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  • houmank

    Member
    March 15, 2018 at 10:16 am

    Unfortunately it is very true. Two big PP groups in Milwaukee affected by this.  

    • Unknown Member

      Deleted User
      March 15, 2018 at 10:43 am

      What is the name of the group? Let’s start discussing actual names. Radiologists need to know that there will be consequences to their reputations if they engage in this type of predation.
       
      Is it [link=http://www.radalliance.com/directory/people]this group[/link]?
       
       
       
       
      (Someone feel free to let me know if this is a violation of the TOS, but these are not anonymous people or groups, and discussing these processes openly is no different from what one would see on the pages of the Financial section of the newspaper.)

      • Unknown Member

        Deleted User
        March 15, 2018 at 10:45 am

        Is it [link=http://www.radalliance.com/directory/people]this group[/link]?

      • cieminsjohn

        Member
        March 15, 2018 at 11:30 am

        hmmm

        • deepikatallam

          Member
          March 15, 2018 at 11:47 am

          [link=https://www.businesswire.com/news/home/20170130005158/en/MEDNAX-Announces-Acquisition-Radiology-Practice]https://www.businesswire….ion-Radiology-Practice[/link]

          • deepikatallam

            Member
            March 15, 2018 at 11:49 am

            For some reason the copy/paste didnt print the entire link. Just Google “Vrad Nashville radiology”.

            • Unknown Member

              Deleted User
              March 15, 2018 at 12:02 pm

              That’s what I did before I posted my link. Frankly, I would like confrmation prior to listing the names of the radiologist in the group.

            • Unknown Member

              Deleted User
              March 15, 2018 at 12:18 pm

              That’s what I did prior to posting my link. My hope was to get confirmation before listing the names of the radiologists in the group.

              • alysskoe

                Member
                March 15, 2018 at 12:23 pm

                Which contract? Seems odd, so theyll send their boots on the ground people from Nashville? And how big were the displaced groups? Was it their only contract or a small piece of their business?

                • david242

                  Member
                  March 15, 2018 at 12:35 pm

                  Deleted

                  • afazio.uk_887

                    Member
                    March 15, 2018 at 2:57 pm

                    If this is predatory and the future business plan for MEDNAX, I don’t think they will be successful long-term.

  • satishkumaravula04

    Member
    March 15, 2018 at 2:59 pm

    Loudog and lotus1 — As is usual with these threads — rumor has festered into misinformation and “alternative facts”. The group in Milwaukee was “acquired” by Premier radiology. I have it from our VRAD sales force that it is premier radiology, not radiology alliance that has “partnered/acquired” the group in Milwaukee. 
     
    While they are located in Tennessee, they have NOTHING to do with Vrad or their Nashville partner Radiology alliance. ([link]http://www.radalliance.com). [/link]
     
    Sorry VRAD haters — just more false rumors

    • Unknown Member

      Deleted User
      March 15, 2018 at 3:10 pm

      Quote from radrunner

      Loudog and lotus1 — As is usual with these threads — rumor has festered into misinformation and “alternative facts”. The group in Milwaukee was “acquired” by Premier radiology. I have it from our VRAD sales force that it is premier radiology, not radiology alliance that has “partnered/acquired” the group in Milwaukee. 

      While they are located in Tennessee, they have NOTHING to do with Vrad or their Nashville partner Radiology alliance. ([link=http://www.radalliance.com).]http://www.radalliance.com). [/link]

      Sorry VRAD haters — just more false rumors

       
      This is why I’d like confirmation from someone in the know before holding any group culpable.
       
      While I do have a great degree of dislike toward VRAD, I have far more contempt for radiologists engaged in the field’s self-smothering.

      • david242

        Member
        March 15, 2018 at 6:02 pm

        If that’s the case, I would like to delete this thread.  I have no intention of spreading false rumors.  

        • Unknown Member

          Deleted User
          March 15, 2018 at 8:00 pm

          Who is premier radiology?

          • Unknown Member

            Deleted User
            March 15, 2018 at 8:28 pm

            [link]https://www.premierradiology.com/[/link]

            • Dr_Cocciolillo

              Member
              March 15, 2018 at 9:46 pm

              x

            • Unknown Member

              Deleted User
              March 16, 2018 at 10:07 am

              The other large & obviously growing group in Nashville. Radiology Alliance is VC backed while premier is not to my knowledge at least. The other big game in that region Vanderbilt

              • houmank

                Member
                March 17, 2018 at 9:19 am

                For my statement above- I apologize because I don’t know if premier radiology is affiliated with VRAD. What is true however is that premier radiology DID take over/win the contract from two PP groups in Milwaukee ( this was not a merger etc etc). Close friend of mine is in one of the groups– currently looking for another job. 

                • dipaktc_99

                  Member
                  March 17, 2018 at 11:01 am

                  Would those potentially displaced have local opportunities? Medical college of Wisconsin practice is in Milwaukee, correct?

                  • Unknown Member

                    Deleted User
                    March 17, 2018 at 12:11 pm

                    I am told contract was given to premier through backdoor channels.  vulture group.  one group has folded.  the other, not so much.

                    • drprasannaghimire_390

                      Member
                      March 17, 2018 at 12:38 pm

                      What’s the benefit of a healthcare system in Wisconsin hiring a group from Tennessee ???i find it crazy how cut throat this business is ( naive on my part I guess)

                    • Patrick

                      Member
                      March 18, 2018 at 12:44 am

                      I don’t see any news releases, so all I can do is follow the rumors and innuendo here.  Please, disabuse me of any misinformation:
                       
                      Follow the icons on the Web Sites…  Premier Radiology is affiliated with St. Thomas Health…  St. Thomas Health is part of Ascension.  Wheaton Fransican (MRL rad group) and Columbia St. Mary’s (WRS rad group) recently merged under the Ascension parent.  2 Rad Groups (MRL ~ 42 rads and MRL ~ 32) have been displaced by Premier Radiology (~47) based out of Nashville, TN.   Rumor has it that there was an initial attempt to merge the radiology groups and an RFP went out because the radiology groups could not come to an agreement amongst themselves or with the health system.  Anyone want to verify?  
                       
