 |
|
Edition: August 2021
|
 |
|
Table of Contents
|
|
|
| Letter from the Editor |
 |
Welcome to a new academic year and the FRS 2021-2022 season. We hope you all had a chance to attend the in-person 2021 FRS annual meeting at the Ritz-Carlton Grande Lakes in Orlando (7/15-7/17). The program chair, Andrew Bowman MD from Mayo Clinic, Jacksonville, put on an incredible conference despite the challenges of planning during such dramatic uncertainty with regard to the pandemic. At the 2021 Annual Meeting (in conjunction with our partners and friends at the FRBMA), we heard from then-President Doug Hornsby and FRBMA President John Detelich, our Florida legislative liaison Alison Dudley, keynote speakers giving named lectures, including Kent Thielen, Frank Lexa, Laura Golding, and Michael Raskin, our ACR update speaker Howard Fleishon, A.I. point-counterpoint debaters Eliot Siegel and Bradley Erickson, and several other exciting speakers like Steven Miles, Larry Muroff, Cooky Menias, and Justin Stowell. We also had well-attended and well-received tracks for the Residents and Fellows Section as well as for the Radiation Oncology Program (Drs. Mailhot, Kotecha, Mellon, Ahmed, and Desai). At the Gold Medal Reception, the FRS was proud to award the 2021 FRS Gold Medal to Dr. Jeff Stone, from Mayo Clinic Florida. His colleague, Dr. Joe Cernigliaro, gave a touching introduction to Dr. Stone. Despite the challenges in hosting such an event, the 2021 annual meeting was a great success, showing the strength and draw of the society and the excellence in education, networking, and camaraderie that it delivers. We look forward to an exciting year as we hope the pandemic fizzles out, despite the recent resurgence of the delta variant and its new stresses on our health care system. Our board hopes to increase membership, promote more communication between the society and its members, create an active social media presence for the society, and deliver education on a regular basis to members and trainees (above and beyond the annual meeting). We hope to ensure that the strategic vision of the FRS is sound and safeguarded for the short-term and long-term future, with financial stability, strategic alignment with partner organizations, and continuity of membership and leadership. To that end, we encourage all those who are members of the FRS to do the following if they are willing: please recruit new members from your practices, please donate if you can to either the FRS PAC (https://flradpac.org/) or the FRS Foundation (https://www.flrad.org/frs-foundation/), and please get involved in the FRS, either by attending a meeting, joining a committee, or participating in the ACR Annual Meeting in April 2022 in Washington, DC. Our state chapter is one of the strongest and most engaged in the nation, and we hope to keep it that way! The coda to the 2021-2022 year will be our 2022 FRS Annual Meeting, to be held at the Ritz-Carlton Amelia Island from July 15 to July 17, 2022. Dr. Edem Chen of the Medical Center Radiology Group in Orlando will be the Program Chair for the 2022 meeting, which we all greatly look forward to. I would also like to introduce to the readership our FRS 2021-2022 Executive Board. I speak for all of us when I say that our one unswerving goal is to serve. We understand we have a broad range of diverse constituents throughout radiology and radiation oncology, and we seek to serve you all with enthusiasm, passion, and results. Please feel free to contact any of us with ideas, suggestions, constructive criticism, or anything you feel may help us in our service. Transparency and communication are important to us, and we hope to deliver excellence to our members.
