RFPs - A Waste of Time?

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Hospitals and other medical facilities often utilize RFPs or RFQs (Request for Proposal/Quote) as a means of acquiring goods and hiring service providers. We understand, some municipalities, county, state, and federal organizations are required to do so. But for many, it's a process they may not be required to do, but have always "done it this way.”

RFPs are thought to streamline the purchasing process and level or measure the playing field between competing companies. While this may be true for acquiring new equipment or securing janitorial, grounds or linen services, RFPs are likely not the wisest choice when it comes to choosing a teleradiology partner.

You wouldn’t use an RFP to hire a physician or business partner, so why would you use one to determine if a physician partner group is a right fit for your facility?

If the goal of an RFP is to gather the necessary information to make the best decision in your purchasing and hiring practices, then you need to make sure the questions you’re asking are getting to the heart of what you need to know:

  • What kind of services does the company provide?

  • Are they reliable and can they back up their claims?

  • Do they have a good retention rate for current clients?

  • Are they focused on elevating patient care?

In our experience, an RFP will get you a TON of information – but the time it takes to gather that data and the subsequent analytical effort to get the answers you need is not worth the FTE hours required.

Moreover, the utilization of an RFP generally doesn't produce the result of a "shared mission/shared vision" that the hiring facility is hoping for. Remember, you are seeking a partnership, not a transaction. With this in mind, we suggest an alternative method for finding the right fit.

A Better Way to Find the Right Fit

The labor-intensive process of using an RFP often results in 2-4 potential options to present to the hiring/awarding board. This alternative method can help you get to those 2-4 much more efficiently. If you go through this process you will wind up with the important information you need to make a wise decision. It will also save time collecting and analyzing the information derived from many unqualified bidders, saving several FTE resources.

We recommend sending out a three question pre-qualifier survey (yes, you read that right, just three questions), to narrow down the pool of providers and quickly move you to the oral interview portion of your hiring process.

Question 1.) What percentage of your present tele-radiology volumes are from:

  1. radiology group clients ____%, b.) hospital clients ____%, c.) other clients ____%  


REAL Radiology’s Answer: Radiology group clients 40%, b.) Hospital clients 40%, c.) Other clients 20%  

Reasoning for this question: Not all teleradiology companies serve the same client base as others.


For instance, you should be aware if the teleradiology company you’re hiring to service your emergency department works primarily with urgent care clinics. A teleradiology company that works primarily with urgent care clinics will be heavily focused on reading x-rays. However, an emergency department or similar hospital facility will require a great range of expertise for CT, CT body scans, CT head, neck, spine, etc. Asking this question gives you insight into the range and experience of the services provided. Using this survey, you want the first two categories, "radiology groups", and "hospitals", to hold the majority. If the “other” category shows a 75-90%, it should prompt a follow-up question to determine if that potential partner is the right fit and can provide not just speedy x-ray reads, but also more complex radiology services.

Bonus tip: Be wary of promises of speed. Teleradiology companies that have “fast,” “quick,” or “rapid” in their name or tagline are typically referring to reading x-rays. If your facility requires support for the hospital, multi-modality emergent, and critical reads, be sure to question these companies about their experience working with clients outside of the urgent care sector.

Question 2.) What is your retention rate for your radiology group and hospital clients represented in question 1?

REAL Radiology’s Answer: 100% retention rate of Radiology Group / Hospital (employed-model physician) clients.  

The reasoning for this question: Quickly determine if the bidder has lost accounts due to service-related problems.

You want to know if your potential teleradiology partner has a marred track record. Have they lost accounts because they grew too quickly and couldn’t cover the workload? Have they had service-related TAT delays that resulted in the loss of clients? Quality issues? If there are issues with retention, they most likely have not mended the deeper issue. If they say they have, how will they keep the issues from recurring?

Watch out for bidders who have (for any number of reasons) a.) not been able to support the customer's contracted coverage hours, b.) had to ask their customer (rad group or hospital) to help provide their own coverage for a season, c.) not been able to cover and know their customer (rad group or hospital rads) were called in by the hospital ED staff.

Unfortunately for the industry, many of the larger teleradiology companies have been failing in this respect. And their client retention rate is suffering as a result.

Question 3.)  If the answer provided in question 2 isn't "100%”, please explain the reason for the loss:

REAL Radiology’s Answer: Not applicable for REAL Radiology as we have 100% retention.

Reasoning for this question: If the reason of the client-loss wasn't due to the facility/group being acquired or bringing their after-hours coverage in-house, then this question will get to the root of the issue.

The answer to question 2 may not knock a teleradiology company out of the running if the answer isn’t 100%, but as you're doing your due diligence, understand what caused the bidder's client-loss. Was it turn-around-time issues? IT/Integration issues? Quality issues?

In the teleradiology world, there are only a handful of companies capable of handling the numerous IT integrations, 24/7/365 customer support, 24/7/365 physician accessibility, coverage (state licensures), credentialing, AND have 100% client retention. REAL Radiology is one of them. (link to http://realrads.com/real-radiology-services-teleradiology/)

The Underlying Question for Your Hiring Process:

Does an RFP process allow you to select the best teleradiology company for your needs?

To answer this core question, you need to determine if teleradiology is a staffing question or a purchasing question.

RFPs are driven out of purchasing, not HR. So, are you approaching the hiring/selection process as if you’re going out and hiring a radiologist using a physician board or HR group within a hospital, or are you putting together an RFP, which is a purchasing decision?

Remember, you are hiring for a physician partner group that is going to enable you to provide better care to your patients and improved quality of life for your radiologists & care providers. This requires a completely different process than an acquisitions decision. It is the difference between entering into a partnership and conducting a single transaction. You not only need to make sure the partner group is reliable and cost-competitive, but you also need to make sure you are in alignment with your mutual goal: The elevation of patient care.

If you grind the selection process into an arduous or even "cookie-cutter" RFP, you are potentially missing out on this crucial alignment of goals.