By Matt Skoufalos
How hard is it to retain talent on your HTM team, including in-house imaging service professionals? Mark Seago says he recently lost a technician to a cross-town colleague … over a better parking space.
“I had him for about a week,” Seago said.
Seago is the Operations Manager for Clinical Engineering Services at the University of Virginia Health System in Charlottesville, Virginia. The guy who poached his talent, in this instance, serves alongside him on the executive board of the Virginia Biomedical Association. And the hot-commodity prospect in this case? An ex-military tech with a medical background.
“It’s a dog-eat-dog world out there if you find somebody qualified so you don’t have to start from scratch,” Seago said. “I’d much rather take a military person just because they pretty much know how to work as a team, discipline, focus; I’ve never gone wrong hiring a military person. You get wind of that, you hop all over it.”
Why are military personnel so valuable? In a field where the veteran technicians are aging out of the job, talent is in high demand, and opportunities to train new blood exist mostly in-house – yours or someone else’s – Uncle Sam’s as good an instructor as can be found.
“We’ve been working hard to help promote our profession and handle growth, but it’s just not out there,” Seago said. “I hear stories about people having problems finding qualified folks, and I have the same problem. For me, the bar has really been lowered over the last 20-some years. You have to be prepared to take these guys a long way because they’re coming in with virtually nothing.”
Asked why that’s the case, Seago scratches his head. There aren’t any four-year degree programs that would offer an undergraduate degree in clinical equipment maintenance; there’s plenty on the engineering, design, and research infrastructure side, however. Other talent that’s not sourced from a military background usually originates in a tech school or must be brought in tabula rasa.
“What I’ve seen now is it’s 100 percent computers or 100 percent nothing,” Seago said. “I’ve hired one technician that went through [the IT program at a local community college], and I had to teach him what a wrench was.”
Woe betide the fate of the biomedical engineer; the unsung hero of capital equipment uptime. From ventilators to infusion pumps to telemetry devices don’t stay in service as long as they need to without his hands touching them. For some institutions, the responsibility for equipment maintenance is given over to its original manufacturer (OEM) on a service contract; for others, it’s outsourced to a third-party service organization. And for those institutions that want the work to be done in-house to cut costs, shorten response time, or just exercise tighter controls over their assets, hiring, training, or retaining a talented team is a daunting task. Getting staff up to speed on how to wrangle your imaging equipment is just that much harder — and sometimes, even when you do, it’s the fastest way to show them the door.
“I can train my guys, but if they can’t use my training because the departments won’t let us work on a bed or a CT, it’s just wasted skills,” Seago said. “They’ll just take it elsewhere. We are completely ready to train and build our group, but historically I’ve not trained them on [imaging] modalities because they’re not going to work on them.”
“I’d be setting them up to leave, and I don’t want to do that,” he said. “You make them marketable, and if they can make more money elsewhere, and they’re into relocating, you bet, I will lose them.”
Even at the University of Virginia, where Seago can incentivize his staff with the opportunity to pursue a four-year degree while they work there, many who do might only switch tracks for a career in IT, which is, by some measures, far less stressful. He’s had to push the university to put the higher-skilled biomeds on a pay scale on par with IT employees who hold those four-year degrees.
“That helps, but if you can’t compensate your guys, they’re gonna leave,” Seago said. “I’ve been through that a lot, especially with [another] hospital down the road. It’s a constant battle.”
Overall, Seago says his team particularly “has kind of been starved for training, unfortunately.” Working at a teaching institution that’s home to higher-end PET and CT scanners without a team that’s well versed in their maintenance means depending on the original equipment manufacturer (OEM) for service, which can add costs, wait time and limit options for replacement parts when necessary. After 30 years on the job, Seago has some staffers who are versed in general radiography equipment, fluoroscopy, and portable X-ray and ultrasound systems, but arranging training on more advanced imaging systems for his team through OEMs is expensive. To overcome that hurdle might mean inking an exclusivity deal with a single vendor for all imaging modalities, which could also lower costs, but is ultimately a handcuff on future flexibility.
“Just by mentioning that we might go to single-vendor has [other OEMs] going back and sharpening their pencils” when it comes to service and training opportunities, Seago said. “It’s done nothing yet, but we have light at the end of the tunnel. If this is truly implemented, we have a path for my guys as far as training to do what they want to do, which is imaging support.”
“You’ve got to be able to show leadership in the imaging department that you can minimize downtime and keep your equipment running,” he said. “Right now, we have a service guy that lives here, and they are just dependent on him – and so are we until we get my guys up to speed.”
Such circumstances are typical of many equipment managers throughout the industry, said Jeffrey Rindfleisch, vice president of operations for Appleton, Wisconsin-based Technical Prospects.
