What this year cost, and what I would do again

Radhiant Diagnostic Imaging has been shortlisted for The Easies 2026 (the Investec and OPUS awards for early-stage founders) in The Future of Services category. The public vote runs until Thursday 29 October 2026 and the judges review the finalists in the first half of November.

I am proud of it. Still, a shortlist is only a summary and the year behind it was harder than a summary can show.

What the fleet did

As at 23 October 2026, the network stands at seven mobile 3D mammography units, working from five bases in Johannesburg, Bronkhorstspruit, Durban, East London and Cape Town. The first unit went on the road in March 2023. We have screened more than 25 000 to date, across more than 300 communities in all nine provinces, and referred more than 430 suspicious findings for biopsy.

Every unit carries 3D tomosynthesis. A specialist radiologist reads every study, and the report is back with the referring doctor within 3 to 5 working days. An abnormal result is phoned through to the woman and her doctor by a person, and every woman screened goes onto next year’s recall list.

All of that was in place before this year. Over the last 18 months we worked to make the day-to-day screening operations less dependent on my direct involvement.

What went wrong

Three things went wrong. The last was the hardest to fix.

The first was mechanical. A mobile fleet earns its keep on the road, and we had months where one unit’s availability decided whether a province got screened at all. We learnt to treat a missed site day the way a hospital treats a cancelled theatre list: as an incident, with a cause, a fix and a name on it.

The second was demand, and it remains the constraint. The trucks are built. The capacity to more than double our volume exists today, on days that are already on the road; what is missing is enough confirmed bookings, at enough sites, to fill those days.

For most of the year, too many days ran with empty slots. We rebuilt the booking discipline around one rule: a site is advertised fourteen days out, pushed at ten and confirmed or released at seven. We improved the recall follow-up and brought outreach in-house.

Call-to-book conversion went from 19 per cent to 34.8 per cent in six weeks once the rule was enforced. It is still the number I watch first every morning.

The third was language. For a long time our material said “cancers detected”. That was never the number we had.

What we count is suspicious findings, BI-RADS 4 and 5, referred on for biopsy. Confirmation comes from the biopsy result under the treating doctor’s care, and until a consented follow-up loop is running we cannot publish a detection rate honestly.

We have corrected the wording in our material, including the pages of this site. That correction is not finished everywhere yet.

What it cost

I left full-time private practice in September 2024 to run this. My own capital and my own guarantees stand behind the fleet. Too much of the clinical governance and too many of the relationships with the organisations that pay for the screening still sit with me, which is a weakness in the business and mine to fix.

I still read the studies, hold clinical governance and supervise a research protocol running on our own aggregate screening data. The clinical work is the reason the business exists, and I intend to keep reading.

What I would do again

I would put the machine on a truck and sell a full screening day rather than a scan. I would hold one clinical standard, whether the site is a platinum mine, a shopping centre or a rural town. And I would correct the number, even when the wrong one sounds better.

I would do the hard year again. The alternative was a service that reached only the women who could already get to a clinic, and the women who cannot get to one are the reason the fleet exists.

If you would like the fleet’s record with dates and definitions, it is on the Radhiant Diagnostic Imaging site. If you would like to vote, the shortlist is at theeasies.com. Thank you for reading.