Radiology and imaging can be a successful business that can earn lots of profits if managed efficiently. Despite huge investments in cash and efforts, (Okaro and Ohagwu 2010: 324) identifies several other challenges which may face private medical imaging practices such as poor infrastructure, unstable economic climate, poor business and managerial skills just to mention a few. However, Yousem and Beuchamp (2008: 22), states that these challenges can be overcome with adequate attention to technology, capital planning, business planning and finance, entrepreneurship development and operational efficiency, and the fact that failure can be minimized and growth maximized.
Given the cost, complexity, and skill requirements of radiologic services, the sustainability of radiology in developing countries has been a long-standing challenge (Daniel et.al. 2010:496). South Africa is also a developing country, the curriculum of allied health professionals particularly radiographers, has very little emphasis on business skills and entrepreneurship, therefore qualified radiographers do not possess skills and ‘enterprising attributes’ to open their private radiography departments. According to Kneale (2011: 5), enterprising attribute refers to people who are innovative, inventive, and think outside the box, people who are the best in a tough market, good at communicating ideas, enthusiastic, professional, ethical, persistent, committed, driven and multi-tasking, while Martin & Sugarman, (1996) and Chell (2007) in Farmer and Kilpatrick (2009:1652), define entrepreneurs in health sciences as individuals who make opportunity where others do not see. They describe opportunities as mental constructs, with entrepreneurs envisioning what might happen and how to realize it.
Entrepreneurship studies in Radiology, particularly in South Africa have centred mainly on the Radiology business for radiologists. There has been very little or no focus at all on radiographer’s point of view, regarding radiographic imaging business as far as literature is concerned. This necessitates the need to investigate the perceptions of radiographers’ view on this issue.
Bellalize Steenkamp (ref), has identified insufficient codes and fees that do not include equipment and practice costs as the primary barrier for radiographers who might want to open their private practices, she states that the cost structure is not representative of the examinations done, therefore it is not financially feasible for Radiographers to venture into private practice. Other concerns include issues with the Radiographer's scope of practice; e.g. contrast administration, examinations such as Barium meals and fluoroscopy examinations. Lack of business knowledge, accounting skills, financing of practices, as well as lack of clarity from the Radiation Board regarding ownership and licensing of equipment were other factors she identified to be a major entrance barrier into private practice.
It must be emphasized that, there has been a number of radiographers who have successfully opened and operated private radiology practices in South Africa, with the aid of teleradiology which was discussed earlier in this report; however there is very little proportion compared to the number of radiographers registered with the HPCSA (Health Professions Counsel of South Africa). This study will focus on Radiographers who have not opened their practices with the aim of establishing their perceptions which will later be used to develop guidelines to help radiographers interested in private practice to do so with fewer obstacles.
PROBLEM STATEMENT
According to Okaro and Ohagwu (2010: 324), radiology and imaging can be a successful business that can earn lots of profits if managed efficiently. Radiographers are one of the few professionals allowed by the radiation board of South Africa to own a license to operate hazardous radiation equipment used to produce X-rays, however there has been very little interest shown by radiographers in South Africa to actively participate in establishing their private imaging practices like most radiologists in the country.
There is no study that has been done in South Africa to explore perceptions of radiographers about entrepreneurship in private practice, specifically opening and managing their own radiography practices.
AIMS/ PURPOSE STATEMENT
The aim of this qualitative phenomenological study is to establish and describe what perceptions prevail within the radiographers employed in the public and private sector regarding entrepreneurship in radiography as a profession.
In pursuit of the aim stated above the following three research objectives have been identified:
- To explore and describe the perceptions of radiographers in public and private practice regarding entrepreneurship in radiography.
- Explore the opinion of radiographers regarding the minimal role played by radiographers in private practice.
To compile a narrative report of the
PHC radiographers on their experiences,
meanings and understandings
of the need for role extension at this
RESEARCH QUESTION
The research question that arises from the problem statement is “What are the perceptions of radiographers about entrepreneurship in radiographic imaging”.
Significance of the Study
This type of study may help us establish whether radiographers perceive the lack of their participation in private practice as a problem, or if they are satisfied as employees and not interested in this type of venture. The study may also assist in highlighting barriers that exist in this industry from a radiographer’s perspective, and also outline the role that radiographers are willing to play. Lastly the guidelines that may be developed may be useful to help willing individuals to open their private imaging centres, especially considering the fact that the current available guideline from the South African Society of Radiographers regarding private practice, is a one page checklist that does not have any guidance or details on process to follow when one considers to open their practice.
