The ACR is a longtime advocate for the impact that radiology leadership skills can have on the delivery and advancement of high-quality healthcare. Since its inception in 2012, the Radiology Leadership Institute® (RLI) has embodied that value proposition — teaching radiologists the business and management skills to successfully navigate a shifting healthcare environment.
Over the course of this series commemorating the RLI’s 10-year anniversary, the Bulletin looked back at the history of the RLI, the topics and skills that are critical to advancing the careers of future radiology leaders, and how its world-class faculty designs the RLI courses to keep pace with changing times. In the final installment of this four-part series, the Bulletin connected with ACR staff and RLI leaders and faculty who are forging the path to the next decade of radiology leadership.
Building a Culture of Leadership
In 2022, the RLI celebrated a decade of educating strong radiology leaders. At the same time, the team guiding the RLI recognized that the challenges facing today’s radiologists have never been greater. “To help the specialty navigate an increasingly complex practice environment, we convened a series of ‘listening sessions’ comprising radiologists at all career stages and practice environments to gain insights to guide our strategic vision and the programs that will help radiologists succeed into the next decade and beyond,” says RLI Chief Medical Officer Frank J. Lexa, MD,
Coupled with the ACR Strategic Plan, the input from radiologists gathered in the sessions helped the RLI team formulate a “manifesto” for the future — a set of four pillars expressing shared values and beliefs that will guide decisions about developing next-generation leadership programs to help members tackle the challenges ahead:
Pillar 1: Leadership is for everyone.
Pillar 2: Leadership education should begin early and be a lifelong endeavor.
Pillar 3: Non-interpretive training and volunteerism should be highly valued across all practice environments.
Pillar 4: A foundational set of leadership skills is imperative.
“The RLI is committed to ensuring all radiologists are ‘future-state and leadership ready,’ and we believe that by focusing on these four areas, we will be able to accomplish that and deliver the most value in the coming decade,” says Anne Marie Pascoe, senior director of the RLI. “It’s essential that we not only help individual radiologists succeed, but that we give them tools to help their departments and practices succeed.” So, what’s next for the RLI? There are four pillars that RLI leaders say will lead the program into the future.
Pillar 1: Leadership Is for Everyone
We believe it is critical for radiologists at all career levels, regardless of title, to have strong leadership skills.
Whether leading a department or practice or serving in a clinical role, these non-interpretative skills support the development of more effective teams, enable the creation of stronger relationships within and across practices and the health system, provide a structure for managing the inevitable changes radiologists face, provide mechanisms to facilitate better communication and deal with
difficult situations/people, and provide a framework to understand the importance of strategic planning and ensure radiology is prepared to meet all future challenges.
All radiologists have a role to play in the future success of their practice/department and the specialty, and it will be important that the RLI continues to share this message and provide examples of the way radiologists are leading at all levels.
The future state of healthcare will impact every radiologist — whether you’re in a leadership role or a practitioner in a reading room or interventional procedure suite. According to Richard Duszak Jr., MD, FACR, chair of the department of radiology at the University of Mississippi Medical Center, radiologists can no longer float along with the current; otherwise, they’ll wind up on the rocks. “Chance favors the prepared mind,” he says. “You might not have a title but, as a physician, you have to be a leader to be effective. Leadership training is what takes you from being a good radiologist to being a successful one.”
As CEO of Triad Radiology Associates, Lauren P. Nicola, MD, feels strongly that radiologists shouldn’t wait until they’ve practiced for decades to consider taking on leadership roles. “We try to get
people involved in committee and leadership roles early on in their careers. We want the future of our practice to be driven by the people who will be there the longest. Having a voice is important,
and anybody who wants to make their voice heard needs skills in communication, change management, setting goals and priorities, negotiation, and many other things that aren’t taught in medical
school and residency. That’s where the RLI comes in.”
Pillar 2: Leadership Education Should Begin Early and Be a Lifelong Endeavor
We believe leadership education should begin in medical school and be embedded as a component of every resident curriculum.
The RLI will work to continue to increase engagement with medical students and residents. It is never too early to start building a strong foundation and talking about the variety (and importance) of leadership opportunities that are available during medical school, residency, and throughout a radiologist’s career. The RLI is committed to providing programs for residents and fellows and, in the coming years, will work to expand our reach further into residency programs.
The ACR is formalizing a process to create meaningful opportunities to engage medical students in the work of the College in alignment with the ACR Strategic Plan. The RLI is committed to increasing its role in these medical student initiatives and developing future leaders.
When asked about the optimal time to start leadership training, Lexa says, “There’s an old cliché that the best time to plant a tree was 20 years ago. If you want to be a good leader, the time to get
training was yesterday. Everyone needs to take steps to be leadership ready. So, when the opportunity presents itself or the need arises in an organization, radiologists are prepared, and they can step in and be most effective.”
