10 minute read
Get to Know... Guy Messer, Vice President of Radiation and Radiology Services
How long have you been with AON?
3½ years.
What does a “day in the life” look like for you in your role?
As general manager of AON’s Radiology and Radiation Services (R&R), much of my role has transitioned in the last three years from day-today operational oversight of existing radiology locations to the development and expansion of services for both existing and newly onboarded practices. As AON continues to grow, the development side of my role has evolved into a larger component of my day-to-day activities. Tasks like forecasting, financial analysis, project management, physician relationships, revenue cycle support, payer contract review and the new services development now fill up more of my time. Fortunately, we have established an excellent team of local radiology and radiation managers who effectively manage the day-to-day operations of their particular facility. I feel very fortunate to have such a talented team of managers and couldn’t be prouder of their performance.
What goals are you and your team working to achieve?
We just completed an extensive review of our radiology standard operating procedures (SOPs) with input from all AON’s radiology managers. As a result, revised radiology SOPs have been uploaded into our internal system, and widespread consensus has been reached from all AON’s radiology facilities. We will look to do the same for radiation over the next 12 months as we grow our technical staff and human capital in that segment. We also recently achieved approval for Radioligand Treatments (RLTs) at our final radiology location in Georgia. With this approval, all our radiology locations have added RLTs to their Radioactive Materials License to bring this important treatment for prostate and neuroendocrine tumors to their region. This also sets the stage for future approvals of new RLTs currently under development for such indications as breast, lung and colorectal cancers and lymphoma.
How does your role contribute to AON’s overall mission and goals?
AON’s primary mission has always been to support the needs of community oncology practices so that they can continue to provide lifesaving cancer care to their patients where they live and in the most efficient and cost-effective ways. AON’s radiology and radiation services support this mission by directly bringing important diagnostic and treatment technologies to where this care is provided. In addition, we can provide these services more efficiently and at a lower cost than hospitals can — sometimes at half the cost. We also have the added benefit of providing these services in-house, thereby reducing one more stress our patients have to endure in navigating larger institutions while improving access to schedules and results for our physicians. My role is to expand these services to all practices, where it makes reasonable financial sense, and continually improve the efficacy and efficiency of our existing R&R operations.
What are you most proud of when it comes to your team and department?
While we have achieved so many milestones in the nearly four years of my tenure, I am particularly proud of the work we’ve done surrounding radioligands. I’m grateful to AON’s physicians and executive leadership for recognizing its value and allowing AON to be an early adopter of this technology. RLTs involve tagging therapeutic radioisotopes to ligands or molecules designed to target specific cancers. The ligand drags the isotope to the cancer and then the isotope administers therapeutic levels of radiation directly to the area of interest. One example is a currently approved RLT from Novartis called Pluvicto which binds Lu-177 (a beta-emitting isotope) to a PSMA (prostate-specific membrane antigen) targeting ligand effectively creating a cruise missile that goes directly to prostate cancer. It was approved for recurrent late-stage metastatic prostate cancer's post-androgen deprivation therapy and taxane chemotherapy. However, Novartis has already submitted to the FDA to expand its use in pre-taxane situations based on positive clinical trial data. I would hope to see an expanded indication in the notso-distant future. This RLT concept has been the goal of nuclear medicine for 40 years, but the technology to bind the necessary ligand and isotope is only now coming into its own. I’m excited to see where this technology will lead as there are 30-plus companies with RLTs in various stages of clinical trials. I believe we will see an explosion of treatment options over the next three to seven years with some new ones likely to receive FDA approval as early as 2025.
What principles guide your work and vision?
Always strive for more knowledge and be cognizant of your approach toward your role and its responsibilities. In other words, allow your day-to-day actions to be driven by one major principle: make decisions as if the business were your own. I spent 20 years making those decisions for myself and my business, and when I joined AON, I found it difficult to turn that decision-making process off. What I discovered was that by applying those same principles in my role at AON, I seldom made a decision that I regretted. By implementing an “ownership” attitude to my everyday decisions, I typically choose a lower-cost option when purchasing supplies. I recommend projects to the executive team with higher margins or could at least justify proceeding ahead with lower-margin deals. I think twice before approving expensive purchases and consider how this purchase will advance our goals. I also ask important questions. Do we really need to hire that additional staff member, or is the recent increase in business activity transitory in nature? Finally, I try to instill these same principles in the managers who report to me as they make many decisions daily that I’m never involved in. Developing an entrepreneurial spirit in our managers not only benefits AON but sets up the individual for success in their future endeavors.
