Rationale and objectives: To evaluate prevalence and demographic factors associated with both burnout and fulfillment of private practice radiologist leaders within the United States. Materials and methods: The study cohort was the largest coalition of wholly radiologist owned, independently practicing radiology groups within the United States. Two designated leaders within each of the 30 radiology private practices within the organization Strategic Radiology were electronically mailed a weblink to a confidential IRB-approved survey in July 2021. Surveys included questions from the Stanford Professional Fulfillment Index, individual and practice demographics, and self-care. Results: The overall response rate was 67% (40/60). Fulfillment and burnout scores were calculated from the individual questions, and radiologists were classified as being fulfilled or not and burned out or not based upon score cutoffs previously validated from the Stanford Professional Fulfillment Index (PFI). The overall professional fulfillment rate of staff was 43% and the overall burnout rate was 33%. (Cronbach's alpha = 0.90 for fulfillment and 0.91 for burnout). The inverse correlation between professional fulfillment and burnout was highly significant (r =-0.42, p = 0.007). No statistically significant association was seen between either burnout or fulfillment and age, gender, ethnicity, practice geography or practice size. Conclusion: Utilizing the validated Stanford PFI for assessment, the prevalence of burnout in private practice radiologist leaders was 33%. The prevalence of professional fulfillment was 43%, with a mild inverse association between professional fulfillment and burnout. Summary: In private practice leaders, the prevalence of burnout was 33% and the prevalence of professional fulfillment was 43%.

Objective: The coronavirus disease 2019 (COVID-19) pandemic resulted in significant loss of radiologic volume as a result of shelter at-home mandates and delay of non-time-sensitive imaging studies to preserve capacity for the pandemic. We analyze the volume-related impact of the COVID-19 pandemic on six academic medical systems (AMSs), three in high COVID-19 surge (high-surge) and three in low COVID-19 surge (low-surge) regions, and a large national private practice coalition. We sought to assess adaptations, risks of actions, and lessons learned. Methods: Percent change of 2020 volume per week was compared with the corresponding 2019 volume calculated for each of the 14 imaging modalities and overall total, outpatient, emergency, and inpatient studies in high-surge AMSs and low-surge AMSs and the practice coalition. Results: Steep examination volume drops occurred during week 11, with slow recovery starting week 17. The lowest total AMS volume drop was 40% compared with the same period the previous year, and the largest was 70%. The greatest decreases were seen with screening mammography and dual-energy x-ray absorptiometry scans, and the smallest decreases were seen with PET/CT, x-ray, and interventional radiology. Inpatient volume was least impacted compared with outpatient or emergency imaging. Conclusion: Large percentage drops in volume were seen from weeks 11 through 17, were seen with screening studies, and were larger for the high-surge AMSs than for the low-surge AMSs. The lowest drops in volume were seen with modalities in which delays in imaging had greater perceived adverse consequences.

Good leadership connotes different mental images depending on the individual.Frequently a mental image of a famous military figure, political figure, or personality in a religious or social cause first comes to mind.For example, I have indelible images of actors portraying famous people:

The ACR recognizes that radiology practice leaders play a vital role not only in our groups but for our profession as well. Over the past few years, the ACR has raised the awareness of its commitment and support to leadership development within radiology.

The universe of medical practice is changing at an ever increasing rate, an exponentially increasing rate. In examining Earth's history from the beginning of time, it is not necessarily change per se that has threatened countless species but the rate of change that has challenged species survival. Darwin's thesis indicates that those who are most able to adapt to change will be more likely to survive. Medical technology, especially imaging technology, has been on a exponential growth curve for the past 2 decades, dramatically changing not only the field of medical imaging but the environment of all of medicine. Change in our practice environment represents both threats and opportunities to medical specialties to adapt and survive in the context of radiology and remain relevant to the future practice of medicine. Can we as radiologists survive and remain relevant in the future practice of medicine? What is the path to survival? The approach to survival will be multifactorial. We must continue to put our patients first, maintaining high-quality patient care in our adaptation strategy. We must do a better job of developing and investing in leaders, not only within radiology, but within all of medicine. We will need to hypersubspecialize within our profession and with that hypersubspecialization develop an integrated team concept, working together like a well-oiled Swiss watch. Last, we must as a profession invest in ourselves vigorously, supporting imaging research in a number of arenas, searching for the next imaging breakthrough, and exploring and adapting nanotechnology applications in both imaging and therapy.

Perhaps the most important trend in the practice of radiology is the move outside the traditional bricks-and-mortar setting, as practices break the conventional mold by transitioning from the “sneakernet” to the Internet. The question is “Why?” In certain venues there have been a lot of discussions focusing on disruptive technology and, while that is certainly a factor, in many ways we are simply experiencing incremental improvements of two previous “new technologies”—digital imagery and the Internet. In his book, The Innovator’s Dilemma—When New Technologies Cause Great Firms to Fail, author Clayton Christensen describes this as the normal progression of sustaining technologies.

