2026 Moreton Lecturer: Radiologists and their C-suite must partner to steal back time, bolster efficiencies, save money and provide higher quality patient care.
A staple of the College’s Annual Meeting, this year’s Moreton Lecture, “Finding a Seat at the Health System Table: Radiology in a Time of Transformation,” was presented by Richard P. Shannon, MD, senior vice president, chief quality officer and chief medical officer of Duke Health. The annual address is named after Robert D. Moreton, MD, FACR, a respected radiologist and leader within the ACR and the Texas Radiological Society and focuses on the future of the profession — filled with evolving challenges and opportunities that will move the specialty forward.
As a member of the health system C-suite and with a career focus on quality and safety across his health care system, Shannon assured the audience that he was on their side. “I think it’s important to bring you inside the heads of the executives and organizations where you work so that we can understand where the common ground is,” he said. “We both try to navigate a type of really unprecedented transformation.”
What is shaping transformation today? There are dynamic changes happening within the workforce, and those coupled with mounting clinical complexity make it imperative to consider a “significant reimagination, redesigned around how we want to get things done,” Shannon said. “This means a partnership that requires trust, and I’m here today to convey to you that there is a mutual platform for you and your health system.”
This type of partnership is vital, he said, as trillions of dollars in expenditures in the U.S. for healthcare is causing health professionals to make untenable social choices. The growing aging population is putting a critical strain on imaging services. “Imaging has become the new currency of clinical acumen — and as a consequence, a disproportionate share,” Shannon said.
“I want to tell you that radiology is a CEO's best friend. Radiology services are integral to cash flow and positive margins,” Shannon said. “But we need to establish partnerships because you have your own set of real issues — including declining reimbursement and collaboration to mitigate growing workforce challenges. There are also significant concerns over burnout and turf wars.”
“Sometimes shared adversity creates and catalyzes unique partnerships,” Shannon said. He shared the philosophy of Kara Lawson, the women's basketball coach at Duke. She tells her players that things will get hard. To get through those hard times, you can’t just wait for things to get easier — because they likely won’t. “The key is to become someone who handles the hard stuff better. To her point, a mental shift needs to occur in each of your brains,” Shannon said. “If you go through life waiting for things to get easier, it’s never going to happen.”
There can no longer be iconic individualism. We must create shared visions and goals and above all trust.
“I don't like the word resilience. It’s this notion that I can stand up against anything and be battered around and get back up. I prefer the term adaptability,” Shannon said. “What this calls for is the ability to bounce forward — to actively adjust your strategy, your skills and your behaviors to thrive in a very different world.”
Collaborating and partnering is the way to adapt, he says. “There can no longer be iconic individualism. We must create shared visions and goals and above all trust.” The latter comes in small implements. It comes with daily routines that establish relationships, and it is about inclusivity and representation and governance within healthcare organizations. “It is also about establishing our interests, not necessarily asserting our demands,” Shannon said. “Sometimes that takes facilitation, but I would suggest to you that when the moment calls for that, as I’ve said, you are our best friends.”
Shannon shifted his talk to interventional radiology. “That field is projected to grow at a compound annual growth rate at 5.2 percent and be worth nearly 50 billion dollars over the next 10 years. That is something worth co-collaborating, co-sponsoring, co-investing in for all of us,” Shannon said. Interventional radiology, he said, is a cost-effective way to deal with complex care.
Moving on to the safe and effective use of AI, Shannon cautioned the audience on integrating the technology into workflows. “AI is a powerful tool that can enhance well-designed work processes, but it is not a magical solution to fix fundamentally flawed work processes,” he said. “It will not replace you, but it will help you in automating the many complex processes that cost your business money.”
Shannon shared an anecdote from his time at University of Pennsylvania School of Medicine. “When I became chair, Penn was just coming out of a major financial crisis (in the early 2000s). I walked into the CEO's office, and he told me that money for a new parking garage was being held up. I asked, ‘Why do we need a new parking garage anyway?’ I was told that I was new to Philadelphia and didn’t understand the traffic and how nobody could find a parking space at the hospital between 3 p.m. to 9 p.m., Monday through Thursday.” The CEO added that patients, as a result, get very upset when they come in for services.
“They thought the solution was to build a costly new parking garage. But the real problem had nothing to do with parking problems — it had to do with the inefficiency of the work process. So, we undertook redesigning workflow,” Shannon said.
The existing process went something like this: If you were coming from outside of the three square miles of Center City, it took patients nearly an hour to get to the facility, 22 minutes to park and half an hour to register. Then there was at least a 20-minute wait in one of the waiting rooms. “About half of our clinical space is for waiting rooms,” Shannon noted. “The most efficient step in the process was the three minutes it took to get your vitals; then back out to the waiting room you went. By the time a patient left, they had spent about four hours there.”
“We redesigned the process, not just across my clinic, but across all those moving parts, and reduced that time to two hours. We were able to cut the cost of pricing per hour and increase the volume in the clinic,” he recalled. The result: Increased on-time performance, increased patient satisfaction, decreased lag days to appointments and no need for a costly new garage. “That was an $80 million dollar save through the redesign of the work process. If you can partner with your CEO to redesign work and improve efficiency, you can take back some of the dollars wasted in healthcare.”
Time is your biggest commodity. “If I could find just a fraction of the time radiologists spend on nonsensical tasks, that would lead to huge savings,” Shannon said. “There are activities you engage in that are deeply value-added — diagnostic interpretation, clinical consultation, all the quality and safety work that I know you do. Then there’s the other stuff you have to deal with on a daily basis that adds no value.”
“I encourage you to try to get your leaders out of their offices and to your point of care — let them see the work you are doing,” Shannon told the audience. “Nothing is possible without leadership, but with leadership, anything is possible. This is my invitation to you. You are cordially invited to take a seat at the table — and get there as soon as you can.”
By Chad Hudnall, senior editor, ACR Bulletin.
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