Nearly 90% of early career radiologists believe corporatization is harming the speciality
Corporate forces have made a significant foray into radiology in recent years, a trend that’s drawing negative reactions from physicians just entering the field.
A recent survey of more than 600 early career imaging physicians found that 86% believe that corporate entities harm radiology as a specialty. And another 83% said they’d prefer to work for an independent practice, rather than one owned by a corporation, researchers reported in March’s Journal of the American College of Radiology.
Such emotions are casting a pall over radiologists’ early practice years, with 72% saying they're worried about a national chain gobbling up their workplace, driving down salaries and prioritizing profit over patient care.
“The survey revealed a prevailing belief that the trend of corporatization has been fueled by older generations of radiologists ‘selling out’ both [early career radiologists] and the future of radiology for selfish financial gain,” experts with the universities of California in San Diego and Los Angeles wrote March 2. “This perceived generational gap has led to animosity between practice associates and partners. One respondent stated that since being acquired, the older partners waiting for stock vesting have become apathetic in their clinical duties, leaving the juniors to work longer hours with less pay.”
To reach their conclusions, lead author and former UC San Diego fellow Daniel Ortiz, MD, and colleagues conducted an online survey with hundreds of younger rads. Those targeted were part of the American College of Radiology’s Resident and Fellow, and Young and Early Career Professional sections. Out of those large groups, the surveyors only included junior or senior trainees, along with junior radiologists pursuing a partnership track, or nonpartners at firms recently acquired by a corporation.
Ortiz and colleagues were motivated in their work by the “uptick in acquisitions” of radiology practices by large national entities that are backed by private equity, venture capital or publicly traded corporations. He and coauthors specifically pointed to three “major players” in rad practice acquisition—Radiology Partners, Mednax and Envision Healthcare. Imaging certainly isn’t alone in this trend, the authors added, with private equity deals in healthcare topping $63 billion in 2018 alone, and the latter two aforementioned companies working in other specialties.
Overall, about 85% of survey respondents were aware of radiology’s corporatization, and half said they know a peer who was harmed by this trend (about 10% said they know someone who benefited). Ortiz (who is now in his first year of private practice in Georgia) and colleagues also included a free-form section in the online survey to explore reasons behind these answers.
One key takeaway for practice leaders is that young radiologists want to be engaged in leadership and the business side of the specialty. And they’re loathe to let leaders take over who do not have a clinical background and mind toward improving patient care, Ortiz and colleagues reported.
“The possibility of nonphysician administrators potentially dictating local policy and infringing on radiologist autonomy was raised by many respondents,” the authors noted. “A general aversion to nonradiologist ownership was highlighted, with several respondents stating that they do not want to work in any system in which executives, nonphysician administrators, and public stockholders are reaping the financial rewards of radiologists’ work output.”
Respondents also highlighted the importance of practice transparency. Numerous respondents expressed “frustration” that they interviewed with a provider, and were not informed about merger and acquisition talks occurring behind the scenes.
“When asking interviewers about plans for acquisition, these plans were hidden, often because of nondisclosure agreements during negotiations of an acquisition. It is our view that this practice is unethical, and that applicants and practice associates should be informed of the possibility of an acquisition so that they may make informed decisions during this critical point in their careers,” Ortiz and coauthors wrote.
Leaders must practice transparency on this trend in general in order to foster a healthy work environment in the years ahead, the authors concluded.
“In the coming years, we will likely see early reselling of practices, which we believe will change the dynamics of the field. It is important that [early career radiologists] be informed about this trend. Furthermore, it is important that the [American College of Radiology] as well as corporate and practice leaders take into consideration the perceptions of ECRs regarding corporatization of radiology practices,” they concluded.
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.