Turbulent Waters

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The current environment in radiology is changing quickly—and the pace of change is accelerating. Radiologists are accustomed to change. In fact, some would say that radiology is the primary field of change, but never has the pace of change been so rapid. In addition to the new technological developments that are revolutionizing the way that we practice medicine, we are seeing marked changes in the way that radiology is organized into corporate structures, as well as new ways for payors to buy imaging services. All of these changes can leave a radiologist’s head spinning, and they can lead to confusion if there is not close alignment and good communication within the group practice. This is where leadership training is highly valuable. In order to accomplish the changes that we need to make at such a high level (and so rapidly), we must have physician leaders who know how to communicate and gain alignment. Our partners are unable to take in all of the changes and come to alignment by themselves. Without leadership, we would have a mess: multiple physicians vying for specialized interests. With the gravity of the changes that we are seeing, a successful group practice needs alignment. Instead of having multiple camps pulling in different directions, the successful practice will have all partners pulling in the same direction. Radiologist partners in a group practice can’t get alignment without somebody, or some people, ensuring alignment. Leadership is a real job, and somebody has to do it. Some practices outsource leadership, hiring a professional administrator or practice manager. The professional administrators, however, often lack the backgrounds needed to understand the highly technical work of the radiologist. It’s almost certainly easier to teach a radiologist leadership skills than it is to teach professional leaders something about radiology. In other words, if the current health-care environment is the ocean, and the group practice is the ship, the ship needs a captain who knows the ocean well—but also knows how to sail a ship. In the time leading up to my assumption of a leadership role in my radiology group practice of 75 physicians, I was encouraged to take a formal leadership-training course. I agreed to do so, not having much idea about what I would learn there (or how I would learn it). I enrolled in an 18-month curriculum, called Physician Leadership College, hosted by the University of St Thomas (at its Minneapolis, Minnesota, campus). The group was composed of 16 students, all in various phases of their careers and each taking the course for slightly different reasons. The course was intriguing because it focused exclusively on physicians, as well as because it focused on leadership, rather than management. The stated objective of the course was to increase the student’s capacity to provide leadership in the health-care environment through a combination of didactic learning, self-analysis/introspection, and network building. The didactic-learning portion of the course addressed topics such as health-care economics, accounting, marketing, quality, and strategy. It is critical to understand each of these topics before embarking on a leadership role in health care. Interspersed with these didactic-learning assignments, however, were periods of time dedicated to looking at oneself. This introspection (sometimes guided by classmates) was perhaps the most surprising part of this curriculum to me. In the end, however, it was probably the most important. By taking a close, hard look at yourself, you get a much better sense of your own strengths, weaknesses, and opportunities to improve. This was the hard work of increasing my personal capacity to provide leadership. The opportunity to work closely with 15 other emerging leaders (with whom I normally do not interact) throughout the regional health-care community was also a great blessing. I experience all problems through the eyes of a radiologist, so it was very instructive to see the problems of health care through the eyes of a cardiologist or those of a primary-care practitioner. As I learned during my course, much of leadership in radiology has to do with seeing matters through the eyes of others. In summary, the practice of radiology is going thorough massive structural changes. Solid leadership is necessary for the transition of the radiology practices of today into the radiology practices of tomorrow. Formal leadership training helped me develop myself to fill my role as a radiology practice’s leader through a combination of didactic learning, introspection, and regional networking. If nothing else, the leadership training allowed me to visualize the problems of radiology better through the eyes of nonradiologists—such as our partners and customers. Neeraj Chepuri, MD, is president and CEO, Consulting Radiologists, Ltd, a 75-radiologist practice based in Minneapolis, Minnesota.