The Cultural Revolution: Two Case Studies on Corporate

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Private and public companies alike have long sown the seeds of success by conceiving and adhering to a corporate culture that dictates how employees interact with customers and clients, as well as with each other. The rationales for adopting an unimpeachable corporate culture within the health care sector are airtight and multifaceted. Perhaps most important, establishing and adhering to a set of cultural values paves the way for improved patient services and care.

imageRodney Owen, MD

Rodney Owen, MD, serves as president of Arizona’s Scottsdale Medical Imaging, Ltd, (SMIL) and is an executive vice president of Southwest Diagnostic Imaging Inc, of which SMIL is an affiliate. “Radiology, like all health care, is a service industry,” he says. “Only with a strong corporate culture can radiology practices achieve the caliber of care, patient service, and satisfaction needed to survive in an increasingly competitive market.”

Lisa Mead, RN, MS, SMIL’s chief administrative officer, corroborates Owen’s comments, adding that functioning within a corporate-culture model is especially critical for practices that offer imaging services at multiple sites and are in a growth mode. SMIL operates 10 outpatient imaging centers in the Scottsdale area, employing more than 40 radiologists in eight subspecialties, along with more than 200 technologists and administrative personnel. “Patient care and the manner in which everyone within the organization approaches his or her job need to be consistent,” Mead states. Corporate culture is the linchpin here.

Culture and Reform

Having the right corporate culture in place also bolsters radiology practices’ potential to flourish despite outside forces, particularly the paradigm changes that accompany the rising tide of health care reform. This was the catalyst that drove Boston University Medical Associates (BUMA) in Massachusetts to embrace a new corporate-culture model, according to David J. Spinale, MBA, director, who was tapped to lead the charge. A 42-physician academic practice, BUMA performs more than 425,000 imaging studies annually for Boston Medical Center (its affiliated community hospital) and 15 community health centers in the greater Boston area.

Boston Medical Center is the nation’s largest free-care hospital, and it serves a disproportionate number of indigent patients. “For years,” Spinale says, “the state of Massachusetts would routinely ask the cost of serving these patients and write checks to cover those expenditures, so efficiency was not a driver in its departments.”

Three years ago, however, landmark legislation spearheaded (and about to be signed) by Mitt Romney, who was governor at the time, set the winds of change blowing. Enacted in 2006, Massachusetts’ health care reform law requires health insurance coverage for nearly every resident of the state. The state provides health care for residents earning up to 100% of the federal poverty level and partially subsidized health care for those earning up to 300% of that level, using an income-based sliding scale.

imageAlexander Norbash, MD

Alexander Norbash, MD, BUMA’s chair, says, “It became clear to us that we had a short time window in which to become a competitive, metrics-driven business (particularly if we were to attract and efficiently serve patients who now had insurance cards and a choice of providers) while remaining profitable. It was also clear that we had to abolish the fiefdoms that were in place” in various subdepartments in order to achieve consistency and integration with hospital-wide operations management. “Adopting core cultural values was, for us, the best solution,” he says.

A desire to minimize the ill effects of subspecialization within radiology also pushed the corporate-culture envelope where BUMA was concerned, Norbash adds. “On the academic side, radiology tends to be subspecialized, and the subspecialties aren’t necessarily aligned,” he explains. “Corporate culture allows for an alignment of mission, with the shared values that are critical to better patient care propelling us forward.”

Common Values

It’s not surprising that the building blocks of an ironclad corporate culture do vary subtly from radiology practice to radiology practice. There exist, however, myriad shared cultural values. In addition to an emphasis on high-caliber service and patient care above all else, such elements, many of which have a direct impact on these two overarching values, include innovation, a push