Employer of Choice

A strong leadership team can't successfully lead a medical group without a talented, dedicated staff willing to follow. Recognizing that teamwork must permeate throughout the organization, the six-person administrative team at Radiological Associates of Sacramento Medical Group agreed on a mission: to be the "employer of choice," as well as the preeminent imaging services provider, in the greater Sacramento area.

What makes RAS' initiative stand out is the environment in which it occurred. When reimbursement cuts and staffing shortages were pushing other providers to eliminate unprofitable services or pinch pennies, RAS poured money into an internal marketing campaign, offered up to $6,000 employee referral bonuses for hard-to-fill technical positions and up to $12,000 sign-on bonuses for new recruits, set up a $15,000, two-year scholarship program for employees who want to become technicians, and continued to invest in facility and equipment upgrades.

The transformation began in 2003, when RAS hired an outside firm to conduct its first employee satisfaction survey. Many groups would have been satisfied with ranking in the top 10 percent of all healthcare organizations--particularly if they were managing 750 employees and more than 70 physicians spread out over 15 diagnostic and nuclear imaging centers and seven radiation oncology offices. But the RAS administrative team concluded that wasn't good enough given the industrywide shortages of radiologic technologists and other key positions, says Fred Gaschen, the group's executive vice president.

The team started with basic budgetary questions: "Where do we put our money? Should we cut back?" The conclusion, Gaschen says, was to focus on the long-term success of the organization and not obsess over short-term financials. "We've taken the high road and said if it means less profitability for the physician owners, so be it, as long as we are continuing to move in the right direction," he says.

The team pitched new ideas and shared success stories in weekly two-hour administrative meetings. For day-to-day administration, RAS encouraged team leaders to walk a few feet to their peer's office for one-on-one interaction, rather than communicate through e-mail or over the phone.

The close teamwork and willingness to invest paid off, Gaschen says. When employees were resurveyed in 2006, ratings had gone up in all of the 44 survey categories. The RAS leadership team has lowered turnover in an industry where 25 percent to 35 percent turnover isn't uncommon, and it has reduced its number of locums employees from 14 to two.

All of this occurred while the group's revenues continued to grow almost 300 percent over nine years. "That's kind of like proof in the pudding that the emphasis on employee satisfaction and employee input in the operations has had a positive impact on our overall business, because we continue to see month over month, year over year, increased patient volumes," Gaschen says.

--Elyas Bakhtiari