OPINION
Reflections on Principles of Good Leadership David C. Levin, MD In the past few years, there has been increasing interest within the radiology community in leadership and how to prepare for it. Both the ACR and the RSNA have developed leadership programs, and this journal has featured articles on the subject. Department chairs or group presidents have an obligation to mentor their younger colleagues on what it takes to fulfill the responsibilities of leadership and to help prepare them for the day when they might assume such a role. To that end, I propose a set of simple and straightforward principles that I believe radiologists who aspire to leadership should adhere to once they get there. They were formulated during the 16 years I chaired the Department of Radiology at Thomas Jefferson University Hospital and the prior year and a half during which I was acting chair at the Brigham and Women’s Hospital. They are particularly germane to an academic department of radiology, but to a considerable extent, they can pertain to a private practice group as well. Some are applicable to division head positions. Don’t Micromanage: Be Willing to Delegate Some Responsibility and Authority
No one can do it all. Radiologists are smart people, and the likelihood is that your division heads or other younger colleagues will have the capability and ambition to pick up some of the administrative responsibilities of the department. Give them the ball and let them run with it. It makes them feel they have a stake in the organization. But first, make sure they share your values and vision for the future. A key figure in the department is 338
your business manager. You will need to delegate much responsibility to that individual. Make sure you hire the right person, since he or she can make or break you. That person is the most important recruitment decision you will ever make. Put the Interests of Your Faculty Ahead of Your Own
As department chair, you already have enough power and prestige. Let your colleagues know that one of your main goals is to help them foster their own career goals. Things will run much more smoothly for you if they’re on your side. Your legacy is more determined by their accomplishments than by yours. Get to Know the Technologists, Nurses, Receptionists, Billing Clerks, Transporters, and Other Nonphysician Personnel Working in the Department
In many large radiology departments, there are people who have spent years and perhaps even their entire working lives there. Most play crucial roles in keeping things running efficiently and keeping your customers (patients, referring physicians, hospital administration) happy. The department’s success depends to a large degree on them. They will be more motivated and work harder if they know you and know that you care about them. Treat People Fairly
When problems or conflicts arise, as they inevitably do in large organizations, be fair and even handed in trying to resolve them. Don’t ever allow any personal vendetta to influence your handling of the situation. Be Accessible to Your Faculty
Your colleagues will often have ideas, concerns, and gripes. It’s
important that they have access to you so that they can bring them to your attention. One of the worst mistakes a chair can make is to sequester himself or herself in the office and be seen only at monthly faculty meetings. One idea is to periodically make unannounced walking rounds through the department. Go from section to section and just drop in to see what’s going on. Talk to people and observe them at work. As you do this, you will hear about those ideas, concerns, and gripes. Your faculty members will greatly appreciate your interest and availability. It’s an excellent way to build loyalty and support among them. Listen to the People Who Work for You
This is a corollary of the previous principle. As leader of the department or group, two of your major responsibilities are to solve current problems and plan for the future. Good ideas will flow to you from your faculty members, as well as from nonphysician personnel in the department. The important thing is to listen carefully, and take action on those suggestions that are worthwhile. Most departments have various faculty committees, and you ought to attend as many of their meetings as possible. That will give you an opportunity to hear your faculty members out. If others in the department know that you are listening to them, it will motivate them, stimulate their ingenuity, and enable you to build a consensus. Show Your Faculty You Care About Them on a Personal Level
The importance of this was driven home by Norman Beauchamp, MD, in a presentation at the 2013
ª 2014 American College of Radiology 1546-1440/14/$36.00 http://dx.doi.org/10.1016/j.jacr.2013.10.028
Opinion 339
meeting of the Society of Chairs of Academic Radiology Departments. These are stressful times for physicians, and chairs should try to be alert for signs of burnout or serious psychological problems among faculty members. Let them know that you care about them on both professional and personal levels. In one-on-one sessions, ask them how they’re doing. When they achieve something positive, such as publishing a paper, getting a grant, or receiving an award, acknowledge it and congratulate them at monthly faculty meetings. Be Tough When Necessary, Even if You’re Basically a Nice Person
If you’re unable to do this, think of some other line of work. No one should ever see you as a pushover. It’s okay to lose your temper once in a while when someone in the department or the hospital administration does or says something stupid. But Learn How to Control Your Anger
This again is a direct corollary of the previous principle. Being a chair of an academic radiology department or president of a practice group inevitably entails dealing with a myriad of frustrating or irritating situations. If you allow every one of them to lead to a temper tantrum on your part, you will soon be perceived as a sorehead by the people you work with and for. This will lead to more fights, and you might start losing them. Learn to roll with the punches, at least much of the time. Don’t waste your “anger quota” on small things. Save it for the really important issues.
