Opening a satellite office is an excellent way for cardiologists to expand their reach within a community and grow their patient base. But what level of services should you be offering at the satellite offices? Imaging is often one of these question marks. Sure, it would be great to provide full ultrasound and nuclear imaging services, but equipment and staffing for diagnostic imaging require a sizable capital investment. Knowing the options will help you minimize the pitfalls and position yourself for the best chance of success. We’ve identified three options that practices take when considering how to offer imaging at satellite locations. These approaches include the Hub & Spoke, Mobile First, and All-in. Let’s take a look at each one in detail.
Hub & Spoke Approach
The concept of the Hub & Spoke approach is to limit your capital risk by simply not offering imaging at the satellite office. That may sound simplistic, but many times cardiologists take a “wait and see” approach to satellite offices and are unwilling to invest in any equipment or imaging staff until the location proves itself as viable.
Using this method, these offices are designed to create imaging referrals and not straight diagnostic imaging revenue for the satellite. No nuclear imaging equipment is located in the office and patients who need additional testing are directed to the central office. The glaring drawback is that this works against the two key features that satellite offices offer. First, you are only offering patient convenience for office visits. If a patient chooses the office because of where it’s located, you may see attrition if they have to drive 15+ minutes for their imaging needs. With a patient travel time of 30+ minutes for diagnostic testing, the failure rate is high in terms of capture rate. Second, you are presenting to the referring physician community that you are not fully committed to provide your full list of services to them and their patients. Referring physicians may stick with existing referral patterns if they feel their patients will be inconvenienced. This also limits the opportunity for the physicians assigned to the satellite office to fully connect and engage with the local referral base. Although the financial outlay of the Hub & Spoke approach is minimal, the capture rate for diagnostics is significantly compromised. This fact will limit the overall success of the satellite office concept.
The reason many physicians hedge when considering imaging at a satellite is that it does involve risk and a higher amount of capital. Because of this, some practices choose to use a “Mobile First” approach to offering imaging at a satellite office.
With a Mobile First methodology, clinics opt for providing imaging on a limited basis (one or two days a week) scalable to the clinical needs. Simply schedule all patients who need the services on the same day. Some practices choose to move staff and equipment from the main office to the satellite office for the imaging days. Another alternative is to utilize a mobile imaging company to handle all the imaging.
The intent with this approach is to use the resources you already have available until you can gauge patient volume, referral patterns and general success of the office. Either of these options would give you the time and realistic, concrete feedback about the likelihood of financial success and eventually the grounds to solidify your long-term plans for your satellite office.
The All-in approach involves investing in everything needed to run what is essentially a smaller-scale main office. The office is staffed & equipped for in-office imaging, and patients are imaged five days a week. While this approach sounds like a recipe for success, it brings with it more risk than the other approaches. It requires a significant financial investment, and the actual volume might not match expectations.
However, many physicians who currently offer nuclear imaging choose this route with varying levels of success. Having been through the process before, and having a base of knowledge to build from, allows them to have a better grasp of what it takes to get the department running, how to scale and what is required for financial success.
What is right for your practice?
There is no “right” way to offer imaging services at a satellite office, and the approach you choose should be the best fit for your practice and your patients. Your experience, the location of the satellite, and your local market all factor into the decision, but finding the right balance of risk vs. reward will help your satellite succeed.