                      Read: Large consolidating health system in an area with questionable payor mix tries to consolidate its radiology operations to achieve financial and operational gains and opts for an aligned radiology group already functioning within its system, likely through a pre-established relationship with executives at parent company, promoted or transferred, that had been happy with the selected group’s operations (Opinion: Yes, it was an inside job in that they went with a known entity).  The execs are confident or arrogant enough to believe that radiology is a low hanging fruit for creating efficiencies? The incumbant rads were confident/arrogant/naive enough to not see credible threats to their lively hoods vis a vis a 22B multistate enterprise?
                       
                      Open questions: I note an Aris Icon (~250 Rads) on Premier’s Website?  Is Premier truly independent?  Is there a partnership/ownership relationship with Aris?  Is there a bigger corporate group at play here, as telerads or more?  ARIS has already swallowed US Telerads and Optimal.  
                       
                      Will Premier be able to retain and or recruit to staff contract? Betting on economies of scale through remote operations and boots on the ground for local service? Will local medical staff have anything to say about displaced groups?
                       
                      Maybe someone should open another thread…  The consolidation frenzy among providors (Be it Northwell, CHI, Dignity, etc) is going to have real implications for all stripes of radiology practice models–employed (Northwell), corporates (HCA/CHI), and private practices (HCA/CHI/Dignity). RP/Envision/Mednax are not the only pieces on the board.
                       

                    • ljohnson_509

                      Member
                      March 18, 2018 at 9:29 am

                      Forget about all these crazy details. The entire field is circling the corporate toilet bowl. Be happy your mid to late career because there is a light at the end of the tunnel. For the young ones, be prepared for years of corporate servitude and grinding cases at max capacity totally disconnected from your professional charges.

                    • afazio.uk_887

                      Member
                      March 18, 2018 at 10:45 am

                      I basically agree with the above.  The field is changing, and for the worse significantly.  You can thank your elders in the field for this negative change as well. 
                       
                       

                    • henriqueabreu

                      Member
                      March 18, 2018 at 11:10 am

                      Its so lame to constantly blame the older generations for perceived problems in our specialty (which while real are overblown). First of all, humans will always do whats best for their wallet so of course will sell out to highest bidder; youd do the same – I highly doubt all the loud complainers would give up large sums of money including theirs spawns and grand spawns inheritances for the greater good of complete strangers following them.

                      Also, the job market has gotten better, these predatory corps arent filling (constantly having to flood the listings with jobs nobody wants) and accordingly Rads is again becoming a more competitive specialty with fewer unfilled spots in the match.

                      Things are looking up.

                      The new generation just has to be smart about what practices to join , be able to recognize the snakes and avoid them. Its actually not that hard. If its a Wall Street venture capitalist backed Corporation, look elsewhere. Easy to spot and avoid.

                    • afazio.uk_887

                      Member
                      March 18, 2018 at 11:36 am

                      While I always appreciate an optimist, I think your optimism is a bit misplaced.   The private equity guys are not dumb, unfortunately.  RadPartners, for example, has groups basically throwing themselves at them to join.  They cannot keep up with the interest level to sell to them.  They will soon have dominant positions in many major markers and within large health systems.  Look at Houston, TX – one of the largest cities in the US – pretty much completely will be corporate radiology very soon. 
                       
                      At this point, if a young rad wants to make big money while they still can – the only option is a BFE job until the contract is lost or the community hospital closes or is purchased by a large chain.
                       
                      I am not into whining or blaming – just summarizing the facts of current PP radiology.  To be frank – I am not a young rad any longer, been in this game a while now and done fine – but I don’t like what I see going on but the forces behind it are strong and powerful.
                       
                       

                    • Unknown Member

                      Deleted User
                      March 18, 2018 at 12:21 pm

                      Quote from NYC

                      Follow the icons on the Web Sites…  Premier Radiology is affiliated with St. Thomas Health…  St. Thomas Health is part of Ascension.  Wheaton Fransican (MRL rad group) and Columbia St. Mary’s (WRS rad group) recently merged under the Ascension parent.  2 Rad Groups (MRL ~ 42 rads and MRL ~ 32) have been displaced by Premier Radiology (~47) based out of Nashville, TN.   

                       
                      How does ADI/Premier Radiology out in Nashville, TN plan on staffing procedures performed in Milwaukee, WI? Doesn’t Wheaton have a residency associated with it? We’ve seen this sort of take over before. It hasn’t worked longterm. You can outsource the imaging, but eventually, someone has to physically put in contrast, drain the abscess, biopsy the tumor, and run the tumor board. You can’t outsource it all.
                       
                      I don’t know much about ADI/Premier Radiology, but I’ve heard enough to steer clear. Caveat emptor.
                       
                      edit: one quick check on the acr job board, and there’s this from an ADI/Premier Radiology ad:  “Expanding radiology group in Nashville, TN seeks multiple diagnostic radiologists due to significant practice growth.”  Sounds about right.
                       

                    • Patrick

                      Member
                      March 18, 2018 at 2:46 pm

                      I would add that the outsourcing model with limited boots has proven far more difficult than many have assumed, leading to lost contracts. Lots of economies of scales promised with little delivery. I know enough hospital admins and execs to know that they can be very skeptical.