“I don’t think that there’s much argument in the industry that there’s going to be an extreme need for imaging engineers,” Rindfleisch said. “There’s a bubble of engineers that is getting to retirement age. Typically, they start out in biomed and go through some other fashion of training; we provide an augmentation to that with our training classes.”
Since 2014, Technical Prospects has offered a variety of such classes to bring those biomeds into greater proficiency in the imaging space. Courses are taught in five-day or eight-day modules that cover servicing everything from general radiography equipment through the newest flat-panel detectors; from fluoroscopy systems to CT and angiography (MR is the next modality on the horizon). Students have access to 16 bays with staged equipment, which offers an opportunity to learn general equipment repair theory and how software interacts with it in a hands-on fashion. In fact, Rindfleisch said, the bulk of every class is designed with practical cause-and-effect scenarios, showing students what happens when things aren’t functioning properly, and how to recognize error codes and their correlations to specific failures. Instructors even stack the deck by pre-loading systems with broken parts to see if students will catch on.
“Of course, we have the parts to help them out as well,” he said. “That’s the nice thing about coming here for training. If we break something, we’ve got a warehouse full of inventory to get it back up and running. It’s not like training in a hospital where you break a CT and it’s not a good day. And we rarely run a course where we don’t break something.”
The courses offer “very practical knowledge for guys in the field,” Rindfleisch said; an opportunity for people coming out of biomed programs and who have an interest in servicing medical imaging equipment to cut their teeth.
“We try to offer our students a great experience,” he said; “we try to tailor our classes to their needs, and make sure we give them the best education for their dollar. We appreciate the fact that it’s hard for them to come out of the field and spend five to eight days with us. We hope and trust that by the time they get done training with us, that they more than make that [time] up with proficiency and being able to save time and money for their companies and perform for their customers: the hospitals, and ultimately, the patients on the equipment.”
Students come from a variety of backgrounds, be they multivendor, independent service organization (ISO), in-house biomed or international. Custom sessions are created upon request for companies willing to commit a minimum of three students to a course. In-person labs are supplemented with online, self-paced education taught on the blackboard software system. Like Seago, Rindfleisch cited the general difficulty of finding students to enter an HTM career, much less schooling them up to snuff on servicing high-value medical imaging equipment.
“We are working with a number of tech colleges in the area and biomed associations to get the word out that we provide training in this area,” he said. “I think anybody who wants to get into the field has got a bright future because of the extreme need.”
Once students graduate the program at Technical Prospects, they leave with a portable hard drive loaded with a complete textbook that includes system schematics and access to free follow-up technical support.
“You can always call us and we can walk you through trying to diagnose what the issue is,” Rindfleisch said. “We try to develop a longstanding relationship with the people who come through our classes,” he said, another nod to the lifeboat conditions for technicians in the field.
Circumstances such as those lend themselves to a necessary creativity within the industry to advance not only opportunities for training but also to keep pace with the direction of imaging technology. For Tri-Imaging Solutions of Madison, Tennessee, expanding its course offerings to include training that helps biomeds transition into imaging expertise is part and parcel with finding the next generation of technicians to take those courses, said National Accounts Manager Kimberly Rowland.
“Thirty to 40 percent of imaging engineers plan to retire in the next five to 10 years,” Rowland said. “It’s really changed the landscape for the crossover from biomed into imaging. A lot of the younger people want the IT jobs, but we’re really trying to develop these imaging engineers from the biomed background that’s available now. How do we bridge that gap more quickly to the imaging side?”
For a start, like Technical Prospects, Tri-Imaging focuses on getting its students onsite access to the prep, theory and instruction that comes with the primary background of a biomed. From there, it builds their imaging expertise, starting with X-ray equipment, portables, and then eventually plugging them into the higher-end imaging systems onsite. Rowland said the coursework is also focused on building a multi-disciplinary understanding of different imaging systems.
“We really tried to broaden the experience and become familiar with more than one OEM,” she said. “[As a biomed], you’re not going to have one health system that’s going to be all Siemens or all GE [equipment]; we want to give them a broader range of being prepared.”
To that end, the training offered at Tri-Imaging is supported after the fact by the staff at Tri-Imaging, which Rowland describes as “a wide base of very seasoned engineers with varying degrees, who have done it for 20 or more years.”
“With parts and technical support, we’re helping to build imaging engineers,” Rowland said. “We have the full, complete structure on the back end. We have a whole list of things that we prep them for.”
Whether such offerings will be sufficient to create a roster of imaging-proficient biomeds ready to take up the banner for another 20 years will be a question answered only by time. But with cross-training, professional support, and knowledge-sharing across the industry, it’s more likely than ever.
“The greatest thing about our industry is that even when we’re competing, the best thing we can have is a healthy industry based on how we can work together,” Rowland said.