Instilling a Service Philosophy in Radiology, Imaging Practices

The importance of behaving in a manner that reflects integrity in the radiology industry

As radiology moves into value-based compensation models, there is an even greater emphasis on imaging as a service business. And with that, the importance of each person in the organization behaving in a manner representative of a “leading” philosophy. At its simplest, there is a higher emphasis on the quality of integrity: acting in a manner consistent with the values you state you stand for, doing what you say you’ll do when you say you’ll do it. Simple, but not easy!

In an era when we are pleasantly surprised at receiving great service in an airport or restaurant, for example, we have to think about what our customers (hospitals, patients, referring physicians and even the health plans that have begun to measure customer satisfaction) think of our practices. At about the time we think we’re doing just fine, let’s look at this from another perspective.

What is being communicated when the most disruptive physician in the practice continues to ignore the hospital rules, fails to sign reports, throws tantrums in the IR suite or reading room and barks at the technologists as if they were indentured servants? What does it say when the technologist looks for a radiologist to read a case and is too often told, “I’m busy. Take it to Dr. X?”

How does it reflect on the group when referring physician offices say they hate to call for assistance solving a problem because the person answering the phone is rude and always makes them feel they’re interrupting her? (We all have that person somewhere, the one even you’re relieved didn’t pick up the phone when you called). Yes, we all have bad days but some people are more chronic and share their bad lives.

Each person related to the practice, good or bad, is the practice at the time they are communicating and cooperating (or not). It’s a frightening thought sometimes. All of the work we put into hiring skilled physicians, honing IT options for greater responsiveness and building up subspecialty capabilities can be undermined by a lack of regard for the power of human interaction.

So where do we begin in order to instill a service philosophy into our practices and what does that mean in real life?

Model Desired Behavior

It’s tough being in an official leadership position but important to recognized you’re being watched—always. If you are the chief administrative person in your company, have you noticed what happens when you have a bad day? The entire office reflects your behavior and if you’re down, the overall tone of the office is down.

It’s a heavy burden to bear and more than once I’ve lamented at not having the luxury to have a bad day without feeling the ripple effect of it throughout the entire staff.  The same holds true in the imaging center or hospital radiology department and now those attitudes are being “graded” by our hospitals and health plans.

Understand the Game

One of the saddest things in our industry is watching a good radiology practice (good defined by competence of physicians) lose a professional services contract because they insisted on maintaining an old-style adversarial relationship with the hospital. Gone are the days of “What are they going to do, replace all of us?” when geography offered a moat of protection.

Hospitals are truly seeking collaboration and groups that work with them to meet market expectations will be prized partners. Those who do not will be gone.  Being a jerk or a “cowboy” these days can be expensive!

Communicate Expectations

Rather than assume everyone will see themselves in terms of corrective behavior, review clearly what is expected. For example, hospitals are measuring technologist satisfaction on an ongoing basis and those scores are primarily influenced by radiologist interactions during the day. And measuring work habits such as punctuality. Is a patient too often left on the table early in the morning because the radiologist can’t seem to get to work on time (or get started once they arrive?) There is no place to hide anymore.

Don’t Tolerate Bad Behavior

This comes with a caveat in some instances. For example, while I wouldn’t hesitate to terminate that administrative person who is rude on the phone, it would only be fair to evaluate whether her job responsibilities are realistic, whether the behavior is cultural and perhaps only comes across as abrupt and how that person interacts with peers within the company. If other aspects of her work are outstanding, the first goal would be to move her to a position requiring much less interaction with the public. On the other hand, as much as I hate the process of firing someone, there are times when a strategic termination can be highly effective if it reinforces you are serious about a directive.

“Value” is Still a Work in Progress

This means about the time we understand the rules and expectations, someone will change them. Chances are this means they will tighten down further. If the goal is effective use of healthcare dollars (and it’s always about the money), how will that impact radiology? At its most basic, that could translate into meaningful radiology reports with clear direction for the referring physician who is seeking help solving a problem. Lately, I was in a “collaborative meeting” with a major referring group where the request was to have greater clarity in report findings—and a minimal discussion of technique used. They wanted to be able to read a report that would help answer the question, “What do I need to do next after receiving this information?” (And they didn’t mean ordering another CT scan).

Bottom line? It all counts. Every great service interaction that solves a problem or forwards the value of the practice to key stakeholders as well as every rude, inept or condescending response. How does your group stack up in terms of leadership down through the front lines? Does each person know he or she is representing the practice with every phone call, radiology report or conversation? We are all leaders now.

This column was made possible by a partnership between ADVANCE and RBMA. For more information on RBMA, call 888.224.7262 or visit

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