                      If all this is true, success IMHO will all depend on the willingness of local rads to stay under any new arrangement and the newcomers ability to recruit. Success or failure will have implications for what is done more broadly in this health system.

                    • Patrick

                      Member
                      March 18, 2018 at 3:28 pm

                      I still don’t understnad ADI/Premier’s structure–ADI is telerads and hospital based and Premier is OP, same practice and partnership structure?–and its relationship with ARIS.
                       
                      This may not be an example of a national corporate displacing PPs.  It may be the case that a PP is competing, successfully…  ADI offers partnership track…  It may be that they have a secret sauce that St. Thomas/Ascension like and felt the incumbants lacked?  Any insights? 
                       
                      I am early mid-career, so these “crazy” details are important in understanding the market in which I function.   I have said it many times and will say it again: the direction the market takes is not a forgone conclusion.  Radiologists can remain in control, though the organiziation structure required will need to adapt–we will need to get bigger, conduct ourselves in a more “corporate” manner, and assume risk/invest in ourselves to compete, but we don’t have to give up ownership to do so.  Even in VC/PE/consulting/banking/law, true partnership sturctures persist.  I question whether or not the fear and fatalism some display on this board is just meant to drive people into the arms of corporates and employed positions?

                    • medvidr

                      Member
                      March 18, 2018 at 3:41 pm

                      Someone that would know told me that ADI’s partnership tract is 4-5 years.

                    • Unknown Member

                      Deleted User
                      March 18, 2018 at 8:40 pm

                      i have heard churn and burn and 5+ from someone who left.

                    • raghunadharelli_57

                      Member
                      March 19, 2018 at 3:03 pm

                      Quote from NYC

                      Open questions: I note an Aris Icon (~250 Rads) on Premier’s Website?  Is Premier truly independent?  Is there a partnership/ownership relationship with Aris?  Is there a bigger corporate group at play here, as telerads or more?  ARIS has already swallowed US Telerads and Optimal.  

                       
                      I believe that Premier remains independent. I was told that Chad presented at the RBMA conference in Chicago about practice integrations and M&A trends in radiology. So, he is seen as an expert in that field presumably.
                       
                      The ARIS logo is related to Chad’s role as the ARIS Chief Medical Officer. However, I don’t have anymore information than stated above.

                      [link=https://www.premierradiology.com/chad-l-calendine-md/]https://www.premierradiol…m/chad-l-calendine-md/[/link]
                      [link]https://arisradiology.com/clinical-team/[/link]
                       

                    • raghunadharelli_57

                      Member
                      March 19, 2018 at 3:11 pm

                      [b]More data Premier/ADI – ARIS connection[/b]
                       
                      November 14, 2012
                      [link=https://www.prnewswire.com/news-releases/optimal-radiology-partners-with-leading-radiology-practice-179331321.html]https://www.prnewswire.co…ractice-179331321.html[/link]
                      [link=https://www.bizjournals.com/nashville/morning_call/2012/11/premier-radiology-forms-new-company.html]https://www.bizjournals.c…forms-new-company.html[/link]
                       
                      (Note, this is the deal that resulted in ADI/Premier leaving Strategic Radiology)
                       
                      then
                       
                      April 7, 2016
                      [link=https://arisradiology.com/news/aris-completes-acquisition-optimal-radiology/]https://arisradiology.com…ion-optimal-radiology/[/link]

                    • Unknown Member

                      Deleted User
                      March 19, 2018 at 8:11 pm

                      Wonder how much money ARIS paid for Optimal and who got the payout. 
                      Bet wasn’t Optimal radiologist but someone in ADI
                       
                      ADI got kicked out of Strategic for predatory behavior ? 

                    • consuldreugenio

                      Member
                      March 19, 2018 at 9:04 pm

                      Strategic Radiology. What do they do and offer? How do they generate revenue? Seems like a good service. But after all these warnings on entities that skim, would like a little more general info. PM is fine.

                    • Patrick

                      Member
                      March 19, 2018 at 9:19 pm

                      Thanks TNRad, org structure looking very complex with a corporate entity attached.  I’d definitely want all of this explained to me before signing.  What would one be a partner in?  Who owns what?  Not sure this qualifies as a totally independent group…
                       
                      If true, I predict 5 year to partnership is not going to cut it in Milwaukee if even offered.  They’d best try and seduce the incumbents to stay.

        • Unknown Member

          Deleted User
          December 5, 2018 at 9:25 pm

          [link=https://arisradiology.com/executive-leadership-team/]https://arisradiology.com..cutive-leadership-team/[/link]
           
          President of Premier is however also CMO for ARIS (GPP backed) and his plans for the Milwaukee group he is setting up likely involve some form of sale down the line which certainly would benefit no one in Wi  

  • Unknown Member

    Deleted User
    April 27, 2018 at 11:18 am

    Strong warning not to work for Premier radiology (Tn) or their new ADI subcontracted group in Wi.

    To clarify, the president of premier radiology in Tennessee was awarded a contract for all southeast Wisconsin by a personal friend of his who was recently promoted from Ascension Tennessee to run Ascension Wisconsin. They achieved this outcome by pitting the two southeast Wisconsin groups (almost 70 radiologists) against one another. These two groups were otherwise about to merge but told not to by the head of Ascension, then told they lost contract because they didnt merge.

    Premier radiology intends to basically employ a skeleton crew of rads in Wisconsin (not as partners) while reporting as many of the studies as they can from Tn. They are also infamous for their own puppy mill in TN where few ever make it to partner.

    • nicolasvg.1003

      Member
      April 27, 2018 at 12:08 pm

      ^^ Wow, disgraceful. Such scumbag radiologists out there it is disheartening and a terrible reflection on our profession.

