10 Questions with Lawrence R. Muroff, MD, FACR

Our “10 Questions” series asks the same questions to a diverse group of professionals in the medical imaging community.

Here, we profiled Lawrence Muroff, MD, FACR.

1. Please state your name, title and the organization you work for. 

My name is Lawrence R. Muroff, MD, FACR. I am the CEO and President of Imaging Consultants, Inc. I am also a clinical professor of radiology at the University of Florida and the University of South Florida Colleges of Medicine.

2. How did you get where you are today?

I was fortunate to have several mentors who took an interest in me early in my career. That, combined with a diligent work ethic and a determination to fulfill the assignments given to me by our national societies, enabled me to ascend to major leadership roles in both imaging and specialty (nuclear medicine and MRI) societies. Mentoring and a lot of productive work seem to go together. When you are willing to work, people seem more willing to help you with your career development.[[{"type":"media","view_mode":"media_crop","fid":"24309","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_1641065138862","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2080","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 215px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

3. Why did you choose your profession?

My profession chose me. I was determined to be a pelvic cancer surgeon. It was the Vietnam war era, so I volunteered for the Berry Plan (residency deferment) in all three armed services. It was a lottery, and my number was not chosen by any of the services. During my senior year of medical school, I had taken an elective with Dr. Judah Folkman (the father of angiogenesis). Several national laboratories invited me to spend my two years of service obligation at their facilities replicating the work that I had started at Harvard. The best fit was the National Center for Radiologic Health, which morphed into the Bureau for Radiological Health. Once I got to the lab, I became exposed to radiology and nuclear medicine. Just before I was to return to my surgical training program, I switched specialties and opted for a radiology residency. That turned out to be the best professional decision that I could ever have made.

4. What is your biggest day-to-day challenge?

My biggest challenge is to help radiologists see the need to change. The attitudes of radiologists need to change, and the culture of the specialty needs to change, as well. Change is difficult for anyone, but is particularly difficult for radiologists because we have had a great professional “run” for a long period of time.

5. What worries, if any, do you have about the future of radiology? If none, where do you think the field is going?

I see denial mixed with a pervasive sense of entitlement. Both are barriers to needed change. We have to understand that we are in a difficult environment. Reimbursement is declining, non-traditional competition is intensifying and turf wars will be increasing. Radiologists will have to make a difference or they will be irrelevant. Others will gladly take what we believe is ours.

I ask attendees at ACR and other leadership meetings, “What is the role of radiology on House (and other popular medical TV shows)?” The audience quickly says that there is no role. Nothing could be further from the truth. Radiology plays a central role on any TV show depicting modern medicine. The problem is that radiologists are nowhere to be seen. This is a parable for modern medicine. The future for radiology is bright; the future for radiologists is far less certain.

6. What one thing would make your job better?

I like my job the way that it is. That said, it would be beneficial if radiologists understood the need for leadership training. We have to be more effective stewards of our specialty because, as I noted above, there are many entities that would gladly take what we believe to be ours.

The majority of practices that I visit throughout the country are dysfunctional. For those practices, decision-making is difficult; governance is sub-optimal; and their business infrastructure is antiquated. This combination of issues makes radiology groups vulnerable to aggressive non-traditional competition that mainly is coming from national entrepreneurial radiology companies. These entities are well-funded, aggressive (and a bit desperate), and trying to grow in areas outside of the shrinking night call coverage market. For these national companies, hospital contracts are a logical source of needed income.

7. What is your favorite thing about radiology?

My favorite thing about radiology is the constant evolution of technology. Radiologists are at the center of patient care, and we can have a major role in alternative payment models - if we are willing to understand that these new reimbursement models will redefine the role of the radiologist. Nobody should regret the decision he/she made to become a radiologist; rather, each radiologist should make every effort to learn how he/she can be significant in new reimbursement systems. Radiology is intellectually challenging, financially rewarding, and the quality of life is difficult to beat.

8. What is your least favorite thing about radiology?

My least favorite thing about radiology is the failure of many of its practitioners to understand that this is a time of transition. We must acknowledge that fee-for-service has treated us well, but soon it will be supplemented (and possibly replaced) by alternative payment models. To survive and thrive, radiologists will have to provide an added value. In other words, we will have to establish our relevance. In order to do this, we will have to make our specialty accountable for speed, accuracy and appropriateness. To do these things will require a major change in how we interact with patients, referring physicians, and hospital administrators. In order to effect change, it is first imperative that radiologists perceive that change is necessary. The temptation is to try to “ride it out” (do what has served us so well in the past). That strategy is a formula for disaster.

9. What is the field’s biggest obstacle?

My good friend, David Levin (chair emeritus of radiology at Thomas Jefferson University) once told attendees at a radiology leadership course that radiologists have had it too good for too long. We cannot survive as a specialty if we are wedded to the past. Radiologists must understand that change provides opportunity, while failure to change the way we practice makes us vulnerable to aggressive competition and major turf incursions.

In the past, almost every radiologist was a winner (although to different degrees). In the future, there will be winners and losers, and unfortunately those who succeed will often do so at the expense of their less adaptive radiology colleagues.

10. If you could give the radiology industry one piece of advice, what would it be?

We are members of a terrific specialty. It is imperative that we understand this and strive to do what is necessary to thrive in the future. This will take work, and it will require a change from “volume to value.” Currently, the fee-for-service model reimburses more based on the more studies that one performs. New payment models will compensate physicians based on keeping patients well (and/or shortening the time that they are sick). We must all learn how to provide significance in these systems, and we must understand and determine what part of the bundled dollar radiologists will be entitled to receive. I believe that the ACR Radiology Leadership Institute and the Neiman Health Policy Institute should play pivotal roles for our industry in this educational process.

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