It doesn't seem that long ago that I began penning my first JACR column, thinking about which directions to steer the College over the next two years, and what I should try to accomplish during my time as chair. Time has passed quickly. We have accomplished a lot (as I outlined in my last column about how the College has changed), not just during my term as chair, but over the last two decades. I have commented on the degree of that change in the practice of medicine as well as the rapidity of change. Yet, while much has been accomplished, much still needs to be done. There is no shortage of challenges for us to face. The real task is how best to prioritize taking on those challenges to optimize the use of the resources we have.

Over the last several years, our College has initiated some unprecedented changes for radiology, changes that will provide a lasting benefit to the profession for years to come. I am quite proud of the ACR’s recent accomplishments; and further I am encouraged by them as we face the challenges of the near and distant future. I believe that the ACR has changed more in the last several years than any other time in the College’s history, making numerous changes and improvements in the areas of quality and safety, education, research, government relations, communications, and member benefits.

From residency through retirement, the College works to provide you with the professional, educational, and informational tools you need to uphold radiology’s position in today’s increasingly challenging health care environment. And the top-quality products and services that the ACR provides are a direct result of the dedicated efforts of the employees working in Reston, Virginia, Philadelphia, and Washington, DC.

The 2008 ACR Forum brought together a diverse group of participants from clinical radiology, radiology leadership and practice management, managed care, economics, law, and entrepreneurship in Washington, DC, in January 2008 to discuss current models of radiology practice and anticipate new ones. It addressed what forces shape the practice of radiology, how these forces are changing, and how radiology practices can most effectively respond to them in the future.

Last January, your ACR Board of Chancellors embarked on a bold initiative to create a new educational paradigm for radiology. The concept was to create an education center focused on learning in radiology that will take our profession well into this century by developing a new way of learning.

The 2007 ACR Forum highlighted the importance of cultivating leadership, identified key traits of effective leaders, and outlined a number of practical steps the ACR, radiology leaders, and the field as a whole can take to promote leadership. If we heed this message, we can develop the abilities of people who will provide effective leadership for radiology organizations and assume even wider leadership roles in medicine and health care.

Noted author and activist Marian Wright Edelman once suggested that education is for improving the lives of others and for leaving your community where one lives, and also the world, a better place than you found it. This maxim is especially true for the radiology community where we continually strive to deliver the highest quality of care to our patients that we can by ensuring that we are up to date on the latest skills and thinking as well as new technological advancements in our rapidly changing specialty.

Radiology is faced with many challenges these days. We categorize them and look for solutions, and we often focus on micro-level issues since they are typically the issues de jour. For example, the Deficit Reduction Act (DRA), the recent Five-Year Review of the physician fee schedule by the Centers for Medicare and Medicaid Services (CMS), and the now-annual Sustainable Growth Rate (SGR) “fix” that needs to be implemented by Congress are all economic issues that have captured our attention recently as we worked hard to delay or reverse some of these trends. We also are faced with nongovernmental challenges to our profession, some of which we characterize as “turf” while others we categorize as rapidly evolving technology, manpower, 24/7 coverage issues, etc.

Talk to any number of your colleagues, no matter their subspecialty, and chances are the conversation will quickly turn to the relentless emphasis on professional oversight from government agencies and third-party payers that forces radiologists to continually engage in and foster new methods that we use to prove our professional competence.

As a profession, we are fortunate that the College has represented our interests in Washington. Over the years, the ACR's Commission on Government Relations has worked hard to keep radiologists' concerns in the legislative forefront. One of our more recent achievements was the founding of RADPAC® at the close of the last decade to help us improve our access to the political process. Through perseverance and planning, we have grown RADPAC so that it currently ranks as the nation's fourth largest political action committee for a medical specialty society and is now recognized as one of the most important medical voices in politics today. But long before RADPAC began, ACR leadership was affecting the opinions of key decision makers in Washington on policies important to radiology. Dedicated members have also devoted a considerable amount of time and energy working to ensure that our interests receive careful consideration in the complex and cluttered halls of Capitol Hill.

As physicians we are entrusted with one of the most precious and important things one can have––a person’s life. As the health care professions’ imaging specialists, we have an astounding array of instruments and technology by which we can satisfy that trust. But, in our efforts to detect and treat cancers and other serious illnesses at the earliest possible stage with our skills and devices in order to have the best chance to affect a cure, is there the possibility that we are doing our patients more harm than good?

It goes without saying that radiology has changed in recent years. But I’m not talking the advent of state-of-the-art 64-slice scanners producing CT coronary arteriograms, digital mammography, or virtual colonoscopies. I’m talking about our profession in terms of who we are, not what we do.

“We make a living by what we get, but we make a life by what we give.” These are the compelling words of Winston Churchill, whose extraordinary character led him to become one of the world’s most recognizable figures. And, because he was a hero defined by a vision of the future he strived to create, Churchill also inspired others to take action. The heroes of our profession are those who volunteer their time and skills to better our profession for the benefit of our patients and to provide radiological services to those who have a need, but lack access to these important life altering and innovative technologies.