    • Unknown Member

      Deleted User
      December 6, 2018 at 5:49 pm

      Nice arbitrage play. Charge Wisconsin rates and pay Tennessee rates. Wisconsin has some of the highest reimbursement rates in the country. A better move would be to send to Florida at 20 per wRVU. Now that is knocking it out of the park.

      • Dr_Cocciolillo

        Member
        December 6, 2018 at 9:07 pm

        Heard from some people involved that he is shopping around to Private equity the one group that gave in (WRS). He will make 30 mil in 6 mo and they will wonder what happened.

        • sugansuvaraj

          Member
          May 30, 2019 at 9:58 am

          As a 2020 fellow, I am exploring a move to southeastern WI. WRS has multiple postings on ACR. Any update on ADI-WRS relationship. The job ad doesn’t mention ADI Tennessee. Have the worst predictions about the pseudo-corporate takeover come true. The other group (MRL) doesn’t look too stable either. 

          • alkhaldiraghda_487

            Member
            November 14, 2019 at 2:14 pm

            I’d be careful about taking that WRS job. Their contract is held by ADI in Nashville who are about to sell out. 

            • Dr_Cocciolillo

              Member
              November 14, 2019 at 6:06 pm

              Wise observations

  • Unknown Member

    Deleted User
    November 23, 2019 at 10:07 am

    Premier/ARIS and Optimal is owned or affiliated closely with ADI. ADI is acquiring ALL Ascension healthcare radiology contracts and using RadPartners to be the boots on the ground. ADI is planning on selling everything to RadPartners. So one day in the future it will be Envision MedNax/Vrad & RadPartners. Private groups everywhere should beware.

    • charnie

      Member
      November 24, 2019 at 8:26 am

      That doesn’t surprise me, but with probably 100 Ascension hospitals to get on board simultaneously, it would be a tall order even for RP.

      Any further details appreciated either on forum or pm.

      • Unknown Member

        Deleted User
        December 26, 2019 at 7:24 am

        [link=https://www.radpartners.com/events/k4blscxz22/Radiology-Partners-and-Nashvillebased-Advanced-Diagnostic-Imaging-Enter-into-Partnership]https://www.radpartners.com/events/k4blscxz22/Radiology-Partners-and-Nashvillebased-Advanced-Diagnostic-Imaging-Enter-into-Partnership[/link]
         
        It was finally made official. Milwaukee groups in big trouble now unless they can fight this. They’ll be forced to sign up with RP without the buyout..

        • Dr_Cocciolillo

          Member
          December 26, 2019 at 7:56 am

          WRs telling their new hires that they are not affected (laughing )

          • Unknown Member

            Deleted User
            December 26, 2019 at 9:49 am

            I know nothing about Wisconsin rad market but why should RP buying a competitor make a good solid pp group worried. Last time I checked RP has like 100 openings on ACR

            • Unknown Member

              Deleted User
              December 26, 2019 at 11:08 am

              ADI owned the Wisconsin Ascension contract so now RP does. WRS was subcontracted to by ADI (see all the prior discussion)

              • josephbardwell

                Member
                December 26, 2019 at 11:59 am

                It was my understanding that ADI already made the rads from WRS sign with them when they got the Ascension Hospital contract. Im sure the unfortunate rads who stayed got a pay cut and non-equity or permanent employee status with ADI. Now that ADI has sold to RP, they are left with the same dilemma. They can stay with RP or leave. I doubt the employment terms of RP are much different than the prior terms of ADI.

                If someone in Wisconsin has more info please update us.

                • Unknown Member

                  Deleted User
                  December 26, 2019 at 12:15 pm

                  From what I hear WRS’s subcontract with ADI was reasonable in terms of keeping local control and revenue (it was a voluntary arrangement they signed onto ostensibly to ‘keep’ the Ascension contract, although clearly not well thought out by WRS). In retrospect it was the sale to RP where ADI was looking to profit. 

                  • arinakost99_755

                    Member
                    December 26, 2019 at 2:08 pm

                    I’m no longer with WRS but I’m fascinated that our business is a ‘national’ topic. You’ve got good sources.  You’re obviously talking to someone in WRS or you’re a WRS rad.

                    Quote from Overraded

                    If someone in Wisconsin has more info please update us.

                    MinnieB has good info.

                    Quote from MinnieB

                    From what I hear WRS’s subcontract with ADI was reasonable in terms of keeping local control and revenue

                    At the time and at least to now AFAIK, you are correct-no change in control or revenue.

                    Quote from MinnieB

                    (it was a voluntary arrangement they signed onto ostensibly to ‘keep’ the Ascension contract, .

                    “Voluntary” as in do you want to keep your job or not. 

                    Quote from MinnieB

                    although clearly not well thought out by WRS).

                    Not sure what we (WRS) could have done differently.  As explained by others, deals were being made above our heads and out of our control.

                    • Dr_Cocciolillo

                      Member
                      December 26, 2019 at 2:18 pm

                      The danger of signing with ADI was always exactly this. They would not commit to not selling the contract. That was their end game

                    • arinakost99_755

                      Member
                      December 26, 2019 at 2:25 pm

                      It was not something we were aware of beforehand when we were forced to sign with Premier.  Not that it would have made a difference since we had no choice.  Maybe we should’ve been reading the AuntMinnie forums earlier.  Or we were just naive/are radiologists without enough MBA cynicism.
                       
                      On their website, I see WRS has eight new young rads who are unaware or ill- or mis-informed or willing to take the risks with the new WRS corporate owners.

                    • Unknown Member

                      Deleted User
                      December 26, 2019 at 2:31 pm

                      Thanks Eeiko.  One possibility still is that the radiologists (WRS and MRL) together refuse to sign with RP. Normally when RP buys a group they have a core set of radiologists to cover their contracts. In Wisconsin RP then wouldn’t have any radiologists on the ground to cover the many Ascension sites..perhaps they would be forced to lose the contract. 
                       
