The 50 Largest Radiology Practices
Why compile a list of the 50 largest radiology practices? We acknowledge that the list is far from complete, and that there may be some inconsistencies in the way that respondents answered the questions. Some radiology groups chose not to respond, and some may not have been aware that the survey was being done, so they are not included in the list. We do believe, however, that this is a pretty good start. We expect greater accuracy next year and more respondents every year.
The benefits of such a survey are well understood in other fields. In the accounting world, each year, we wait for a couple of organizations to publish their annual list of the largest accounting firms in the country. I see three main benefits of this distinction.
There is, however, an inverse relationship between median revenue per FTE employee and the size category, with the smaller groups earning higher revenue per FTE employee than each successively larger group. 
The largest of the groups (with more than 65 radiologists) employ small armies of staff members, ranging from as many as 846 at American Radiology Services, Baltimore, to as few as 18 at Advanced Radiology Services in Grand Rapids, Mich, which was the third largest group by FTE radiologists, but also the group that employed the fewest FTE employees. Next year, we will be much more specific in our questions to verify that, for instance, all 450 FTE employees reported by Brigham and Women’s are employed by the radiology practice and not the hospital’s radiology department. We also will specify that academic departments report only their clinical FTE radiologists and not include research FTEs. 
We asked respondents to include data for the years 2007 and 2008, and although we only shared the data from 2008, a clear trend of the big getting bigger emerges. We can report that four of the 86 practices that responded have lost members, a dozen have stayed the same size, and the rest have added FTE radiologists. Of the total respondents, including the practices that did not make the 50 largest practices ranking, 46 practices provided income data. Of those, seven practices report flat revenue for 2008 over 2007 and six practices report declines in revenue, but the remainder report growth. 
A total of 86 practices responded to our survey, and we regret that we were unable to include 36 practices. One midsized teleradiology company entered, which leads us to question what it is that distinguishes a practice from a teleradiology company. Several practices in the list of the largest 50 have significant teleradiology components to their businesses, but they also cover local hospitals or own imaging centers. We decided not to include teleradiology-only companies.
We plan to expand this list next year to include the 100 largest radiology practices, and we welcome your thoughts on how to improve and build on this survey.
- It can be a source of organizational and employee pride to be able to say that you are one of the largest groups in the country.
- It can be used as a recruiting tool for new radiologists; some will see bigger as better.
- It can possibly be of benefit in contracting.
There is, however, an inverse relationship between median revenue per FTE employee and the size category, with the smaller groups earning higher revenue per FTE employee than each successively larger group.
The largest of the groups (with more than 65 radiologists) employ small armies of staff members, ranging from as many as 846 at American Radiology Services, Baltimore, to as few as 18 at Advanced Radiology Services in Grand Rapids, Mich, which was the third largest group by FTE radiologists, but also the group that employed the fewest FTE employees. Next year, we will be much more specific in our questions to verify that, for instance, all 450 FTE employees reported by Brigham and Women’s are employed by the radiology practice and not the hospital’s radiology department. We also will specify that academic departments report only their clinical FTE radiologists and not include research FTEs.
We asked respondents to include data for the years 2007 and 2008, and although we only shared the data from 2008, a clear trend of the big getting bigger emerges. We can report that four of the 86 practices that responded have lost members, a dozen have stayed the same size, and the rest have added FTE radiologists. Of the total respondents, including the practices that did not make the 50 largest practices ranking, 46 practices provided income data. Of those, seven practices report flat revenue for 2008 over 2007 and six practices report declines in revenue, but the remainder report growth.
A total of 86 practices responded to our survey, and we regret that we were unable to include 36 practices. One midsized teleradiology company entered, which leads us to question what it is that distinguishes a practice from a teleradiology company. Several practices in the list of the largest 50 have significant teleradiology components to their businesses, but they also cover local hospitals or own imaging centers. We decided not to include teleradiology-only companies.
We plan to expand this list next year to include the 100 largest radiology practices, and we welcome your thoughts on how to improve and build on this survey.