By Matt Skoufalos
For the better part of the past decade-plus, staffing concerns in the medical imaging space were mostly concerned with managing the institutional knowledge loss of generational retirements. But in the chaos of the novel coronavirus (COVID-19) pandemic and its aftermath, nearly every employment sector in the U.S. economy has experienced some impact of the Great Resignation – the phenomenon of long-tenured professionals changing careers or exiting the workforce altogether – which has only compounded underlying concerns in the medical imaging space.
Some radiology administrators are finding success through creative approaches that simultaneously incentivize and empower their employees to play a more active role in their own workplace environment and flexibility. Josh Laberee, administrator at Advanced Imaging of Orlando, Florida, generated positive results with his front-desk staffing demands by paring back his team, raising hourly wages and enabling his best workers to handle more responsibilities.
“To me, it’s about quality over quantity,” Laberee said. “I used to have eight full-time employees ranging between $15 and $18 per hour. I have to offer an attractive workplace and competitive pay. How do I compete with somebody who can work at home for 20 bucks an hour?”
Laberee reduced the number of front-desk positions from eight to six, raised the rate of pay for the role by $3 per hour, and still saved on labor costs. Moreover, by offering better pay, he discovered he was attracting more and better qualified candidates for the jobs he had available. The approach enabled him to replace four of his original eight staffers with workers who more closely align with the professional atmosphere Advanced Imaging had been trying to cultivate. He went from finding three or four interview-qualified applicants out of 100 who applied for each position, to 20 to 30 out of 300.
“At the $19- to $22-per-hour range, it attracts a higher-quality employee,” Laberee said. “Instead of an entry-level person, you have a shift leader, an independent thinker, a multitasker. We’ve continued to follow that model, not just for front desk positions, but techs as well.”
In addition to improving wages, Laberee also empowered his front-desk staffers to create their own work schedules among the group, and cultivated their feedback on how to improve the workplace atmosphere, “and that’s gone very, very well,” he said.
“They have the best ideas; they’re the ones who are in there daily,” Laberee said. “I now have a monthly staff meeting as well, and that has gone extremely well as far as coming up with ideas from efficiency and workflow perspective.”
In addition to wages, Laberee said he offers competitive benefits packages, which include seven paid holidays, two weeks of paid vacation, and birthdays off. By the first year of tenure, those benefits increase to three weeks of paid vacation; at three years, employees get four weeks off, and five weeks by year five.
Understanding that everyone has interests outside of work in which they enjoy having time to participate, the flexible scheduling and paid time off incentives are strong employee retainers. Monthly perfect attendance earns a $100 cash bonus, and Laberee established additional monthly bonus incentives from $100 to $300 per employee tied to revenue collections. Moreover, Advanced Imaging also celebrates its employees and their families with quarterly off-the-clock events, whether it’s a picnic, dinner or an experience like an escape room outing.
So far, the moves have increased employee retention in each of the 39 practices he manages by 40 percent. Part of the reason the system has been so successful is that earnings are shared with the employees who generate them, and the process for generating bonuses is transparent among staff and administration.
“Everybody’s incentivized to keep the schedule full,” he said. “If the money’s coming in the door, everybody benefits; everybody’s bonused. You’re talking about $3,000-$5,000 a month [in bonuses], and I’ve been able to increase revenues $15,000-$20,000 a month.”
“Transparency’s everything,” Laberee said. “I know everybody thinks that we’re printing money in private practices and outpatient services, but that’s not the case. I did 22 percent more volume in 2022 than I did in 2014 for the same amount of money. Amid decreasing reimbursement and rising costs, we have to figure out what we can do to keep our overhead as low as possible while providing quality service.”
Laberee also believes that understanding generational differences in the corporate environment helps to retain quality employees. He blames “a combination of deliberate lack of education and transparency in corporate America” for failing to address this circumstance for too long, and added that “it’s up to us as small business owners to educate our employees and our general patient population on what we’re facing.”
Josh Block, president of Holt, Michigan-based Block Imaging, said he believes that leadership can have a bigger, more positive impact on employee retention and recruitment than almost anything. He’s publishing a book on transforming workplace culture around thoughtfulness, togetherness, transparency, and how they pave the way for building trust.
“I’ve enjoyed every job I’ve ever had,” Block said. “I grew up in a house where work was a positive thing, and a good part of life. Then as I moved into the workforce, work was the four-letter word of our time. I wondered if it was possible to create a place where people loved to work.”
“We needed to create a place where people felt safe, seen and successful,” he said. “We’re far from perfect, but continually blown away by the way our team brings their best and cares deeply for one another, our customers and the business as a whole.”
Block believes that many organizations struggle from a leadership perspective because “they’re focused first on their own needs versus the needs of others.”
“It’s been said that people don’t leave jobs or companies; rather, they leave leaders,” he said. “In any relationship where the person primarily focuses on themselves, it usually doesn’t go very well. There are a lot of cowboy leaders who don’t take time to slow down and ask for advice. In doing so, leaders often miss the bullseye and end up cleaning up a lot more messes.”
“Beyond doing it together, transparency is key,” Block said. “That could be anything from sharing our approach during COVID, to marketplace challenges or even performance. It could be organizational performance or personal performance. Feedback is crucial to growth.”
Block also believes that good leadership doesn’t countenance poor employee performance, regardless of the available talent pool. Although the medical imaging world is suffering a shortage of technologists, that doesn’t mean looking the other way when people let down their team.