                       

                    • cieminsjohn

                      Member
                      December 26, 2019 at 4:11 pm

                      Quote from MinnieB

                      Thanks Eeiko.  One possibility still is that the radiologists (WRS and MRL) together refuse to sign with RP. Normally when RP buys a group they have a core set of radiologists to cover their contracts. In Wisconsin RP then wouldn’t have any radiologists on the ground to cover the many Ascension sites..perhaps they would be forced to lose the contract. 

                       
                      They go in assuming no retention of radiologists and will look for locums.  They hope to retain some.  They will offer more $$ to IR and enough diagnostics to cover procedures/mammo on site.  Everything else can be farmed out to the matrix eventually.   But its not immediate.  They will be generous with paying local rads enough to tide them over till get more perm locums.  Our buy in only makes it easier for them, but if everyone opted out, it doesn’t stop anything.  
                       
                       

                    • Unknown Member

                      Deleted User
                      December 26, 2019 at 4:32 pm

                      I just thought given the size of WRS + MRL, RP wouldnt be able to cover the contracts without the groups cooperating.

                    • cieminsjohn

                      Member
                      December 26, 2019 at 4:44 pm

                      Quote from MinnieB

                      I just thought given the size of WRS + MRL, RP wouldnt be able to cover the contracts without the groups cooperating.

                       
                      they may be unable to do so, but they will never admit it.  They will say they are prepared for it and have the “best” recruiters and locums read, etc.   I mean they’ve been preparing and training there “elite navy seal team” for months now. 
                       
                       
                       
                       

                    • josephbardwell

                      Member
                      December 26, 2019 at 2:29 pm

                      I believe this situation got clicks was because a unique situation. A PP group in Nashville is poaching the contract of a group in Milwaukee. The only link between the groups is they both work with Ascension.

                      We are wondering what this will mean for the WRS group since the RP transaction. There is concern that aggressive groups like ADI could pull this scheme anywhere.

                    • arinakost99_755

                      Member
                      December 26, 2019 at 5:20 pm

                      Quote from Overraded

                      We are wondering what this will mean for the WRS group since the RP transaction. There is concern that aggressive groups like ADI could pull this scheme anywhere.

                      Lots of the older partners are retiring and a lot of others have left (Medical College of WI). 
                       
                      I can’t imagine this will be repeated too often given it involved dealings between friends in the Ascension and Premier Radiology hierarchy.  I may have limited imagination though.

                    • Dr_Cocciolillo

                      Member
                      December 26, 2019 at 6:26 pm

                      No one from MRL will work for RP they turned it down from what I understand. WRS on the other hand is lying to all their recruits and I suspect the partners will 1) retire In 1 year 2) go to other systems 3) stay least likely.

                      The culture at WRS was not one that tolerated independent thinking based on people who moved on.
                      In the end , the only winners here are behind the scenes .

                    • Unknown Member

                      Deleted User
                      December 26, 2019 at 8:32 pm

                      I dont know anything about the culture of the groups but if we are to learn anything from all this it seems the bigger problem was that these two Wisconsin groups allowed administration to convince them to stop their merger, fight one another for the contract and ultimately voluntarily sign themselves over to an out of state predatory group that otherwise would have had no way to cover a Wisconsin contract..

                    • benoit.elens

                      Member
                      December 26, 2019 at 9:32 pm

                      Depressing thread.

                    • moroztolik74_186

                      Member
                      December 27, 2019 at 5:27 am

                      I don’t work there, but I did interview there as this was all initially happening. Like the other poster above said, this all seemed mostly out of WRS’s hand. They could only react to preserve their jobs or be out of one. Every radiologist I met there seemed great. They were upfront about the arrangement with ADI. Although, I don’t think they anticipated the sale to RP. I simply couldn’t sign on to a job where a group in a different state controlled my entire livelihood.
                       
                      The real issue is the backroom dealings between Ascension and ADI. The people in power there made out like bandits, I’m sure. I think we will see more and more of these Ascension contracts being funneled through a select few predatory groups backed by PE. If I was part of a small PP that depended significantly on Ascension hospitals, I’d be very worried.

                    • al.georgiev_193

                      Member
                      December 27, 2019 at 5:54 am

                      In reading this thread, I found myself wondering- if these practices are so confident that they can continue to attract new radiologists once they become corporate controlled, why are they so often tricking or surprising their employees when they sell out? The truth is that they wont be able to recruit like they did before, but the partners who are collecting those checks arent thinking about the long term effects to their practice 10-20 years down the road. Look at their shady recruitment ads online- theyre always using tactics like disguising that theyre corporate, using tons of exclamation points, re-branding jobs like traveling locums as Elite Seal team, etc. All I know that the one local group in my city that became RP is now toxic to new grads and multiple rads have left.

                    • moroztolik74_186

                      Member
                      December 27, 2019 at 6:08 am

                      They are not confident of recruitment at all. They are hoping people with few options or local ties will sign on for a bum deal. They also offer small perks when you sign on that in the long run don’t amount to much at all but look good to a naive fellow.

                    • Unknown Member

                      Deleted User
                      December 27, 2019 at 6:46 am

                      Agree w the last couple posts. Its not a 10-20 year plan. Its a 3-5 year cash grab plan.

