Looking in the Mirrorlooking in the mirror

As we strive to reach higher and higher goals, there are no truer words of guidance than those in the chorus of a famous Michael Jackson song: "I'm starting with the man in the mirror, I'm asking him to change his ways, And no message could have been any clearer, If you wanna make the world a better place, Take a look at yourself and then make a change."


The ACR Board of Chancellors is not a governing board. It is a working executive board that is charged to carry out the policies of the College faithfully, effectively, and efficiently. Performance is a key element of this charge. In 2008, drawing on longstanding corporate models in the business world, then Board Chairman James H. Thrall, M.D., FACR, engaged the board in a trial effort at self-evaluation.

Due to the success of that trial, I decided to institutionalize that initiative by establishing a standing Board of Chancellors Self-Evaluation Committee in 2010. The committee is comprised of four operational commission chairs (Leadership, Quality and Safety, Education, and Economics); two specialty commission chairs (General/Small and Rural and Radiation Oncology); and, the vice speaker of the Council. The committee is appointed at the board winter retreat during the first year of the chair's tenure and delivers its report to the board at its next fall meeting.

The charge to this committee is to assess the performance of the board and to make recommendations for performance enhancement. This charge is accomplished through conduction of mini-surveys after each board meeting and an additional comprehensive in-depth survey of overall board performance. The mini-surveys asked 10 questions, 6 scaled and 4 open, to assess the materials, process, efficiency, and venue of the meeting. The comprehensive in-depth survey contains 45 questions, divided into 8 subgroups, including board membership, orientation, communication, process, policy management, chair's performance, staff support, and future direction. The surveys are collated by staff, then reviewed and discussed by the entire committee, which then makes recommendations to the board for performance enhancement.

The mini-survey of May 2011 revealed essentially all positive results with a few neutral responses. Board members were most impressed with the efficiency and organization of the meeting, the discussions on economics and resolutions, as well as the open dialogue by "motivated and bright advocates." Recommended improvements were to revise the schedule to allow more time for open discussion and to promote increased collegiality between the board and the Council Steering Committee (CSC).

The mini-survey of October 2011 again indicated all positive results with the point-counterpoint focus sessions receiving the most praise. Board members were also "supportive of CSC and BOC integration efforts" and pleased by "the comprehensive and robust discussion by all and the lack of any internal conflict."

The response rate to the in-depth survey conducted in the spring was 80 percent, with greater than 50 percent of the responses indicated a response of "very satisfied." The vast majority of board members indicated that they were well informed of the ACR mission and felt that serving on the board is an extremely worthwhile experience. Lower approval scores centered around some process issues, such as SharePoint access and handbook availability, but also around some key elements, such as receptiveness of differing views and the working relationship of the board and CSC. Recommendations for enhanced performance included encouraging the chair and vice chair to demonstrate openness and sensitivity when handling different perspectives, as well as a recommendation that the chair, vice chair, speaker, and vice speaker explore ways together to improve the working relationship of the board and CSC, focusing on finding ways to engage the CSC more productively and in the best interests of the College. Also encouraged were increased interactions among board members between meetings such as already occur among economics, quality and safety, education, and staff.

Some of these recommendations have already been implemented. For example, for the past 18 months, the chair, vice chair, speaker, and vice speaker have had face-to-face strategy meetings at least four times per year to discuss enhancement of the working relationship between the board and the CSC. As you will read on page 9, I included three point-counterpoint focus sessions at this year's fall meeting instead of the usual two. This permitted more time for open discussion of a wide range of opinions on issues of key importance for our specialty. I also instituted what I hope will become a tradition by reserving one of these sessions exclusively for presentation by members of the CSC. These sessions were extremely well received and the lengthy discussions provided guidance for future direction.

I was also extremely pleased to be invited by the speaker to attend the meeting of the CSC and hear their issues. We are all looking in the mirror and striving for improvement. That introspection, combined with the talent, experience, and dedication of the members of the Board of Chancellors and Council Steering Committee, will serve our specialty well into the future.

BOC headshotBy John A. Patti, M.D., FACR, Chair, Board of Chancellors

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