METHODOLOGY
RESEARCH SETTING
The study will be conducted in private as well as public diagnostic radiology departments in Gauteng that have information rich Radiographers.
RESEARCH DESIGN
The study will use a qualitative phenomenology design; this will allow the researcher to explore the subjects’ experiences and personal opinions. It also allows in depth exploration of the phenomenon under study (Brink, 2008:113).
POPULATION AND SAMPLING
The population frame will constitute of all radiographers employed by the public and private radiology departments, as well as those that have their own private practices around Gauteng Hospitals, clinics, and medical centres. Purposeful sampling will be used to select information rich radiographers for focus group discussion. Purposeful sampling, another type of non probability sampling enables in depth exploration of the phenomenon under study because participants who are most knowledgeable about the phenomenon under study are chosen (Brink: 2008, 133). Participants will be interviewed until data saturation is reached on a given topic.
Inclusion criteria for participants in the focus group discussion will be
- Radiographers who are able to speak in a group.
- Radiographers who are willing to discuss their professional experiences and share their ideas.
- Individuals who are open minded and have adequate experience to contribute valuable input to the proposed subject.
DATA COLLECTION
The central question for the focus group interviews which will be posed to the participants will be,
- “What are your opinions about entrepreneurship in radiographic imaging, particularly private practice?
- Would you, as a radiographer at any stage in your career consider opening your own private practice?
- In your opinion, what are the challenges experienced by radiographers in opening their private imaging departments?”
The focus group discussions will be audio taped. In addition, field notes will be made by the researcher.
DATA ANALYSIS
The interviews will be audio taped and later transcribed. The transcribed data will then be read to obtain a general sense of the information; the data will then be coded. Themes will be generated from the codes and the meaning of the data will be interpreted (Creswell, 2003:191).
TRUSTWORTHINESS OF THE STUDY
To ensure trustworthiness of the qualitative data the principles described by Murphy and Yielder (2010: 62-67), Guba’s model will be employed, which requires, credibility, dependability, confirmability, and transferability.
Credibility
To ensure reliability, the questionnaire proposed for use will be piloted at a diagnostic radiology department. The results of the pilot study will determine whether any amendments to the questionnaire will be necessary.
Dependability
It will be ensured by extended engagement through conducting focus group interviews until data saturation. Peer reviewing will be done in an effort to collaborate themes. All the data that will be collected will be validated by respondents; participant will also be required to validate data that will be presented in the report. Triangulation using focused group discussions, in depth interviews and field notes, consistent with Guba’s model.
Confirmability
It will be ensured by extended engagement through conducting focus group interviews until data saturation. Peer reviewing will be done in an effort to collaborate themes. All the data that will be collected will be validated by respondents; participant will also be required to validate data that will be presented in the report. Triangulation using focused group discussions, in depth interviews and field notes.
Transferability
Background information about the participants and the setting will be provided to allow assessment of transferability of the findings. This will also be ensured by extended engagement through conducting focus group interviews until data saturation is reached.
ETHICS
Written consents will be obtained from all the participants before they participate in the research study (Annexure A). The purpose of the study will be explained to every participant before commencing with the focus group interviews. Participants will be informed about the procedure to be followed during the focus group interviews and the nature of participation expected.
This research will be planned and executed in a way that will foster justice, beneficences and will exclude harm and exploitation of participants. The participants will be told that they could terminate their participation in the research study if they feel they would not like to continue without any detrimental cost. Participant will be made aware that they would not be forced to answer any question if they feel it would violate their rights and confidentiality.
Authority to conduct the research at participating departments will be obtained from the executive director of each hospital (Annexure B). Ethical approval will also be sought from the University of Johannesburg. Furthermore, the right to justice, equity and human dignity will be observed by treating every participant equally when providing an opportunity to participate.
POSSIBILITY OUTCOMES
It can be anticipated that the results from a study such as this may give insight to an aspect of business and entrepreneurship amongst Radiographers and other Allied Health Professions, and encourage health care professionals to take the initiative of expanding their career paths by venturing, or to an extent enquire further about private practice and entrepreneurship in their respective fields. Furthermore, this study may encourage embedding of ‘entrepreneurship’ (as described in this research paper) in the curriculum of all allied health professions, by learning institutions concerned, this is appropriate since current literature suggests that there is a deficit of entrepreneurial attributes among health workers, stating that this is a primary reason for shortage of adequate health care services globally, especially in developing countries (Daniel et.al. 2010:494).