How do you define the word success?
Is the organization better off with me on the team than before I joined? Have I imparted my skills and experience to make the organization more successful in its mission? Finally, have I helped establish a platform for continued success even after I’m no longer part of the organization?
How do you lead your team? What is your leadership style?
I’ve worked hard over the years to move away from the general micromanager in me and instead, develop managers with strong supervisory skills. I try to encourage the R&R management team to view their actions and decisions through a looking glass that measures whether each choice is the right thing to do and serves the organization’s interest. I also strive to seek input from my reports on most major decisions and, where possible, consensus. This, typically, leads to more widely accepted outcomes. In the end, however, I’m tasked with making many difficult decisions within the scope of my responsibility, even if those decisions are unpopular. An effective leader needs to be prepared for those situations and willing to stand by their choice if they believe it's right for the organization. Leaders not only manage their operations, but they also keep vigil for situations that can harm the organization. If I fail to implement a service agreement for this expensive piece of equipment, I could save the company a lot of money. But what risk am I subjecting AON to? Will an unexpected repair cost more than the savings achieved by foregoing the service agreement? Can I go one more year with this PET/ CT scanner even though the manufacturer no longer makes parts for it? If I choose that path, how do I repair it in the event of mechanical failure? Does the potential patient volume justify purchasing an expensive imaging device? Are we inadvertently billing for procedures inappropriately, which may result in a large clawback from our payers down the road? These questions keep a good leader up at night, and I try to make the right choice in these situations in hopes of getting a good night’s sleep.
What’s your favorite part about working for AON?
I’m grateful for the opportunity to grow AON’s R&R business and the relatively long leash I’ve been given to do so. Since I’ve been with AON, we’ve gone from three radiology locations to six and added three radiation facilities. Over the next six months, we’ll add at least four more radiology locations. While this is very similar to what I’ve done in my previous business life, I am truly enjoying the widespread geography of this growth. Most of my experience was centralized in Georgia, and now I have the opportunity to participate in this expansion of services across the country.
What has been the most memorable moment for you while you’ve worked for AON?
While becoming more frequent, one of the first memorable moments for me at AON was seeing the PET/CT department open at Messino Cancer Centers in Asheville, North Carolina. This was the first AON PET/CT center I was involved in from the ground up. We didn’t acquire it as a pre-existing facility or as part of a practice acquisition. In fact, Messino had to pursue a Certificate of Need (CON) from the state to gain approval to install the PET/CT. This is a lengthy legal process that I had experience with, and I was able to provide some insight into Messino’s CON application. I’m pleased to say that Messino is now one of the busiest PET/CT facilities in the AON portfolio.
What motivates you to get up and get to work in the morning?
Accomplishing something meaningful. Whether implementing a new diagnostic imaging scan or radiation treatment, growing a segment of the business or expanding operations into a new territory, there is nothing more satisfying than looking back and thinking that there was nothing here before I started and now something meaningful has been established. Patients now have access to care and treatments that were previously unavailable, and new practices are enjoying the benefits that AON has to bring.
What is a quote you live and/or work by?
“Therefore, do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” – Matthew 6:34
What are your favorite hobbies outside of work?
While not necessarily my favorite hobby, it seems that home improvement projects have become my wife’s favorite hobby for me, and I hate HGTV.
What is your favorite book (or books)?
Anything by Dean Koontz.
What is a fun fact about you?
My grandfather shot the sheriff, but he did not shoot the deputy. Ask me sometime and I may tell you the story.
What piece of advice would you give your younger self?
See answer to #12.
List three adjectives that describe your personality.
Opinionated, stubborn, compulsive. But I work hard to soften the edges on all of these and convert them to more positive traits.
What is one of your favorite travel destinations, or where do you hope to travel to in your lifetime?
Western Europe.
Who is your hero?
I don’t have one particular hero, but I’ve always had great admiration for people like Elon Musk who manage to accomplish more by themselves than with ten other people.
If you had three wishes, what would they be?
That my three children live a better and more fulfilling life than I did. I think all parents want that for their children.
