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OPINION

© 2009

he ACR’s Commitment to Practiceeadership

oward B. Fleishon, MD, MMM, Cynthia Sherry, MD, Arl Van Moore Jr, MD

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he ACR recognizes that radiologyractice leaders play a vital role notnly in our groups but for our pro-ession as well. Over the past fewears, the ACR has raised thewareness of its commitment andupport to leadership developmentithin radiology.Group practices are the bedrock

f Radiology. The effectiveness ofur leaders is fundamental to theuccess of these institutions. Asuch, the training and success ofurrent and future leaders benefitsll radiologists and our profession.

Whether academic or private prac-ices, our enterprises are indeed small,edium, or in some cases, large busi-

esses. Critical topics such as ac-ounting, strategic planning, humanelations, financing, and operationalngineering are not taught in medicalchool. They are, however, integral tohe sustainability of any successfulractice. As physicians and as practiceembers, we need to embrace the

esponsibility and accountability forhese real-world business manage-ent challenges.There are a variety of ways to

chieve skills in these disciplines.rguably, nonphysician employeesan furnish some of this expertise.evertheless, abrogating the re-

ponsibility of ownership is fraughtith risk. Successful practices rec-gnize the need to support theirractice leaders and give them bothhe time and resources they need toe successful.Five years ago, the ACR began

ponsoring meetings for group prac-ice leaders. That concept evolvednto the formation of the Practice

eaders Committee. Constituted in o

010 American College of Radiology1-2182/10/$36.00 ● DOI 10.1016/j.jacr.2010.04.012

008, the mission of the committeeas been to:

promote leadership in radiologyand the ACR,advocate for educational pro-grams for practice leaders,enhance communication betweenthe ACR and practice leaders, andidentify the ACR as the primaryeducational and information re-source for practice leaders.

Practice leaders are a vital demo-raphic for the ACR. First, they areesponsible for the strategic plan-ing of their organizations. Theyan also significantly influence theirroups’ recognition and commit-ent to organized radiology. Prac-

ice leaders represent an experi-nced and motivated subset ofembers who, in many cases, vol-

ntarily devote their talents notnly for their practices but as lead-rs in the College.

Despite the variations, leaderseed similar skills and resourceshen taking on the challenges ofanaging practices. The roster of theractice Leaders Committee reflectshe diversification of practices acrosshe country. Not only representingifferent regions, members hail fromoth private practices and academicenters, urban and rural centers, andmall and large groups.

The current Practice Leadersommittee has taken on the respon-

ibility of organizing ACR-sponsoredeetings since 2008. We have taken

he approach to partner with otherrganizations and agencies with sim-lar missions. Last year, we jointlyponsored a meeting with the Radi-

logy Business Management Associ- M

tion. The meeting was well receivednd will be reengaged in 2010. Were reaching out to other similar-inded organizations as well.In June 2009, the Practice Lead-

rs Web site was introduced, atttp://practiceleaders.acr.org. Theoal is to become the primary re-ource for current and future prac-ice leaders. The design providesot only content but also a gatewayor radiology resources, especiallyithin the ACR. The Web site fea-

ures a catalogue of leadership-re-ated articles for reference. Therere also podcasts of leadership pre-entations. There are related linkso state chapters, organizations, andcademic institutions, includinghose that offer postgraduate train-ng in leadership skills.

An important feature of the Webite is the forum. The forum is a pro-essional networking tool for leadersnd members to discuss and share re-ated experiences and issues. Therere two sections: the moderated sec-ion features experts in the field whoead important and timely discus-ions. The Leaders Lounge providesn opportunity for all members toost issues or ask questions. The sites monitored by ACR staff membersnd leaders, who share their thoughtsnd experiences.

