At Radiological Associates of Sacramento (RAS), the policy and financial decisions are made by a 50-member board of directors that meets monthly and by a 12-member executive committee that meets once a week, according to executive vice president Fred Gaschen.

According to RAS president Michael K. Haseman, MD, newly hired doctors are put on a 2-year track to partnership. "During that 2-year period, you get to decide if you really want to stay here, and we get to decide whether you're able to cut the mustard," says Haseman. Once the probationary period is over, the new doctors can buy in as partners. They then share in the ownership of the physical plant, the technical equipment, and the company's other assets. RAS prides itself on the fact that all its doctors, regardless of specialty, are paid the same salary and have the same vacation allowance. There are now 51 RAS partners who serve as members at the board of directors.

The board makes decisions on capital outlays for new equipment. "Capital equipment requests come up through the divisions. Basically, pro formas are done. The requests are whittled down by the finance committee, and the board decides," says Haseman.

Haseman says RAS has been able to fund imaging equipment for its diagnostic, nuclear medicine, and radiation oncology divisions without much competition between the three divisions and without a denial of one in favor of another. "It has been fairly objectively looked at based on the benefit to the entire organization," he says. "We've been lucky that there has been no head-to-head competition where one group had to be voted down. There is the potential for that to happen. We've been successful enough that we've been able to stay on the cutting edge as new technology is introduced."

George Wiley is a contributing writer for Decisions in Imaging Economics.