for aggregated volume discounts and tiered pricing, but also to engage these vendors in strategic partnerships to provide research and development, testing and deployment of products and services, and quality assurance. SR also collectively engages in shared savings opportunities through group purchasing of various insurance products, including medical malpractice, health insurance, cyber security, and even disability, property and casualty,”
Other services and initiatives available to members include a data analytics for demonstrating metrics and key performance indicators, improved decision-making, and benchmarking; discounts on various recruiting platforms; internally developed patient satisfaction surveys; adverse events tracking; partially subsidized revenue cycle optimization and compliance consulting services; and a private practice advocacy initiative. “We are all about helping our member practices succeed in their local and regional markets, because that is where health care is delivered,” Dr. Bundy explained.
The National–Local Connection
How exactly, asked Mr. Arnold, does banding together nationally help practices in their local markets? Is it about the value gained from size and scale?
“The key is that it needs to be patient focused, because that’s our job.,” Dr. Bundy replied. “Strategic Radiology operates the nation’s first imaging-specific PSO listed by the Agency for Healthcare Research and Quality under the Department of Health and Human Services. The SR-PSO is solely dedicated to improving patient care through the sharing of HIPAA-compliant confidential patient information in a protected environment.” (see related article).
When the talk turned toward corporatization, Dr. Bundy expressed skepticism about the underlying motivations of private equity investment in medical practices. “That is a definite concern, not just for radiology but for the House of Medicine as a whole,” he replied. “What is the long-term goal and what are non-physician, investment-interested individuals hoping to gain out of entering the health care space? I’m not sure that their ideals and mindset is aligned with the physician’s Infinite Game mindset. This is a career that we have chosen. We have dedicated ourselves to taking care of patients above all else.”
“Our membership practices are wholly physician owned and physician led,” he continued. “We feel that patient decisions should be made by physicians and their patients, not third-party shareholders. We are genuinely concerned about the conflicts of interest that can arise when health care decisions are influenced by non-physician owners. Therefore, we really don’t see a place in the value equation for third-party investors.”
“Dollars taken out of health care to line the pockets of third-party investors are gone from health care forever,” he added. “Instead, we feel that we should re-invest those resources back into our practices so our patients have access to the latest and greatest technology and make sure that we can continue to have the resources to attract and retain the best and brightest in our profession so that we can continue to provide the high level of care that our patients deserve.”
Even the so-called deep pockets of private equity fail to impress Dr. Bundy. ”Collectively, with our 33 practices and 1,400 radiologists, we have access to the capital necessary to invest in the future of our practices,” he said. “We hae the ability to pool our resources to invest in the necessary technology to keep our practices operating in the forefront. We also have the resources to engage administrative talent to help us navigate the ever-evolving complex business environment of health care so that we can focus on doing what we do best, and that is taking care of patients.”
To Mr. Arnold’s question about what keeps him up at night, Dr. Bundy cited three things: physician burnout and overwhelming workloads; the negative reimbursement policy radiology has faced since 2005; and the desires to expand the scope of practice of non-physician trained providers. “Medical imaging is an amazing tool for diagnosing and setting up treatment plans for patients,” said Dr. Bundy. “It has revolutionized health care and arguably may be the most impactful contributor to health care in the last 100 years. I don’t see how limiting access to that technology is beneficial to our patients, nor do I foresee imaging utilization decreasing in the future.
"We need to embrace that," he added. "In order to effectively manage this volume, we also must embrace technology and AI tools that can allow us to be more efficient, without negatively impacting quality of care. At SR, we have partnered with a number of AI organizations and are currently utilizing and testing products and services, that can be deployed throughout our practices to help us mitigate mismatches in exam volumes and available radiologists."
An Ownership Mentality
When asked what advice he had for young radiologists entering today’s workforce, Dr. Bundy was enthusiastically optimistic. “I would love to be coming out now,” he said. “This is an exciting time, and I think we are going to see technology advance rapidly. This is a really exciting time to be coming into radiology.”
Dr. Bundy urged residents and fellows as newly minted professionals to have an ownership mentality, no matter which path they take. “We think health care should be delivered locally by physicians, and health care decisions should be made by physicians and patients without conflicts of interest coming from outside investors,” he said. “We need to take an ownership mentality in everything we do whether it is a career in academic research (own it!), or a career in private practice (own it!).”
Don’t be afraid of making mistakes, because you will, he assured. “But you need to own those mistakes,” he said. “You are going to learn more from making those mistakes than you will from always getting it right. It’s tough to stay down on yourself when you know you have given it your best, and with an ownership mentality, you always know you have given it your best. Coming out of training, you’ve accomplished a lot thus far, but do not miss out on the gratifying feeling of accomplishment that comes along with ownership.”
Challenges that at times may seem insurmountable will also be encountered, he added. “However, you have the tools to persevere. You have the knowledge, training, and experience to meet even the most daunting challenges. The moment you let a non-aligned person or organization take that problem off your plate is the moment you have missed out on a potential opportunity that could have come your way had you solved that problem yourself.”
Hub is the monthly newsletter published for the membership of Strategic Radiology practices. It includes coalition and practice news as well as news and commentary of interest to radiology professionals.
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