ACR Bulletin

Covering topics relevant to the practice of radiology

The Next Step

Transitioning into a leadership position within a radiology practice or department requires a specific skillset and a lot commitment.
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“My story about becoming a department leader is a short one: I stepped in because, at the time, no one else wanted the job.”

—Joseph D. Calandra, MD, FACR, chair of the department of radiology and program director at Presence St. Francis Hospital and chief medical officer of Midwest Imaging Professionals in Evanston, Illinois
March 13, 2020

Radiologists move into leadership positions within practices and departments through a variety of paths. For instance, Joseph D. Calandra, MD, FACR, chair of the department of radiology and program director at Presence St. Francis Hospital and chief medical officer of Midwest Imaging Professionals in Evanston, Ill., stumbled into a leadership role in 2004 when his group’s chair resigned abruptly, leaving an unexpected vacancy at the helm. “My story about becoming a department leader is a short one: I stepped in because, at the time, no one else wanted the job,” says Calandra, who has since led his group through a series of acquisitions that have increased the size of his team from six to about 40 members.

Sohail G. Contractor, MD, professor and interim chair of the Department of Radiology at Rutgers New Jersey Medical School, in Newark, N.J., on the other hand, has had an entirely different experience. Contractor became interested in leadership during his residency and has been on the leadership track ever since. He has been residency chief, fellowship program director, section chief, vice chair, and is now preparing to become chair of his department. “For me, transitioning into a leadership position has been a process — not an on/off switch,” Contractor says. “I have seen and seized opportunities to move into different types of leadership roles at every stage of my career.”

Whether radiologists fall into leadership serendipitously, like Calandra, or march into it through a series of deliberate actions, like Contractor, they are sure to encounter new situations and challenges as they grow into their positions. “As practice and department leaders, radiologists are transitioning into an area that’s both exciting and to some degree, perhaps, unfamiliar,” explains Alexander M. Norbash, MD, FACR, professor and chair of radiology at the University of California, San Diego, and faculty member with ACR’s Radiology Leadership Institute (RLI). “They must be cognizant that they’re moving into a different space within their organizations and intentionally gain experiences to help them do their best in this new role.”

New Role

When radiologists advance into leadership positions within their practices and departments, their responsibilities change. For example, Jocelyn D. Chertoff, MD, FACR, chair of the department of radiology at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., says that since she became interim chair in 2014 and chair the following year, she has performed less clinical work and has taken on more management, customer service, and human resources responsibilities. “As chair, my job is to ensure the department is functioning optimally,” says Chertoff. . “I answer complaints, troubleshoot problems, and analyze data about the department’s operations. I also hire staff and handle reappointments, things that have an impact on employees’ lives and work.”

Managing such responsibilities requires a special skillset. Ian Weissman, DO, staff radiologist at Milwaukee Veterans Affairs Medical Center, in Milwaukee, Wis., who holds a Certificate of Leadership Mastery from the RLI, says one of the most important skills leaders must possess is the ability to listen to and respect different points of view. “To be a great leader, you really have to listen and then you collaborate and then you team build,” Weissman notes. Another essential leadership skill is the ability to see the larger picture and act toward that vision, Contractor says. “To be an effective leader, you must realize you’re working to advance the entire group and not just one or two people,” he says. “You should make decisions with that in mind.”

Trained Leader

Typically, radiologists do not learn leadership skills as part of their clinical training; therefore, they must take other avenues to gain such skills. Some radiologists pursue advanced degrees in business administration for this purpose. In her case, Chertoff earned two master’s degrees, and also completed the Executive Leadership in Academic Medicine (ELAM) program, a course for women leaders in academic medicine. “These are things I was interested in doing regardless of which direction my career went,” Chertoff says. “But my studies in health care and delivery science and through the ELAM program have been particularly useful in preparing me for my role as department chair.”

