How Radiologists Can Manage Change

CHICAGO - Change is the only constant, as the old saying goes, and nowhere is that more true than in healthcare. But instead of resisting change, said speakers appearing in a Tuesday session at RSNA 2013, practitioners should anticipate and promote change with an eye toward organizational culture.

“The pace of change in our society is quickening,” said N. Reed Dunnick, MD, president-elect of RSNA and chairman of the Department of Radiology at the University of Michigan Health System in Ann Arbor, Mich. “This is true not only for imaging technology, but also for the entire healthcare industry and the regulations that govern our behavior. If our field is going to respond effectively to these challenges, we must understand the cultures of our professional organizations to enable them to better implement the needed responses.”

Healthcare in the United States is seen as too expensive for the quality it delivers, Dunnick said, and market-based healthcare reforms are forcing radiologists to make their practices more efficient, patient-focused and results-oriented. Diagnostic imaging will likely no longer be a 9-to-5-job, and the culture - that shared set of attitudes, values, goals and practices - of many organizations will need to evolve to meet new demands.

Success breeds complacency, added Michael N. Brant-Zawadzki, MD, executive medical director of Neurosciences at Hoag Memorial Hospital in Newport Beach, Calif.., and while diagnostic imaging technologies have been incredibly successful, they are one reason that healthcare costs are so high in the United States. As a result, cost has become the dominant message, not their effectiveness in supporting healthcare.

“People don’t buy what you do, they buy why you do it,” Brant-Zawadzki said. “We have to articulate the ‘why’ of the process, and the ‘why’ is that we are at the core of the emerging healthcare system. Our information is critical to diagnosis, triage and decision support. We provide better value for the dollar. We can help patients decide whether they go further down the patient-care road or not.”

Without cultural change, however, organizational efforts to improve quality, add value or restructure will fail. “It’s really the culture that has to change for these tools to work,” Dunnick said. “Is the culture consistent with the strategic plan? If not, you must move the culture or rewrite the plan.”

To build support, leaders must empower people by sharing the timeframes, measurements and metrics for the changes ahead. “As leaders, we must walk the talk,” Dunnick said. “Recognize that people will be anxious about change, seek input, develop a plan and communicate that plan clearly.”

Organizations that plan for change can exercise more control over it. “We have to have a systematic method for change,” said William T. Thorwarth Jr., MD, principal of Catawba Radiological Associates in Hickory, N.C. “The first steps are a vision and a mission statement. A mission statement is a guiding light and filter for strategic planning, [and] a living document. It cannot sit on a shelf or in a closet.”

Get buy-in from colleagues on the plan and its revisions. Understand who your allies and adversaries are in effecting change, and monitor the plan at every stage from the drawing board to post-implementation review. “Surprises are unavoidable, but they are inversely proportional to planning,” Thorwath said. “If we keep the patient the primary focus of what we do, we will stand in good stead.”