Radiology in an Economic Downturn Strategies for Success
In the near term, radiology practices must turn their attention to managing expenses instead of growth. Physicians in radiology who believe that the current economic downturn will somehow bypass their practices, and who do not gird themselves for the new reality, may be left on the scrap heap of failed enterprises. Because we are in a service industry, we are susceptible to the vagaries of available disposable income. Those practices currently exploring strategies for adjusting to the ongoing chaos will thrive. Those not engaging—right now—in strategic planning will suffer. The graphs of increases in imaging services provided to CMS participants are misleading. Not only are the data from 2008 not readily available, they include imaging services provided by nonradiologists, where the largest growth is occurring. While it is clear that self-referral and subsequent overutilization are hurting our industry, they hide the fact that our own growth in the past two years has flattened, and that was in bullish times. How do we survive when utilization falls? It’s coming. I believe that the decline in health services will result from:
- the existence of fewer employer-sponsored health plans, and an increase in the number of uninsured people;
- the performance of fewer elective surgeries, such as cosmetic procedures and vein stripping;
- the choice, by injured patients, of medical therapy of rest and immobilization instead of orthopedic procedures;
- reductions in screening studies (such as mammography, virtual colonoscopy, and bone densitometry); and
- the lag time before any government-based or tax-credit–based program is instituted, if any such program is created at all: I predict that the tax credits will be used for basic household expenses and not for medical care, particularly when health care premiums exceed tax credits and the choice becomes one of buying food and making credit-card–debt payments versus purchasing health care coverage.