In addition to academic instruction, radiologists can gain valuable leadership training through professional programs such as the RLI. “The RLI is created by radiologists for radiologists who are specifically interested in leadership training,” Norbash explains. “The institute embeds radiologists in a community of individuals who are either interested in leadership or who have moved into leadership positions. It also gives them access to educational opportunities and settings where they can learn about the challenges and pitfalls associated with leadership.” Weissman says one of the program’s greatest benefits is that it connects participants with seasoned leaders who share their experiences and knowledge. “The RLI has been an amazing resource and has helped plug me into the radiology community’s leadership network,” Weissman says.

Radiologists can also learn a lot about leadership from mentors within their own institutions and other social circles. Calandra says that while he wasn’t expecting to step into a leadership role when he did, he was successful thanks to two mentors who helped him early in his career. “They were my role models,” says Calandra, who has also attended the RLI conference every year since it launched in 2012. “It’s thanks to these mentors that I had some idea of what I was doing when the opportunity to become a practice leader presented itself.” In addition to mentors, Contractor adds that he has learned lessons from leadership books. He recommends “Leadership” by Rudolph W. Giuliani and “Radiology Business Practice: How to Succeed” by David M. Yousem, MD, MBA, and Norman J. Beauchamp, Jr., MD, MHS.

Flexible Figure

While radiologists can do a lot to prepare for leadership positions, they can’t possibly be ready for every scenario that crops up. Some leadership training happens on the job, so radiologists must be prepared for missteps along the way. “Oftentimes as you move forward, you experience setbacks,” Norbash explains. “The thing you must keep in mind is that just because you’ve had a setback does not mean you don’t have leadership potential.” Norbash says he experienced his own setbacks nearly 13 years ago, when he became a department chair for the first time. “I was overly confident, and I made a number of mistakes as a result,” Norbash says. “The good thing is that I learned from them. I’m much more careful, much more thoughtful, much more deliberate, and much more humble than I was before, which has made my transition into my current position much easier.”

Radiologists must also be prepared for the responsibility that comes with being a practice or department leader. Leaders are responsible for the group’s operations every day and must handle unpredictable situations as they arise. For instance, Contractor recalls a time recently when he was on vacation in another state and a colleague called to tell him the hospital’s electrical power would be down the next day, with only enough emergency power for some imaging units. It was Contractor’s job, as interim chair, to prepare the department for the power outage — vacation or not. “You can’t hang up the phone and say, ‘This is not my problem because I’m on vacation,’” Contractor says. “It’s your job to figure it out.”

Another thing radiologists should consider when becoming a practice or department leader is the time commitment. Calandra, who continues to read a full load of imaging studies in addition to managing the practice’s operations and running Presence St. Francis Hospital’s residency program, says being a leader requires a lot of sacrifice. “You have to want to do this, or it’s going to be a job, not a passion,” he says. Contractor agrees and says being a practice or department leader is not for everyone. “You have to reach into your inner self and figure out whether you’re cut out for this and whether it’s a good time to step into a leadership role,” Contractor says. “It’s not something that you say, ‘Okay, next week, I’m going to start taking on some leadership roles.’ It takes a lot of effort.”

Community Engagement

Radiologists who are committed to becoming leaders but who don’t have the opportunity to move into a practice or department chair position shouldn’t feel discouraged. They can still become leaders in the radiology community. “A practice or department setting allows you a more consistently engaged leadership opportunity. But if you don’t have that opportunity and you want to get into leadership, there are many other outlets you can find to do that,” Norbash says. “You can work in your state radiological society or as a physician chair with the ACR.”
Casey A. Melcher, MD, second-year radiology resident at the Medical College of Wisconsin who plans to become an interventional radiologist, says he is interested in leadership track and has already begun gaining experience by serving as a board member and resident leader of the Wisconsin State Medical Society and as an active member of the Wisconsin Radiological Society. Melcher has advice for anyone who wants to get involved: show up. “I got involved because somebody invited me to a meeting with our state medical society, and I showed up. Then the next thing I knew, somebody told me about another opportunity,” he says. “Once you start getting involved, more opportunities open themselves up to you. The key is to stay focused on your passions.”

Author Jenny Jones,  Imaging 3.0 content specialist