In Memoriam: Bruce J. Hillman, MD, FACR

The radiology community lost one of its most prominent influencers in January with the death of Bruce J. Hillman, MD, FACR. As founding editor of the JACR and Academic Radiology, a thoughtful leader and dedicated mentor, Hillman helped countless peers and rising radiologists discover their potential to advance the field. Those closest to him remember a diligent researcher, a groundbreaking editor and a caring physician who never accepted the status quo.

For his work as a radiologist and an advocate for the specialty, Hillman was well-decorated. Hillman served on the ACR BOC for 19 years and was a 2017 ACR Gold Medal recipient. He was also awarded gold medals by RSNA, the Association of University Radiologists and the Society of Uroradiology, now under the Society of Abdominal Radiology (SAR). He was recognized by the ACR in 2015 with the Luminary Leadership Award.

Hillman was chair of the University of Virginia (UVA) School of Medicine’s department of radiology from 1992 to 2003. There he played a significant role in developing the university’s first outpatientimaging center and oversaw the major shift from film-based imaging to a PACS system. He took on the role of JACR founding editor-in-chief soon after leaving UVA.

During his distinguished career, Hillman was a tireless author and consumer of research. He was an outstanding writer and editor, with more than 400 published works, including three creative nonfiction books. He was an outspoken champion for mentorship and sponsorship programs, and his namesake fellowship, the Bruce J. Hillman, MD, Fellowship in Scholarly Publishing, offers a concentrated experience in medical editing, journalism and publishing for talented physicians pursuing medical journalism as an aspect of their radiology careers.

He made North Carolina his home and passed away on Jan. 9, 2024, at age 76. The ACR Bulletin recently spoke with several people who knew him well to learn more about the remarkable life and career of a true icon in the specialty. We share their stories here in their own words. 

E. Stephen Amis, MD, professor emeritus, Albert Einstein College of Medicine

I got to know Bruce through what was then the Society of Uroradiology, and knew him personally and professionally for many, many years after. When I was elected vice chair of the ACR BOC back around 2000, I pitched the idea for a new ACR journal to then-BOC chair Harvey Neiman (the namesake of the Harvey L. Neiman Health Policy Institute^®), who immediately said he had the same idea and that we should do it. ACR was the only major radiology organization that didn’t have a journal, and there were no other journals that addressed the things that were of extreme importance to the College — appropriate utilization of imaging, education, practice management, leadership, and the list went on and on. We knew we had to have these types of articles in the new journal. Harvey and I immediately started thinking about what would lead to its success. Obviously, the answer was a great editor!

We both knew Bruce, and at the time he had been chairing the radiology department at UVA. In that post, he oversaw much of the switchover from analog to digital imaging. He also led the trend from inpatient to outpatient imaging in his tenure there. It was a huge transformation.

Harvey suggested him for the editor job. Based on what I knew of Bruce — as the editor of Investigative Radiology and a founding editor of Academic Radiology — it made all the sense in the world to me. He worked full-time to get the journal up and running, and more than 20 years later, now with Ruth C. Carlos, MD, MS, FACR, as editor-in-chief, it remains an important and unique radiology publication. I wrote about those early days in an article the JACR published in 2018.

Long before the launch of the JACR, I think one of Bruce’s biggest contributions was the work he did on imaging utilization based on Medicare data that was published in the New England Journal of Medicine. His research showed that self-referring non-radiologist physicians used imaging services at a much higher rate than when they referred patients to radiologists. That really established him as a serious clinical researcher, and it opened the door for him to launch the ACR Imaging Network (ACRIN), which he oversaw beautifully for years. The ACRIN trials evaluate the applications of diagnostic imaging and image-guided treatment to cancer.

I remember Bruce was good friends with John Cronan, MD, who headed up radiology at Brown University. John once told me that when Bruce first took the job as founding editor of the JACR, Bruce called him every week for several months asking him to get his faculty to author papers and submit them to the journal. He even asked John to write papers for submission. My guess is that Bruce was not just calling John, but other chairs around the country to solicit interesting and top-flight articles to get the journal off the ground.

Those of us who knew Bruce saw that he was very meticulous in everything he did. His appearance was no exception. I think he prided himself on his style — tailored suits and designer glasses — and was always put together well and presented himself as such. He was quite a dashing figure! But that was deliberate and the way he wanted to come across. It was all part of his personality and his desire to connect with people and have a positive, lasting impact on the field.

Ruth C. Carlos, MD, MS, FACR, JACR editor-in-chief

Most people know about Bruce’s impressive professional achievements in radiology. What they may not know is that Bruce was also a hedonist. He wanted to bring as much leisure into his life as possible — whether that was traveling to Mongolia to fish or fishing the small creek near his house for 20 minutes each morning before going to work.

Once when I was visiting Wake Forest — not long after he had retired — Bruce found out I would be there and thought we might do a little fishing. He said, “I know of a little fishing spot that’s not too far away.” It ended up being a four-hour drive each way — so that we could fish for four hours. We had ended up at a lake in Tennessee. I remember we left at eight o'clock in the morning and I dropped him off at 10 o'clock that night, but it was a good day. It was a great experience for me, and I think it brought him a lot of joy.

