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Hello and welcome to Noon Conference Co-hosted by Modality

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and the a CR Radiology Leadership Institute

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Noon Conference connects the global radiology community

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through free live educational webinars that are accessible

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for all and is an opportunity

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to learn alongside top radiologists from around the world.

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Today we are honored to welcome Dr. Frank Lexa

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for a lecture entitled, getting Started In Leadership, how

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to Lead When You Aren't In Charge.

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Dr. Lexa is an academic neuroradiologist

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and healthcare leader with a distinguished career in

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medicine, business and international education.

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He's held senior faculty

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and leadership positions at multiple academic institutions

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and has lectured globally on

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healthcare strategy and leadership.

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Dr. Lexa has authored over 175 peer-reviewed papers,

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delivered more than 2000 lectures

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and written the book Leadership Lessons

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for Success in Healthcare.

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He served on several key national committees

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and task forces for major organizations in the

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United States Radiology.

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He currently serves as Chief Medical Officer

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of the A CR Radiology Leadership Institute,

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lectures in several top programs

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and continues to advise healthcare ventures worldwide.

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At the end of the lecture, please join him in a q

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and a session where he will address questions

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you may have on today's topic.

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Please remember to use that q

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and a feature to submit your questions so we can get to

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as many as we can before our time is up.

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With that, we're ready to begin today's lecture. Dr.

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Lexa, please take it from here.

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Thank you again, Ashley, for that very kind introduction,

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and I want to thank modality for working

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with us at the ROI on this project,

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and a special thank you to my colleague, ERY Pasco, who, uh,

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is an a CR staff leader in the Radiology

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Leadership Institute.

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So, as you just heard, we're gonna, uh, talk today about how

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to get started in leadership,

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and particularly the conundrum that many of us face in

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our careers, particularly at the beginning

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and in the middle of how to lead when you're not in charge.

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I know that that sounds like it's almost like a,

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a zen statement

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because you, you really have to at times take the initiative

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and start leading before you have a title,

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and that's gonna be the theme of, uh, for today.

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Um, and I'll just start with some advice from Hollywood,

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and I won't ask for anybody in the, uh, chat to put,

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put in the answer, but, um, this is from a Hollywood movie

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and, um, this is real Power can't

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be given, it must be taken.

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Now, I'm not here to start a revolution,

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and I'm not telling you to take over leadership positions

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and kind of, you know, ERP them,

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but it does reflect the notion that, you know,

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leadership leaders need to start by trying to lead.

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And in that sense, that's

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what we're gonna be talking about today.

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For those of you who didn't get the reference,

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it's from Godfather Part three.

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It's not the Best of The Godfather movies,

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but it, the first two were, you know, iconic, um, you know,

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pieces of American film.

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So it's hard to compete with that, but it is a good tagline

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and it does bear on, you know, observations that, you know,

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I think we all make about good leaders

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and how good leaders become better leaders.

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And it's also a reference to this, that you shouldn't wait

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until you really need to lead

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before you start trying to lead

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and learning about leadership.

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So I'm a pilot and I'm one of the people who,

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if they ever called, you know,

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like they do in some Hollywood movies, is there anybody here

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who knows how to fly an airplane?

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I would actually be thrilled.

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Now, this picture's obviously from a simulator,

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because normally you wouldn't have a jet airliner at, uh,

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two or 3000 feet here

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with nobody sitting in either the pilot

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or the co-pilot seat.

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But you can imagine also how frightening that would be,

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and that's how many people do feel when they get tapped on

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the shoulder and are asked to take over a role,

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whether it's joining the board of their private practice,

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or it's becoming a medical leader in a hospital,

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or becoming a division chief in your academic department.

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And you shouldn't feel like, I have no idea

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what all these controls are.

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You should, you know, be able to step in

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and kind of like getting tapped

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by your coach to go into a game.

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You should, you know, at least be ready.

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You shouldn't wait until that happens.

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And in my consulting practice

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and I, I do, you know, do work with people who are leaders

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who are struggling with issues

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and groups that are struggling with issues,

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and this should be a lifetime process.

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But I've now helped a couple people who, you know,

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found out, um, in one case with about three hours notice

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that they were the new head of a practice

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because something awful had happened

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with their, uh, prior leader.

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And, you know, that's not something you wanna have happen,

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and it's really, you know, it's just, you know, trying to go

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through the finances and the managerial issues, it's hard.

