ACR Bulletin

Covering topics relevant to the practice of radiology

The Council Is Born

The development of the ACR Council has been a source of pride for the College, representing a governance structure that survives the test  of time while also evolving to meet changing needs in the radiology profession.
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Diversity is only going to increase, and that's important. It helps keep our organization fresh.

—Amy L. Kotsenas, MD, FACR
January 01, 2023

The ACR Council has come a long way since the start of the College back in 1923. Originally, the ACR was governed by a small BOC, which guided the College’s efforts. As the College grew, the BOC began exploring ways to change the organization’s structure. The Commission on Constitution and Bylaws, led by Ross Golden, MD, presented a new College structure in 1939, which led to an amendment added in 1941 for the appointment of councilors across the country.1 A total of 34 councilors formally met for the first time in 1955. The following year, the councilors were invited to a joint session with the BOC.

The first iteration of today’s Council came about in the 1960s, when the group consisted of representatives from state and local societies who attended the ACR Annual Meeting. The representatives
began taking an interest in the business side of the College and eventually gained independence from the BOC. In the early 1960s, George Cooper Jr., MD, pitched the idea of transforming the Council into a delegate assembly that would create policy rather than act as an advisory group to the BOC.2 A committee was created to study how to charter both state and local societies to become ACR chapters. In 1963, the BOC decided to approve charters for state chapters and for the Council to act as a delegate assembly of the ACR.

It wasn’t an easy transition, with chapters required to coalesce existing state and local societies to a singular group due to new bylaws from the BOC to ensure fair representation. This especially held true for states like New York and California, where state societies had to work with their local counterparts within the state’s major cities to combine interests. As the Council developed over time, the BOC began to understand how valuable councilors were to the organization. This would lead to the councilors becoming either selected or elected, depending on the chapter’s preferred method.

The Power of Voting

With the delegate model in place, the next major shift occurred in the 1990s with updates to the process for elected contested and uncontested leadership positions. The Council Steering Committee (CSC) became the representative voice of the ACR membership, facilitating and developing College policy while providing oversight of Council activities.

“The CSC is made up of councilors, as well as the Council speaker and vice speaker, who run the Annual Meeting as the chair and vice chair of that committee,” says William T. Herrington, MD, FACR, chair of the ACR Commission on Membership and Communications. “They cannot be councilors themselves. They are the moderators of the Council but have no vote.”

According to Herrington, there was a feeling that only a insular group got to participate in top leadership. There were plenty of elections for ACR positions, but many of them included only one candidate. The Council decided some changes needed to be made. Because councilors originally were appointed, the pool of candidates was limited to the networks of the BOC. Moving to open elections broadened the slate of candidates and brought new perspectives to the Council. When the new system debuted in 1999, the ACR saw an increased number of open elections for BOC and CSC seats that were becoming vacant. 

One of the most important changes that has rapidly increased representation of young people in the Council is giving the state chapters the ability to have an extra alternate councilor position that is dedicated to a young physician.

—Amy L. Kotsenas, MD, FACR

The Council Today

Today, the ACR Council is made up of roughly 380 councilors from all 54 chapters, 24 subspecialty societies, governmental bodies (such as the U.S. Department of Veterans Affairs, military branches and U.S. Public Health Service), the RFS and the YPS. The Council is charged with setting policy for the organization, as well as considering Practice Parameters and Technical Standards and bylaws amendments.

ACR Council Speaker Amy L. Kotsenas, MD, FACR, has seen the Council change in many ways. “One of the most important changes that has rapidly increased representation of young people in the Council is giving the state chapters the ability to have an extra alternate councilor position that is dedicated to a young physician,” she says. Another area of change has been in practice type among Council members. “The Council was previously dominated by independent private practice radiologists, and they still have a very strong voice there,” she says. “But we’re seeing more representation from hybrid private practices and academic practices. We’re seeing some of the big national corporate practices. We’re seeing a lot of teleradiology, which was controversial around the time that I started. Now there are a lot of people who practice that way — and who are represented in the Council.”

The Changing Times

Even today, the ACR Council is still evolving and adapting to new challenges. A significant moment for the Council came in the spring of 2020, when the COVID-19 pandemic brought the world to a temporary stop. With the ACR 2020 meeting approaching, Kotsenas knew the Council had to move quickly.

“We had about six weeks to go from what we had been planning to be a fully in-person meeting to one that was 100% virtual,” she says. “Certain elements of the Annual Meeting are specified in our bylaws. We have to conduct elections, we have to have the Reference Committee open hearings to discuss policy, and then we have to approve those Reference Committee reports and essentially
vote on what becomes policy of the ACR. And we had to find a way to do all of that virtually.” The team worked quickly to set up a virtual meeting when many were still getting comfortable with the
idea of meeting over Zoom. When the date arrived, the Council was ready and the ACR’s first virtual Annual Meeting was a success, as was the second virtual meeting in 2021. In 2022, the meeting returned to Washington, D.C., with a unique hybrid format combining in-person participation with remote access via Zoom. The 2023 meeting is expected to be similar.

In the Council’s next era, Kotsenas predicts great things: “Diversity is only going to increase, and that's important. It helps keep our organization fresh. It helps to make sure we’re considering new, innovative ideas. Overall, the future is bright for the ACR and for the Council. We’ll continue to have a lot of dynamic conversations.”


1. del Regato JA. The American College of Radiology: Fiftieth Anniversary.1973;107(1):113.

2. Linton OW. The American College of Radiology: The First 75 Years. Reston, VA: American College of Radiology; 1997.

Author Alexander Utano  editorial assistant, ACR Press