ACR Bulletin

Covering topics relevant to the practice of radiology

People Skills

Relatability bests title and position in great leaders.
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Imposter syndrome is real.

—Patricia Balthazar, MD,
December 12, 2019

The “hard” definition of non-interpretive skills — as outlined in the section by the same name in ABR’s core exam study guide — includes displaying professionalism, upholding quality and safety standards, understanding malpractice, and staying current on regulatory compliance. While these skills are expected of all radiologists, many would agree that the “soft” skills inherent to great leaders and the best radiologists are what will move the specialty forward.

Referring to a basket of non-interpretive or non-clinical skills as “soft” may suggest that they aren’t important, says Ryan K. Lee, MD, MBA, section chief of neuroradiology at Einstein Healthcare Network in Philadelphia. But these character traits are embodied in physicians who lead with compassion and empathy, Lee says. They are found in leaders who exude optimism, communicate openly and without bias, and prove themselves in the eyes of patients and peers by creating a positive atmosphere and valuing their team’s success more than their own.

Evident Intelligence

“The great leaders in radiology I admire and aspire to be like have not only mastered clinical skills, but project a social and emotional intelligence that makes them a whole radiologist,” says Patricia Balthazar, MD, chief radiology resident at Emory University and secretary of ACR’s RFS. “It may not come as naturally to us to think about emotional intelligence when compared to intellectual intelligence,” Balthazar says. “Emotional intelligence will not be scored on a multiple choice test. However, once someone is in a leadership position, their emotional quotient becomes evident and will likely dictate their level of success.”

Social and emotional intelligence is evident in leaders who get along well with others — and who can prevent toxic situations by encouraging cooperation within a team. Such leaders can recognize and understand emotions in the workplace and are cognizant of managing them — especially within themselves. Doing so can have a positive influence on the emotions of others, and showing empathy for colleagues seeking guidance is something they can measure and emulate.1

Evolving Skills

For those in leadership positions now, inspiring other members of the team through relatable non-interpretive skills can redefine the notion of what it means to be a leader. They promote collaboration and problem-solving — drawing on individual strengths — and instill confidence in clinicians who may not realize their full value.

“Imposter syndrome is real,” Balthazar says. “We have all felt at some point that we don’t belong in a certain position or are underqualified.” Still, every radiologist has the potential to be a leader, Balthazar believes, regardless of their title or role within a practice. By the nature of the job, every radiologist is already a leader to some extent, she says. “We can lead multidisciplinary teams, regardless of where we are in our training. Even as a trainee on-call, surgeons may ask for your opinion, and you have an opportunity to guide them in the right direction.”

Building the non-interpretive skills that shape future leaders depends largely on how invested current leaders are in a culture shift away from traditional thinking. For instance, Balthazar says her chair of radiology at Emory University, Carolyn C. Meltzer, MD, FACR, stresses unconscious bias training for anyone involved in the hiring process. Being unaware of your biases could lead to missed opportunities in securing potentially great leaders for your group. Institutions should consider investing in leadership development training for faculty, which is something we have here at Emory, Balthazar says. ACR’s Radiology Leadership Institute® also offers good leadership training programs, she adds.

For radiology leaders who have a say in hiring new members of their team, identifying emotional and social competence is a must, says Scott Taylor, MBA, PhD, associate professor of organizational behavior at Babson College in Wellesley, Mass. “You can’t just look at their clinical experience and where they got their degree.”

It can be tricky assessing things like empathy, emotional self-control, effective communication, and team building during an interview process, Taylor admits. “When you find people who already have these types of skills, it benefits everyone. They will expect an environment that fosters these skills, and in turn often generate positive changes in others.”

Positive Links

The good news is that changing the way radiologists think or behave in certain situations can be developed, Taylor says. “Compared to trying to change personality or increasing cognitive capability, managing emotions, having inclusive conversations, and encouraging open and honest interactions can be much more easily developed,” he says.

It is widely acknowledged that competence in non-interpretive domains is critical to adding value to patient care and to the well-being of a radiology practice.2 Good leaders must be change agents — always diligent in identifying disruptive influences and confronting them quickly and head-on.3

According to Taylor, the work he and his colleagues have done over the years in dozens of countries has borne out a common perception of good leaders. His team has asked everyone from high school students to boards of directors to think of a person they know with strong leadership skills, and someone they know who is a horrible leader. These two people did not necessarily hold a managerial title or sit in a position of authority.

The responses have revealed, repeatedly, that good leadership comes down to two components. “Number one, outstanding leaders create a connection with others and are outwardly focused. Number two, leaders create an overall positive environment,” Taylor says.

Inquiring Minds

Being mindful of a universal association of good leadership with a connective and positive workplace is increasingly important as a new wave of radiologists enter the field. With different expectations for diversity, work-life balance, and physician-patient interaction as part of their career, aspiring leaders want to learn from veterans who have more than just sharp clinical skills.

“Leaders now need these non-interpretive skills to establish purpose and meaning for the people on their team,” Taylor says. “It’s often the younger generation that doesn’t want to just know what they’re supposed to do and how they’re supposed to do it. They want to know why.”

This expectation doesn’t mean future radiology leaders want fast promotions and top titles, Taylor says. “In reality, what many are looking for is leadership by someone who shows them how important non-interpretive skills are to doing the job to its fullest potential.”

Number one, outstanding leaders create a connection with others and are outwardly focused. Number two, leaders create an overall positive environment.

—Scott Taylor, MBA, PhD

Leaders accustomed to running a team with unbending directives are not going to be as successful, Taylor says. “They need to spend more time conveying the importance of a team’s work, and how it can
meet patients’ expectations.” The result is often higher job satisfaction and increased pride in performance among team members, he says. In turn, leaders will see less turnover among the team — meaning fewer disruptions in workflow and higher patient satisfaction.

“With the way medicine is evolving, especially in terms of patient-centered care and population health management, radiologists really need to be comprehensive physicians,” Lee says. “Good leaders don’t want to be on the fringes, disconnected from what is important to their team and to their patients.”

Leaders need more training in soft skill sets to develop a deeper understanding of the value of non-clinical skills. Many academic institutions and radiology societies offer courses and host events to educate
radiologists on more than payment policies, informatics, or regulatory changes.

“These soft skills can be difficult to teach, but are central to our growth,” Balthazar says. Current leaders should realize the expectations of rising radiologists, she says, and radiologists at all levels should know that you don’t need a title to start leading now. According to Balthazar, “The best leaders serve their team and their patients without acting like a boss.”


  1. Salovey P, Brackett MA, Mayer JD. (edited by) Emotional intelligence: key readings on the
    Mayer and Salovey model. 2004. Port Chester, NY, US: Dude Publishing.
  2. Heitkamp DE, Kerridge WD, Ballenger ZE, et al. A leadership development program for
    radiology residents. J Am Coll Radiol. 2017;14(11):1468–1470.
  3. Davenport MS, Dunnick NR. Lessons on leadership. Radiographics. 2018;38:1688–1693.

Author Chad Hudnall, senior writer, ACR Press