Paul Berger, MD, founder of NightHawk Radiology, whose company name became synonymous with night coverage, has formed a management and services organization (MSO) focused on helping radiologists integrate into the broader healthcare team.

Partners in the Imaging Enterprise (PIE) pulls together five prominent industry figures, some with considerable track records in the consulting world: Lawrence Muroff, MD, Richard Abramson, MD, former special advisor (Medicare Policy), White House Budget Office; Michael Webb, MD, president, Mountain Medical Physician Specialists, a 72-radiologist practice based in Murray, UT; and Bob Maier, CEO, Regents Health Resources.

Change is the focus, and Berger says it can’t happen too fast. “We need to focus on greater degrees of alignment with the systems that we work with, and we really need to focus on a lot of the things that we’ve gotten away from,” he says. “It’s not a productivity world, it’s a value-based world. We would like to be able to provide the resources that even the large groups need to take us into a value-based era.”

Berger asserts that PIE will not just tell radiologists, hospitals and other care-delivery organizations what needs to change to achieve better integration, but will be the resource responsible for implementing those changes. To that end, PIE has built an equally prominent advisory board heavy in IT and business expertise.

“We are not an independent consulting business,” he says. “A consultant, to me, is generally someone who borrows your watch and tells you what time it is. Once the consultant leaves, very often not a whole lot takes place because people get caught up in doing what they used to do.”

Reengineering the job description

“Leaders need to face reality,” Berger says, suggesting that while radiology has faced challenges in the past, this time is different. “Protecting the status quo and doing things the way we used to do them—only maybe a little bit better—is not going to cut it.”

Taking the giant steps necessary to achieve a truly integrated health system and doing for patients “what we would expect our loved ones to receive when they are patients” are key, he says.

“What that means to me, very fundamentally, is we need to reengineer the job description of the radiologist today,” he says. “We need to say, ‘What do we really want to do to provide tremendous value?’”

Is there just a little bit of irony in the fact that someone who might be considered the father of teleradiology is now is making it his business to de-commoditize radiology? Berger says no.

“Teleradiology was and still is a means of getting work done,” he says. “It’s a methodology of providing access to highly skilled physicians all around the country—or all around the world for that matter. If the name of our game is (and I think it is) providing the highest possible patient care we can possibly provide, then teleradiology is just a step in that process.”

Berger fell off the radiology radar in 2009, after resigning from the NightHawk board of directors following the Imaging Advantage takeover of Mercy Health Partners in Toledo, Ohio. NightHawk was Imaging Advantage’s teleradiology provider.

Berger makes it eminently clear that the goal is to work with both radiology practices and hospitals and health systems in tandem on alignment. “If a hospital came to us today and said, ‘We’d like you to help us do this,’ the first words out of our mouths would be, ‘We will do that in conjunction and with the acknowledgement and commitment of the radiologists that you work with today.”