“I would ask people in those environments, what does it feel like to work there?” Block said. “Are people proud and feel a deep sense of purpose, or do they leave at the end of the day like their backpacks are on fire?”
“Do we as leaders know what we’re asking people to do?” he said. “Do we understand and respect our engineers who spend 150 nights on the road? It’s not that people don’t love their people, it’s that they don’t know their people.”
When organizational culture must change – because of circumstances like leadership turnover, poor performance, or rapid growth, for example – Block is adamant that such a transition must be navigated thoughtfully, transparently and with the inclusion of the people upon whose work the business depends.
“So many people just do a Reader’s Digest version,” he said: “share the information, the motivation, and the challenges. The more you’re able to say, ‘Our job as leaders is to support everyone even though you’re in all different places,’ the better. Change management is what you would need to know on both sides of the change.”
Block also encourages organizations to consider all its leaders when making major shifts in approach, including those on the board of directors of a business or entity. That oversight often has a strong impact on how organizations are philosophically and practically led, but is typically less considered in the calculus of leadership impact.
“When organizations get huge, it’s very hard to stem the tide of bureaucracy and politics,” Block said. “What is the culture that the board has created? Is it one of anxiety and fear and doubt? That starts at the C-suite and works its way down to director level and beyond. Is there any way that work can be fun, or can be good, or can be meaningful?”
Nanci Wozniak, vice president of education and workforce solutions at Siemens Healthineers North America of Malvern, Pennsylvania, said its response to the looming labor shortage of the medical imaging space has been to regroup its resources around supporting holistic workforce development solutions. By expanding the focus beyond technology education to upskilling growing teams of professionals who can fill the added staffing demands of medical imaging environments Siemens Healthineers has pivoted in an industry that is short on qualified talent and long on employee burnout.
“We’ve seen this coming for several years now,” Wozniak said. “We provide imaging technologists across every imaging modality to our customers; we are here to support them while they figure out how to attract and recruit from a shrinking pool of technologists in the industry.”
“We’re also working together with our partners in the academic settings to cultivate talent for the imaging profession,” she said. “We’re working together with industry partners, academia and our customers, to cultivate that talent underneath. It’s what I call a workforce sustainability challenge, all-encompassing around bringing in a talent pipeline, and making sure it’s effectively supported with the training, skills, and enabling flexibility to progress on a career path.”
For Wozniak, the shift ultimately is rooted in improving patient care and health outcomes. To her thinking, better-trained, more qualified workers can capably operate the technological advancements that underpin the high-performance medical imaging systems of today’s health care environments. If a piece of equipment is under-utilized because its operator doesn’t have the skill, the staff, or the training to run it to its highest optimization, that has a direct impact on patient care. Additionally, it leads to extensive patient backlogs and unmet demand across clinical specialties.
“We historically have spent a significant amount of time and money investing in our clinical experts,” Wozniak said. “They need to be scanning at the top of their game so they can drive utilization and quality, and all the operational metrics that our clients are held to. If we see deficiencies in that, we give them the training they need.”
Moreover, she argues, providing contemporary training also helps passionate, career-driven professionals “feel like they’re being invested in,” which makes them more likely to stay with an organization that supports their growth, instead of seeking out greener pastures.
Jeremy Goldberg, head of workforce solutions at Siemens Healthineers North America, said that the company speaks to some 400 to 500 imaging technologists on a weekly basis. Although compensation is a top priority for every medical imaging professional, he also believes that opportunities for career development comprise a significant aspect of job satisfaction.
“When we take a step back and listen to the technologists, they want better pay, flexible hours, more than one option to drive their career forward,” Goldberg said. “A technologist in our time also is looking for more out of their careers in addition to the compensation. They want to work on more complex cases, they want to be affiliated with prestigious health care systems, and I think Siemens is positioned to be in that conversation.”
“We do a lot of the same structural, programmatic outreach that you would see in a top-tier recruitment agency,” he said. “Now you’re starting to say, ‘I’m competing on the salary side, I’m able to find people by the traditional means that other organizations are,’ and truly that’s the secret sauce.”
“Everyone has access to all the same candidates; there’s no one out there doing something uniquely special and different,” Goldberg said. “We all utilize the same technology. It’s what starts to happen when you have that conversation about aligning objectives and goals between employer and employee. We’ve taken great pride to be able to design our opportunities not only in alignment with what our clients are seeking, but also our technologists to meet the same goals and objectives.”
So far, the approach is paying off. Goldberg said Siemens Healthineers is seeing triple-digit growth in technologist placement year-over-year in a variety of environments.
“For a tech with ARRT certification, you’re looking at 70 days on average for a placement,” Goldberg said. “In Hawaii, it’s well over 100 days; in other markets, it could be in the low 60s. We’re able to do it well below 30 days, depending on the modality that’s out there. We have an 80-percent extension and retention rate when our technologists go onsite.”
When technologists don’t take an onsite placement, Wozniak said, they can connect with health care environments in distributed and rural networks through teleradiology, remote advanced scanning via its Virtual Cockpit solution, and other forms of distributed support.
“We understand the technology and education coming out to support the quality of care that we want and need in the industry,” she said. “The way we’ve always done it is not the way we’ll continue to do that in the future. Technology, market expectations and demographics are all driving that change.” •
