By Matt Skoufalos
A skilled service professional can be a godsend to anyone tasked with the management and upkeep of medical imaging equipment, which are frequently the most expensive and highest revenue-generating devices in any organization.
But in the catch-22 world of health care, employers are waiting for the right technician just as much as the best technicians are waiting for the right placement. In a specialty with a widely acknowledged talent deficit and few replacements for retiring veterans, those with the ability to do the job well can call their own shots.
Dale Cover, president of the Radiological Service Training Institute (RSTI), said that organizations like his can help prospective engineers skill-build, but that the primary driver of any technical career is “attitude, not aptitude.” What he sees among successful imaging service engineers is an innate drive toward information and continuous learning.”
“Some people are motivated strictly by money, but most people in our field are motivated by challenge,” he said. “Challenge is sending them to school to learn their stuff; it’s offering them career progression.”
“You’ve got to find the guy who will accept the inevitable unscheduled overtime,” Cover said. “The opportunity to go home at the end of the day usually is not there; you’ve got to stay until you find a solution to the problem.”
Another invaluable skill set is communication. Service engineers who can reach their customers without overwhelming them or talking down to them about the technical depth of the problem can be a rare breed. Among its technical instruction, RSTI’s basic X-ray training course also incorporates customer service training. Cover said learning to manage a client’s frustrations about downed equipment or the high-stress needs of a facility manager is a critical part of the job.
“A lot of times, engineers are just as sensitive as anybody else,” he said. “The owner of the machine bites their head off and they take it personally. You’ve got to understand, they’re not mad at you. You’ve got to take it in stride, and that’s a skill in and of itself.”
“I know people who are great in the technical field, who aren’t necessarily the best technically, but are the best I’ve met in customer service,” Cover said. “Customers are happy to have them back even if they don’t always solve their problems.”
Recruitment can also turn on finding out-of-specialty staffers. A popular source of service technicians has always been ex-military workers with a BMET or CBET certification, or a background in radar and electronics systems.
“They’re sharp, and they’ve already got that mentality that the job gets done first,” Cover said.
But there are not enough of those folks with an interest in the imaging service field to repopulate it. Cover believes the industry must create some of its own engineers, and to do that means hiring entry-level biomed trainees with an interest to learn on the job.
“I see it as fallout that the entire biomedical field doesn’t have as many people going into it,” he said. “I think it starts in high school with recruiting. We tell our kids they can be computer engineers, and everyone wants a master’s in computer science. The field needs nurses, the field’s going to need doctors, and we’re going to need people to take care of the equipment, but we’re not recruiting enough.”
Steven Kelley, manager of diagnostic imaging repair at the eight-hospital Piedmont Healthcare system in Atlanta, Georgia, agreed. Kelley, who serves on the board of West Georgia Technical College in LaGrange, Georgia, said imaging service professionals “need to go back to high school and convince [students]” of the viability of the trade.
“Everybody’s telling their kids they need a four-year degree; a biomed job does not require a four-year degree,” Kelley said. “It requires a two-year degree, and you can make just as good, if not better, money.”
The issue of sourcing replacement talent is close to Kelley’s heart, too: he’s facing retirement within a few years, and, until then, is looking to train his replacement. Nor is Kelley the only one on his immediate team in that circumstance: about four of his colleagues are on their way out of the business in the next few years. To find the next generation of imaging service professionals to replace them, Kelley said he’s looking for technicians who are “in an always-learning mode.”
“A biomed can become an expert in a certain area – patient monitors, ventilators, anesthesia machines – and know everything there is to know about them,” he said. “You will never accomplish that in imaging. You have to learn to troubleshoot systems running different functions, not a device.”
Kelley prefers training employees with a biomedical engineering background because they understand patient and hospital safety guidance. Taken a step further, he’d ideally bring on staffers who have worked in ISO (independent support organization) or multivendor (MVS) environments, and not only for original equipment manufacturers (OEMs).
“If you take a person who’s worked for an OEM, and that’s all they’ve done is work for a manufacturer, when they go in-house, it’s a whole different ballgame,” Kelley said. “If the Philips engineer who’s used to working on Philips CTs no longer has the proprietary tools, or can’t call the tech support guru who’s the specialist … you’re on your own. A lot of people who are good with OEMs don’t necessarily make good in-house biomeds because of that.”
Kelley also stands behind the adage that “It’s more important to fix the customer than it is to fix the equipment.” Those staffers who have the customer service skills to build relationships with clients as well as what’s needed to follow a fix all the way through to its conclusion will survive in the diversity of settings into which they may be thrust. A big piece of it is “learning how the customer needs to be communicated to,” Kelley said.