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So this should be something that you start at the beginning.

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And in smart companies

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and in some other organizations, including the military,

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people are always scouting to try to figure out

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who are the young people who are promising,

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who might be able to go into leadership

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and then starting leadership,

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then not starting it when they get, uh,

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after a certain number of years in life

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or years in your career, um, years in your department.

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It should start at the beginning.

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The quote at the bottom is one that's been attributed to me.

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I don't remember saying it, but I am owning it now

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because I think it is a important point

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that in knowledge organizations,

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and we'll come back to this in a moment

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with some comments from a very famous knowledge leader,

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that leadership is too important to be left just

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to the people who have the leadership roles.

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And that's true in most knowledge organizations.

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In another career, I did a fair amount

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of work in Silicon Valley,

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and if you look at organizations that are in it

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and other, um, you know, really cutting edge types

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of organizations, people are making leadership decisions at

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multiple levels in the organization

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because they're moving fast,

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they're moving into unknown areas,

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and the person at the top can't be

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the person who does it all.

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So I hope that you'll understand

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that this is an important thing that you should be doing.

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Um, you saw a couple slides during the rollers

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before I came on about the ROI,

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and certainly one of the ways that I would encourage you

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to look into getting leadership training, um, is

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to take a look at our, our program portfolio.

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Emory and her team have put together a fantastic, uh, set

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of programs, everything from in-person to fully online

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and fully asynchronous with focus, you know,

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on different levels of your career,

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different times in your career.

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And I encourage you to take a look at this

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and understand that one of the reasons why we need leaders

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and why we need strong leaders to understand radiology is

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that we are constantly being challenged.

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And during the 10 years that I've had the, you know,

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privilege of being the chief medical officer for the ROI,

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um, the number of challenges has increased

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and the intensity of some

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of the challenges has have increased.

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So this is a great time for you to become a leader,

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and we need you to be a leader.

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We're gonna come back to that too.

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My goals, I've got a lot of goals for the next 40 minutes,

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but I certainly wanna get rid

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of some fallacies about leadership.

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Um, there are a lot of misconceptions.

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Many people who are in STEM disciplines

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and related disciplines like medicine think

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that they aren't gonna be good leaders.

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And in fact, one of the things

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that sometimes makes a great leader,

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it is somebody who's an introvert.

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Somebody who thinks, well, I can't be a leader.

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I I wasn't a leader in high school.

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I didn't, you know, do this

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or didn't do that, which is all nonsense.

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Um, introverts make better leaders than extroverts.

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And that's been looked at, uh, by, you know, several,

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you know, well-written academic papers, understand

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how good leadership is the secret to the challenges

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and crises that we face in 2025 and beyond.

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We are gonna need good leaders

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to bring us through these times.

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I'm gonna review some common psychosocial hindrances

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for why some people don't go into leadership who should,

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and also why they sometimes drop out of leadership

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because it is different than doing scientific research,

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you know, working in the reading room.

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And it's important that you get past those obstacles.

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We'll talk about why good leadership skills

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and team management are really gonna be essential

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ingredients for your success going forward,

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and also the success of the house of radiology as well.

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So you're gonna help yourselves, but also help your brother

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and sister radiologists.

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We're gonna talk about a paradigm.

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You know, sometimes I get asked, well,

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how do I really get started, Frank?

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How, how can I do my first project?

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And I will give you, um, an example, um, of how you can do

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that and how you can build a good team to do it.

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And this is just from a book that had some, uh, you know,

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you know, structured approach

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to doing leadership, some additional goals.

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Um, I'm gonna talk about who should lead radiologists by.

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Now, you've probably figured out

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that I think it should be you, it should be people

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who understand medicine, people who've dedicated their lives

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to doing, uh, medical imaging.

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I would rather be led by you than led by somebody else.

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And your choice, there's no middle choice.

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You're either gonna be led or you're gonna lead.

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And I would rather see you leading again than somebody

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who doesn't understand what we do.

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Um, again, we're gonna get rid of some common myths like

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that somehow me, you know, leadership is in your genes.

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It's not, there's a lot of terrible literature

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that's outdated that talks about stuff like that.

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But basically, leadership is something that you can do.

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Um, when the answer for this, it's like,

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when should you have planted a tree a while ago?

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When should you have started getting in shape a while ago?

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When should you have learned about the cranial nerves

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before you sit down with me to read a case?