Raj Kedar, MD, FACR – President Raj Kedar, MD, FACR is a professor of Radiology at the Univ. of South Florida and also in private practice with Radiology Associates of Florida. He is chair of the Department of Radiology at Tampa General Hospital and educational director for Body Imaging and fellowship. He is also Vice president of an outpatient imaging venture comprising 20 centers. He has more than 60 publications, 120 scientific papers and invited lectures, book chapters, and 19 “Teacher of the year” awards. He loves the business of Radiology, fantasy football, and traveling. Chintan Desai, MD, FACR – President-Elect Dr. Desai is Founder/Co-Founder/Co-CEO of Multiple Healthcare Companies. Dr. Desai graduated with a special distinction from the University of Miami School of Medicine. He completed a Diagnostic Radiology Residency at the University of Tennessee, Methodist Healthcare, and a Musculoskeletal MRI training at Duke University. He is a Fellow of the American College of Radiology (ACR). He is based in Tampa, Florida. He is especially interested in AI and Machine Learning development/deployment in HealthCare to improve Patient Care and Wellness. Laura Vallow, MD – Treasurer Dr. Vallow is a Professor of Radiation Oncology and Department Chair at the Mayo Clinic Florida. She specializes in the treatment and research of breast cancer. She has held multiple leadership positions within Mayo Clinic and committee service in ASTRO and ABR. She has served as the Radiation Oncology Residency Program Director since 2015. She enjoys gardening, beach days and spending time with her husband and their 4 kids.
Juan Carlos Batlle – Secretary
Dr. Batlle is a private practice radiologist serving Baptist Health South Florida and Miami Cardiac & Vascular Institute in Miami-Dade, where he also serves as Associate Professor for FIU College of Medicine. He has served the ACR on the Informatics Commission, the Data Science Institute, Appropriateness Criteria panels, the Education Center, and currently on the Council Steering Committee. He enjoys Ultimate frisbee, crosswords, and travel to state and national parks.
|
Juan Batlle, MD
Secretary, FRS
juancarlos98@gmail.com |
|
| Meet Your 2021 – 2022 FRS Executive Committee |
 |
President
Rajendra Kedar, MD, FACR |
 |
President Elect
Chintan Desai, MD
|
 |
Treasurer
Laura Vallow, MD |
 |
Secretary
Juan Batlle, MD |
 |
|
|
|
|
|
| FRS President’s Message |
I would like to thank all who attended the Florida Radiological Society meeting recently at the Ritz-Carlton in Orlando, Florida. It was great to see colleagues, exhibitors, and residents who attended in large numbers with very positive feedback. Our Program Committee under the leadership of the immediate past President, Dr. Douglas Hornsby did a fantastic job. We had great national and local speakers. Highlights of the conference included Effects of the Pandemic in Radiology, Corporatization of US Radiology, and AI Radiology with Interactive Debate.
My initiative as President of the Florida Radiological Society is to ensure that members receive maximum benefit from their ACR and FRS membership. We will continue to drive our mission for the professional, political, and economic success of Radiology. Please make sure that you get involved with the Florida Radiological Society. There are multiple ways to get involved: becoming a board member, joining a committee(s), councilor/alternative counselor, and/or involvement in teaching activities. Please reach out to me or one of the officers and we will make sure that you are part of our team.
Surprise Billing
“Surprise Billing” is one of the successes of the ACR, FRS, and other state societies. The “Surprise Medical Bill” legislation was signed into law as part of the Consolidated Appropriations Act, 2021, which held patients harmless and created an equitable process for provider-insurer dispute resolution.
At the urging of the ACR, Congress removed the monetary threshold to access independent dispute resolution and removed provisions using the median in-network rate as an initial benchmark for payment. They also inserted language to explicitly exclude Medicare, Medicaid, and workers’ compensation payment rates from consideration in the independent dispute resolution process; and removed the problematic timely billing provisions. The new law represents a significant step forward for patients and providers. The ACR and others in the physician community will monitor the regulatory processes associated with the scheduled 2022 implementation of these protections and update members as information becomes available. (Source ACR –Advocacy and Economics). |
Very Respectfully,
Raj Kedar, MD, FACR
President, Florida Radiological Society
Professor of Radiology, University of South Florida – Morsani College of Medicine
Director- Body Imaging Education and Fellowship
Chief -Dept of Radiology, Tampa General Hospital |
|
 |
Past President
Douglas Hornsby, MD
|
 |
Legal Counsel
Michael M. Raskin, M.D., J.D., FACR |
| |
 |
|
|
|
|
|
| FRBMA President’s Message |
Private Practice Model vs Corporate Practice model. Is it really an obvious choice? Is there a third option
I have been in radiology practice management for thirty-three years. Twenty-nine of those years in a private practice model and four years in a corporate practice model. In my view, it is not an obvious choice, and secondly, there is a third option. In this article, I will compare private vs corporate and in next month’s article discuss a third option.