As a member of the ACR BOC, Duszak serves as chair of the Commission on Leadership and Practice Development and, in that role, helps oversees the RLI. “It helps if you start early with leadership development — before you know you need the skills,” he says. “A key goal of the RLI is to help teach the teachers so that this becomes self-sustaining within the culture. Empowering people can be quite contagious. The goal of a leader should be to build future leaders, not simply create followers. That’s where the magic happens. People can take action and accomplish things on their own without lots of handholding — all because you’ve made it clear where the organization is headed.”
It's critical for practices and departments to invest in leadership skills and provide opportunities to a broad and diverse group so they can exercise their leadership muscles and build their strengths.
Pillar 3: Non-Interpretive Training and Volunteerism Should Be Highly Valued Across All Practice Environments
We believe that the value of non-interpretive training and volunteerism should be understood and embraced by everyone in every practice or department.
The discussion around the value that radiologists add for their non-clinical work is well established, but it is important that radiologists understand the importance of volunteerism and the value it brings to a practice or department and to the specialty as a whole.
The RLI will work to help reshape the culture to encourage an increased level of support for those who want to serve in volunteer roles in their practices, their institutions, and professional organizations. We will highlight the short- and long-term value that volunteerism brings — personally, professionally, and to the specialty — so that it becomes embedded into the culture.
Today’s RVU-driven culture is often the biggest roadblock to developing radiology’s future leaders. Building a culture of leadership requires a shift in mindset and a deeper understanding that non-clinical training is highly valuable and should be supported for every team member.
“It’s critical for practices and departments to invest in leadership skills and provide opportunities to a broad and diverse group so they can exercise their leadership muscles and build their strengths,” says Lexa. “In that way, you’re building a cadre of leaders versus having a small number of people making most of the key decisions. That’s how to future-proof your practice or department.”
Ryan K. Lee, MD, MBA, chair of radiology for the Einstein Healthcare Network and an RLI faculty member and co-chair of the RLI Resident Milestones program, notes that the ROI pressure is
on for both private practice and academia alike. “The clinical work radiologists perform continues to grow, which in turn decreases time available for leadership development. It’s left up to individual practices and departments to figure out how to cover non-clinical time when there aren’t enough radiologists. Today’s radiology leaders need to develop a plan that allows the organization to invest in leadership training. We absolutely need people to take care of patients, but we also need individuals to steer our practices in the right direction and help us evolve with the times.”
Pillar 4: A Foundational Set of Leadership Skills Is Imperative
We believe that all radiologists, regardless of career stage and role, should have proficiency in a foundational set of leadership principles.
At every stage of their careers, radiologists can benefit from leadership training. It is important that radiologists understand strategy, finance, business planning, and other non-clinical topics. To succeed in academics or private practice, they need to know how to build strong teams, manage change, and overcome difficult work situations. The RLI can provide the keys for success at each step in the career path.
Radiologists who want to hold their own among the ever-shifting healthcare landscape must deepen their knowledge of business and leadership practices. While some physicians choose to pursue a
business degree to gain leadership skills, the ACR aims to put that knowledge within reach of all radiologists — with programming that was designed by radiologists for radiologists.
“In the next decade,” says Lexa, “we want to deliver leadership programs that have high impact and are useful to radiologists at all stages of their careers. Our goal is to help them be better leaders and to contribute to their practices and to the specialty. Another goal is for us to make foundational leadership training as accessible and affordable as we can and to ensure that training and education is compatible with the work and lifestyle of radiologists.”
“Leadership training’s the one thing that will make you indispensable,” Nicola says. “Being a good radiologist has many facets, but the one thing that’s going to lead to job security and potential for
advancement and satisfaction in what you do every day is leadership training and lifelong learning. That’s where the RLI excels. These are the core things that will help you become a better radiologist and enhance the specialty. That’s true for radiology and for medicine, in general. We need to get the leadership skills that will allow us to stand on par with the non-physician administrators who are in leadership roles. It’s the only way we can ensure that patient care looks the way we think it should.”
Paving the Way for the Future of Radiology
For the past 10 years, the RLI has helped more than 9,000 participants — ranging from residents to young professionals to seasoned leaders — fill critical gaps in their non-interpretive skills. Looking to the future, Pascoe says that the RLI aims to reach even more radiologists and notes that there are two keys to success in the next decade of radiology leadership: community and collaboration.
“When you have community, you have a shared mission that exemplifies the value of leadership. Everyone can find a place,” Pascoe says. “Participants can come together in a safe space to share ideas, brainstorm solutions, gain perspective, and tackle challenges. The more people who are a part of the RLI, the stronger the community becomes and the more value it provides.”
She adds, “Collaboration is the long pole in the tent when it comes to value-based care and contributing to population health. Prioritizing collaborations within the ACR and with medical schools, residency programs, other national societies, international partners, and other specialties is how we will continue to foster and grow the RLI community. More broadly, my hope is that we’ll see more radiologists collaborating with other specialties and departments within their institutions and be seen as valued members of the patient care team for decades into the future.”