“It’s attitudes, but attitudes are built from personalities,” he said. “I tell people all day long, ‘I can train you electronically, I can’t fix your personality.’ Somebody that’s got a negative personality is going to come across that way with their attitude, and the customer’s not going to appreciate that. You’ve got to let them know, ‘I’m the guy who’s going to own this problem, I’m going to take care of this.’ ”
Sometimes, what’s easier than sourcing new employees is keeping happy the ones you have on staff, said Jenifer Brown, president-owner of national talent search firm Health Tech Talent Management. Brown works directly with large hospitals that are trying to bring service contracts in-house as a cost-saving measure. She said many of them know that avoiding turnover in skilled positions means avoiding what can be a long-running hunt for qualified applicants.
“The pool of very qualified imaging engineers seems to be getting smaller and smaller,” she said. “A lot of the really skilled imaging engineers have retired, and they know they’re in demand. A majority don’t want to relocate; they want the position to come to them. It makes it even harder with a smaller pool.”
One antidote is to cultivate your own in-house staffers, which Brown said is mostly a strategy that only larger organizations can afford. Yet the fear of developing talent that flies the coop is a real one. With technical training running tens of thousands of dollars per course, Brown said many organizations worry about investing in a person who will parlay that knowledge into a better position elsewhere.
“It’s like the dog chasing its tail,” she said. “You have to make sure you’re really taking care of your existing engineers; make sure they have the support they need, and that their territory or workload has some kind of work-life balance.”
Employers should also note that without competitive salaries, the most qualified imaging service engineers won’t be available to them, Brown said. She’s told clients that not paying their hires enough will adversely affect their promised savings from bringing the work in-house. Although salaries vary by skill set and geography, a good imaging service professional can command a director-level salary, and hospitals should be prepared to pay it.
“The ones that treat their engineers well, they have a competitive salary plus an opportunity for overtime or bonuses,” Brown said. “I have placed candidates with those kinds of companies and never hear any kind of negativity.”
Brown said connecting in-house service professionals with OEM staff also still plays a large role in the structuring of equipment service plans, as many OEM customers require a bridge to their equipment manufacturers for technical support. That’s a perspective shared by Bonnie Hemingway, director of global learning innovations for GE Healthcare, and her colleague, Rick Sidlo, manager of customer technical training for GE.
Hemingway said GE can repair 40 percent of its network-connected devices remotely, placing a significant emphasis on AI and remote monitoring algorithms to help predict device breakdowns before they occur. The company is also developing in-field training applications and performance support tools for its service technicians, including “mixed reality” using wearable devices, and web-enabled technology that supports guided instruction for service and repairs.
“The direction we’re going, the service engineer can leverage support from an online expert back in the office,” she said.
In the meantime, Hemingway said the company is placing an emphasis on ongoing performance support for the technicians it trains, through videos, 3D-simulated repairs, and reference documents, “so training is not a one-and-done” experience.
“In general, we want our partners to feel that we’re ensuring their success,” Sidlo added. “We want to help them accomplish their service strategy. We have many different flavors of shared-service arrangement that’s all managed at several different levels between the customer and GE.”
Sidlo said there’s a lot of work that goes into learning how equipment buyers think and how manufacturers can best work within the institutional needs of their customers. Even when clients transition their service needs to in-house staffers Sidlo said OEMs must offer flexible, scalable training that’s both product-specific and modality-wide, from classroom and lab training to virtual and onsite simulation. He described the need for institutions to plan “a long-term training path for an imaging service professional,” and described GE’s in-house customer training services as a growing business line.
“Last year we demoed our simulation technology at AAMI; this year, we plan to demonstrate VR training,” Sidlo said. “We’re going to have a presentation about networking and cyber-security, [and] from a topic perspective, it’s probably one of our highest-growing areas of training right now. We hope that by having multiple ways to deliver content, we’ll be able to hit the many different learning styles of the next wave of biomeds and service professionals.”
In bottom-line terms, whatever service arrangements a health care system makes, whatever talent it can recruit, acquire or develop, its ultimate aim is to address costs. Whether through a shared-service agreement, schooling an in-house technician, or adding a new hire, bringing the right people onto your team – and keeping them there – can do a lot to keep things running well. As Sidlo put it, “If you’re able to avoid unplanned downtime, that enables you to better maintain your revenue stream. How much does it cost you when the system goes down?”