Be Ready and Willing to Fire People Who Will Not or Cannot Be Good Citizens
In my experience, this seems to happen more among senior faculty members than among junior individuals. This may be because a sense of entitlement or complacency develops as time goes on. If you perceive this to be happening, you should counsel that individual promptly. This can be done with a personal meeting or a letter. If the former, make sure you document the details of the discussion in writing and place it in the person’s file. Firing a recalcitrant faculty member can be difficult and can lead to charges against you of various types of discrimination. But if you have a thoroughly documented paper or electronic trail showing that you warned the person about the problem on several occasions and tried to provide constructive counseling, you will be on much stronger ground and your institution should support you. Don’t Let Other Interests Distract You From Your Primary Job
The primary responsibility of an academic chair is running the department. It is a multimillion dollar business with many different challenges and requirements. Leading such an organization is a fulltime job. However, temptations to do other things may present themselves. These include doing more clinical work, doing more research, accepting outside speaking engagements, or serving national radiology organizations. Doing these things is gratifying and ego boosting and probably more enjoyable than attending to the often mundane
details of running a department. It’s certainly good for a chair to stay active in clinical work, research, and national radiology organizations to at least some degree, but a good leader should not do these things at the expense of that primary responsibility. Remember That the Legacy You Leave Behind Is Not About You
Rather, it’s about what kind of a department you built and bequeathed to your successor. You will be measured by a number of parameters: how happy the faculty was under your leadership, how productive the department was in research, how entrepreneurial you were, the strength of your training program, and how the department was viewed by the outside world. None of these things will show up on your curriculum vitae. CONCLUSIONS
A good leader must possess certain qualities. These include honesty, integrity, dedication, modesty, fairness, and toughness. But perhaps most important of all is plain common sense. One final bit of advice is to remember a lesson from history: being an academic chairperson can be a risky business. There are no hard data on this, but I suspect that if one were to study the history of every university hospital radiology department over the past 3 decades, one would find that in about 20% (or perhaps even more), a department chair was either fired or eased out under less than favorable circumstances. That is precisely why adhering to sensible principles of good leadership is so important.
David C. Levin, MD, Thomas Jefferson University Hospital, Department of Radiology, Main 1090, Philadelphia, PA 19107; e-mail: [email protected].
Reflections on Principles of Good Leadership David C. Levin, MD In the past few years, there has been increasing interest within the radiology community in leadership and how to prepare for it. Both the ACR and the RSNA have developed leadership programs, and this journal has featured articles on the subject. Department chairs or group presidents have an obligation to mentor their younger colleagues on what it takes to fulfill the responsibilities of leadership and to help prepare them for the day when they might assume such a role. To that end, I propose a set of simple and straightforward principles that I believe radiologists who aspire to leadership should adhere to once they get there. They were formulated during the 16 years I chaired the Department of Radiology at Thomas Jefferson University Hospital and the prior year and a half during which I was acting chair at the Brigham and Women’s Hospital. They are particularly germane to an academic department of radiology, but to a considerable extent, they can pertain to a private practice group as well. Some are applicable to division head positions. Don’t Micromanage: Be Willing to Delegate Some Responsibility and Authority
No one can do it all. Radiologists are smart people, and the likelihood is that your division heads or other younger colleagues will have the capability and ambition to pick up some of the administrative responsibilities of the department. Give them the ball and let them run with it. It makes them feel they have a stake in the organization. But first, make sure they share your values and vision for the future. A key figure in the department is 338
your business manager. You will need to delegate much responsibility to that individual. Make sure you hire the right person, since he or she can make or break you. That person is the most important recruitment decision you will ever make. Put the Interests of Your Faculty Ahead of Your Own
As department chair, you already have enough power and prestige. Let your colleagues know that one of your main goals is to help them foster their own career goals. Things will run much more smoothly for you if they’re on your side. Your legacy is more determined by their accomplishments than by yours. Get to Know the Technologists, Nurses, Receptionists, Billing Clerks, Transporters, and Other Nonphysician Personnel Working in the Department
In many large radiology departments, there are people who have spent years and perhaps even their entire working lives there. Most play crucial roles in keeping things running efficiently and keeping your customers (patients, referring physicians, hospital administration) happy. The department’s success depends to a large degree on them. They will be more motivated and work harder if they know you and know that you care about them. Treat People Fairly
When problems or conflicts arise, as they inevitably do in large organizations, be fair and even handed in trying to resolve them. Don’t ever allow any personal vendetta to influence your handling of the situation. Be Accessible to Your Faculty
Your colleagues will often have ideas, concerns, and gripes. It’s