                    • forgottenegao_866

                      Member
                      December 27, 2019 at 7:20 am

                      I have had a some dealings with RP and some of there Corp cronies like Jay Bronner CMO. I can say this without a doubt from my interactions they have no plan or worry for the young rad/next generation the scheme is 100% about a cash grab for partners mostly directed at those in leadership who are often close to retirement and miss the glory days of radiology. They try to us PC buzzwords to attract the younger rads like transforming radiology and junk. Funny thing is they cannot understand why no one wants to sign up or people leave soon after finding out the truth. I think that the overall goal of RP and the others is to get enough market share that graduating fellows have to take their garbage offerings and in some markets (ie Houston, Nashville, Phoenix) PE groups are almost the only option left.

                    • Unknown Member

                      Deleted User
                      December 27, 2019 at 7:51 am

                      @[link=https://www.auntminnie.com/forum/showprofile.aspx?memid=52751]Eiko[/link]
                       
                      Quote from MinnieB
                      although clearly not well thought out by WRS).
                      Not sure what we (WRS) could have done differently. As explained by others, deals were being made above our heads and out of our control.

                      It seems if WRS hadnt supported ADIs bid for the Wi contract then ADI wouldnt have gotten the contract. I believe the alternative was joining with the other private group in the area.

                    • moroztolik74_186

                      Member
                      December 27, 2019 at 7:58 am

                      WRS had no say in ADI getting the contract. The Milwaukee groups got played by ADI and Ascension.

                    • Unknown Member

                      Deleted User
                      December 27, 2019 at 8:29 am

                      Actually WRS joined ADIs bid for the contract which is why ADI got the contract. I understand why they did it because they were told it would all work out and they were told the other group was out to get them but of course none of that was true.

                    • cytek1

                      Member
                      December 27, 2019 at 11:51 am

                      So from your standpoint, you thought the other group was going to get it over you, but you were under the impression ADI had some pull in getting it over the other group, so you signed on with them? I guess I’m confused what went wrong with merging with the other group, instead of signing on with an out of state group to support their bid. Were there not many questions asked about what a random Tennessee group is doing bidding on a wisconsin contract?

                    • zgozdeozkan_315

                      Member
                      December 28, 2019 at 3:10 pm

                      One thing I’m having trouble wrapping my head around was the incentive for Ascension to give the contract to ADI.
                       
                      Did ADI agree to pay Ascension to cover their sites? I doubt MRL and WRS were charging Ascension for their services. No administrator of a gigantic health organization could reasonably assume that quality would improve using a group several states away.
                      Was there outpatient imaging center revenue that the local groups weren’t sharing with Ascension? 
                       
                      The whole thing has an awful look to it.

                    • audreyharts_881

                      Member
                      December 28, 2019 at 3:29 pm

                      Any idea on how, if at all, the Aurora-Advocate group is impacted by this? Even if they are hospital employed, there must be some general impact on the local market.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 3:35 pm

                      Quote from skiMD

                      Any idea on how, if at all, the Aurora-Advocate group is impacted by this? Even if they are hospital employed, there must be some general impact on the local market.

                      I doubt it impacts them.  Columbia-St. Mary’s / Ascension has never done business well compared to them.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 3:41 pm

                      Quote from RWIII

                      One thing I’m having trouble wrapping my head around was the incentive for Ascension to give the contract to ADI.

                      Did ADI agree to pay Ascension to cover their sites? I doubt MRL and WRS were charging Ascension for their services. No administrator of a gigantic health organization could reasonably assume that quality would improve using a group several states away.
                      Was there outpatient imaging center revenue that the local groups weren’t sharing with Ascension? 

                      The whole thing has an awful look to it.

                      1.  Does there have to be an incentive other than someone paying off their buddy?  (and possibly getting something in return?)
                      2. MRL and WRS were not charging Ascension.  Quality is usually quite low on administrators list of values.
                      3. Not with WRS.  Probably with MRL.
                      4. Yes.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 3:44 pm

                      Quote from Ourad83

                      So from your standpoint, you thought the other group was going to get it over you, but you were under the impression ADI had some pull in getting it over the other group, so you signed on with them? I guess I’m confused what went wrong with merging with the other group, instead of signing on with an out of state group to support their bid. Were there not many questions asked about what a random Tennessee group is doing bidding on a wisconsin contract?

                      From my understanding, what MinnieB said in an earlier comment is correct.  Shenanigans behind the back of MRL and WRS.  It wasn’t a random TN group, it was someone the administrator was friends with.
                       
                      Nothing wrong with merging two groups in theory.  In practice, mergers are complicated by personalities.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 3:50 pm

                      Quote from MinnieB

                      Actually WRS joined ADIs bid for the contract which is why ADI got the contract. I understand why they did it because they were told it would all work out and they were told the other group was out to get them but of course none of that was true.

                      Maybe you’re talking about later stuff?  The contract in 2017 was given to Premier after WRS was told the contract was out for bid and after WRS and MRL tried to merge. 
                       
                      “they were told the other group was out to get them” – could well be true that administration said that.  But the other group probably was indeed out to get them.

                    • zgozdeozkan_315

                      Member
                      December 28, 2019 at 4:00 pm

                      Sure seems like loyalty has taken a backseat to money in almost all of the current physician-hospital interactions. As much grief as the older generation gets for taking the corporate deals, I understand why they do it. Who in their right mind would trust any of the hospitals/health care organizations to not sell off their livelihoods to the highest bidder?

                    • arinakost99_755

                      Member
                      December 28, 2019 at 4:09 pm

                      Completely agree.  I assume because MBA’s are now running hospitals.  When I started, St. Mary’s (Milw) was still run by nuns.

                    • Unknown Member

                      Deleted User
                      December 28, 2019 at 4:34 pm

                      Nothing wrong with merging two groups in theory. In practice, mergers are complicated by personalities.

