RFS news highlights resources, issues, and news relevant to in-training members of the ACR. If you have a topic idea or would like to contribute to the blog, please email RFS Secretary Patricia Balthazar, MD.




The Business of Radiology



Radiology is one of the most exciting and rapidly changing fields of medicine. New developments such as AI and increasingly powerful scanners have the potential to radically change and improve how we care for our patients. With innovation, however, comes an increasingly complex set of leadership and management challenges. As radiologists, we must be the ones leading the charge in finding solutions to these challenges to best serve our patients. However, effectively accomplishing this task will require skills beyond those learned in clinical training.

I have always had an interest in management and finance, so I decided to pursue an MBA degree on a part-time basis at the Indiana University Kelley School of Business. Taking evening classes during residency for more than three years was certainly challenging at times. However, I have had a wonderful experience learning about operations management, marketing research, and finance.

This newfound knowledge has been enlightening. However, it has been taught by businesspeople, and learning how these skills could be directly applied in radiology would be helpful to my future career and help me provide better, more valuable patient care.

Fast forward to ACR 2017, when I happened to be chatting with the radiology chief at one of the hospitals within our institution. We were talking about my experiences in business school and started discussing how to create an immersive month-long administrative elective in which I could apply my MBA education to the specific problems facing a radiology department.

Securing approval for the elective was a process, as no resident in our program had ever done anything like this before. We needed buy-in from the residency program director, the radiology department chair, and the chief medical officer of the hospital (among several others). I outlined goals and expectations for the elective, which were shared with my faculty mentor as well as the other leaders within the hospital’s radiology department. The groundwork was laid and all that was left was to begin the elective.

Participating in this administrative experience was eye-opening. During the month, I had the chance to attend a multitude of committee meetings related to topics such as credentialing, EHR/PACS updates, and finances/capital requests. I was also tasked with independently analyzing and brainstorming solutions to multiple problems currently facing the radiology department — several of which were ultimately implemented as department policy.

Perhaps the biggest challenge during this entire elective was determining how to organize it in the first place. With no precedent to work from, I, along with my faculty mentor, had to create the entire structure of the rotation. Having first written a thorough outline of my goals for the rotation was critical — as it allowed us to pinpoint what types of specific meetings and experiences would be most salient to my development. For example, since I have a strong interest in finance, we made sure to build in opportunities to learn about some of the financial challenges facing a radiology department. Many of the specific meetings/conferences that were beneficial to my education only occurred at certain intervals — therefore flexibility with my schedule was important to be able to attend them.

The lesson learned during this elective was that leading a radiology department is a difficult undertaking that is always a work in progress. The issues facing healthcare organizations are complex and certainly require more than a month to fully understand. However, as a result of this experience, I believe I will have a significant advantage when the time comes to deal with them during day-to-day practice. I now have a much better understanding of the inner workings of radiology departments and how my business skills can be applied to more efficiently lead in the context of radiology.

The entire field of medicine is in the midst of an unprecedented time of transition, and radiology departments will need strong leadership to help navigate the approaching era of value-based care — while continuing to do right by patients. Those in the best position to help lead departments during this time of transition will not only be skilled radiologists, but also will have intimate knowledge of how organizations operate. I hope my experience can serve as a blueprint for future residents to replicate and improve upon as they take on their own leadership journeys.

 Kalen Riley, MD, is a radiology resident at Indiana University School of Medicine.

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