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How the ACR Works

The Functions of the American College of Radiology

The American College of Radiology (ACR) is a professional society whose purpose is to improve the health of patients and society by maximizing the value of radiology and radiologists by: advancing the science of radiology, improving radiological service to the patient, studying the socioeconomic aspects of the practice of radiology, and encouraging improved and continuing education for radiologists and allied professional fields. The College also supports its members as they adapt to a rapidly changing health care environment. The challenges for the College are complex because the needs of patients are many. In addition, ACR members' needs are diverse and require attention in many areas. To best represent radiology, the ACR must relate to many different organizations and entities: the Congress, federal and state agencies, other professional societies, and a variety of medical providers, corporations, and suppliers.

To meet the challenges the ACR faces, it has developed an efficient and effective organizational structure. To be most responsive and effective, the ACR has separated its policy setting function from its programs that implement the policies. The ACR is organized in a fashion similar to our government, where the legislative branch sets policy and the executive branch puts that policy into action. In the ACR structure, the state chapters and specialty organizations select councilors who meet once a year during the ACR Council meeting. It is here that the Council establishes policy. The Board of Chancellors, through commissions, committees, and task forces, is then responsible for developing and implementing programs to respond to the Council's policy decisions.

The Council

In the late 1950s, the ACR organizational approach to policy-making was established. This approach begins with the recognition of the importance of ACR Chapters, which elect representatives (councilors) who meet annually at the Council meeting. Each chapter may have a councilor (and an alternate councilor) for every hundred ACR members in their chapter. Each year the ACR Council convenes with the primary purpose of debating and approving ACR policies. This activity is critical as the policies establish the priorities and practice standards regarding a large variety of issues. The Council meeting is an exciting and busy meeting, where many resolutions are debated during four reference committee hearings before final decisions on the resolutions are made before the full Council. Much like organizations which coalesce before the U.S. Congress, various chapters collaborate in caucuses to focus on the four days of formal Council meetings.

Currently, the Council has 301 members representing ACR chapters, the branches of the military and other federal agencies and radiology subspecialty societies

In order to organize the Council meeting and to maintain activities during the year between Council meetings, the Council elects a speaker and vice speaker who serve as its leaders for two-year terms. The speaker and vice speaker are assisted in their work by the Council Steering Committee (CSC). The CSC is both elected and appointed. The CSC is representative of the entire Council according to its diversity, geographic distribution, radiologic subspecialty, gender, and practice patterns. In addition to organizing the annual Council meeting, the Council leadership and the Steering Committee represent the Council throughout the year, providing communication pathways both to and from the state chapters and interacting with the Board of Chancellors.

The Board of Chancellors

The Board of Chancellors (BOC), the executive body of the American College of Radiology (ACR), has the authority and jurisdiction to conduct its business and affairs in accordance with the ACR bylaws. The BOC is made up of a maximum of 25 voting members of the ACR. The speaker and vice speaker of the Council are ex-officio, nonvoting members of the BOC. On the recommendation of the Board Nominating Committee, the BOC elects the chair and vice chair, who can serve two one-year terms, and the secretary-treasurer, who can serve a one-year term renewable for five years. The president and vice president are elected by the Council. Additionally, the Council elects a number of chancellors, not to exceed twelve, to serve a term of three years, renewable for an additional three years. The chair of the BOC communicates with the College Nominating Committee to select a representative from each of the following societies: the American Roentgen Ray Society, the American Society for Therapeutic Radiology and Oncology, the American Radium Society, the Canadian Association of Radiologists, and the Radiological Society of North America. Additionally, the chair of the BOC can appoint a maximum of five chancellors, who must chair a commission, to serve a one-year term renewable for an additional five years.

The BOC does not establish policy; it is responsible for implementing programs and activities to accomplish policy goals. These activities are led and monitored through commissions, committees and special task forces formed to work on specific issues and needs. Each year, they submit a report to the Council on these programs and activities. The BOC usually meets in January, June and September. In addition, special meetings of the Board or Executive Committee are held on an as-needed basis. The members of the BOC volunteer many hours per week and spend a minimum of three weeks away from their practices to fulfill their responsibilities.

The Commissions, Committees, and Special Task Forces

In 1991, the Board of Chancellors decided to restructure commission and committee activities to reflect the operational activities of the College. The current operational commissions include the areas of Economics, Education, Government and Public Relations, Human Resources, Research and Technology Assessment, and Standards and Accreditation. In addition to these operational commissions, specialty commissions were created in the areas of General and Pediatric Radiology, Interventional and Cardiovascular Radiology, Neuroradiology and MR, Nuclear Medicine, Medical Physics, Radiation Oncology, Ultrasound, Molecular Imaging, and Small and/or Rural Practices. Horizontal integration was accomplished by placing a committee structure that parallels the operational commissions under each of the specialty commissions. For example, each of the specialty commissions includes a committee on government and public relations.

Volunteerism

The success of the ACR's programs and projects is directly linked to the tremendous efforts of its members who volunteer to serve their colleagues. These members are not paid for their time or efforts on behalf of all members, but take their own time away from practice and family to contribute to their specialty. Hundreds of members representing private and academic practices and representing all of the subspecialities of radiology volunteer in the vast array of College programs and committees. This volunteerism also supports the work of the state chapters and local radiology societies. Chapter leaders and members alike spend time every week visiting legislators, working with insurance carriers and Medicare, and developing local educational programs to advance the profession. The number of members involved in various projects at any one time is extraordinarily impressive. In addition to the work of councilors and alternate councilors in setting policy, over 450 members participate in the practice standards development and review process. More than 400 radiologists, radiation oncologists, and medical physicists work almost daily on accreditation programs. The ACR Appropriateness CriteriaT project has involved more than 200 physicians and medical physicists. Volunteers are chosen for various projects so that a proper mix of practice types, subspecialities, and geographic representation exists.

Leaders of projects are often chosen from those with experience. Experience and dedication are keys to the success of this massive volunteer effort. The state chapters choose their officers and councilors from the most experienced, dedicated, and committed members. The same is true for the College as a whole. While there is a general term limit of four years for College appointments, many members serve longer by volunteering for different or new projects. The experience also prepares them for greater future responsibility. As with any organizational activity or business, the value of this experience is immeasurable.

This experience is also critical for the radiologist volunteers on the Board of Chancellors. The majority of Board members have exceptional experience at both the state chapter and College levels. This tremendous body of service from volunteers on a state chapter and College level is the key to the ongoing success of all the various areas of ACR involvement.

As noted in the pages that follow, the experience and expertise of ACR volunteers continues to be the ACR's greatest asset.

Fellowship

One of the rewards of volunteerism in the ACR is Fellowship. ACR Fellows are characterized by a history of service to the College, organized radiology, teaching and/or research. Fellowship is one of the highest honors that the American College of Radiology bestows on a member. Only 10% of College members have been awarded this honor. Fellowship is awarded to diagnostic radiologists, interventional radiologists, radiation oncologists, and medical physicists during the ACR annual meeting at a special ceremony called the Convocation. All College members are expected to maintain high standards throughout their careers. The honor of Fellow is given to those with distinctive accomplishments beyond this expected high threshold of achievement.