                      There really is no such thing as a merger. The vast majority of the time one group is taking over the other.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 4:56 pm

                      Quote from boomer

                      There really is no such thing as a merger. The vast majority of the time one group is taking over the other.

                      yeah, MRL thought they could take over WRS.  WRS wasn’t having any of that.  So both MRL and WRS were left in the lurch.
                       
                      I remember the University of Minnesota Hospitals and Clinics’ “merger” with Fairview Hospital.  The new sign outside of the U of M Hospitals reading “Fairview-University Hospital” really clarified how much of a merger it was.

                    • Dr_Cocciolillo

                      Member
                      December 28, 2019 at 5:07 pm

                      The ascension contract was going to go to premier / ADI almost regardless. Had the groups merged there would have been excuse A ; had they not , would have been excuse B. Based on someone i know , WRS was run by a board and not by by shareholders with a lot of inaccurate information being passed down by the former president who left 6 mo later and took a salaried job at ascension. Very different from mrl.
                      In the end , it only takes 1 group to unable this to happen. From what I understand , mrl gave ADI the finger while WRS welcomed them

                    • Unknown Member

                      Deleted User
                      December 28, 2019 at 7:25 pm

                      Most pp radiology groups are confederations; not a cohesive republics. 
                       
                      Leadership is typically weak; so they potentially dissolve easily.
                       
                      Think of the Articles of Confederation. Thomas Jefferson wanted to preserve state’s rights. Like TJ, radiologists like a weak central government.
                       
                      There would be no USA without Federalism.
                       
                      Most pp groups are like preconstitutional America; they want weak central government; so are prone to take over and failure.
                       
                      It’s not personal; it’s just the system.
                       
                      That’s it. 
                       
                      My history lesson may be somewhat obtuse; but is as I understand it.

                    • Patrick

                      Member
                      December 28, 2019 at 8:45 pm

                      Most, but not all.

                    • ingatodorski_175

                      Member
                      December 29, 2019 at 8:51 am

                      I started another thread, but anyone in here who can give me more info on MRL, please pm me. Thanks.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 4:51 pm

                      xxx

                    • arinakost99_755

                      Member
                      December 28, 2019 at 4:42 pm

                      Quote from MinnieB

                      Actually WRS joined ADIs bid for the contract which is why ADI got the contract.

                      Just realized ADI is Premier.  I only knew it as Premier. 
                       
                      What you say about how it went down could be correct AFAIK.  It just wasn’t quite how I understood that it went.

                    • arinakost99_755

                      Member
                      December 28, 2019 at 3:55 pm

                      Quote from AlexMorph

                        Every radiologist I met there seemed great.

                      That was my experience.  WRS was an straight shooting, fair group of people.  Most put doing quality work and being good people over money.

                    • 122276695

                      Member
                      December 29, 2019 at 9:48 am

                      Quote from Eko

                      I’m no longer with WRS but I’m fascinated that our business is a ‘national’ topic. You’ve got good sources.  You’re obviously talking to someone in WRS or you’re a WRS rad.

                      Quote from Overraded

                      If someone in Wisconsin has more info please update us.

                      MinnieB has good info.

                      Quote from MinnieB

                      From what I hear WRS’s subcontract with ADI was reasonable in terms of keeping local control and revenue

                      At the time and at least to now AFAIK, you are correct-no change in control or revenue.

                      Quote from MinnieB

                      (it was a voluntary arrangement they signed onto ostensibly to ‘keep’ the Ascension contract, .

                      “Voluntary” as in do you want to keep your job or not. 

                      Quote from MinnieB

                      although clearly not well thought out by WRS).

                      Not sure what we (WRS) could have done differently.  As explained by others, deals were being made above our heads and out of our control.

                       

                      Excellent thread. Synopsis of radiology across the US at several levels. While this is the Midwest, similarities apply to east, south and west, just different entities. 

                      Yes, there is an abundance of insider information out there. Quite detailed in fact. Im sure my experience is similar to other rads. Fortunately, Im content in my practice. However, many of my good friends and colleagues are not content. I, like most of you, have friends and colleagues in radiology working in different practice environments around the country; corporate, private equity, private practice, VA and academic. Everyone talks. Most details are reviewed through individual discussions and not posts. There is substantial detailed information on many groups, out there in the unwritten/unspoken world. Unfortunately, most of that information is not available to docs changing jobs/locations or those coming out of training.  There will never be full disclosure from groups hiring. Many groups are using bullying tactics and fear of financial loss or litigation to prevent open and honest dialogue. Well see how things go as increasing details become available to the ACR and congressional leaders. Many of those I talk to feel the ACR has become biased as private equity increases its foothold on the organization, intentionally. I still hold out hope for the organization to do the right thing. 
                       
                      Many of those looking for positions are calling as many docs as possible. This is where details of the position are reviewed, privately. There are plenty of open positions out there. It is critically important to do ones due diligence to an entirely new level given the intentional lack of transparency in many practices these days. All the more important reason to review details closely and obtain an appropriate contract. That being said, there are so many unknowns, most groups will not know their construct 3-5 years from now given the significant changes and rate of change in radiology. We, as a profession, are to blame for our commoditization. 
                       
                      Tough sledding in WI for the next few years. With the good payer mix in WI, look for even great levels of corporate and private equity sell outs/takeovers. Hospitals in WI are also on the 2020 shopping list. Good luck!
                       
                       
                       

                    • mario.mtz30_447

                      Member
                      February 18, 2020 at 12:09 am

                      Any significant updates on this thread?  
                       
                      How are WRS and MRL doing relative to before and relative to ADI?
                       
                      I realize theres a separate MRL thread going right now. 

                    • Unknown Member

                      Deleted User
                      February 19, 2020 at 5:22 pm

                      ADI is sold to RP. WRS has a subcontract which expires in a year or so and then will have to negotiate with RP. MRL is still working under their own contracts and slowly phasing out of Ascension sites. 

