New Skills Required for Imaging Leaders

Today’s complex health care environment has placed increasing demand on imaging administrators and radiologist group leaders to actively prepare for changing market trends.

Experience and education, along with the ability to mentor staff and guide change, are strong foundations, but they are no longer enough. Negotiation, communication, and engagement skills across many levels and the ability to understand emerging regulatory, policy, and payment structures are becoming essential.

Government involvement in health care has created a ripple effect and left no area of imaging untouched. The result has been practice mergers, large scale conglomerations, alternative payment models, and the cultural shift from volume to value.

These are changes that, quite simply, increase the skill set required for leaders to manage such disruptive times.

“The good old days are way gone and the world has changed 180 degrees,” said Jacqui Rose, MBA, CRA, FAHRA, a 28-year director of imaging, telecommunications and IT at Upper Valley Medical Center in Troy, OH. Increased requirements and regulations coupled with a faster pace, makes resiliency the key characteristic today’s imaging leader needs to succeed, Rose said.

Frank Lexa, MD, chief medical officer of the Radiology Leadership Institute (RLI) since 2015 and a neuroradiologist, venture capitalist, and professor at the Wharton School, in Philadelphia, PA agreed: “radiologists mid-career or older could never have imagined this amount of change this consistently.”

Leaders must be prepared for the unexpected.

Today’s Imaging Leaders Face New Challenges
Unlike years past when radiologists and technologists were both more likely to arrive in leadership positions, the way Rose did through an internal desire to advance in her career, today’s imaging leader on the hospital administration side comes from many backgrounds and a short learning curve is the norm.

“Time is one of our biggest challenges,” said Rose, who has developed a self-described servant leadership style over the years. The industry has created extremely lean management structures that don’t offer the internal luxury to properly train and get new leaders up to speed, she said.[[{"type":"media","view_mode":"media_crop","fid":"53295","attributes":{"alt":"Leadership in radiology","class":"media-image media-image-right","id":"media_crop_3093065115089","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6643","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 159px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©mypokcik/Shutterstock.com","typeof":"foaf:Image"}}]]

“It is difficult to send staff to seminars and industry meetings for two reasons in particular: funding the trip and staffing the department,” said Janice Eurton, CRA, FAHRA, manager of imaging at Clark Memorial Hospital in Jeffersonville, IN. Declining reimbursement and shoe string budgets result in a constant struggle to meet daily metrics while still providing high levels of satisfaction and engagement.

 “Even groups that have done that well in the past are going to come under pressure today from the national trends of consolidation and evolving government regulations,” said Syed Zaidi, MD, president of Radiology Associates of Canton in Ohio.

 Survivability will require smaller groups to partner and consolidate, he said, and their leaders need new skills, including change management, strategic management, contract negotiations, and relationship management within the group to build consensus.

“Seeking out and finding the appropriate channels to implement meaningful change can be a seemingly impossible task if you don't understand or have appropriate guidance to find the person or people that can get things done," said Matt Hawkins, MD, director of pediatric interventional radiology at Emory’s Children’s Healthcare of Atlanta, Egleston campus. Hawkins believes that understanding the unique organizational chart and leadership hierarchy in an institution is one of the greatest challenges leaders face.

Imaging-specific Leadership Skills Provide Strong Value
External complexity has resulted in an internal assessment amongst leaders when it comes to getting the job done. On the radiologist side, the exploration of what an MBA degree offers is a common topic amongst professionals Lexa works with at the RLI. Administrators alike, realize that today’s patient-centric world is looking for easily identifiable suffixes behind names. Leaders who haven’t yet obtained higher levels of education are growing their base, while others are seeking the specific radiology administrator certification (CRA) to distinguish their expertise.

With over 4,000 MBA programs available at over 400 institutions within the U.S., the practical foundational skills of business schools are attainable but simply cannot offer the tools needed to navigate imaging specific trends. “For most radiologists, it is not the right answer,” said Lexa, who actively works with both radiologists and MBA students in different capacities.

Programs designed around busy leadership schedules and led by experts in the field of imaging can offer the ideal setting to gather information, share expertise, and collaborate. They also allow imaging professionals who have strong clinical expertise to develop new skills that elevate their profession while offering a proactive way for emerging leaders to mentor and guide others as they progress.

Luckily, two such models already exist.

Fostered and supported by nationally acknowledged imaging organizations; the RLI developed by the American College of Radiology along with the Certified Radiology Administrator designation within The Association for Medical Imaging Management (AHRA) offer programs aimed at empowering leaders while offering flexibility and self-guidance for involvement.

One Size Does Not Fit All But All are Welcome
We are all in this together, is the current campaign for the AHRA said CEO Edward Cronin, CAE, who has seen membership grow to 5,300 administrators from hospitals and outpatient settings since he started with the organization eleven years ago. As a driving force for improving the health care environment, AHRA acts as a resource and catalyst for professional leadership development on the administrator side. “We used to have mostly directors but now are seeing more front line supervisors and managers as members,” said Cronin who helped develop a Leadership Institute within the AHRA nine years ago that provides achievement-based learning for both the experienced and novice leader across two tracks.

With emerging talent embracing the need for advanced skills, the AHRA offers information and education on a personal level, said Cronin.  From a policy and procedures team to a regulatory team, this multi-faceted approach provides the most current and comprehensive information to guide administrators.

Clark Memorial’s Eurton, who is on the Board of Directors at the AHRA, said her connection with the organization has been invaluable. “A constant source of peer-networking via conferences, access to the new AHRA- Connect web site and of course our annual meeting each year provide ongoing support and education for both the new and seasoned leaders,” Eurton said.

On the physician side, The Radiology Leadership Institute has grown since its inception in 2012 to over 3,600 participants, approximately 10% of the total ACR population. With four levels of certificates that can be applied towards credits, Lexa said that radiologists learn valuable skills to leverage themselves within a group, from managing projects, to learning how to delegate and coordinate. Shifting away from a one-size-fits-all model, Lexa said, “the RLI will have what you need when you need it in the upcoming years.” Career must-haves for everybody from a radiologist’s first job through their first leadership posting.

Zaidi said his work with RLI is an integral part of developing as a leader. Having attended sessions since 2012, he has learned a range of skills including: negotiation tools, contracts, change management principles, and strategic planning. He credits the sessions with providing him with better, more diverse sources of information that provide an understanding of why some organizations succeed and some fail.

With his small group of 20 doctors deciding to partner with a large radiology group at the end of last year, Zaidi said his work with RLI helped his group adapt to change and get more information to help diversify differences and engage in a larger partnership.

Understanding the evolution of leadership, Lexa has seen radiologists shift their focus in learning over time from the more concrete skills of accounting, finance, and contracts to the more sophisticated challenge of dealing with people as their leadership roles develop. “How do you build consensus, deal with difficult negotiations, and develop people to do better or think differently?” he said.

While teaching radiologists to do all the things a smart executive would naturally be doing, Lexa said the benefits of working with the RLI is that it creates a learning experience for the busy radiologist that allows them to walk away saying, ’This is so different from anything I’ve ever done in my life.’