Have no fear: Radiation oncologist Beatriz E. Amendola on opening a practice

Radiation oncologist Beatriz E. Amendola, MD, founded the Innovative Cancer Institute in South Miami, Fla., after holding several academic positions.

At RSNA 2015 in Chicago, Amendola made a presentation about the experience of opening up a private practice. After RSNA, she spoke with RadiologyBusiness.com via telephone.

RadiologyBusiness.com: What made you want to open up your own private practice?

Beatriz E. Amendola, MD: I worked in academics all my life. I was acting director of the radiation oncology department in Michigan, I was director of residency training in Philadelphia, I moved to Miami and I was also director of training. Although I was quite satisfied with the teaching and the training, I felt that I needed something more and I tried private practice.

However, in radiation oncology—at least during my time, maybe it’s different now—any new technologies or any advances, they were behind. We had to wait for everything.

Then I said, what about if I did it myself? I could really get the technologies as they come out. I could get them. That was one thing.

The other factor was that after my academic years, I was in a private practice twice in Florida, and I never got to become a partner. When it was time for my partnership, something happened, and I couldn’t be a partner.

So talking to my physicists, talking to some of my friends like surgeons, other doctors. They’d say, ‘well why you don’t do it?’ I’d think, you know, it’s easy for a surgeon to be in a solo practice and it’s easy for a psychiatrist, and even a radiologist, but for a radiation oncologist to be in a solo practice is extremely unusual, because you have to have equipment that is extremely expensive. And also personnel—you need one or two or three physicists, etc.

It was a hard decision, but I said, ‘if I don’t do this, I’ll never get what I want.’ And it was a lot of investment and money and time and life, but I’m glad that I did it.

RB: What approach did you take when hiring employees to work with you?

BA: To me, it’s extremely important who you have working for you. Hire a strong and competent staff. Choose the best people available for your group.  For example, if you’re going to have a radiation oncology department, you know physicists are key. So you need to have an excellent medical physicist with a lot of experience.

You’re as good as your team. If your team is not good, you are not good. You’re a team; it’s not like there is one person here. Everybody does a piece of the job. The way this operation works, everybody wants to do better, and they’re all like a family.

You need a very good IT Department because informatics is key, a good front desk because they are the face of your operation, and a good office manager, because I’m not a good one. Get a good lawyer and a great accountant.

We’re all there for the benefit of the patient. We try to treat the patient like a person, individually; the way we would like to be treated ourselves as patients. It’s not like they’re all the same or a medical record number.

RB: Access to the most advanced technology is obviously very important to you. What makes that such a necessity?

BA: You can have a beautiful, fantastic department, but if you don’t have the latest technology, you can’t offer the patients the best treatment.

You need to be up to date, you need to contribute to the literature, you need to see that your outcomes are good, but if you don’t have the technology, you cannot do a lot of the treatments that are currently done in our specialty.

RB: What are some of the biggest challenges you encountered while opening up your practice?

BA: The worst thing is that you’re not prepared for business when you get out of medical school. The challenge is not being able to be a business person, not to have the knowledge; for example not being able to negotiate with insurance companies for better rates ... that was one thing that was very hard for me.

And the other thing that was hard for me was that I, as a lot of doctors, don’t know how to do billing. Not only because you need to document what you do, but you need to bill correctly. If you leave your practice to a billing company, they usually are expensive and sometimes they may not do the best job for your practice.

RB: What advice do you have for others who may be considering opening up their own private practice?

BA: The advice is, do not fear anything. You have to take risks. If you think you’re safe in a location or you want to work in a group because it’s safe, then doing what I did is not going to be a possibility. If you do not take risks, you may be working for somebody who does.

The other thing is, you need to do something different. Do something unique and get involved.  Participate in tumor boards, hospital committees, volunteer in local, national and even international societies.

RB: What makes the Innovative Cancer Institute unique?

BA: In our practice, we wanted to create a different, better product, being innovative and providing something unique such as a combination of patient-centered care with cutting-edge technology.  We have the third radiosurgery unit of this type in the world, and the first installed in a freestanding outpatient facility. 

Our group is totally dedicated. They are dedicated to the practice. They like to take care of patients.

Editor’s note: Minor edits were made to these answers for length and clarity.