RSNA: Hospital employment may not work for rads
CHICAGO—The security of employment through a hospital is a draw for some radiologists looking for guaranteed pay, low overhead and other benefits, and some hospitals are seeking to incorporate radiology departments as a way to maintain quality control and produce additional revenue. But the grass may not be greener on the employment side of the fence, at least according to a case study presented by Patricia Kroken, principal of Healthcare Resource Providers of Albuquerque in New Mexico, during a Nov. 29 presentation at the 97th Scientific Assembly and Annual Meeting of the Radiology Society of North America (RSNA).
Kroken described a composite group representing commonalities of several radiology employment situations. Typically, radiologists under employment with a hospital earn competitive base salaries, with modest bonuses, as well as attractive vacation benefits. However, retirement benefits tend to be lower. The financial security is appealing, as is paid overhead.
In an initial consult, Kroken said hospital groups were wondering why they were losing money. “There is a strong likelihood many of these groups would have been more productive privately, than in the hospital,” she said.
After looking into the problem, Kroken found multiple potential causes.
Within the hospital, billing and collections results indicated that there was underperformance in terms of collections per radiologist. The hospital was using a legacy billing system which they were contractually obligated to bill with, but it was failing to correctly bill for many procedures.
Another conflict was centered on the perception that radiologists seemed unwilling to take on additional work, because they would not be paid more. They did not work well being managed, and radiologists found they were unsuccessful in persuading hospital leadership to purchase equipment they needed or wanted. Within the hospital, the radiology groups were frustrated with an inability to recruit many highly qualified subspecialists as well.
Ultimately, production and profitability couldn’t be resolved within the hospital because the radiogoists were unlikely to increase production, recruitment continued to be difficult and the billing procedures couldn’t be changed, said Kroken.
Breaking up may be hard, but it is survivable
In an amiable departure, the radiologists contributed to a pool of funds to pay legal fees, business start-up fees and consulting costs. Meanwhile, the hospital subsidized them for a certain period of time, and the practice assumed the quality assurance program implemented by the hospital.
After the split, the group hit projections sooner than expected—which confirmed the billing discrepancies—and the group provided feedback to the hospital which, in turn, helped them solve billing issues. From the hospital standpoint, radiology costs were eliminated and there were improved service levels.
“Radiologists group well in private practice, but in the cases in our composite group, they chafed at employee status,” she said. “They were less productive, resentful of being managed and didn’t work well in a large organization structure.”
Kroken described a composite group representing commonalities of several radiology employment situations. Typically, radiologists under employment with a hospital earn competitive base salaries, with modest bonuses, as well as attractive vacation benefits. However, retirement benefits tend to be lower. The financial security is appealing, as is paid overhead.
In an initial consult, Kroken said hospital groups were wondering why they were losing money. “There is a strong likelihood many of these groups would have been more productive privately, than in the hospital,” she said.
After looking into the problem, Kroken found multiple potential causes.
Within the hospital, billing and collections results indicated that there was underperformance in terms of collections per radiologist. The hospital was using a legacy billing system which they were contractually obligated to bill with, but it was failing to correctly bill for many procedures.
Another conflict was centered on the perception that radiologists seemed unwilling to take on additional work, because they would not be paid more. They did not work well being managed, and radiologists found they were unsuccessful in persuading hospital leadership to purchase equipment they needed or wanted. Within the hospital, the radiology groups were frustrated with an inability to recruit many highly qualified subspecialists as well.
Ultimately, production and profitability couldn’t be resolved within the hospital because the radiogoists were unlikely to increase production, recruitment continued to be difficult and the billing procedures couldn’t be changed, said Kroken.
Breaking up may be hard, but it is survivable
In an amiable departure, the radiologists contributed to a pool of funds to pay legal fees, business start-up fees and consulting costs. Meanwhile, the hospital subsidized them for a certain period of time, and the practice assumed the quality assurance program implemented by the hospital.
After the split, the group hit projections sooner than expected—which confirmed the billing discrepancies—and the group provided feedback to the hospital which, in turn, helped them solve billing issues. From the hospital standpoint, radiology costs were eliminated and there were improved service levels.
“Radiologists group well in private practice, but in the cases in our composite group, they chafed at employee status,” she said. “They were less productive, resentful of being managed and didn’t work well in a large organization structure.”