When Opportunity Knocks

An insider's look at health system leadership and how to get there from hereknocks

Three radiologists embark on a journey that takes them from internship to leadership. No, that's not the opening line of a joke.

These are the stories of what it takes to become a health system leader, along with practical advice about how to make it happen from three trailblazers who have risen to the top.

Leap and the Net Will Appear

The path to leadership for Sanjay K. Shetty, MD, MBA, president of Steward Medical Group, has been filled with unexpected twists and turns. "At the end of my fellowship, I decided to get an MBA, and people thought I was nuts," says Shetty. "I was in a full-time academic radiology job, and flying from Boston to Philadelphia every other weekend to earn my MBA."

dr shettyAfterward, Shetty spent several years on a pure radiology track. Then he decided to go into consulting. Again, people told him he was crazy. But Shetty replied, "If I don't do this, I'll always regret it." A few years later, he was approached about joining an embattled health-care company as chair of radiology. The leaders there had big dreams that appealed to Shetty.

"I could see that each had taken a risk, leaving a solid practice to do something a little bit crazy and entrepreneurial," Shetty says. "And I thought, 'Why shouldn't I try it too?' As an academic radiologist, there will still be a job for me. But I will never have another opportunity to become a department chair at the age of 36. Now, a local health system that couldn't sell itself for a dollar is growing into the largest privately owned hospital operator in the U.S., with over $8 billion in revenue. If I hadn't taken that first leap, I would never have been in this leadership position."

Get Out of Your Comfort Zone

Being willing to take a risk is also what launched Sarah Reimer, MD, medical director of population health and risk at Aurora Healthsarah reimer Care, on her journey to leadership. "My undergraduate degree is in business. Then I went into medicine and started practicing," she says. When the multi-specialty group she was in was acquired by Aurora, there was an opportunity to participate in the PACS selection committee. Working well across historic institutional divides got her noticed.

A year or two later, there was a need for a radiologist to serve on a system-level committee to optimize the distribution of imaging equipment. One of the system senior leaders tapped her for the job, which was the first time she really used her business degree. She says, "Getting internal experience in a project outside my usual responsibilities was pivotal. It exposed me to senior leaders, broadened my view of the view of the organization and my network, and forced me to develop new skills. Working across business lines also showed me how to exert influence without having formal authority."

Reimer emphasizes that the route to leadership involves the willingness to take stretch assignments and to look for opportunities to stretch other people. "Believe that you've got something to offer and take your shot. Then look for the potential in others and encourage them to do the same," she urges.

Just Say Yes

According to Michael P. McDermott, MD, MBA, president and CEO of Mary Washington Healthcare, one of the most important steps on the path to leadership is to say yes when you're asked to do things.

michael dermott"Early in my career, the hospital was looking for physicians to be on a credentials committee, and they asked me," he remembers. "I didn't know what that was, and we had to meet every month at seven in the morning. You don't get anything for it, but you learn a lot about what goes on in the hospital. So, you say yes. You show up to those meetings, you act with integrity, and people start to know you. The next thing you know, they're asking you to do more things at the hospital. They're asking you to chair the radiology department and then lead a joint venture with the health system for the imaging centers."

In addition to accomplishing all those things, McDermott was also invited to serve on the board of trustees for the health system, where he gained perspective from the governing side of health care. He also had an interest in the business side of medicine and was involved with his group's finance committee. Then when the health system's long-time CEO announced his retirement, McDermott threw his hat in the ring and landed the job after a national search.

"There are opportunities everywhere, all the time," he says. "All you have to do is say yes to a few. If no one asks, go poke around a little bit. There are plenty of places where you can get involved. There are a thousand committees. There are work groups meeting in the hospital and in departments every day. If you show up and help solve a problem, people will start knocking on your door to ask you to do more. That builds your credibility in the community over time."

