Lessons for Radiology from the Service Industry

Doctors seem to love to lament the demise of health care when we get together. Many of my conversations include frustrated comments about our jobs becoming too much like other businesses.

Recently, one of my colleagues cringed, contending that radiology had become just a commodity. That thought stuck in my mind. Since it was the holiday shopping season, businesses and their commodities were plentiful. I started to think about how treating radiology as a commodity could be a challenge for us - and how it might help our customers and our industry.

Several recent articles have talked about radiology “price-shopping” websites that compare prices. More rather than less free market would be a good thing for health care and radiology. But we have to be a little different than the grocery store. People can tell when they get a bad banana or stand in slow check-out lines. They know quality in other parts of their world. And they know about quality in some parts of their radiology service, particularly appointment availability.

But much of the quality of our care is not apparent to health care consumers, especially in radiology. Unless you are going to include a quality metric, having a price shopping site for radiology is a dangerous game, and could mean getting lower service too.

Should we differentiate cost based on quality? Should you get a cheaper study if you are scanned on an open, low field magnet instead of a 3T new unit?

While participating in a price shopping site world may be not be ideal now, there are few strategies that seem more reasonable in an age of consumerism as radiology becomes a commodity. A few holiday lessons for us to think about:

1. When you rent your car for that holiday trip, car rental companies offer you a discount for pre-paying. That is a big plus for them; they get your money upfront and it guarantees your reservation. Before you balk about radiology being like car rental, note a few parallels; both book services in advance and do not require payment until completion of service.

Many businesses offer cash discounts; but now we could kill two birds with one stone. If you have cash-paying or uninsured patients, you could offer additional pre-pay discounts. You’ll get upfront payment and you’ll reduce no-shows in your schedule - and your patients will pay a little less.

2. When you book an airfare, the choice flight times cost you more. We’re in the same spot as the airlines. We want to fill our capacity and have to figure out how to incentivize patients to use the less crowded parts of our schedules. Certain parts of your schedule are always booked and others are less desirable. So, you can offer premium time slots for an additional charge to your cash patients, and even consider a discount for the less desirable ones.

3. When you’re late shopping and want your presents overnight, you pay for it. Well, paying for quicker access is no different. Not for medically urgent reasons, but for convenience. Offer patients an earlier slot for a premium or the corollary; offer a later spot for a discount.

The more you look around, the more lessons you’ll see that can be applied to radiology. In the long run, these will serve to make health care more efficient and help with costs. Since not all of these strategies are allowable for certain patients, they may only impact us a little to start. But if allowed to work, even on the small scale of cash patients, we can hope they will become more widespread for all of our patients, including those insured by the government or commercial payers.