Leadership and leadership development are going to be important for the survival of our profession. If we don’t get involved and engaged, then we abdicate the responsibility, and we only have ourselves to blame for failing to take the appropriate steps to advance our profession and protect the interests of our patients moving forward.
A commanding presence in radiology for many years, Arl Van Moore Jr, MD, FACR, FSIR, Strategic Radiology (SR) CEO, reached into his former Navy life—training and serving as an officer in the nuclear submarine service—to share leadership lessons from the military during SR’s Executive Education event in Fort Worth in September.
By the end of his talk, he made clear that leadership and effective teams would be the key to radiology’s ability to lead the profession into the future and to ensure that the interests and well-being of patients are kept first and foremost in the practice of radiology.
Moore set the stage with a brief history of strategy and innovation in the military, driven by the technology of the times: wind in the 16th and 17th centuries, coal in the 19th, oil in the early 20th and the breathtakingly advanced—and expensive—nuclear power, computers, and cellular technology into the latter 20th and 21st centuries, drawing occasional analogies to medicine and radiology throughout.
“I see the same challenges for leaders faced with technology advances in radiology,” Moore noted. “Our tools cost a lot of money—as do the costs of complying with quality mandates that we face—so how do you pay for and staff a radiology service over time?“ he asked. “It’s a problem.”
Leading in a VUCA World
In the late ‘80s and ‘90s, a time of growing uncertainty in the Middle East, the military conducted a wide-ranging survey to understand how war had changed, not just in terms of technology but also world dynamics, using a framework called the VUCA strategy, which references the amount of volatility, uncertainty, complexity, and ambiguity in the world as defined by four levels of limited—or unlimited—possible outcomes. VUCA strategy emphasizes the importance of strategic planning, readiness planning, risk management, problem solving, and scenario planning.
“Does that sound a little bit like the environment we are trying to manage today?” Moore asked. “Thirty or 40 years ago, we had a pretty clear future. When you negotiated, Blue Cross came up with a price plan, and that was the end of it until you went back and renegotiated four or five years later. In medicine, we are going from a clear view of the future to a range of possibilities, possibly even true uncertainty.”
Moore also sees a parallel between the military’s individual combatant and the individual physician. “If you envision the soldier or sailor on the frontlines, it is analogous to the individual physician in the way we deal with patients within the organizational structures that we operate,” he said. “You’ve got a lot of physicians and health care professionals working to provide patient care, but you need to have the structure, support, and connectivity of all services and supply chains in order to do it effectively.”
Modeling the Navy Seals
Underscoring the importance of team and individual leadership, Moore used one of the most successful and studied combat units in the military, the Navy Seals, to explore effective ways to develop a team with a strong, collaborative nature, suggesting that physicians may be more aligned with the ideas and goals of the Navy Seals than they suspect.
“I have to say that during my training, I’d see them running on the beach with telephone poles on their shoulders and wonder why anyone would want to do that,” Moore said. “What you see is a level of commitment that is intense and above and beyond what you would expect from a normal individual. I think that is probably what drives us—why do we go into medicine? Because we are committed to patient care.”
Moore focused on the following leadership principles embraced by the Navy Seals.
1. Teamwork is the top priority. Know who you are as a team and your guiding principles. Why is the team working together in the first place? At Strategic Radiology, we are patient-focused and working together for the betterment of our patients.
2. Culture is king. The Navy Seals thrive on this: They work to align their actions, behaviors, and decisions through shared core values of:
3. Diversity. Not everyone has the same skills: “Each person has a different core competency and they need to bring that to bear for the team and how we can do a better job of taking care of our patients and improving medicine in general,” Moore said. “I am more and more convinced that this is important over time.”
4. Meticulous Preparation and Rehearsal. Navy Seals define a strategic goal and the level that they want to go to, and then they execute. They:
“Execution becomes so familiar that even though the level of uncertainty remains in place, you are trained to be able to react to the unexpected,” he noted. “That’s a lesson we can learn. If something you do doesn’t go the way you want it to go, that isn’t necessarily a bad thing. But we need to be able to think through what needs to be done to take the next step. Make what seems like a bump in the road a success, and then move on.”
5. Communication. “This should probably go first,” Moore said. “Communication is a part of everything I’ve shared so far. It’s critical to understanding the big picture, the vision, the purpose, and that aspect of making the necessary critical changes in plan execution. In football, they call it ‘the audibles’ when the quarterback makes a change. You have to be able to make the change in an audible so that the team members understand what you are doing, and everyone needs to be supportive because that is important for the team to succeed.”
6. Relationships. Having the self-awareness to understand one’s strengths and weaknesses as well as those of the team is fundamental to the success of the team. Great things are possible if a team works together to take advantage of the strengths of individual team members and to compensate for its weaknesses.
Moore highlighted an example from sports that was shared earlier by Babson College professor Scott Taylor, PhD: retired coach John McDonnell, the most successful coach in NCAA history, who led the University of Arkansas track team to 20 conference triple crowns and 25 consecutive conference titles.
“None of the individuals on the team had the fastest times, but collectively they all had times that were above average, which made them the most successful of all collegiate sports organizations of all time, bar none. Everybody performs at the best of their ability and the other team members compensate for any weaknesses: Together the team succeeds in the long run. It was the way they pulled together as a team, and the Navy Seals do the same thing.”
Call to Action
Moore concluded by sharing some personal thoughts on leadership in radiology. “Should medical professionals be led by an MBA?” he asked. “Or should medical professionals be led by someone who is a physician first and then over time develops the leadership skills to take things forward. It is my opinion that radiologists should not leave the leadership and the business aspects of our profession to others.
“If you haven’t gotten involved in the Radiology Leadership Institute, then look to do that,” he continued. “Make leadership development an important aspect of what your practice does. If we truly want to be responsible for our profession, then we need to develop the leaders who can pull us together to work as a team, so that we do not relegate the responsibility and well-being of our profession to others.
“Leadership and leadership development are going to be important for the survival of our profession. If we don’t get involved and engaged then we abdicate responsibility, and we only have ourselves to blame for failing to take the appropriate steps to advance our profession and protect the interests of our patients moving forward,” he concluded.
Hub is the monthly newsletter published for the membership of Strategic Radiology practices. It includes coalition and practice news as well as news and commentary of interest to radiology professionals.
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