Take a linear accelerator, for example. We are talking a couple of hundred thousand dollars in vendor costs, plus the service contract on the entire system is between 170-250 thousand dollars a year. So you are already in that 400-500 thousand dollar price range just to get something moved.

DMN: Was there also an appeal factor that new equipment might have for the facility?
MW: We wanted to upgrade and talked about it, but we thought we'd do it after we moved. But because Accuray's TomoTherapy received U.S Food and Drug Administration approval, and coincided with our building opening, it was perfect timing. And staff adopted TomoTherapy quickly. We knew we could pull it off.
DMN: What new modalities did you add?
MW: Radiation therapy equipment stayed in numbers about the same, but the radiology department is easily three times the size it was before. We have CT, nuclear medicine, an interventional suite and MRI.

DMN: Why did radiology increase?
MW: Because we were outsourcing patients — it's a revenue discussion and also convenient for patients. For example, we had a big discussion about MRI — people were skeptical if we could support it. We have 20 docs and 14 are medical oncologists. It doesn't take long to realize you are sending patients out for MRI, and every time they have to make the trip, it's inconvenient for them. The imaging was inevitable, that it grew the way it did.

DMN: What has your patient load been like?
JB: For the TomoTherapy unit, we are at about 43 patients. On the conventional linear accelerator, we are at roughly 23 patients. Since moving into this building, our patient load has almost doubled. It's a significant increase.

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