At the Radiology Leadership Institute® (RLI) Leadership Town Hall: Leading in Times of Crisis, five leaders shared their thoughts on how radiology has adapted to the COVID-19 pandemic, which changes have been advantageous, which have been detrimental, and what the lasting impact will be. 

J. Jacob Kazam, MD, vice chair for clinical operations at Weill Cornell Medicine’s radiology department, spoke plainly that patients will avoid facilities that have treated large numbers of COVID-positive patients. “Fighting those perceptions is going to be a battle, and we’re going to have to be very cautious about safety going forward,” he said. However, he noted that same issue has led to positive innovations in streamlining care and creating a better workplace. Some patients now fill out necessary forms online, or drink contrast in their cars before being called in for their procedures. Kazam also shared how leaders at his facility have worked to increase educational opportunities for staff, and provide more flexibility for telework environments. “At the end of the day, we’re going to have a better patient experience,” said Kazam.

Other speakers noted increased efficiency. Judy Yee, MD, FACR, professor and chair of the department of radiology at Montefiore Medical Center in Bronx, N.Y., praised the more equitable allocation of space in response to the pandemic, as well as the rapid rollout in construction at her site. “Within one to two weeks, we built over 11 new ICUs and new inpatient medical wards to accommodate all of these patients,” said Yee. Standardization of reporting was an area of improvement seen by Daniel Ortiz, MD, a radiologist at Summit Radiology Services, P.C. “Being in a private practice,” Ortiz said, "a lot of our radiologists do things as they see fit, rather than using a unified approach.” He expressed hope that this would lead to further standardization in the field. “We’re going to use this culture of unified response and reporting, and try to blossom that out,” he said.

Mahmud Mossa-Basha, MD, associate professor of radiology, vice chair of clinical operations, and chief of radiology at the University of Washington School of Medicine in Seattle, identified the incorporation of patients and ordering physicians into the exam process as an asset that had come about in his practice’s response — especially in the cancelation and rescheduling of exams that had been previously identified as elective. “There are certain studies that are easy to determine if they are elective,” Mossa-Basha said. “But with other things, it’s tougher to tell from a three-word history whether it is a critical study or not.” In response, the practice employed its automated text messaging system to collaborate with patients and doctors in gathering information to determine the urgency of discrete exams.

We’re going to use this culture of unified response and reporting, and try to blossom that out.

When the question was put to her, Dana H. Smetherman, MD, MPH, FACR, chair of the ACR Commission on Breast Imaging and associate medical director in the department of radiology at Ochsner Medical Center in New Orleans, stated that she was concerned about the rapid switch to telehealth, jesting that, “the physical exam is dead.” While she acknowledged that the shift will likely have economic benefits, she expressed concern about the deterioration of the doctor-patient relationship, and the incapacitation of teamwork in medical facilities. 

Reflecting a common theme among the speakers, Smetherman advised the best response to the pandemic was clear and supportive communication. “Show that everyone’s safety is your first priority,” she said, and encouraged the usage of any available psychological wellness services. Above all, she called for humility among leadership. “I’m going to make mistakes,” she said. “I have told people over and over again that I’m not going to be perfect. No one is.”