JACR: Strong leadership provides key to radiology's success

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As imaging moves into an era of increased scrutiny and regulation over questions of cost-effectiveness and productivity, strong leadership from radiologists will be needed to demonstrate the value of imaging, according to John A. Patti, MD, of the department of radiology at Massachusetts General Hospital in Boston and chairman of the American College of Radiology’s (ACR) Board of Chancellors.

In a memo published in the November issue of the Journal of the American College of Radiology, Patti wrote that there have been great developments in radiology in recent decades, but with them came concerns about the overuse of imaging, escalating costs and the emergence of new payment models.

Patti said the most recent era for radiology has unfortunately featured attitudes of entitlement and isolation among radiologists. “We will constantly be confronted with the need to defend medical decision-making as never before because society can no longer afford unfettered growth of medical procedures, especially imaging,” wrote Patti. “Society has cast us as an ancillary cost burden, and we must therefore turn an introspective spotlight on who we are, what value we provide and how we can improve patient outcomes with current tools.”

Despite the uncertainty of the times, Patti is optimistic about the future of radiology, with new frontiers as exciting as when x-ray was first discovered around the turn of the 20 th century, but success will come only from strong leadership.

There is a difference between leadership and management, explained Patti. Managers have subordinates whom they control in an attempt to increase efficiency and productivity. They are focused on organizational structure and tend to be risk-averse.

Effective leaders, however, understand both the big and small picture, and lead by example, according to Patti. Followers are motivated and voluntarily join the cause.

“Leaders create a vision and have followers whom they empower,” wrote Patti.

Patti described the three leadership styles as defined by psychologist Kurt Lewin: authoritarian, participative and delegative. Authoritarian leaders provide firm direction, but at the cost of group input. Delegative leaders offer little guidance and while group members can make their own decisions, roles are poorly defined.

Participative leadership splits the difference, allowing group input with guidance from above. This style has generally been accepted at the most effective, according to Patti.

Radiologists in the 21 st century must accommodate their leadership styles to recognize the diversity of perspectives among their followers, wrote Patti. Leaders must make sure they tailor their vision to their organization.

“For our specialty not only to survive the challenges it faces but to continue to thrive in the future, the overarching vision of every leader in radiology should be for radiologists to capture the center of the healthcare enterprise through the provision of added value, beyond interpretation,” concluded Patti.