RSNA 2016: Organizational change requires strong physician leadership

Academic medicine does a great job of producing physicians—but leaders? Not so much.

A lack of effective leadership can paralyze an organization, making affecting change all but impossible according to a Sunday afternoon session at RSNA 2016.

“One of the problems we have is that leaders are selected because they performed well in their previous positions,” said University of Michigan Radiology Chair N. Reed Dunnick, MD. “We haven’t given them any training for the new position, no succession planning, little exposure to see if they would like the new job—we just thrust them into it.”

Repeat this cycle enough and everybody is stuck in a position where they fail, according to Dunnick. Instead, taking advantage of leadership training programs and a working understanding of how to affect organizational change can increase a department’s chances for success.

While standard leadership training programs run the spectrum from disreputable to acclaimed, major radiology societies such as the American College of Radiology (ACR) and RSNA have begun offering educational programs. RSNA’s approach goes by the Academy of Radiology Leadership and Management, featuring 12 hours of educational content at RSNA 16. Using resources such as these can help physician leaders, but they also need effective change management, according to Dunnick.

Humans naturally resist change. We like to be comfortable, we don’t like surprises and we’re wary of change, even when it sounds positive. Overcoming that resistance requires clarifying the impact of change on people, assuaging fears of uncertainty.

“We can do things formally, like an updated job description. We can do things psychologically; do people in the organization trust you to make good decisions?” said Dunnick. “And, there’s a social aspect; we must practice what we preach. Did we do what we said they should do?”

The next step to successful change in understanding the culture of an organization, which dictates how people behave and make decisions. A shared set of goals and values, it can support the change process by bringing people into the fold.

“Don’t impose change, include the people who are going to be involved,” said Dunnick. “Let them help create policies, structures and systems to meet those changing needs.”

“These individuals know their jobs much better than we do, and if we can get them engaged, they can come up with solutions superior to ours,” he added.

However, before departments start thinking about solutions, they need to sell people on the problem. According to Dunnick, change will be exhausting to initiate unless the organization understands the need for it.

“Look at U.S. healthcare, it’s too expensive. It’s unsustainable,” he said. “So what do we need to do? We need to practice more efficiently, think about the risk/benefit ratio for procedures, recognize it’s not appropriate to do everything for everyone.”