important that they have access to you so that they can bring them to your attention. One of the worst mistakes a chair can make is to sequester himself or herself in the office and be seen only at monthly faculty meetings. One idea is to periodically make unannounced walking rounds through the department. Go from section to section and just drop in to see what’s going on. Talk to people and observe them at work. As you do this, you will hear about those ideas, concerns, and gripes. Your faculty members will greatly appreciate your interest and availability. It’s an excellent way to build loyalty and support among them. Listen to the People Who Work for You
This is a corollary of the previous principle. As leader of the department or group, two of your major responsibilities are to solve current problems and plan for the future. Good ideas will flow to you from your faculty members, as well as from nonphysician personnel in the department. The important thing is to listen carefully, and take action on those suggestions that are worthwhile. Most departments have various faculty committees, and you ought to attend as many of their meetings as possible. That will give you an opportunity to hear your faculty members out. If others in the department know that you are listening to them, it will motivate them, stimulate their ingenuity, and enable you to build a consensus. Show Your Faculty You Care About Them on a Personal Level
The importance of this was driven home by Norman Beauchamp, MD, in a presentation at the 2013
ª 2014 American College of Radiology 1546-1440/14/$36.00 http://dx.doi.org/10.1016/j.jacr.2013.10.028
Opinion 339
meeting of the Society of Chairs of Academic Radiology Departments. These are stressful times for physicians, and chairs should try to be alert for signs of burnout or serious psychological problems among faculty members. Let them know that you care about them on both professional and personal levels. In one-on-one sessions, ask them how they’re doing. When they achieve something positive, such as publishing a paper, getting a grant, or receiving an award, acknowledge it and congratulate them at monthly faculty meetings. Be Tough When Necessary, Even if You’re Basically a Nice Person
If you’re unable to do this, think of some other line of work. No one should ever see you as a pushover. It’s okay to lose your temper once in a while when someone in the department or the hospital administration does or says something stupid. But Learn How to Control Your Anger
This again is a direct corollary of the previous principle. Being a chair of an academic radiology department or president of a practice group inevitably entails dealing with a myriad of frustrating or irritating situations. If you allow every one of them to lead to a temper tantrum on your part, you will soon be perceived as a sorehead by the people you work with and for. This will lead to more fights, and you might start losing them. Learn to roll with the punches, at least much of the time. Don’t waste your “anger quota” on small things. Save it for the really important issues.
Be Ready and Willing to Fire People Who Will Not or Cannot Be Good Citizens
In my experience, this seems to happen more among senior faculty members than among junior individuals. This may be because a sense of entitlement or complacency develops as time goes on. If you perceive this to be happening, you should counsel that individual promptly. This can be done with a personal meeting or a letter. If the former, make sure you document the details of the discussion in writing and place it in the person’s file. Firing a recalcitrant faculty member can be difficult and can lead to charges against you of various types of discrimination. But if you have a thoroughly documented paper or electronic trail showing that you warned the person about the problem on several occasions and tried to provide constructive counseling, you will be on much stronger ground and your institution should support you. Don’t Let Other Interests Distract You From Your Primary Job
The primary responsibility of an academic chair is running the department. It is a multimillion dollar business with many different challenges and requirements. Leading such an organization is a fulltime job. However, temptations to do other things may present themselves. These include doing more clinical work, doing more research, accepting outside speaking engagements, or serving national radiology organizations. Doing these things is gratifying and ego boosting and probably more enjoyable than attending to the often mundane
details of running a department. It’s certainly good for a chair to stay active in clinical work, research, and national radiology organizations to at least some degree, but a good leader should not do these things at the expense of that primary responsibility. Remember That the Legacy You Leave Behind Is Not About You
Rather, it’s about what kind of a department you built and bequeathed to your successor. You will be measured by a number of parameters: how happy the faculty was under your leadership, how productive the department was in research, how entrepreneurial you were, the strength of your training program, and how the department was viewed by the outside world. None of these things will show up on your curriculum vitae. CONCLUSIONS
A good leader must possess certain qualities. These include honesty, integrity, dedication, modesty, fairness, and toughness. But perhaps most important of all is plain common sense. One final bit of advice is to remember a lesson from history: being an academic chairperson can be a risky business. There are no hard data on this, but I suspect that if one were to study the history of every university hospital radiology department over the past 3 decades, one would find that in about 20% (or perhaps even more), a department chair was either fired or eased out under less than favorable circumstances. That is precisely why adhering to sensible principles of good leadership is so important.
David C. Levin, MD, Thomas Jefferson University Hospital, Department of Radiology, Main 1090, Philadelphia, PA 19107; e-mail: [email protected].
