Saturday, April 19, 2008

"The Politics of Greed"

Eradicator, over on, found an incredible article in, written by Curtis Kauffman-Pickelle, who is "a strategic business consultant to more than 30 imaging centers and radiology practices and CEO of the Imaging Center Institute." Obviously, Mr. Kauffman-Pickelle knows his way around the outpatient imaging world. He decries the "pollution" of this sector by the "dark attraction of greed":
What is difficult to control, however (and extremely difficult to train salespeople to penetrate), is the political referral that clearly falls within the category of an expected quid pro quo: I will send you my scans if you give me something in return.
Kauffman-Pickelle goes on to describe the ways in which unscrupulous operators will go around the law and regulations trying to bribe their way into a full schedule. He goes on to say,

Back to the fundamental question: How do you compete with this greed?

You don’t. Greed is as old as civilization itself, and money—as a manifestation of this one of the seven deadly sins—has been changing behavior and sinking people for centuries.

What ethical and honest businesses need to do is rise above the temptation, knowing that those operating sleazy businesses are really in the minority and that they stand a very good chance of being caught and punished; they are not likely to be happy with themselves and their lives, and are not respected members of the medical community. You need to be able to look at yourself in the mirror each day and know that you are helping people, running a clean and effective operation, and inspiring your staff and teammates to achieve success through your leadership. Your ethics, values, and character will win in the long term.

This is good business as well. Never apologize for your success or for making a good living at your chosen craft. You have earned it, and our society is based on the hard work and commitment of entrepreneurs in all kinds of professions, including medical imaging. Don’t be distracted by those who seem to be getting away with illegal behavior. You really would not want to trade places with them, so leave them to their own devices.

This is of course very good advice, and an excellent analysis. I would carry it over to the problem of imaging self-referral, which is really the same sort of greed-based pursuit of money as described above.

Mr. Kauffman-Pickelle's approach makes sense for those who are of high moral and ethical fiber. Naturally, they are not going to lower themselves to borderline or overtly illegal activities to make an extra dollar. Sadly, those who do participate probably don't care. I would have to disagree with the author about the perpetrators being unhappy and not respected in the community, at least as far as physician self-referrers are concerned. They are happy as clams, wallowing in their ill-gotten gains. They feel completely immune from penalty, that they deserve every cent. Very few of their colleagues care about the source of the revenue in the least; they are only envious of the parade of Mercedes and BMWs and the other swag flaunted by those who abuse the system.

This is why the government will eventually have to step in; there isn't much self-policing going on here. The politics of greed rule.


General Custer said...

Great article indeed.

First let me introduce myself

As a Radiologist I often feel surrounded by special interests, by Radiologists who undercut each other and would cut each others throat just to make a short a term buck.....I also feel abandoned by our Professional organization the ACR in many ways over the past few years.....Hence My name.....General Custer

I would like to add 2 points to this excellent article.

First and foremost Radiologist have to stick together.

We need to be wary of outside interest such as Telerad companies that undercut us and each other based on price as eventually it cheapens our entire profession. We especaillly need to be wary of predatory telerad groups that attempt to steal contracts from Local rads usually with promises that they cannot keep. We need to be wary of the locums and the locums companies that suypply Radioloigst to these facilites that attempt to go down this path.

Secondly, We need an organization that promotes Radiology. The ACR today has several individuals, one in particular who is in a very high leadership position whho always finds himself in the middle of these controversial issues such as Outsourcing imaging overseas or Predeatory Telerad groups. If he continues on his course he will destroy Radiology as a viable profession.

Robedby dr's said...

Having worked in the medical field for 20 years as a Sonographer I have seen enough to sicken me. Greed is alive and well and one way Radiologist make more is by adding a phrase to their dictations that similar to this. If warranted would suggest an Ultrasound, CT, MRI.... This will 90% guaranty one of these or all will be requested by an ER or other DR thus increasing the Rads income. This occurs even if the diagnosis is very straight forward and clear as a bell. This gets done on just about every non OB or cardiac Ultrasound requested. Greed is killing medicine in the US and its people