Corporate practice model
There are three main attributes of the corporate model that set it apart from private practice. The equity control of corporations is held by investors rather than radiologists. Therefore, strategy and decision-making are mostly performed by executives that are too local to the market. Second, a portion of professional revenue must be diverted to the corporation to compensate the corporate investors. Finally, corporations have the ability to scale their business and obtain national or regional market share.
Stakeholders
Radiologists, to some extent, are stakeholders in a corporate model but they have much less influence on the direction of the business. Their involvement and the degree to which they can influence decisions could differ and depend on the type of transaction used by their company.
For example, some corporate models are set up as an employed corporate models where the radiologist will not be taking any risk. In this scenario, the radiologist sells their practice for cash and an employment agreement. Because there is no risk of being involved in these transactions, the radiologist typically would have limited or no control over practice management.
A newer model is the equity corporate model where the radiologist sells their business and receives a combination of cash and stock in the corporation. In this model, the radiologist has taken a risk by taking some of the proceeds in stock. To fully benefit from this transaction, the company must do well and increase in value. This is a shared success strategy and radiologists retain a certain amount of control over their local practice. However, over a period of time the “equity radiologists’” may leave to work elsewhere or retire and be replaced with an employee radiologist. As this occurs, the replacement radiologist will not be taking a risk and will have less control. Over some period of time, the equity model will be the same as the employed model where there is little or no control by the employed radiologist.
Funding Corporate Investment
The corporation has to be profitable in order to create value for the investors. Investors are expecting a significant return and the potential to sell their equity position. The revenue of a single radiologist does not materially change regardless of whether they work in private practice or corporate practice. Therefore, in order for the corporation to generate profits, a percentage of the radiologists’ revenue will be paid to the corporation into perpetuity.
Scale
Scale is the primary purpose of building a corporate practice. The corporate model has access to significant capital from private equity, venture capital, and/or debt.
Private Practice Model
Radiologists are owners of their businesses. They are driven by the duty they feel towards their patients and the medical community. Profit is a secondary consideration and is typically not factored into decision-making.
Comparison
Infrastructure
Corporations have the ability to attract the top administrative talent. For example, a corporation could hire one of the top Chief Information Officers in the country with a benefits package that offers stock options and a salary of $300,000 – $500,000 annually. The depth and quality of their infrastructure will generally far exceed what can be done in private practice.
Radiologists
At least as of now, there is just a subset of radiologists that prefer the corporate model. Therefore, private practice will have the edge when it comes to attracting and retaining radiologists. The main draw from a corporate perspective is the radiologist can focus on his clinical duties and leave the business side to the corporation.
Strategy
Whether it be the Radiology owners of a private practice or the C-suite at the corporation model the strategy will have the most to do with the ultimate success of either model. An effective strategy vs. an ineffective strategy can be the difference between flourishing and bankruptcy. The track record for private practice has stood the test of time with many groups operating 50 years or longer. Corporate models do not have a similar track record. Several corporations that provided radiology service in the 1990s and early 2000s have either exited or divested themselves from their radiology business.
Unknown
Given the access to capital and their ability to scale, the corporate model can become a powerful competitor and pose a real threat to private practices. The corporate model needs to develop productivity benefits to offset the perpetual revenue decrease. Without achieving improvements in productivity, it will be difficult for the corporate model to compete for radiologists. Secondly, they need to provide quality equal to or better than private practice. If corporations end up providing no benefit that can be measured by payers, patients or radiologists then Corporations become an unnecessary expense to the delivery of healthcare.
