In light of dramatic changes to the U.S. healthcare landscape over the last two decades, an article published in the Journal of the American College of Radiology addresses key areas of concern for physician-owned radiology practices to focus on in order to remain independent and competitive.

Historically, the primary model for providing radiology services in the U.S. has been through independently physician-owned practices, which had been accepted as the most efficient arrangement for providing such services.

However, over the last two decades, technological innovation and increasing costs related to the introduction of new payment models, regulatory compliance, IT, and infrastructure have resulted in more competition from academic hospitals, and multispecialty consortiums.

The increased strain on independent radiology practices has resulted in a growing number of them being acquired by academic institutions for the purposes of regional expansion, or otherwise consolidated into or acquired by private radiology groups and corporate medical consortiums.

“Private equity and publicly traded radiology groups, whether radiology-specific or part of a multispecialty consortium, are aggregating the market,” the researchers wrote. “These groups present consolidation as an attractive alternative to handle constantly changing issues by offering significant payouts to current partners, promising a better work-life balance as employees, promoting economies of scale to consolidate administrative duties, providing robust IT, and complying with government regulations.”

Here are five critical factors for physician-owned independent radiology practices to focus on if they wish to remain that way, according to the JACR study, entitled Best Practices and Critical Factors in a Successful Private Practice.

1. Lean into your strengths: Independent community-based radiology practices, particularly in rural or other smaller healthcare markets, have the advantage of being able to offer more flexibility and individualized attention and care to the patients and hospitals they serve, compared with large corporate conglomerates and institutions.

Additionally, due to a smaller management structure, they are better able to structure the goals of the practice around the specific unique needs of the community practice area and build a reputation and loyalty around providing a superior service.

2. A focus on value: In order to successfully compete with larger consolidated entities, it is important that independent practices highlight and create awareness around the value of their practices and services. This can be done by offering more comprehensive services such as biopsy consultations, participation in professional conferences, service on radiation safety, hospital, and peer review committees, and other activities that nurture reputation and loyalty.

3. Innovation: Discovering and implementing new innovative ways to provide value to providers and patients to meet the needs of a dynamic and changing healthcare market can further distinguish an independent practice from competitors and add to the collection of value-added services boasted by the practice.

Early career radiologists overwhelmingly disapprove of the loss of professional autonomy that has come with the corporatization of their field. Recruitment of new radiology professionals into an independent practice can bring fresh ideas about novel ways to innovate and demonstrate value in a way that is tailored to meet the needs of local hospitals and patients

Additionally, independent practices may find limited consolidation with other independent practices with respect to specific costly areas such as electronic medical records, IT infrastructure, human resources, retirement plans, among other areas, worth sacrificing some degree of practice autonomy.

4. Internal division: As the practice grows, it is important for leadership to be cognizant of the proportionally increasing difficulties that may arise when it comes to implementing a unified top-down vision. As with expansion into new services and areas, new partnerships and employees should be added carefully and incrementally so as not to produce dissatisfaction and apathy that deteriorate the effectiveness and cohesion of the operation as a whole.

5. Ensuring satisfaction of members: Steps should be taken to ensure and maintain a high level of satisfaction and promote open communication and feedback so as to maintain physician/staff inclusivity as a practice grows. Given the high level of burnout in this field, it is important to foster realistic productivity goals and scheduling for staff, provide prompt positive feedback when warranted, and offer appropriate rewards for productivity and value-added work. Offering parental leave and mental health services, work from home options, among other measures, may also be beneficial in order to safeguard an adequate quality of life and level of satisfaction for practice members.

“Practices that establish core values of the highest commitment to patient care and physician and staff inclusivity, foster personal and professional engagement, respond to referral sources while demonstrating value, and show genuine concern for the emotional well-being of individuals in the practice will be the ones best suited to remain successful and independent,” the researchers wrote.