Radiology Myopia: How Good is Your Group’s Vision?

The conclusion that the leadership of a radiology group is the direct cause for a failing practice is typically not well received. In radiology it is easier to place the responsibility for the failure on the clinicians, the administration, the changing markets, changes in health care, governmental changes or changes in reimbursement. Placing the blame on these external factors forms the root cause of the primary failure.

In a landmark article, Theodore Levitt first discussed the concept of "marketing myopia." This idea has now been extrapolated and applied to many other companies and industries. Radiology, being in the business of medical care, also needs to evaluate its view of the future and potential for growth or decline within this framework.

Marketing myopia is the idea that with time, a business's growth stalls or fails due to a failure of the leadership to understand the true and/or changing nature of its actual product or service. This is not a failure of leadership, it is a failure of the leadership. What this means is that even groups with good leaders are not immune to the process of developing a fatal, myopic view of what the group’s purpose and services are.

The leadership fails to take the broad view of the niche that radiology fills, opting instead for a narrow, constricted view of product rather than service. Many believe our product is the report. Not true! In radiology, we are in the service business, not the product business. Our service, working in conjunction with our clinician colleagues, is to deliver accurate and appropriate patient care to injured or ill patients. In this paradigm we are a part of a team and not in a vacuum. We deliver our service - performance of procedures or interpretation of images - to the patient and our clinician colleagues functioning as a part of this team.

How we provide our service to the patient and our patient care team determines whether we are a necessary member of that team - or simply available. In a myopic radiology culture, the leadership ceases to evaluate or look for cues in the environment that will lead to improved satisfaction by the patient care team. The outcome is that the group stops addressing the care team’s concerns and requirements. Instead, the group is lead towards a more introspective or insular view of radiology as a product and concentrates more on increased speed, production and efficiency.

This lack of vision leads to a failure by the local group to maintain its place as specifically necessary to the team. The result is that radiology becomes a commodity which can potentially be delivered by any radiologist, anywhere. By failing to focus on service and the patient care team, radiology services become a product that can be obtained by other radiologists and radiology groups. Once this commoditization is complete in the minds of those that depend on radiology as a partner, the group is expendable and a change to another provider of radiology services is not uncommon.

A "self deceiving cycle," as discussed by Theodore Levitt, is one in which a group locks itself into a course of action that appears to be the right choice, but is actually the catalyst behind the group’s failure. All further actions revolve around this flawed choice.

So, how does a group avoid this trap? There are three basic questions to ask when moving from a product focus to a service focus:

1. Is the course of action or goal designed to improve patient care and will it result in the clinician being better prepared to treat the patient?

2. Is the course of action or goal designed to answer a client (patient or clinician) concern or question and will it result in improved patient care?

3. Is the course of action or goal designed to improve the group’s visibility as a provider of world class radiology services and will it be seen by your clients (patients or clinicians) as an improvement that will have a positive impact on patient care?

All of the group’s actions and goals should result in improved patient care and demonstrate that the service the group provides cannot be obtained as efficiently or effectively from any other source.

Creating a successful vision of what the group does and who it serves is the key. Generating a firm foundation requires keeping an eye on the environment and the needs of the group's clients. Effective group leaders continually look for ways to keep their group in front of the changes that are on the horizon. By acting, and not reacting, effective leaders can steer their groups through the good times and the tough times with equal confidence.