Dr. Janet Sung arrived in the United States in 1972 with only her CPA husband John and the $200 their native South Korea allowed its emigrants at the time. Fifteen years later, the couple opened their own radiology practice in a renovated Pizza Hut with pink doors in Cheektowaga. She was the only doctor and had only one x-ray, one mammogram and one ultrasound machine. Little did she know, in 2002 the Erie County Legislature would honor the business, then known as Windsong Radiology, as the largest free-standing diagnostic imaging center in the United States - and it has continued to grow, now serving more than 400,000 visits annually at five locations across Western New York.
How did you get started in medicine?
My mother, in her mid-20s, she become widow. I was about 3 years old and my brother was 10 months. In Korea, the ladies never worked. It's always being a housewife. But at that moment, she determined that I wouldn't have to go through what she did. So in her mind, I had to be a professional. When I graduated high school, she said, "If you don't go to medical school, I'm not going to support you." And at that time, without our parents' support, it was severely tough to go to college. You know, Korea at that time was very poor. Scholarships were limited. So because of my Mom, I had no choice. And, you know, medical school is not that easy. You really have to work hard.
How did you choose radiology as your specialty?
Very funny, but I thought radiology would be easier for the female. I thought it was an 8-4, 9-5 job and I thought maybe that's good for families. But in Korea, at that time the popular thing was surgery, pediatrics, OB/GYN - and radiology, ophthalmology were minor fields. So when I told my Mom I'm going into radiology, she was upset. And, of course, I thought radiology would be easier for families, but later found out it wasn't true. But if I were to start all over, I would still choose radiology.
I don't suppose there were too many other women in your classes.
No. We had about 140 kids when I went to med school and about 20 of us were girls. One of my pediatric professors was a female and one histology professor was a female, but the rest were all male. And I didn't have much contact with those female professors, so I would say my role model is my mother and my mother-in-law. When we came to the States, I really needed help with the family and knowing what to do. John's parents, my in-laws, dropped everything in Korea and came to the States to stay with us, taking care of my kids and housework.
How did your journey continue from medical school?
My first job was at Sisters Hospital and then I moved to St. Joe's. At St. Joe's they had 50 percent hospital practice and 50 percent outpatient practice. I realized in the hospital setting, it's not that easy to have much direct contact with the patient. Radiology was usually just take a picture and sit in the waiting room anxious. Plus I was a junior, so I couldn't do things the way I wanted. I always had to ask my senior if it was okay to do this and that.
I started to talk with the patients and I got such good response with that. "Test looks really good. Not to worry." If I found something that concerned me, I wouldn't let them go until I contacted their primary care. And it made me feel good that I could be help. And obviously, if I can answer any questions a patient might have, I do. So I realized that communication with the patient, communication with the primary care, is a huge part of health care. But my senior wasn't very happy with that, so when I got home, we'd talk about our day and my husband said, "Why don't you start your own for radiology?" He kept saying, "You can do that. Let's do it."
And with his CPA background, the two of you were a good partnership.
Yes, and that was Feb. 16, 1987 on Harlem Road. In the beginning, I could not afford cleaning people, so John, after his work, he came to the office and he vacuumed. He shoveled the driveway. We used to clean the office after hours, because we don't know how it's going to turn out to be. You know, save the costs. Without him I couldn't do it. He is biggest part.
What cultural or gender barriers did you experience starting up your practice?
I never think anything is a barrier. Anything is a challenge. A challenge makes you excited and you try to solve the problem. You have to deal with it.
Now the $64,000 question: How did you go from one location and a few machines to five locations and more than 400,000 visits a year?
I don't have any idea. It just happened. It's not because of me or radiologists. It's because of all the people working together. We used to have a suggestion box - that was John's idea - and they gave us many ideas. One example is what we call a crying room among us, but it's kind of a comfort room for the patients. I used to do a lot of pregnancy sonograms and some of them lost their baby, or others may have breast cancer. You just don't want to send them out the door. So one of my girls suggested, why don't we have a comfortable room. At that time the cellphone wasn't popular, so we have a phone there so they could call somebody if they want to. That was a great idea.
Another idea was that we had a lot of patients coming in from Lancaster, so why don't we have another office in Lancaster? Today, we have coffee everywhere, but back then coffee wasn't popular. Somebody had the idea to have a little chocolate in the waiting room. If we think it's a good idea, good for everybody - the patients, the doctors, families - then we just do it. That's how we started. It's not one person's vision, it's not one person's ideas. It's all together, including radiologists, the physicians, listening to them and anyone in the Windsong family.
And you can't make 100 percent happy. So if there were some patients that complained, we'd have a little dinner and we'd listen to them about what they want us to improve. Many problems is that you're focused so much, you lose what's going on in the surrounding areas. So you have to have your core people watching and at the same time you have to always listen to what's going on - to their complaints, their compliments.
