ACR Bulletin

Covering topics relevant to the practice of radiology

Observations of a CEO: A Chat with William T. Thorwarth Jr., MD, FACR

Panelists from a Radiology Leadership Institute® (RLI) podcast project offer their visions of the specialty, which strongly align with the College’s commitment to serving current and future members — and the patients who depend on them.
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I truly believe the College’s efforts and commitment of resources to patient safety, accreditation, reimbursement, AI and machine learning, the well-being of physicians and equitable care is truly unique. I think both panels recognized that the ACR is invested in seeing their practice groups thrive — today and into the future.

—William T. Thorwarth Jr., MD, FACR
December 01, 2023

As the ACR’s centennial celebration continues, the Radiology Leadership Institute® (RLI) dedicated two Taking the Lead podcast episodes to a project that shared the perspectives of two different generations of radiologists — those with decades of experience within the specialty and rising radiologists in earlier stages of their careers. Geoffrey D. Rubin, MD, MBA, FACR, moderated the podcast panel discussions. The following is an excerpt from an ACR Bulletin interview with ACR CEO William T. Thorwarth Jr., MD, FACR, sharing his impressions of what both groups had to say — and how their viewpoints continue to drive the College’s core mission.

Play Button Listen to the experienced and rising radiologists podcasts                

What was your impression of the panelists’ responses about the specialty as a whole?

There were accomplished individuals on both panels, of course, but the thing that struck me was their unified voice about the importance of the College and its dedication to continuous innovation. There was real agreement on the need for radiologists to thrive professionally today while staying one step ahead within the healthcare landscape to advance the future of the specialty and improve outcomes for their patients. A common thread between the panels was a recognition that radiologists can anticipate, drive and implement change.

For both panel discussions, I really appreciated Geoff at the end of each session asking each individual how the ACR has contributed to their development professionally. When you look at the topics addressed during the discussions — whether it was advocacy or economics or data science — those are things that have always been core to the ACR’s mission. There are many organizations out there that provide terrific education on clinical content to make radiologists more capable, and I have been a member of a lot of them. But I truly believe the College’s efforts and commitment of resources to patient safety, accreditation, reimbursement, AI and machine learning, the well-being of physicians and equitable care is truly unique. I think both panels recognized that the ACR is invested in seeing their practice groups thrive, today and into the future.

Were there topics you expected to stand out as areas of interest or concern for both panel members?

The use of AI and the importance of well-being and personal satisfaction not surprisingly bridged both groups. One of the panelists from the more senior group said that if he had two asks, one would be that the College look seriously at generative AI and its role in radiology. I can tell you from our most recent board meeting that the ACR Commission on Informatics is making the use of AI in our specialty front and center. His other ask was for a strong focus on the well-being of our radiologists to ensure we have a physically and emotionally healthy workforce. That’s something our Commission on Patient- and Family-Centered Care and our Commission on Publications and Lifelong Learning have made great strides around.

The College also collects stories from members in private practice and in academic departments about what is being done to ensure that their radiologists and staff are well taken care of. I agree with concerns raised around burnout because people need to feel professionally satisfied and gratified. One of the junior radiologists pointed out that AI can potentially assist with diagnostic imaging in straightforward cases, giving radiologists more time to focus on more complex cases. One question, however, was “How does one become an expert on complex findings if she or he gets no exposure to the simpler reads?” The ACR Data Science Institute® has been and continues to work very hard on the pros and cons of AI — its safety and accuracy and how radiologists need to be part of the development and implementation process.

I was encouraged to hear the level of passion in the younger panelists. Their commitment and understanding of our specialty from a clinical viewpoint was clear.

—William T. Thorwarth Jr., MD, FACR

What connections did you see between the work of the more experienced panel members and the evolution of the specialty?

As one example, Dr. Carolyn Meltzer [Carolyn C. Meltzer, MD, FACR] talked about her longtime interest in PET imaging and how she got a chance to work with this modality during training, which led to her help in developing the first PET-CT scanner. She also mentioned that she was burdened earlier in her career with administrative work, though she preferred to focus on serving patients. She is now serving as dean of the Keck School of Medicine of the University of Southern California (USC). She noted that there are not many radiologists serving as deans and that we need more — and she is right.

Back to her work on PET imaging, though, this aligns strongly with the College’s research and advocacy around the use of PET in oncology and most recently in the treatment of Alzheimer’s Disease. Thee ACR was instrumental in changing CMS policy around the number of PET scans that are covered for patients throughout the course of their treatment — not just for Alzheimer’s patients, but for the entire spectrum of oncologic disease. None of that would have been possible without the work of amazing radiology trailblazers or the College’s work and research in this area.

Did you have any specific takeaways from what the more junior group had to say?

I was encouraged to hear the level of passion in the younger panelists. Their commitment and understanding of our specialty from a clinical viewpoint was clear. To hear their respective experiences and how they are looking at things from 30,000 feet — not just from the everyday clinical care they provide — was frankly very impressive and deserving of congratulations. They want to lead change, and some have already assumed leadership roles early on in their careers. They have been taking the lead in areas such as pediatric radiology, breast imaging and clinical uses of AI and machine learning, among others. I was also impressed with their understanding of the complexities of the business side of medicine while always making the care and safety of their patients a priority. I think we are in very good hands.

