Meet the ACR Leadership: Bruce Hillman, MD, FACR
This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR.
For this installment, Anthony Trace, MD, PhD, resident at Eastern Virginia Medical School, interviews Dr. Bruce Hillman, MD, who is the Founding Editor-in-Chief of the Journal of the American College of Radiology, Professor and Former Chair of Radiology at the University of Virginia.
You have been involved in many facets of the ACR. How did you get involved in the ACR and what has kept you involved?
I am fond of saying that without an ACR, I might not have had any career at all. I had only recently become a member, when about 1987, ACR contacted me about my interest in directing a research study about the financial incentives associated with self-referral for medical imaging. I agreed and worked with ACR staff, a New England consulting firm, and a large insurance database company to conduct the investigation. The study we published in the New England Journal of Medicine demonstrated roughly fourfold usage associated with nonradiologists owning radiology equipment as opposed to physicians who referred their patients to radiologists. It was both a career maker and a very positive introduction to the ACR leadership. ACR has kept me busy ever since.
Shortly thereafter, I was appointed to the Board of Chancellors as the Chair of the Commission on Research and Technology Assessment. This led to ACR asking me to write a grant proposal on ACR’s behalf to organize and operate a large clinical trials consortium. We won the grant competition and the outcome was the founding of ACRIN®, which I chaired during the first nine years of its existence.
The last big opportunity ACR presented to me was to found a journal for the organization. At this time, I was chair of radiology at the University of Virginia and still in the process of getting ACRIN up and going. After some thought, I resigned my chairmanship and took on the ground up development of a new journal, what became the Journal of the American College of Radiology. All three of these opportunities were challenging, engaging and allowed me the opportunity to do things of lasting importance to my specialty. What could be better?
You are the Editor-in-Chief of JACR. What does this role entail?
As the Founding Editor, I had an extraordinary opportunity, afforded few others, to invent a journal from the ground up. I began the job in March 2003. The first issue appeared in January 2004. Many questioned the need for another journal in radiology. We responded by producing a journal that uniquely reflected the interests of the ACR – health services research and policy, clinical practice management, training and education, and leadership. The journal has remained true to its founding editorial policy, eschewing the siren call of clinical research, technical reports, and review articles. I believe that this is why the journal has been successful over its 12 years of existence. As editor-in-chief, I set editorial policy, make decisions about what submitted articles are sent out for review, decide on which articles the journal will publish, correspond with authors and readers, and put together each issue. When it became clear that digital publication and social media would be of critical future importance, I brought on Deputy Editor Ruth Carlos, who has done a remarkable job of leading this aspect of the journal into national prominence.
What was one of your favorite experiences in radiology and why?
The most interesting and challenging experience that I’ve had throughout a career now nearly 40 years in the making was the opportunity to organize and chair ACRIN during the period from 1999‒2007. I submitted the grant application, organized the committees and selected their leadership, wrote the bylaws, determined which trials ACRIN would address in its earliest phase, helped secure additional funding for the large screening trials (National Lung Screening Trial, Digital Mammographic Imaging Screening Trial, and the National CT Colonography Trial), and — working with NCI and ACR staff, outstanding clinical trials researchers, and the statistical group at Brown University — oversaw all aspects of an operation that eventually received over $200 million of funding during my tenure and produced results that have had an extraordinary effect on the current practice of radiology. I doubt that anyone in radiology has ever had such a wonderful opportunity nor enjoyed their work as much as I did.
Dr. Hillman, you have a career anyone would admire and through your work you continue to effect so much positive change. Would you share some advice on how a resident or fellow can make a positive impact on the field as they embark on their career in Radiology?
First, and perhaps most important, no one makes it alone. I have had wonderful mentoring throughout my career. Anyone seeking success needs to find experienced individuals who can help guide them. In turn, providing mentorship to others is just as instructive in its own way.
Secondly, there is no replacement for training. I knew very early on that I wished to become a researcher. I added a research year to my residency training at the Peter Bent Brigham Hospital, and when I wished to become a health services researcher, I spent a sabbatical year training at the RAND Corporation. The latter afforded the new skills that both led to the ACR singling me out as someone competent to take on a difficult research task and giving me the tools to make something positive of the opportunity.
Finally, the foundational skills of success in any field are speaking and writing well. Practicing and learning to excel at both are career makers no matter what course an individual pursues.
What makes an excellent radiologist?
This is a hard question to answer, since there are so many things a radiologist can do with his or her training and each requires a different skill set. As I’ve already mentioned, speaking and writing well are essentials regardless of whether an individual wishes to pursue a clinical, research, administration, or organizational career. Inability to work with others and empathy for patients are also essential. Finally, even the most successful people inevitably encounter disappointment. Being successful requires learning from failure and recognizing that, with persistence and creativity, both failure and success are transient. The truly excellent radiologist looks to improve him- or herself in the future.