Radiologists aim to ‘take back the profession from Wall Street’ with launch of new private practice

Two radiologists are aiming to “take back the profession from Wall Street” with the launch of a new private practice. 

Kevin Kadakia, MD, MBA, and Tarang Patel, DO, officially announced the rollout of Radiology One March 1. The move came after Patel—an Arizona-based podcaster, speaker and moderator of the 6,500-member American Radiologists Facebook group—ended his 15 years of employment with Banner University Medical Center in Phoenix. 

The two told Radiology Business they’re frustrated with growing corporatization and private equity involvement in imaging. Radiology One, they added, offers physicians an option that’s flexible, transparent and aligns incentives with radiologists rather than outside investors. 

Kadakia, who lived in Florida’s Sarasota County at the time, said he phoned Patel after resigning from his previous employer ahead of a sale to private equity. 

“I said, ‘What am I going to do next? That's what led me to reach out to Tarang—no different than the 100 radiologists who probably contact him on a weekly basis,” Kadakia, the new company’s chief operating officer, said in an interview. “Just like anybody else, I was asking for advice on what to do—feedback, best practices—and we came up with this idea that [American Radiologists] should be more than just a forum for people to express their frustration. We should do something about it. And that’s how we started Radiology One. It’s just been growing since then.”

The practice provides “augmented” radiology services—they believe the term “teleradiology” has a bad connotation—to hospitals and outpatient imaging centers. Radiology One has about 25 full- and part-time radiologists, and more than 150 others are interested in joining, Patel estimates. The practice has already contracted with 10 hospitals and 15 imaging centers. Kadakia and Patel are in talks with another 15 potential clients. One contract has radiologists helping a local imaging group in Alabama to service a hospital contract, particularly on hard-to-fill nights and weekends. 

Radiology One is not looking to compete with local physician groups but to supplement their work. Patel, the new company’s CEO, said radiologists have signed up for a variety of reasons. 

“It’s a spectrum,” Patel explained. “We have people who are looking for additional work as well as people who have been in private equity and are tired of the way those practices are run. Some are looking for something more transparent.”

Patel said Radiology One is also drawing looks from young radiologists discouraged by the limited paths to growth under private equity control. “Then there are a ton more who are just like, ‘We support what you do. How can we help?’”

 What most have in common, he has observed, is “a belief in our mission of, as we say on our website, trying to take back radiology.”

Individual ownership without private equity  

Radiology One provides radiology coverage and support to both private practices and hospitals struggling with staffing shortages or high volumes. The group’s stated goal is to preserve the local, “boots-on-the-ground,” relationship-based model of radiology rather than the “large corporate approach.” They also are working to build an equity incentive plan to give radiologists an ownership stake in the company. 

“We tell people we don’t want the equity component to ever be that big in terms of financial reward,” Kadakia said. “We want the financial reward to go to the reading radiologist because we think too much money is going to someone other than the radiologist who’s actually reading the study.”

Many other radiologists aren’t keen on being a part of something, Kadakia adds: They just want to be paid as they go. 

On the other hand, some certainly desire a sense of belonging to something bigger than themselves.

“We’re offering both models, but we always tell people we believe in full transparency,” Kadakia said. “The money should always go to the reading radiologist. Because the hardest, most stressful part of the job is reading the studies. I think sometimes that is forgotten by some of the bigger organizations.”

Kadakia continues to work with Mercy Radiologists of Dubuque, Iowa, while serving as COO of Radiology One. 

“My group is very supportive of this arrangement. It helps them, and I think they understand the overall mission,” he said. 

Radiology One does not have or plan to have a large physical office, as Kadakia and Patel have settled on Scottsdale, Arizona, as their humble corporate headquarters. Instead of investing in office space, they prioritize directing those resources into their people and technology. They’ll continue to take on radiologists interested in joining.

“What we’re offering is not sign-on bonuses or anything like that,” Patel said. “Our rates are among the highest in the industry not because we’re charging more but because we have a leaner structure. If you are doing the work, you’re going to get paid the majority of the billed rate.”

The duo believe Radiology One’s payment structure will incentivize radiologists to “do better on a production basis” than they would be able to manage at most other practices. 

“Plus, they’re getting a chance to join a truly radiologist-owned operation,” Patel added. “We’re building something that can impact the national radiology community.”

Patel—who advises physicians on finances, partly by hosting the show “Doctor Money Matters”—hopes to expand Radiology One’s business model at scale. 

“I am very critical of the private equity world— especially in healthcare,” he said. “But one of the things PE leaders understand is that size can deliver some major benefits. There are certain things you can do at scale that you just can’t do in a small practice.”

Patel is convinced such things can be had without taking on millions in debt. 

“I think we can do things in terms of scale that will benefit radiologists and patients instead of investors and middlemen.”

Private equity isn’t the only problematic operator of practice models. 

Patel said frustration is growing with the hospital employment model, particularly regarding how radiologists are sometimes treated in these settings. While he had a positive experience at Banner and departed on good terms, he acknowledges that this is not the case everywhere. 

“The common thread among employed radiologists across the country is that they are not necessarily happy with either of those two models,” Patel said.  “The problem is rarely malicious intent. It’s more just bureaucratic processes that make radiologists feel like cogs in a wheel. I truly do feel that the independent practice model is the best model. And that’s why we’re trying to build this as an option.”

“It’s not rocket science,” Kadakia added. “You don't need to be a genius to succeed in this radiology marketplace. You just have to provide good quality care. Do that, and your good reputation will quickly grow.”