Reinventing Medical Imaging

I recently attended a very interesting and intellectually stimulating conference for top leaders in the field of outpatient imaging services. The Imaging 100 conference was held in Carlsbad, Calif, where imaging executives representing various provider segments assembled to discuss innovative solutions to hot marketplace issues. Most attendees were very focused on finding ways to succeed despite the enormous headwinds, and consensus was built, over the course of the meetings, regarding the criteria for being among the winners in the current market shakeout. The general feeling was that we need to get beyond doom and gloom and seek to reinvent our businesses based on ideas. There were plenty of great ideas floating through the meeting rooms and networking receptions. It occurred to me, as I talked with some incredibly bright and successful entrepreneurs, that similarities exist in all market life cycles of this nature. In a tight economy, one in which innovation is rewarded and mediocrity is punished, buyers of services look for big ideas. They are simply not interested in the same old thing, presented in the same old way. Complacency and products that are bereft of true benefit to the buyer (payor, patient, or referring physician) simply have no reason to exist in a mature market where supply exceeds demand. The winners look at the same set of market conditions as the losers, but see different messages in the data. Winners invest in ways to win market share as referrals are up for grabs. Losers do nothing in the hope that things will one day return to the way they were, when scan volume grew despite their lack of customer focus. Winners diversify and reinvent their businesses to meet new demands, new niche opportunities, and new competitive realities. Losers flail about, mystified by the fact that their old ways don’t seem to work any longer. I was greatly encouraged by some of the things that I heard discussed. Outpatient imaging providers are diversifying their practices to add pain-management clinics, vertically integrated women’s imaging services, interventional capabilities, clinical-trial services, radiation-oncology joint ventures, surgicenter ventures, real-estate deals, regional PACS providers, sleep centers, cosmetic practices—you name it. Imaging entrepreneurs are exploring the possibilities, and some are already succeeding. I spent time with two strong entrepreneurs whose outlook was typical of the practices that are moving quickly to reinvent themselves. One is a radiologist with a thriving outpatient practice in Bakersfield, Calif. Girish Patel, MD, is investing in technology, growing his practice, adding a new state-of-the-art center, and looking beyond today’s malaise to an opportunity for raising his business to a higher level of performance. Likewise, Ravi Chopra, CEO, of The C/N Group, Merrillville, Ind, led a discussion about getting over the doom and gloom by focusing on filling market needs. His company is diversified and is a successful model of how reinvention can lead to new opportunities. In his case, it has led C/N from imaging centers to surgery centers, medical office buildings, and other niche product-line extensions based on the company’s attention to clinical quality and top service through building long-term customer relationships. The upshot: yes, the pending change in the equipment-utilization calculation for the purposes of reimbursement is a very big deal. Everyone is focused on it, and everyone is justifiably concerned about the unintended consequences. The reality, however, is that the better-run businesses and practices will find ways to cope with this new speed bump, and those not finding ways to reinvent themselves will not find them. Many of these businesses have relied on the least innovative solution known to mankind—slashing expenses. It does not take a very creative person to look at a list of expenses and draw red lines through them. The hard part is finding out how to increase efficiency and manage costs effectively while growing the top line. That requires true creativity. I left the meeting encouraged that people like Patel and Chopra are raising the bar, that the more than 100 other top radiologists and executives were equally innovative, and that ideas do exist for people ready and willing to work a little harder, dig a little deeper, and open their minds to new possibilities.