Rely on professional management

In the old days, Busch says, administration handled financing, human resources and other mainly clerical duties, and the radiologist was free to just perform radiology.

"But now it's mixed, and a radiologist has to be a radiologist and a manager."

But the problem is "nobody has time and education for management," Busch observes. "And often it's an add-on job to daily work to a radiologist, and if the radiologist is working hard in his interventional room until 7 or 8 p.m., there's no time for management, and it can't be done in a professional way."

Rather than putting off quality control, staffing issues and other factors to end-of-day working groups, Busch recommends bringing in a consultant, or, if the department is big enough, a full-time employee -- like Busch's economist.

"Management, especially if you are not too small a size, needs a person who specializes in this," he says.

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