Technology is changing rapidly in health care, but it's also very expensive. How do you decide what new technology to include in the practice?
Any time there's new technology, it's for the better care of patients - their comfort, their time, things like that. So whenever there's new technology, I sit down with my doctors and if we view it's a benefit to the patients, we don't hestitate to get the new technology in our practice. For example, with mammograms. First there was 2D: two views. Then with tomo(synthesis), you could see the breast every 2mm or 3mm. We were the first one in the area with it. Another thing is breast biopsies. Before you had to go to the hospital, go through anesthesia, etc. But biopsy at the office is such an easy thing. It can be done within five minutes. Obviously it costs a lot of money, but the expense is a second thing. Consideration first is to the patient's care.
Now we have interventional radiology. It's part of our practice. So many people go to the hospital to get it done, but so much wasted expense and time. It can be done in outpatient. I had always dreamed about it. One example would be uterine fibroids. You used to be only hysterectomy or surgery - not every patient is a candidate - but now it can be treated as an outpatient without surgery, which is huge. Once you have surgery, you have to be out six weeks and you could have complications. As outpatient, you're done with it.
We do a lot of vascular things. My interventional radiologists, now what they're doing, if you have a cancer in your liver, rather than systemic chemotherapy, you can put the CAT scan on the cancer so you only inject the chemotherapy in the cancer. So you don't have to go through all those complications. There are so many new things we can do with interventional radiology.
Another thing I'm very happy and proud of is we're available all the time. If a doctor calls at 5 p.m. to say, "I have a patient in my office who needs a CT scan of the chest because I'm afraid maybe the patient will embolize," we say, "Send them in." We're always available for them.
What advice would you give new graduates just getting started in health care?
I would say put yourself in other peoples' shoes. If you always have a consideration like that, people will recognize that you really give extra to others. I think that's good everywhere, but especially in health care because your'e dealing with many patients who have anxiety. If you really want to do a good job, you really have to have pride and a dedication, too. I went to medical school because of my Mom, but that's really not the right reason, I learned later.
Are there areas of health care you find particularly troubling these days?
Yes, I think there's lots of waste. When I get a bill for one procedure, I say, "How am I going to pay for this?" It's so expensive and I could not figure out why it's so expensive. I don't think it's all direct costs, for care of the patient. It's all other things surrounding it. Someone needs to sit down and analyze and work on that. Our job is taking care of the patients, but many of the physicians spend more time on administration - buildings, insurance companies, getting pre-approvals - those are the things we have to cut down. It's a total waste for doctors. Let the doctors do their job.
Not to put down insurance companies, but when I need an MRI of the spine, why do I need an x-ray first? We know an x-ray of the lumbar spine is not going to show anything, but you end up doing it. There's a lot of education of the insurance companies that's needed. We know what's best for the patient. Let us make the decision, a judgment on that, not according to some protocols. Protocol is a cookbook, but it's not even a good cookbook. You shouldn't just follow the cookbook because everybody's not the same. I'm afraid in the future that young people won't want to work in medicine. It's too much headaches.
What haven't you done that you still would like to do?
If I had written diaries from day one, it would be a big hit. It would be a best seller. That's the biggest mistake I ever made. But at the time, you're so busy. And now, I don't know who has the energy to do that. But we had so many fun memories and people could read it and see how we developed from Pizza Hut to Windsong. It's kind of a history. It was a fun extended family.
You're still involved with the practice, even though you sold it several years ago in order to retire.
Yes, it was time. Then John's health wasn't really good. If I stay here longer, I'm the old people and the old people's vision isn't the same as the young people's vision. The young people have a better idea and it was time to pass along to the young people so they can do better.
I'm busy. I'm an early bird. I get up at 4:30 a.m. and I'm busy until maybe 8 or 9 at night. Retirement is good. I love to travel. I do a lot of exercise. I spend a lot of time at the gym. I used to hate exercise, but once you start. Now, if I don't go, I miss it. I still want to learn how to play piano. Two of my granddaughters started, so I said, "Oh, maybe I can do that and we can have a family recital." And about three weeks ago, I just started playing golf. I joined a ladies league, 9-hole.
So what's your secret to longevity?
It's people around you. Of course you have to work hard. If you ask other people to do the hard work, it's not going to work. You have to show them you really have your heart in what you're doing and you have to have pride in your job. Whatever you do, it doesn't matter, but you cannot do it alone. You have to have people around you. You have to treat them as a family - really as an extended family. Without their support, without their vision, their pride in their job, you cannot do it. I think that's the secret and the way it should be.
Flats or heels?
Oh, I love flats. When we hire new girls, especially upstairs, I like girls who walk fast. People who walk slow, I think I may have to fire them. One time I have to walk from the gym to my house to get something and I walked with my trainer and he said, "I've never seen anyone walk faster than you. I have to catch my breath." I didn't even think I was walking fast. So I like flats.