The 19 physicians of X-Ray Consultants (XRC)—Strategic Radiology’s newest affiliate practice based in South Bend, Indiana—have had a ringside seat on the consolidation that is reshaping the hospital landscape.  The group goes back to the 1940s, when one of its founders Wallace Buchanan, MD, served as president of the American College of Radiology.  In the early ’60s the practice became known as Lockhart & Beach until its incorporation as X-Ray Consultants in 1979. 

Its three primary health system clients have undergone a half dozen mergers and acquisitions over the years, shuffling ownership, merging separate sites into a sole location in some cases, and reorienting alliances.  “We’re seeing a lot of consolidation and joint ventures in our marketplace,” said Edward L. Yang, MD, practice president.

It is an environment in which relationships count, a core value of the XRC practice. “Our core values are relationship, excellence, respect, and business stewardship,” Yang shared. “Building relationships with patients, referring physicians, hospital administrators, hospital staff, and the community at large is an important part of who we are as a practice.”

A four-way joint venture on MRI technology that dates back to the 1980s is a testament both to the practice’s skill in forging and maintaining relationships and its progressive approach to advancing technology and technique in the community.  In the early days of MR technology, XRC built a partnership with two health systems and another local radiology practice that now includes eight scanners in five locations.

New Service Line

XRC’s newest innovation was the addition of one of the area’s only fellowship-trained vascular surgeons to its practice earlier this year. “Our IR physicians are very proactive,” Yang explains. “Eventually, they want to build a vascular center of excellence.” The surgeon sought a new opportunity and had established a good working relationship with the IR section of XRC.

“It’s a bit of a wild idea, but there are precedents around the country where this has worked out well,” Yang notes. “He is doing both endovascular and open procedures, sometimes with the assistance of our IRs, and sees patients in our interventional clinic. Having him on board broadens the vascular conditions we can treat.”

XRC has been quite progressive in introducing new technologies and techniques to the community. “Our group brought PET/CT into the community in the early 2000’s, championed by one of our radiologists, Dr. Rust who has since retired,” he notes. “We also introduced advanced venous laser techniques when we opened the first physician-owned vein clinic in the area.”

Another first for XRC was the area’s inaugural multi-modality outpatient imaging center, which it opened as a joint venture with one of its hospital partners. “We opened that in the early 2000s, but the market became very competitive in the past decade,” Yang explains. XRC sold its share of the center to its health system partner.

“We want to be known in our communities as the experts in technology and techniques,” Yang explains. “We also want to be proactive in our business strategy, stay ahead of the curve, and grow our business to make it stronger overall. That is part of the reason we joined SR—we believe that being a member of SR can promote business stewardship.”

Two other factors contributed to XRC’s decision to join the coalition. “Strategic Radiology was founded by practices that are much larger than XRC,” Yang adds. “We think we do things well, and we follow evidence-based practices, but we want to continually strive for improvement. We believe there is more to learn about best practices and protocols from other radiology groups”

The other motivation for joining the Strategic Radiology movement was its stated support for the independent private practice. “Back in 2010/2011, we unanimously voted to remain an independent private practice,” Yang shares. “We do not want to be corporately owned and employed. We joined SR because of its interest in aligning private practice radiologists so that they can still function independently.”