Blurred lines, conflicting loyalties, cut-throat competition, profitable, polarizing, a threat, a lifeline. No, it’s not a plot line from Grey’s Anatomy—it’s the rise of corporate radiology. 

Okay, it’s not really that dramatic. Corporate radiology groups are just another avenue of employment with potential pros and cons like every practice type. 

This post provides a basic overview of corporate radiology and what you can potentially expect, along with a brief reference guide to some of the major corporate employers. 

ACR definition: radiologists or ancillary personnel are employed by a for-profit corporate entity (e.g., a teleradiology company or a corporation formed from consolidation of radiology groups).

Corporate radiology is an employed physician model within a single regional or nationwide radiology company. The largest national companies are teleradiology companies that have developed organically, but newer companies now include employed radiologists who have sold their private practices [1].  

Corporate radiology groups provide hospitals with specialty radiology services and 24/7/365 radiology interpretation via teleradiology.  Radiologists are salaried employees and the corporation determines salaries and benefits. Radiologists may have to follow corporate policies for performance and efficiency and the corporation may control scheduling and equipment purchasing.  

Corporate groups (meet the monoliths) 

Some of the largest corporate groups are Radiology Partners, RadNet, Mednax (vRad, a teleradiology service, is a Mednax company), Envision Healthcare, and SimonMed Imaging, as well as private equity firms and hospital/health systems.  Note:  In June 2020, Mednax announced that it was selling off its Radiology Solutions business line.

Radiology Partners is the largest physician-led and physician-owned radiology practice in the U.S., with approximately 1,250 radiologists providing services to more than 925 hospitals, clinics and imaging centers across 18 states, and the infrastructure and capital to scale further (www.radpartners.com).  

Local practices that are part of Radiology Partners govern themselves when it comes to all aspects of local operations. This means that local physicians make decisions regarding their schedule, hiring/firing of local physicians, local hospital interactions, clinical policies and procedures and more. They have access to management and clinical resources that exist for the entire practice, but when it comes time to decide what actually gets implemented locally, it’s up to the local team.  

Being part of a large corporate entity gives struggling private practice owners and managing partners access to centralized resources, such as administration, recruiting, contracting, nighttime support, advanced technology, lower malpractice insurance rates, and best practices sharing.  

RadNet is the largest provider of outpatient imaging centers in the United States (www.radnet.com), operating over 300 imaging centers and employing over 500 radiologists.  RadNet’s Imaging on Call service (IOC) provides emergent and routine, daytime and nighttime interpretations to radiology groups, hospitals, and imaging centers. IOC is Joint Commission-accredited for final and preliminary reads. Board-certified, fellowship-trained radiologists are available 24/7/365.  

Envision Physician Services is a national physician group that provides anesthesia, emergency medicine, hospital medicine, radiology, surgical services, and women’s and children’s services in 48 states (www.evhc.net).

Implications of acquisitions/mergers and working for a radiology corporation 

What it means for partners of private practice groups that are bought by a corporate entity, like RadNet, is largely determined by the private group.  The group can still offer partnership, which may mean owning a share of the group’s assets if they own equipment, and/or it may mean owning equity in the larger corporation.  Partners are eligible for elected and appointed leadership positions locally and nationally at the corporate level. Although salaries for those on the partnership track may not change, full partners generally see a drop in salary, which could be substantial after a buy-out/partnership with a corporation.  Working for a radiology corporation may allow a radiologist to work primarily in her subspecialty area of interest and expertise.

With acquisition comes relinquishment of control and decision-making to a remote group of owners/investors whose primary allegiance may emphasize profitability over patient care.  

Many corporations take over existing hospital contracts that were previously served by local private practice radiology groups, and may offer employment to the displaced radiologists.   In sum, transitioning to a corporate radiology setting can be a good news/bad news kind of situation. 

My next post will focus on a particular type of corporate practice – teleradiology.  This option has been growing in need and popularity and represents an opportunity for radiologists to work in an environment that dramatically alters their lifestyle. 

References

  1. Stern EJ, Everett C, Friedberg EB, et al.  2017 ACR annual meeting open-microphone session: navigating the landscape of changing practice models: private practice, corporate radiology, and enterprise systems.  J Am Coll Radiol 2017; 14:1384-1387