Private radiology practices hit hardest by pandemic, with 80% volume dips and doc pay plummeting
The COVID-19 pandemic has hit private radiology practices harder than most, a trend that has tugged down doc pay and may accelerate consolidation in the specialty.
Some such practices have seen patient volume declines as high as 80%, forcing leaders to take drastic measures, according to a special report published Friday in Radiology. Those have included reducing radiologist salaries to keep nurses and technologists aboard, bumping docs down to as few as three days a week, requiring unpaid leave, or eliminating bonuses.
Report authors noted that radiologists have sustained an estimated 40% decrease in compensation this year, and they believe practices may rewrite doc pay rules going forward to help financially protect themselves in the future. Rad base salary may account for a smaller percentage of compensation, with individual productivity and the practice’s overall performance accounting for the lion’s share of pay.
“Some groups may prove unable to survive the COVID-19 pandemic, potentially fueling trends either toward consolidation into larger radiology groups or toward increased employment by hospitals,” wrote lead author Richard Sharpe Jr., MD, MBA, a senior associate consultant at the Mayo Clinic in Scottsdale, Arizona, and colleagues. “We anticipate that small radiology practices may be at greatest risk for consolidation with larger radiology groups that have a more diversified practice model regarding inpatient-outpatient mix, subspecialty service lines and geography.”
Other drastic actions taken by private practices include terminating work for temporary and locum tenens contracted rads, dismissing pre-partner physicians, reducing admin and educational time, and removing stipends for after-hours work. They’ve also suspended infrastructure improvements, renegotiated rent payments and equipment leases, and negotiated interest rate reductions on debt.
While turning toward larger corporate-owned partners may be the answer for some, these entities have suffered the same struggles during the pandemic, the authors noted. Just recently, Standard & Poor’s painted a pessimistic picture for healthcare staffing firms in the future, specifically highlighting concerns tied to the biggest names in imaging.
“The COVID-19 pandemic exposed some of these firms as being more fragile than initially anticipated,” Sharpe and colleagues wrote. “Like a slingshot already retracted to its breaking point, some of these firms were excessively leveraged at the outset of the pandemic. This was the result of a trend of leveraged buyouts that depended on growth to succeed and left little room for increased financial backing during the pandemic.”
Private practice leaders have “appreciated” the rapid sharing of information from the academic imaging world in recent months. But with doc-owned providers accounting for roughly 83% of all practicing radiologists, the authors believe one takeaway from this crisis is the need for private rads to get more involved at a national level in responding to crises.
“Variations in how academic and private practices, particularly those in more rural communities, have experienced the burden of disease has led to differing views on important issues, including the timing of starting and stopping routine screening mammography and nonurgent outpatient imaging,” Sharpe and coauthors concluded. “This phenomenon highlights the need for private practice, community-based physicians to participate in the development of national trends and standards, and for those national trends and standards to incorporate appropriate flexibility for local healthcare environments.”
Read more of the special Radiology report here and a shorter summary of the findings here. The findings were summarized and synthesized from experiences private practice leaders shared with RSNA’s COVID-19 Task Force.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.