Based on both panels’ responses, how did you interpret their confidence in the ACR’s ability to engage, educate and empower members and other stakeholders?

We have in our Strategic Plan what is called an overarching goal: that the ACR be indispensable to all current and eligible members. My comment on that — it’s not a goal, that is the reality of it. The College truly is indispensable. It is just a matter of convincing them and impressing upon them how important we are to their future and their current practices. I think our members, young and old, see that the ACR exists to ensure that radiologists and their practices thrive in the future, from a standpoint of professional satisfaction, being reimbursed fairly and delivering the best patient care. That’s the real distinction between us and other organizations.

I was reminded during our most recent board meeting when someone raised a valid point: So many of our members or eligible members don’t realize the ACR is involved in research. Many of the panelists have participated in — or, in fact, spearheaded — critical research in areas such as population health and equitable access to new and more effective screening services. The ACR has provided much of the infrastructure needed to move research forward into clinical use. So many fantastic clinical trials have come from ACR-led research over the years. Those contributions and the continued ability to support research enterprise are really creating the type of future for radiologists and their patients that members of both panels described as being excited about.

Is there anything you would like to see the College do that the panelists would likely support?

One thing I’d like to see is more bi-directional communication between current and eligible members. These types of panel discussions are one great way to foster that. We want to know what we may not be doing that they think we should be doing, and how we can better convey to those people that we are making a difference in their professional lives through work around reimbursement and advocacy and by our efforts to make their lives better and more satisfying in general.

In parallel with one of the panelists’ comments, we have many educational and professional development offerings through groups like the RLI and the ACR Education Center, and there are other organizations out there that do some of this very well. We don’t want to compete head-on with these groups or duplicate their efforts. Rather, we want to continue to work collaboratively with groups that have common interests and goals to share our unique programs and expertise around moving the specialty forward and ensuring the best-quality patient care.

Were any topics not raised with the panelists that surprised you?

One thing that was not largely addressed during either panel discussion is the need to get radiologists back to where they are only doing appropriate or clinically needed care. A significant percentage of what radiologists are asked to do probably doesn’t directly impact patient care. This is something the College has taken on as a serious charge — to mitigate a sense of burnout or low self-worth when you feel like you are doing things that are unnecessary. There continue to be challenges around the use of clinical decision support and appropriate use criteria, which didn’t come up in a major way in either panel.

We’ve got to be able to guide people to the appropriate use of imaging. There is such a broad spectrum of things we can do. Some things help and some don’t. There are patients who have clinical circumstances where maybe no imaging is clinically indicated. These things were not as prominent as other issues that were discussed. Still, I have no doubt the awareness of such challenges is there, and these are the things we must continue to drive forward.

After hearing both panels weigh in on various topics, do you think there was a high level of confidence in the work of the College to support and shape the field of the future?

There was talk about workforce shortages and workload challenges being potential impediments to research opportunities and developing new programs and educational initiatives. They talked about things like the evolution of more precision medicine and the critically necessary services radiology provides. Everyone knows there really is no significant healthcare happening that does not involve diagnostic imaging or minimally invasive procedures or focused radiation oncology treatments.

There is an ever-increasing need for our services, and they recognize that we must advance our specialty to meet the needs of the public. There is such a broad spectrum of things we can accomplish when we work together.

An example from a long time ago was a change I remember well. It was brought up by one of the radiologists on the more senior panel, who said: Perhaps the most impactful action by the ACR (of many impactful actions the organization has taken) occurred in the late 1960s, when a small group of radiologists persuaded Congress to take radiologists out of Medicare Part A and put us in Part B, like other physician specialists. I think that was a defining point for the specialty, he said. I couldn’t agree more, and I look forward to even bigger victories the College will achieve in our next 100 years through the incredible talent of all our radiologists.

Read the other articles in the project

Centennial Perspectives: A Look at Radiology From All Sides. To determine where the specialty is headed in the future, it's important to first understand where it has been and where it stands today. 

Centennial Perspectives: Longtime Radiologists Recall the Past and Welcome the Future. In the first of two RLI podcasts episodes, host Geoffrey D. Rubin, MD, MBA, FACR, talks to five radiologists about what they have seen in their decades in the field: Johnathan S. Lewin, MD, FACR; Carolyn C. Meltzer, MD, FACR; Lawrence R. Muroff, MD, FACR; Mary H. Scanlon, MD, FACR; and Elliot L. Siegel, MD, FACR. Topics range from technological advancements that have affected the way radiologists work to changing how new generations of radiologists are trained based on their learning habits. The panelists bring great insight to the table as they discuss how things have changed in the specialty and where things are headed in the future.

Centennial Perspectives: Rising Leaders in Radiology Look at How the Specialty Will Evolve. In the second episode, Rubin talks to four radiologists who are early in their careers but have already made their impact in radiology: Kurt A. Schoppe, MD; Judy W. Gichoya, MD; Mathew Hawkins, MD; and Amy K. Patel, MD. They discuss how they’ve grown as leaders, how they define success, how they see the next decade of radiology shaping out and more. It’s a lively and informative discussion from some of radiology’s brightest rising minds.

Behind the Microphone with Geoffrey D. Rubin, MD, MBA, FACR. Rubin shares some of his thoughts on what radiology leaders revealed in both panels. He also talks about his observations from other leaders in the field based on previous podcast episodes.

Author Chad Hudnall,  senior writer, ACR Press