Picture this: A radiology practice with physicians scattered nationwide and all highly skilled at the same thing, reading musculoskeletal MRIs. That's a description of Brentwood-based Radsource, founded in 2001 by two former radiologists at Saint Thomas Hospital.

 

"We recognized the need for focused subspecialty expertise for MRI interpretation," said Radsource President Mark H. Awh, MD, who launched the company with Michael E. Stadnick [cq], MD, now Radsource's medical director. "It turns out that there's just a wide disparity and level of training and experience out there in most communities when it comes to MRI interpretation, particularly musculoskeletal MRI interpretation. We saw the need for a company that could provide a higher level of quality and focus."

 

Awh noted that radiologists in most practices and particularly those in hospitals handle "a little bit of everything," from a barium enema or CT scan to a biopsy or MRI. Yet musculoskeletal MRI reading can be tricky business, and some radiologists are simply better at it than others. Some also boast additional training for the job.

 

"We take radiologists who are expertly trained to begin with, and on top of that, we require them to have clinical experience beyond their fellowship training," Awh said. The company requires a minimum of three years' experience after training, but most of Radsource's radiologists have 10 or more years of clinical experience. Radsource requires that all candidates visit the Brentwood headquarters, where they are asked to interpret MRI test cases. "It's a little bit scary, in some respects," Awh said. "We've had Ivy League section chiefs of musculoskeletal imaging, people who are at prominent and well-known institutions, who fail that test. You can't tell by looking at somebody's resume whether they're going to be good at it."

 

Radsource offers outpatient imaging clients 24-hour turnaround at the maximum. Usually, images received by Radsource in the morning are interpreted and reported to clients in the afternoon. From Saint Augustine, Fla., to Corona, Calif.,  clients are predominantly orthopaedic practices and imaging centers and aren't hospitals. The company serves about 40 locations, including Middle Tennessee's Tennessee Orthopaedic Alliance, Premier Orthopaedics and Elite Orthopaedics, plus large orthopaedic groups in Knoxville, Johnson City, Memphis and Chattanooga. Clients are billed a global fee for the MRI interpretation, and Radsource doesn't deal with third-party payers directly.

 

Radsource uses PACS (picture archiving and communications system), which allows radiologists at multiple locations to access and share MRIs. "We have a highly developed PACS infrastructure," Awh said. Radsource's data center is housed in the old Service Merchandise building in Brentwood and is earthquake tolerant.

 

Most of the company's radiologists work out of their homes, with the technology and training provided by the company. Thus, lifestyle is a primary recruiting tool. "When we put out a job opening on our job listing sites, we'll get 50 or 60 applications from around the country for every spot that we ever have open. We're able to pick from the very best that are out there," Awh said. Plus, there's no call work and no weekend commitments. "It's a no-commute job. I often joke that someday I want to have the job that we offer others," he said. The nature of the work also lures radiologists anxious for a challenge. "In a year working at Radsource, you might see things that other people might never see in their career," he said.

 

Radsource employs 16 physicians, including Awh and Stadnick, who simply double-click on a client's image to accept the case. To establish a rapport with clients, radiologists typically serve the same clients over an extended period of time. When presented with a difficult interpretation, second opinions are a click away. "Within half an hour, I've gotten eight or 10 expert opinions from around the country on a case. It allows a degree of collaboration and sharing that's pretty much unheard of in the industry, and that's another thing that allows us to be more accurate in what we do," Awh said. "Even if you're working alone in Oregon in your pajamas, it still feels like you're in practice with other radiologists." And he added that clients recognize how the collaboration of Radsource radiologists improves their ability to serve to patients.

 

Radsource doctors also collaborate with clients on research initiatives. For example, they have worked on research and education of fellows from all over the world regarding hand transplantation, thanks to the company's association with Kleinert Kutz, MD, [cq] the noted University of Louisville hand surgeon. The Radsource radiology team has collectively written about 350 peer-reviewed articles, numerous textbooks and book chapters and speak frequently at industry gatherings.

 

Radsource is also the host of the company's highly acclaimed MRI Web Clinic, which features a different musculoskeletal MRI each month, asking viewers to interpret the image and come up with a diagnosis. At the end, the diagnosis is revealed, making Web Clinic a popular educational tool. "It has become one of the most popular resources for musculoskeletal MRI on the Internet. We get thousands of hit from all over every day," Awh said.

 

A vast majority of the MRIs interpreted by Radsource physicians are sports-related injuries. In fact, more than 400 sports MRIs pass through the company system each day, leading Awh to says that the company's physicians interpret "a greater volume of sports pathology than any academic center in the country."

 

Radsource is associated with Dallas-based United Surgical Partners International, an ambulatory surgery center company. For more information, visit www. radsource.us.