ACR Bulletin Feature Article

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It Takes an Army

Radiologists should foster a team environment to ensure their practices run efficiently and effectively.

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Those of us in the trenches know what it takes to run a successful radiology practice. The bigger the group, the more unique roles are necessary to ensure that all the moving parts are well-oiled and running seamlessly. From front-office staff to billers and coders, radiology practices need a host of different contributors to function as a cohesive unit. Within this unit, radiologists are typically captains of specific care teams, and practice leaders function like admirals of the fleet. Regardless of one’s role within a practice, whether it be private practice or academic, radiologists at all levels need to lead diverse groups, even if it means simply guiding the team through the daily schedule of patients.

From front-office staff to billers and coders, radiology practices need a host of different contributors to function as a cohesive unit.

The phrase “allowing doctors to practice at the top of their license” is often used to inspire practice-improvement initiatives that enable radiologists to focus exclusively on the activities unique to their role, namely image interpretation and interventional procedures. However, I often bristle at this phrase and quietly ponder the fact that no small measure of my success has come from practicing at the so-called bottom of my license.

While many tasks in our profession may be parsed by role, other menial tasks do not fall in any one individual’s job description. Much as all family members should pitch in to wash the dishes or take out the trash, all team members should at times pitch in to help the team get through the work day, regardless of the task at hand. Even when some tasks are directly attributable to a certain role, it never hurts for more senior individuals to lend a hand or pitch in with those activities to better understand the functions of each person on the team. Moreover, I have growing concern that those radiologists who articulate the need to practice at the top of their license may use this as an excuse to bully team members under their supervision.

Having led an academic department in one capacity or another for over 15 years, I have noticed a recent uptick in the frequency with which miscommunications between professional and non-professional staff have led to significant degradation of team dynamics. Had individuals taken slightly more time to ensure that proper, respectful communication had occurred or had paused to allow their emotional intelligence to anticipate a breakdown in team dynamics, many interpersonal challenges in the workplace could have been avoided.

These challenges reinforce the need for spontaneous and planned opportunities for improved communication among all role groups on the radiology team. As team leaders, we should plan to come together and celebrate each other’s accomplishments. Avoid the us-versus-them mentality when it comes to peer learning and process improvement that affects both professional and non-professional staff. Regular social events that mix role groups can foster an element of collegiality and cooperation that comes from getting to know each team member personally. Understanding the challenges that staff members face in getting to work or arranging childcare can lead to a greater understanding of the distractions in their professional lives that may impact their performance under conditions beyond their control.

I am pleased to see the feature in this issue of the ACR Bulletin focus on the principle that the radiology value chain is only as strong as its weakest link (see http://bit.ly/TeamTrajectory). Radiologists must take the time to get to know the staff and what they do for the practice. Not only does it take an army to run a radiology practice, but it takes a unit that leans more toward utopia than disharmony.


brink By James A. Brink, MD, FACR, Chair

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