His getting me to drive to Tennessee to go fishing might be a good example of how Bruce really wanted to get the most out of life. Apparently at an official ACR function, Bruce and his pals Val Jackson and Bill Bradley — radiology legends in their own right — made such a ruckus that they were labeled “bad children.” They would travel in a pack and people sort of knew them as the fun group — a group you wanted to be in. 

Despite (or maybe because of) his zest for life and new experiences, Bruce’s contributions to radiology were larger than life. When the ACR decided to publish a journal, there was a big meeting of all the societies that then put out journals — and a conversation around the need to add yet another. Bruce really persevered in getting our journal out there because there was no coverage of its kind in the existing space.

Twenty years later, the JACR is flourishing because it fits a particular niche. And I have heard from multiple people that it is the kind of publication that you tend to graduate into, especially as you take on larger and larger leadership roles. I’ve also heard a department chair describe it as their bible for how to manage your practice. Others have told me that when they run into a management problem, they look to the journal, and invariably that issue has been written about. All of this is a result of Bruce’s initial and continued vision of where the JACR fits among other radiology publications.

It was very important to Bruce to have a journal that looked like a journal, but not so big that you couldn’t shove it in your back pocket and read it when you have free time. At the onset, a lot of the content was opinion or perspective pieces and shorter articles. As the journal grew, I think what he really wanted to do was increase the science while keeping it accessible for our general readership of private practice radiologists — to make it relevant for all. 

A constant tension in running a journal is trying to understand what the readers want to see and what they need to know about. Bruce really wanted to understand who the readership was. He also understood that it is a good idea to publish some content even before people think they want it. I think Bruce believed that sometimes you should just go where a question takes you. Questions lead to answers, and those answers lead to more questions. That’s how he generated evidence that could influence the way things were being done in the field.

One thing I always admired about Bruce is that he had almost a sixth sense about who was going to really succeed and change the field. He made it his business to mentor those people. I met Bruce very early on in my career. Maybe a year or two after, he appointed me as assistant editor and then wanted me to be his deputy editor. 

To show you how much he believed in people and helped shape their careers, I initially turned him down, believing I did not have those skill sets. He told me I would be a perfect fit for the job and that I should go home and think about it. I took the advice and thought about it more and realized it was an opportunity that rarely comes along in one’s career. It would have been easy enough for him to say OK and move on to another candidate on his list. 

He wanted people to pause and see in themselves what he saw. I think there are a lot of people who have had even a very brief interaction with Bruce who would say the experience changed the way they thought about a particular problem or an opportunity. He had a kindness about him and was gracious in that way.

Aaron Hillman, senior director of marketing for Philips

I've spent my life in healthcare — obviously around diagnostic imaging because of my dad —  but I've also been a patient, and that absolutely informed my understanding of him and the work he did. When I was in high school, I worked at the UVA film lab because of my father's connection to the university. Still, it was pretty clear to me and my dad early on that I wasn't going to be a doctor. I had different aspirations, and he understood that.

Intrinsically, by him being in healthcare — and such a demonstrative figure, specifically in radiology — I certainly had some inclination to get involved in the field, even if that was subconscious. I have found a great deal of value working in and around healthcare, and I’m still doing it 20 years later at a global level because I see the value it brings to clinicians and patient care.

My dad always wanted to make the radiology industry — and healthcare as a whole — better, faster, easier and more precise. He wanted to help his fellow clinicians and drive improved patient care. He did patient care himself, but his work was largely administrative and academic because I think he knew that’s where he could make the most difference.

My father was an academic in the sense that he always consumed information. He was great at not only consuming information, but also synthesizing it into something that was meaningful, valuable and novel. That’s why he was a good writer. I have read much of his professional literature, and he parlayed that into his personal writing as well. His stories and novels were pretty great!

He worked as long as he did because he loved the work. He wanted to continue to make an impact and help the field, and he sunk all he had into it. He was extremely diligent and hardworking and maintained a really beautiful network of people. This is evidenced by the outreach I’ve gotten from his peers, mentors and mentees. It is clear to me that he was well-respected, well-liked and someone who had a clear impact on the profession.

In 2011, when I was still working for an electronic health records company, I happened to be at RSNA’s annual conference because of the exhibit we had there. My dad was there to accept the RSNA Gold Medal award. What I remember is seeing him accept the award — wearing a bowtie, because that was his thing — followed by a lot of people talking to him, shaking his hand and taking photos. I remember how many people flooded him to get in a word, and hearing about how well-attended his education sessions had been. I guess I was just taken aback by the momentousness of the occasion.

I also attended his retirement party about four years ago in Chicago, and it struck me as such a powerful moment at the end of a very long and illustrious career. I think it changed my view of him in a way — not significantly, because he was my dad, after all. In the moment, I saw what a wonderful, peaceful and happy moment it was for him. It was sort of like the joy he got from fishing, but with friends and family and peers there to acknowledge him. Today, the fly rod once given to him is now mine, and each time I use it, I can think of him and what it stood for.