Radiologist Owned, Radiologist Run

Future Medical Imaging Group

While traditionally, the opposite was true, it is an unfortunate fact that today in Australia the preponderance of radiology practices are run by corporate boards comprised of individuals who possess great business acumen but little to no knowledge of the healthcare field. “The difference between us and the corporations,” explains Dr Andrew Dobrotwir, one of FMIG’s five managing radiologists, “is that we’re always thinking about the patients and the patients’ well-being.”

“I certainly worked for the corporates and all of my partners worked for the corporates, and the issue was that the people who were making decisions weren’t necessarily best placed because they were really just about return on investment instead of looking after patients.”

In establishing FMIG, Dr Dobrotwir and his associates learned a number of important lessons – both in business and in the business of helping people. These lessons are ones which Dr Dobrotwir is eager to share with his contemporaries within the field of radiology, in hopes that more doctors might have the vision and courage to help reclaim the patient-focused approach within the industry by establishing their own similar clinics.

“We can be at the cutting edge and we can stay financially viable and we don’t have to just be slaves to corporations,” he encourages. “We can actually form corporations ourselves and run them successfully… Yes, we haven’t had any training in accounting but that doesn’t mean that we can’t get accounting advice.

“That’s something we discovered along the way; when we first started in 1999 we thought, ‘a spread sheet, what’s that?’ But that’s what we have done over the years and now setting up a new practice becomes a lot easier.”

While the company does, of course, have a duty to be fiscally responsible – in order to continue to offer its patients this care, it must be able to at least cover its costs and enough profit to make the business viable – ultimately the patients and their well-being is number one.

With patient care at the forefront, FMIG undertakes a variety of initiatives not typical to the industry – including reductions and sometimes waivers of fees for patients such as pensioners and asylum seekers who are unable to afford necessary services. Reasonably, Dr Dobrotwir says, the company cannot survive by offering its services for free to everyone, but, he insists, “If it’s a line decision between profit and patient care, it’s a no-brainer. Absolute no-brainer – patient care always comes first.”

The company is able to support this philosophy by operating lean with minimal infrastructure or middle management. “We do what we can but we run lean so we don’t have a massive infrastructure, and we don’t have a whole lot of middle management. We’ve got a really good structure and that allows us to make quick decisions and be both reactive and proactive as needed.”

Comprehensive Care

In order to best serve its patients, FMIG has established four comprehensive radiology clinics throughout Melbourne, in Footscray, St Albans, Moonee Ponds and Hawthorn. Each clinic offers a complete suite of modalities including MRI, Multi Slice CT, Dexa, Fluoroscopy, Mammography, X-Ray, OPG Lat Ceph, Ultrasound (General, Vascular, Colour Doppler and Obstetric), and Autologous Blood Injection, and is overseen by a professional onsite radiologist doctor.

The synthesis of comprehensive services and onsite doctor supervision allows for timely treatment for the patient – which in this field can spell the difference between life and death.

Explains Dr Dobrotwir, “For everything that we do, there’s a doctor onsite who is interpreting it and supervising it, so if there are issues with safety or decisions that need to be made – there might be an urgent finding – there’s a doctor there that then communicates that back to the referring doctor or we send the patient to a hospital. That is a very important thing that sets us apart.”

Advanced Technology

“We’re called Future Medical Imaging Group because that’s what’s important to us,” explains Dr Dobrotwir, “we bring the latest technology into health care.”

This has been the case since the company’s inception, starting with its introduction in 1999 of the completely radiation-free Magnetic Resonance Imagining (MRI) technology at its Moonee Ponds clinic, and continuing on as the company grew to include a vast array of leading edge technologies.

FMIG was able to introduce MRI scanners into its practice earlier than most competing practices because of its strong moral base and its youthful audacity – at a time when government funding and medicare rebates weren’t available for the technology, the group of radiologists took a chance and self-funded the purchase of its first MRI.

“I could see that there was such a huge demand for this non-invasive procedure that really we needed to have a private outlet to allow the overflow for patients who need the testing but don’t want to wait twelve months for it.”

Recalls Dr Dobrotwir, “We took a chance because we said, ‘We’re young radiologists, this is what we’re trained to do, this is what we want to do – we don’t just want to offer part of the service.’

“The possibilities for this technology are quite mind blowing – but it takes a bit of vision and there is risk involved. Why bother pushing the envelope? Why look to the future? We could just sit around doing mundane work without looking to the future, but that’s not what we do. We want to be at the cutting edge of technology and pushing benefits for the patients forward. We’ll get greater returns and also greater professional satisfaction.”

To stay abreast of these new advances, members of the FMIG team frequent events such as the Radiological Society of North America (RSNA) conference. By taking the initiative and seeking out new technology being developed worldwide, the group is better able to cultivate relationships with other companies, thus enabling early adoption within Australia of newly advanced equipment and procedures that might be of benefit to patients.

Reducing Risk

Of important note is the fact that when FMIG introduces new technology it does so across the board; while many competitors might boast the addition of one new piece of technology amidst a collection of aging relics, FMIG is committed to keeping all of its equipment at the leading edge.

“We need to make sure that we minimise harm to patients,” stresses Dr Dobrotwir. “Everything that you do has some potential harm in medicine – and the thing that we use is radiation. We are the only private radiology practice that I know of where every scanner we have is a low dose scanner. We have invested an enormous amount of money in making sure that all of our scanners are new plus low dose.”

The group also offers “non-invasive imaging of the coronary arteries where we’ve partnered with cardiologists to bring the latest in technology so patients can come in and see the cardiologists to look at their heart and at the same time step into the other room and do the cardiac CT. The other way of doing that is to go into hospital with a catheter and inject dye, and has significant risks.”

Moving Forward

“Obviously we want to set up another practice,” says Dr Dobrotwir enthusiastically. “We believe that our model is one that really works – it works and it benefits the patients, the doctors and the referring doctors. They have access to the best possible technology and we try to make things smooth and easy. We want patients to have access to this technology and so for us, we will try and keep our costs down to a minimum and keep the out of pocket costs to our patients down to a minimum as well.

“We really are trying to lead the way in non-invasive and low-dose technologies.”

Making Sense of Management

Management is the art, or science, of getting things done through people. Sounds fairly straightforward – except for the fact that people are not robots waiting to do our bidding. People have their own minds, motivations, and goals. So how do managers keep operations – and the people behind them – running as planned?

December 19, 2018, 5:30 PM AEDT