                    • Dr_Cocciolillo

                      Member
                      February 19, 2020 at 5:52 pm

                      Correct.
                      Mrl is not affected by ADI yet other than giving up sites
                      WRS is selling no change to their applicants but there is going to be a significant downward restructure of their contract in 15 months. A few IRs are jumping out

                    • jdod05

                      Member
                      February 19, 2020 at 5:59 pm

                      Supposedly, WRS contract auto-renews.

                      From what Ive seen/heard WRS post- ADI is operating the same as pre-ADI.

                      MRL has been having a hard time staffing… asking WRS to loan back MRL rads that joined WRS.

                    • Dr_Cocciolillo

                      Member
                      February 19, 2020 at 6:25 pm

                      ADI got sold to RP. The multiple of the WI contract was just paid to the ADI principles.
                      WRS contract will auto renew at RP paying 40- 50 percent less per wRvu in summer 2021.

                      Inquire about recent departures

                    • hiba

                      Member
                      February 19, 2020 at 6:36 pm

                      isnt it ascension who decides who to award the contract to? Who is to say that WRS doesnt get the contact back now that they are almost 45 Rads?

                    • Unknown Member

                      Deleted User
                      February 19, 2020 at 8:15 pm

                      You are either a MRL recruiter or an undercover RP informative. Either way, based on your posting history that’s depressing.

                    • Dr_Cocciolillo

                      Member
                      February 19, 2020 at 9:45 pm

                      Take whatever youd like from these posts.
                      Lots of information and tools provided for any candidate to do due diligence.

                    • jdod05

                      Member
                      February 20, 2020 at 6:29 am

                      Wisdom, since you seem to know so much about WRS, why dont you tell us about recent departures?

                      While youre at it, how about giving the names of recent departures at MRL and names of rads who left MRL to join WRS?

                      Id ask for names of rads who left WRS to join MRL, but everyone in Milwaukee knows there are none.

                      FIRST NAME something or other will suffice.

                      To rads who have to work in Milwaukee: Good luck making heads or tails of the situation.

                    • btomba_77

                      Member
                      February 20, 2020 at 6:37 am

                      Hmm.. who am I going to trust?!?!
                       
                      Wisdom, the guy who’s been regularly contributing to Aunt Minnie in a good faith manner for a decade or more.
                       
                      Or a combination of three brand new AM members, with a combined post total of 25 between them who all just happen to pop up simultaneously to comment about Milwaukee.
                       
                      It’s a conundrum.

                    • jdod05

                      Member
                      February 20, 2020 at 6:51 am

                      I think its interesting to hear another side.

                      But, since you put it that way… go with Wisdom.
                      She/he must be telling the truth.

                    • mario.mtz30_447

                      Member
                      February 20, 2020 at 8:01 am

                      Quote from wisdom

                      WRS contract will auto renew at RP paying 40- 50 percent less per wRvu in summer 2021.

                       
                      Is this as bad as it sounds?  Or will there likely be negotiation so this doesn’t happen?  I can’t imagine this actually being acceptable in this market.  

                    • Dr_Cocciolillo

                      Member
                      February 20, 2020 at 9:25 am

                      Rp already paid out the 40 percent premium to ADI principles x a big multiple.
                      Can cows fly and RP decides to take a loss in this market ? Sure. Could it be only a 30 percent reduction ? Sure. RPs top rates are around 40 percent reduction. Bottom – at 50 percent. Anything is possible in theory.
                      I hope its only 10-20 percent

                    • jdod05

                      Member
                      February 20, 2020 at 9:29 am

                      ADI Tennessee? Or WRS/ADI Wisconsin?

                      Supposedly, WRA/ADI Wisconsin has never been in talks with RP and operate independently from Tennessee.

                    • mario.mtz30_447

                      Member
                      February 20, 2020 at 12:36 pm

                      Are MRL and WRS just two of a number of sizeable Milwaukee groups, or are these the main players?

                    • jdod05

                      Member
                      February 20, 2020 at 12:58 pm

                      They were/are the two largest private practice groups covering Southeastern WI.

                    • Unknown Member

                      Deleted User
                      March 20, 2022 at 6:33 am

                      Bumping an old thread.

                      Looking to possibly move back to Milwaukee and may begin the job search.

                      Any updates on WRS and MRL? Sounded like pretty dire predictions back in 2020. What has happened since?

                      Much appreciated.

                    • thanos.grivas_294

                      Member
                      March 25, 2022 at 11:11 pm

                      Seems like both groups are around still, but don’t know much. Bumping this because I’m curious.

                    • smfst7_929

                      Member
                      August 30, 2022 at 9:39 am

                      Is premier radiology radiologist owned? Is this a good group? Eat what you kill PP and shared equally without skim job?

                    • chinmayadeepak

                      Member
                      August 30, 2022 at 5:47 pm

                      Premier is an RP practice. Im pretty sure

                    • doctorwych

                      Member
                      August 31, 2022 at 3:06 am

                      Premier Radiology is the name of the joint venture Ascension outpatient imaging centers, co-owned by Ascension and radiologists. In WI, Ascension is an 80% owner, WRS is a 10% owner, and RP (ADI TN) is a 10% owner.

                      WRS is a radiologist owned PP which covers Ascension SE WI hospitals and clinics (except Franklin which is covered by MRL). WRS is not RP. ADI TN is RP.

                    • alkhaldiraghda_487

                      Member
                      September 8, 2022 at 9:53 am

                      Although WRS is a radiologist owned PP which covers Ascension SE WI  the Ascension contract was assigned to ADI (now owned by RP) and is  subcontracted to WRS.  Negotiation between RP and WRS will be interesting to watch going forward…