Leadership Training for All Radiologists

Anatomy, physics, and pathology are all hallmarks of the radiology education. Now, the ACR® intends to add another element: leadership training. The college announced in mid-August 2011 that it will launch the Radiology Leadership Institute (RLI) in 2012 with an inaugural invitation-only meeting, to be held July 12–14 at Northwestern University’s Evanston, Illinois, campus. The institute is intended to educate all radiologists and will feature management training for residents, fellows, and practicing physicians. A full curriculum is being developed that will include face-to-face learning (in a variety of geographic locations), team projects, case analysis, and Web-based distance learning. To learn more about the institute, Radiology Business Journal interviewed Cynthia S. Sherry, MD, FACR, chair of the ACR Commission on Leadership and Practice Development and medical director of the recently announced RLI. RBJ: Why has the ACR elected to invest in leadership skills for the profession now? Sherry: In recent years, the ACR leadership has recognized that the business of running a successful medical practice or medical department is challenging for all physicians, not just radiologists. There are a number of reasons for this, including economical, political, and competitive factors that are driving the present need for more sophisticated business acumen among radiologists, in both academic and private-practice settings. Hospitals are under similar pressures. Together, these two parties are finding that they have different expectations of each other. As a symptom of this, we saw longstanding relationships between radiology groups and hospitals becoming strained and breaking down; because these relationships are the bedrock of radiology and the majority of radiologists practice in hospital-based settings, these breakdowns were the first indication that we had to do something about honing our leadership and management skills. RBJ: Are there any specific market conditions or government actions that prompted the founding of the institute? Sherry: The health-care landscape in general is chaotic and uncertain right now, and there are a number of governmental actions and market conditions that are playing a role. There are a few assumptions all of us are likely to be making. Whether or not the Patient Protection and Affordable Care Act is implemented, the amount of governmental intrusion into health care is likely to increase. We all agree that the current rate of growth of health-care costs cannot be sustained, and we all agree that the current fee-for-service model is likely to be overhauled in the next few years. With all of this going on, it is crucial for radiologists, as individuals and in groups, to become more knowledgeable and adaptable, and to gain more effective skills in management and business. Clearly, reimbursement cuts have overly targeted medical imaging in recent years; if unchecked, these continuing cuts will have the consequence of limiting patients’ access to life-saving medical-imaging tests. It is of paramount importance for radiologists to become more actively engaged and influential in the political process. RBJ: Is there a perceived or real shortage of leaders willing to assume leadership positions in the practice or the hospital settings? Sherry: Taking the 30,000-foot view, in all medical specialties, radiology included, leaders have traditionally been selected based upon their clinical acumen, so that the best clinicians inevitably rose into the leadership positions without bona fide management or business training. Most of their knowledge in these nonclinical areas came from on-the-job experience. This probably didn’t work very well in the past, but circumstances were different, and the system was a little more accommodating. Nowadays, the system is less accommodating, the business of medicine has become much more complex and demanding, and the system has higher expectations of physician leaders in general, radiologists included. If physicians—if radiologists—are to play a meaningful part in the rollout of health-care reform, it is critical for them to obtain these leadership skills. RBJ: What type of faculty do you hope to attract? Will academia, medicine, and business all be represented? Sherry: We are setting our sights on attracting a combination of faculty from a variety of business and academic backgrounds, and in addition to that, plan to engage the services of the numerous radiologist faculty who already have demonstrated expertise in these realms. We also think of ourselves as an academy that will draw upon the resources of many other radiology societies. We think that in the early stages of leadership/management education, it is important to tie the business fundamentals back to the relevant issues of radiology because, first and foremost, we have to keep our own house in order before we assert our influence beyond it. RBJ: Will there be a diploma program, or is this strictly designed for CME? Sherry: The institute is designed to award certificates of proficiency in leadership as the candidate advances through the institute. We have divided the institute into different levels, and each level is marked by an award of a certificate. As the RLI unfolds, we are working to provide the participants a number of pathways that can lead to an advanced business degree, and we are in the process of working out details with these graduate business school affiliates. The RLI will differ from traditional business schools and executive programs because of the inherent focus on radiology, especially in the early stages. As a radiologist advances in the institute, his or her interest will naturally broaden beyond radiology and will naturally evolve into a broader interest in general business and health-care issues. The RLI plans to anticipate these needs and keep pace with these advancing interests. RBJ: Whom do you intend to educate, rank-and-file radiologists or practice and department leaders? Will there be something of interest for all members? Sherry: Our philosophy is that there are so many diverse opportunities for radiologists to participate in management and leadership roles that we think it is crucial for all radiologists to acquire at least some modicum of leadership/management training. We don’t think these skills should be limited just to the chosen few who become practice leaders or department chairs. The opportunities out there are just so numerous and varied that every radiologist would benefit by participating in some way. In essence, we need to create a cultural transformation that values, expects, and demands leadership activity, in some form, from every radiologist in our practice. Leadership training will also produce better followers; it is equally important for radiology-group members all to pull in the same direction as their leaders and not to work against them. Leadership training would enlighten all of us and set the stage for a more effective specialty-wide transformation. RBJ: Will there be distance learning, or will it all be classroom based? Sherry: Basically, what we are thinking about that is that there would be a combination. There’s a certain amount of book learning that will take you a certain distance, but many of the leadership skills are behavioral competencies that can be best learned in face-to-face situations, working in teams, working on projects, and demonstrating that radiologists have achieved these competencies. RBJ: Will the institute help radiologists achieve their maintenance of certification? Sherry: The RLI will offer CME credits wherever possible, including some ethics credits, and will work toward providing the self-assessment modules. We are trying to arrange for the RLI credits to count toward the criteria to achieve ACR fellowship. RBJ: What does the college hope to achieve at the inaugural meeting next July? Sherry: We just want to jump-start a collaborative program that will engage ongoing interest from many individual radiologists at various levels of career maturity across the country. We also hope to engage the commitment of practices and practice leaders that they will support their members’ pursuit of leadership education. RBJ: The first meeting is by invitation only. How do radiologists signal their interest in receiving an invitation? Sherry: We will have a limited number of slots available: The size of the class will have to be limited. If radiologists sign up for this launch event, they will become ambassadors for the program and will be given special privileges. If they are interested, they should just go to the website (www.acr.org/RLI). There is a questionnaire, and they just need to sign up for the class.