Summary
It’s too early to judge the potential for success of current iterations of the corporate model. In general, this iteration is better than what occurred in the 1990s and early 2000s. The investments they are making in infrastructure and their focus on improving quality have them going in the right direction. One question to ask is how much of the corporate workforce is made up of “equity radiologists”. Equity radiologists are essentially receiving below-market compensation in exchange for the stock and cash received in the transaction. This operates as a subsidy to the corporate model as long as the equity radiologist works for the corporation. How effective is the transition from equity (subsidized) employee to market-rate employee will determine the long-term viability of the corporate practice model? |
John Detelich, CPA, MBA, CEO
President, FRBMA
jdetelich@radassociates.com |
|
|
|
|
|
| Legislative Update |
It was wonderful to see folks in person at the summer board meeting. The pandemic has definitely made it more challenging to gather together.
During the meeting, we discussed the fact that scope expansion issues will continue to be an issue before the legislature which starts in January this year ending in March. The committee process will kick off the third week in September.
During the meeting, we discussed the fact that scope expansion issues will continue to be an issue before the legislature which starts in January this year ending in March. The committee process will kick off the third week in September.
It is a reapportionment session and the process of drawing the legislative districts is getting off to a slow start due to the census information being delayed. This means that all the House and Senate members will be up for election in newly drawn districts. Also, the Governor, Cabinet officers, and one US Senator (Rubio) will be on the ballot.
Florida will be gaining an additional Congressional seat In the central Florida region.
Any help by donating to the FRS PAC would be greatly appreciated. |
Thanks, and stay well.
Alison Dudley, FRS Lobbyist
AlisonDudley@dudleyandassociates.com |
|
|
|
|
|
|
|
 |
|
|
|
|
| Job Posting Opportunities |
Florida Radiological Society is pleased to introduce the opportunity for interested parties to advertise for potential jobs in our monthly FRS Ebrief bulletin.
Advertisement pricing is as follows:
Ebrief Job Posting pricing:
3 months ($100 monthly)
6 months ($90 monthly)
12 months ($80 monthly)
Please contact Lorraine Roger, our Society Administrator for further information on how to advertise in our monthly publication.
Phone: (813) 806-1070
Fax: (813) 806-1071
Email: lroger@flrad.org
We feel that this will provide a valuable service to both our members and our Florida community of Radiology.
|
Thank you for your interest!
Patricia Mergo, MD, FACR |
|
|
|
|
|
| Become a PAC Member Today |
Attention FRBMA Members! Please support the cause. We encourage you to be PAC members and supporters; you do not have to belong to the FRS. Donations can be made online through our PAC website www.FLRADPAC.org. Thank you for your donation: Drs. Amendola, Banks, Batlle, Beavers, Bowman, Camacho, Cernigliaro, Chen, DePrima, Desai, Eber, Entel, Epstein, Hatton, Hornsby, Kedar, Ledermann, Mergo, Montes, Raskin, Sandhu, and Singer.
It is critical that we support both our Florida PAC and RADPAC in order to bolster our voice in Tallahassee and Washington, respectively. Please join FRS lobbyist Alison Dudley in her special appeal for all Florida radiologists to become Florida PAC members. If you would like to help FRS defend radiology against untoward legislation and introduce bills that have a positive impact on our practices, we need your financial support to re-elect our friends in the state House and Senate. The FRS can also show you simplified ways on how to sign up your radiology group. Contact Lorraine Roger at lroger@flrad.org or contact Alison Dudley at alisondudley@dudleyandassociates.com for more information.
Contact Lorraine Roger at lroger@flrad.org or contact Alison Dudley at alisondudley@dudleyandassociates.com for more information. |
|
|
|
|
|
|
 |
|
|
Telephone (813) 806-1070 • Fax (813) 806-1071
5620 W. Sligh Avenue • Tampa, Florida 33634 |
| The E-Brief is an exclusive member benefit of Florida Radiological Society, delivering monthly member, chapter and industry news. Please do not reply to this automatic e-mail. For comments or questions about the E-Brief, please contact lroger@flrad.org. |
|
|
