Radiology's Tough Love

Last month, I discussed the need (and demand) for a culture and ethos of customer service within medical imaging practices, departments, and centers. Apparently hitting a bit of a nerve, I received some rather interesting responses that point out a significant disconnect between this ideal and the current reality, based on a certain anthropology that exists within the ranks of many radiology groups. A typical response, paraphrased, went something like this: “Curtis, we get it, but how can we have a commitment to customer service when our radiologists don’t care about the customer, arrive at work late, leave early, never even bother to say thank you to the referring physicians, and generally seem to be concerned only with their time off or their incomes?” It sounds like there may be a disconnect here. It’s an old refrain: do as a say, not as I do. Keep in mind that I am a true friend of radiology, but I will approach this from the perspective of those who offer similar criticisms in the payor and referral communities (translation: radiology’s customers). Unfortunately, the universal perception in the referral community seems to be one that describes radiology as the country-club specialty. After discounting a certain percentage of this perception that can be ascribed to simple jealousy, there remains a significant image problem that radiologists need to address, and quickly. Given the fact that real health reform is right around the corner, and that the US health system is financially stressed to the point of requiring major intervention, it would seem clear to anyone looking objectively at the profession of radiology that significant change is inevitable. The status quo is unsustainable. Your world is about to be rocked by a tectonic change. Like it or not, those making the reimbursement decisions buy into the country-club argument. Radiologists need to walk the talk. If you expect everyone within your organization—your partners, your technologists, and your administrative staff—to have high standards of achievement, then you need to set the bar yourself and demonstrate, through your actions, your involvement in every aspect of the practice. Some of it might be boring to you, some might even be downright painful, but in a successful partnership, every partner carries his or her weight within the enterprise. That often means doing things (marketing, administrative time, and customer service) that don’t seem as high in priority when you are facing a stack of studies that need to be read and reports that need to be dictated, but they are just as important—really. It would be interesting for health care’s cultural anthropologists to look back on this period of radiological affluence, some years hence, and ponder how and why the profession eventually became commoditized. My guess is that it will have a lot less to do with disruptive technologies (such as teleradiology and its concomitant impact on virtual practices) than with a general attitude of complacency, entitlement, and apathy on the part of many radiologists. It might not be uncommon to hear, “Don’t bother me with the people issues. Just let me read and pound out these studies so I can go home.” That doesn’t even count the endless problems created by radiologists who exhibit bad personal behavior toward the internal technical and administrative staff. The customer-service disasters created by abusive and passive-aggressive behavior from radiologists make certain urban legends pale by comparison. It’s always hard to be the one to deliver a little tough love, but I sincerely hope that radiologists will look a little more closely at themselves to see if the above could be—even a little—true of them. This bit of introspection is critically important if we are to see the continued ability of radiologists to thrive in a dramatically changed health care structure. Message to radiologists: I want you to thrive. I want you to succeed, but if you see yourself in any of these descriptions, you definitely need a makeover if you are going to do so. Competition will be much fiercer. If you cannot get yourself pumped up to compete for the business and set yourself apart through great customer service, then you will most certainly become one of the commoditized masses, an easily purchased product that will be readily available in plentiful supply, and at extremely low rates. It will not matter whether you practice in a hospital setting or an outpatient center; you will need to meet the increasing demands and requirements of your customers if you are to avoid such a fate. Before you hit the send button on your response, venting at my presumption, rest assured that I know that there are many role-model radiologists out there who have already made the cultural transformation to the new order of the competitive marketplace. I personally know many who are champions of just the type of customer service that I am speaking about here. Many have led the way toward ensuring radiology’s place in the hierarchy of physicians who care very deeply about their profession and its role as medicine’s consultative partner. It is the laggards to whom this message is addressed—the ones who are often the most vocal critics of marketing and of the supposed waste of administrative time by practice leaders who commit extra energy to practice building. Respect must be earned, and those who intend to lead the way forward know this very well. They are the ones who inspire confidence and support from their staff and generate continued business from their referral sources. They are genuinely appreciative of what they have, they do not expect to be given a cushy ride, and they definitely know how to say please and thank you to those they encounter each day.