TIME AND COST BUDGET
Time budget
Cost budget
REFERENCES
Brink, H. (2006). Fundamentals of Reasearch Methodology for Healthcare Professionals. 2nd Edition. Cape Town: Juta & Company.
Daniel, J., Ezana, M., Starikovsky, A., Thelwellc, A., Iosifescud, S., Kimblee, C., Polin, A., Garra, B., DeStigter, K., Short, B., Johnsonj, B., Welchj, C., Walkerk, I., White, D., Javadi, S., Lungren, M., Zaheer, A., Goldberg, B., Lewin, J. (2010). White Paper Report of the RAD-AID Conference on International Radiology for Developing Countries: Identifying Challenges, Opportunities, and Strategies for Imaging Services in the Developing World. American College of Radiography. Elsivier:
Farmer, J., Kilpatrick, S. (2009). Are rural health professionals also social entrepreneurs?. Social Science & Medicine. United Kingdom: Elsevier: 1651–1658
Krefting, L. (1991). Rigor in qualitative research: The assessment of trustworthiness. The American Journal of Occupational Therapy, Vol: 45(3), 214-222.
Kneale, P. (2011). Embedding Enterprise –ways and means, skills for Leeds4Life and R-led teaching. SAAHE Conference, Potchefstroom South Africa. 30/069/2011: 1-20
Murphy, F.J. & Yielder, J. (2010) Establishing Rigour in qualitative radiography research, Radiography, Vol. 16, 62-67.
Okaro, C., Ohagwu, A. (2010). Problems and Prospects of Entrepreneurship in Medical Radiography Practice in Enugu Nigeria. European Journal of Scientific Research. Vol.41, 323-327.
Rushworth, S., Hindle, K. (2000). Global Entrepreneurship Monitor. Swinburne University of Technology. Australia. Pacific Access: 1-60
Steenkamp, B. Radiography Private Practice. . Accessed 07/08/2011.
Yousem, D. Beauchamp, N. (2008) Radiology Business Practice. How To Succeed. Saunders (USA). Elsevier.
ANNEXURE A
FACULTY OF HEALTH SCIENCES
DEPARTMENT OF RADIOGRAPHY
Telephone: (011) 559 6813
Fax: (011) 559 6778
Dear Colleague,
RE: INFORMATION AND REQUEST FOR CONSENT FOR THE RADIOGRAPHERS TO PARTICIPATE IN A RESEARCH STUDY: PERCEPTIONS OF SOUTH AFRICAN RADIOGRAPHERS ON PRIVATE PRACTICE ENTREPRENEURSHIP IN DIAGNOSTIC RADIOGRAPHY
My name is Collen Mbambo and I am busy with my Masters Degree at the University of Johannesburg. I am busy with a study entitled “Perceptions of South African Radiographers on Private Practice entrepreneurship in Diagnostic Radiography”. I wish to request your permission to allow the radiographers at your practice/hospital to participate in this study. The aim of this study is, to explore the perceptions of radiographers about private entrepreneurship in radiology, and to recommend ‘enterprising attributes’ that radiographers should have in order to be able to open their individually owned radiology departments.
The radiographers will be invited to participate in focus groups interviews. During the focus group interviews the radiographers will be required to tell me about their experiences and perceptions about entrepreneurship in Radiology, they will be asked the following questions:
- “What are your opinions about entrepreneurship in radiography?,
- Would you, as a radiographer at any stage in your career consider opening your own private practice?,
- In your opinion, what are the challenges experienced by radiographers in opening their privately owned radiology departments?”
The interview will last for about 1h30 hour/session, the number of sessions are not known at this stage, because it will depend on the discussions.. I will also request participants to help verify my findings by asking them to take a look at my findings and comment on whether they are a true reflection of the discussions that took place during the interview. The results of the study will also be made available to you upon request.
The benefits of participating in the study will include the radiographers being given an opportunity to share their experiences in a positive, supportive environment and to be part of making a positive change to their profession. All participants will be asked to respect and protect one another’s anonymity and confidentiality. The audio tapes will be kept securely and destroyed after 2 years. Only my supervisors, the independent researcher and I will have access to the tapes. The names of the participants or participating departments will not be published at any time.
Strict ethical guidelines will be adhered to throughout the research process and the University of Johannesburg, Faculty of Health Sciences Ethics Committee have approved this study. If you do decide to allow the radiographers to participate, you may withdraw your participation at any time.
UJ Ethic’s clearance number: _______________
My study will be supervised by Ms H Lawrence who can be contacted at the numbers given below.