Separate the Best From the Rest

A new 10-year study by the CEO Genome Project, recently published in Harvard Business Review, identifies four management traits that set successful CEOs apart:

• Adapting rapidly to change
• Engaging stakeholders and gaining buy-in
• Being reliable and predictable
• Making fast decisions with conviction

That's sound advice for anyone looking to distinguish themselves as leaders in medicine. But what actionable steps should radiologists take to get started on their own journeys toward leadership? Here's what our three experts say it takes to get to the top.

Bring Solutions

Shetty advises radiologists to become change agents. “To build your resume, you have to look at what’s coming and think about ways you can help solve emerging problems,” he says. “If you identify a problem, think about it, talk to people, come up with a solution, and bring it to your key leaders as a fully formed idea, rather than just complaining about it. Then, when you bump into the president, you’re prepared to say, ‘Here’s an issue I’m running into, and I have some thoughts on it. Do you have 15 minutes to talk about it?’ It’s as simple as turning hallway conversations into meetings where you’re sharing solutions and not just serving as complainer-in-chief.”

But he adds that you have to be sensitive to politics and work through the right pathways, because you can get burned by going straight to the top. “Make sure you’ve built a network of supporters. Go to them first and say, ‘I’ve got an idea; can you give me some advice? What’s the best way for us to do this?’ Then loop them in going forward, and they can take partial credit in your success. That’s how you create mentors and advocates.”

Carpe Diem

McDermott urges radiologists to take advantage of the leadership opportunities that are already there. “Volunteer for committees or take ownership of an initiative and form a committee. Ask others to get involved,” he advises.

“Be an influencer, even if you don’t have the power to act,” says McDermott. “Knock on a few doors. Start with the director or chair of your radiology department, and say, ‘Hey I want to be more involved. When the next issue comes up, let me help out.’ That’s a perfect place to start.”

Be willing to take on extra responsibilities, he adds, and make it clear to the leader of your department that you can put in the above-and-beyond time without taking anything away from your core job. “All it takes is doing that a few times, and suddenly when they need a leader, they’re going to think of you as a natural candidate,” he says.

Create Value

Reimer recalls that one of her early mentors gave her some of the best advice of her career. “He told me, ‘If you want a seat at the leadership table, bring something of value to the organization,’” she says. “So, I went to the ACR website looking for ideas, hit on clinical decision support, and started championing it all the way to the top of the organization. Then I worked on getting buy-in through the rest of the organization. Next I found a randomized control trial at MIT and asked if we could partner on it. And we made it happen.”

Sometimes you need a little bit of courage, Reimer says. “I really didn’t know much about the trial process when I started, but it’s good to stretch,” she says. “It’s good to get out of your comfort zone.” She adds that it’s equally important to build partnerships across the enterprise. “To deliver on the promise of CDS and the MIT trial, I had to collaborate with legal, finance, and IT. I had to leverage the strengths of the radiology crew and forge stronger relationships between subspecialty radiology and the relevant clinical specialties. It’s really important to engage other people — because individual contribution is not really leadership. Identify people who have gifts to do the work. That’s what my mentor did with me.”

Reimer adds, “To find ways to add value, start with the ACR. You don’t have to reinvent the wheel. We’re all facing the same issues. Go to the annual meeting and learn what people are talking about and what projects they’re tackling to bring value. That can be really inspiring.”

Get Smart

All three leaders agree that it’s imperative to learn the skills that will propel your career forward. “Health care is a business, and it requires solid knowledge about managing people, operations, and finances,” says Shetty.

“You need to get smart on these topics, whether it’s through business training (like an MBA), leadership training (like the Radiology Leadership Institute®), or any number of other ways to learn,” he adds. “It’s important to apply the same rigor to learning about leadership as you did when you were a radiology resident learning about clinical concepts. Simply put, if you can’t speak that language and you can’t drive business people to be better at what they do, you will never be their leader.”

McDermott agrees that education is the baseline for advancement: “Get broad exposure to thought leaders and leadership skills, because they are skills. These approaches are not always natural; there’s a science of persuasion and leadership. I’m big believer in leadership programs. They give you the perspective and the tools you need to move forward.”

By Linda Sowers, freelance writer for ACR Press

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