Some of the moderated threads in-lude “Marketing to Your Custom-rs,” with Frank Lexa, MD, MBA;Palpable Problems, How to Solvehem,” with Arl Van Moore Jr, MD;

Strategic Planning,” with Lawrenceuroff, MD; “The Business Man-

ger Role,” with Mark Bernardy,

D; and “Bundled Payments

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830 Opinion

round Episodes of Care” with Bibbllen Jr, MD.The Leaders Lounge has discussed

uch topics as “Pay for Performance,”Physician Quality Improvement Ini-iative,” “Retail Radiology Clinics,”Changing Relationships Betweenospitals and Radiology Groups,”

Radiology Group Mergers,” and “Ra-iation Safety Issue.”

In May 2010, the ACR’s com-itment evolved further with the

onstitution of the Commission oneadership. The commission will

urther develop and expand theCR’s support of current and fu-

ure leaders for the profession. Theommission on Leadership will re-ort directly to the Board of Chan-ellors.

The ACR board recognizes thathe first decade of the new millen-ium has exposed insidious but ac-elerating threats to radiologistsnd the medical specialty of radiol-gy. By creating the new commis-ion, the board ignited efforts thatill strengthen critical founda-

ional pillars of radiology’s infra-tructure. Some of the threats radi-logy faces today include theollowing:

Professionalism in decline: Radiol-ogists are apathetic, complacent,and accustomed to a culture ofentitlement, and there is a pre-vailing sense that radiologists

have become distanced or segre-

gated from mainstream medi-cine.Disruptive transformation: Telera-diology and outsourcing have ledto the increasing commoditizationof radiology and have emboldenedand empowered radiology serviceproviders to aggressively competewith, and frequently overcome,traditional radiology independentbusiness models.Economic crises: Escalating healthcare expenditures in general andimaging expenditures in particu-lar, have forced government andthird-party payer cutbacks, and inresponse, radiology practices haveintensified their focus on profit-ability and productivity, some-times at the expense of servicequality to patients, referring physi-cians, and hospital partners. Fur-thermore, policymakers searchingfor cost controls are proposing newquality-based payment mecha-nisms, and radiologists and imag-ing too often find themselves notat the table but on the menu.Core purpose confusion: Imagingplays a crucial, central role in themajority of patients’ care andmodern health care delivery, yetradiologists are not commandingan active role in ensuring appro-priateness, access, safety, quality,process improvement, evidence-based decision making, reducing

variations or standardizing pro- a

tocols or communications, andso on.Key relationships: Private practiceradiology groups and the inde-pendent practice of radiology arethe bedrock of our specialty, yetacross the country, conflicts be-tween radiology groups and theirhospital partners are flaring up atrates never before encountered,splintering and eroding thesecore relationships.

The answers and solutions to thisroup of disparate threats are notimple and will not appear spontane-usly or through traditional means.he deliberate development of

killed and strategic radiologist lead-rship, strong radiology business andanagement practices, and soulful

enewal of radiologists’ fundamentalommitment to medical profession-lism will be the drivers. Through ed-cation and enlightenment, the newommission will take steps towardnsuring strong future radiologyractices, skilled radiologist leadersor a wide variety of modern leader-hip roles, and a rejuvenated commit-ent to the noble values of radiolo-

y’s role in medical professionalism.hether radiology endures as a re-

pectable and robust medical spe-ialty depends deeply on the qualityf leadership among our ranks, andhe Commission on Leadership isedicated to radiologist leadership

nd practice development.

oward B. Fleishon, MD, MMM, is from the Department of Medical Imaging, John C. Lincoln Medical Center–North Mountain,hoenix, Arizona. Cynthia Sherry, MD, is from the Department of Radiology, Texas Health Presbyterian Dallas, Dallas, Texas.rl Van Moore Jr, MD, is from Charlotte Radiology PA, Charlotte, North Carolina.oward B. Fleishon, MD, MMM, John C. Lincoln Medical Center–North Mountain, Department of Medical Imaging, 250 Eunlap, Phoenix, AZ 85020; e-mail: hbf@cox.net.