Mrs H Lawrence 0115596887
I would like to thank you in advance for allowing me the opportunity to make a positive change in our radiography profession. Please do not hesitate to contact me should you require any additional information.
Regards
Collen Mbambo email: [email protected]
ANNEXURE B
FACULTY OF HEALTH SCIENCES
DEPARTMENT OF RADIOGRAPHY
Telephone: (011) 559 6813
Fax: (011) 559 6778
Dear Radiologist/ Head of the Hospital
RE: INFORMATION AND REQUEST FOR CONSENT FOR THE RADIOGRAPHERS TO PARTICIPATE IN A RESEARCH STUDY: PERCEPTIONS OF SOUTH AFRICAN RADIOGRAPHERS ON PRIVATE PRACTICE ENTREPRENEURSHIP IN DIAGNOSTIC RADIOGRAPHY
My name is Collen Mbambo and I am busy with my Masters Degree at the University of Johannesburg. I am busy with a study entitled “Perceptions of South African Radiographers on Private Practice entrepreneurship in Diagnostic Radiography”. I wish to request your permission to allow the radiographers at your practice/hospital to participate in this study. The aim of this study is, to explore the perceptions of radiographers about private entrepreneurship in radiology, and to recommend ‘enterprising attributes’ that radiographers should have in order to be able to open their individually owned radiology departments.
The radiographers will be invited to participate in focus groups interviews. During the focus group interviews the radiographers will be required to tell me about their experiences and perceptions about entrepreneurship in Radiology, they will be asked the following questions:
- “What are your opinions about entrepreneurship in radiography?,
- Would you, as a radiographer at any stage in your career consider opening your own private practice?
- In your opinion, what are the challenges experienced by radiographers in opening their privately owned radiology departments?”
The interview will last for about 1h30 hour/session, the number of sessions is not known at this stage, because it will depend on the discussions. I will also request participants to help verify my findings by asking them to take a look at my findings and comment on whether they are a true reflection of the discussions that took place during the interview. The results of the study will also be made available to you upon request.
The benefits of participating in the study will include the radiographers being given an opportunity to share their experiences in a positive, supportive environment and to be part of making a positive change to their profession. All participants will be asked to respect and protect one another’s anonymity and confidentiality. The audio tapes will be kept securely and destroyed after 2 years. Only my supervisors, the independent researcher and I will have access to the tapes. The names of the participants or participating departments will not be published at any time.
Strict ethical guidelines will be adhered to throughout the research process and the University of Johannesburg, Faculty of Health Sciences Ethics Committee have approved this study. If you do decide to allow the radiographers to participate, you may withdraw your participation at any time.
UJ Ethic’s clearance number: _______________
My study will be supervised by Ms H Lawrence who can be contacted at the numbers given below.
Mrs H Lawrence 0115596887
I would like to thank you in advance for allowing me the opportunity to make a positive change in our radiography profession. Please do not hesitate to contact me should you require any additional information.
Regards
Collen Mbambo email: [email protected]
ANNEXURE C
CONSENT FORM (AUDIO TAPE)
I ___________________________________ hereby certify that I have been informed about the nature of the study entitled “Perceptions of South African Radiographers on Private Practice entrepreneurship in Diagnostic Radiography”.
I have chosen to participate in a focus group interview and give my consent for the interview to be audio taped. The tapes will be kept in a secure location for a period of two years after which they will be destroyed. Persons with access to the audio-tapes will be the researcher, the study supervisors and the data transcriber.
Signed at _________________________ this _____day of ______ 2011
______________________________
Signature of the research participant
ANNEXURE D
CONSENT FORM (FOCUS GROUP INTERVIEWS)
I ___________________________________ hereby certify that I have been informed about the nature of the study entitled “The experiences of radiographers working with PACS and RIS in Gauteng”.
I have chosen to participate in the focus group interview and understand that I may withdraw my participation at any time.
Signed at _________________________ this _____day of ______ 2011
______________________________
Signature of the research participant
ANNEXURE F
CONFIDENTIALITY AGREEMENT
I, ____________________________ hereby declare that I understand and agree to the following conditions with regards to the transcription of the audio recordings.
- I understand that the audio recordings are received for the purpose of transcribing records of interviews held with the participants in a research study.
- I understand that the identity of the participants and any radiology departments discussed as well as the content of the interviews are confidential and may not be revealed.
- I undertake to treat all audio tapes received as confidential content to which only I will have access. I will keep the audio tapes and any copied material securely.
- I will return all copies back to the researcher on completion of the transcription
NAME: ________________
SIGNATURE:________________
DATE: _________________