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The point is, start yesterday.

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If you can't do that, start today. Um, don't put this off.

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Um, you'll have a happier,

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more successful career the earlier you get started on this.

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And again, it's a secret to the challenges we face.

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And then we're gonna talk about the

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how, how can you do this?

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How can you get started? Now, I've already, you know,

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put, you know, brought this question out,

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but, you know, I have listened

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to people not just in the United States,

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but in several other countries as well, make statements

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that radiologists should just stick to their,

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and leave the business and leadership work to others.

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And somebody came up to me one of the first times I, I spoke

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outside the United States on this topic.

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So thankfully this quote is from another country

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because I think it's an embarrassing one.

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But, you know, I sort of look at it

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and I've named it, um, according to this industry.

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Um, if you're a local boar

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and you like to eat locally, one

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of the things you can do in Southeast Pennsylvania

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where I live most of my, um, most of the year, um,

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this is, uh, one of our top agricultural products,

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and it's one of the, um, top places in the US

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for this agricultural pro product.

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And for those of you who don't know what that is,

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that's a place where you make mushrooms

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and everybody knows that the way you make,

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you keep them in the dark

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and you put, well just be polite here,

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but you put fertilizer on top of them.

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And that's what I think that school is.

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And I don't think that's the way we should be treated.

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And I really think

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that radiologists are more analogous to these kinds of people.

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And if you've ever had the honor of meeting one

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of these brave people, like the gentleman on the left who's

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gone up into outer space,

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or if you know anybody who flies airplanes like this,

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you probably know that these people want to be led

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by people like themselves in the US Astronaut Corps.

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Whenever people are up there doing dangerous stuff,

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there's one of them on the ground who access the

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intermediary between the NASA administration

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and the astronauts who are up there at the tip.

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And same thing with fighter pilots.

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If you ever have the pleasure of meeting the women

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and men who do this, and I'm related to one person,

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and I've had a bunch of them as Wharton students,

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they're remarkable men and women,

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and they're not gonna be led by somebody

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who doesn't know what they do.

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And I think it's critical that we should be led

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by people who've, you know, been in the same place

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as we've been at three o'clock in the morning, having

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to make very difficult decisions.

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And we also need you to be a leader

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because radiology is being challenged.

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And many of our crises are based on the fact

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that many people in the government,

12:24

many people in the corporations

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and administrations that we work

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with don't really understand us

12:30

and aren't particularly sympathetic to, uh, where we are now

12:34

and probably aren't gonna be the best people

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to take us into our future.

12:37

This list changes, at least in rank order every year.

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Right now we have a, a rather significant labor crisis

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where we have many jobs where are being unfilled,

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and we only make a little over a thousand US radiologists a

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year, and we can't meet the labor demand.

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So we have a labor crisis.

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All of you know about corporatization

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and consolidation, um, ongoing processes

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where intermediaries start to own us and run us.

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Reimbursement continues to decline.

13:06

We sometimes have generational issues.

13:09

Um, AI is an interesting topic,

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but it's often listed as a threat.

13:14

Burnout, one of the areas where I do a lot

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of research is clearly a problem,

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and it's related to many of these other issues,

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and then issues of the changing demographics

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of the United States and issues of equity

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and justice for all of us.

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So, you know, these are just some of the things that again,

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we are being challenged with.

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And many of these will only be solved, at least solved well,

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um, if we have radiologists involved in the leadership.

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Now, many times people just assume that somebody's a leader

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because of, again, how they were born or their genes

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or those sorts of things.

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Um, but you know, when you really break it down,

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it's really about what people do.

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And being a leader isn't a role so much

13:54

as it is a collection of tasks.

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And one of the things that we did early on in the ROI,

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and I did this with Emory Pasco is, you know,

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we really started to look at kinda like, what do we need

14:05

to teach people and how do we break this down into

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manageable chunks?

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And these are some of the things that we expect our leaders

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to do and effectively do in a radiology department

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or in a radiology practice.

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And these are, you know, whether you like it

14:18

or not, they're all there and you have to do them all.

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Um, one of the things that inter interestingly, some

14:23

of the people I've worked with are most resistant

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to is the notion that they're a role model.

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But in fact, if you want to lead radiologists,

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they're always watching what you're doing,

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and you have to walk the walk if you're gonna, you know,

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tell people what to do.

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So you have to be a role model as well,

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but you break it down into the tasks that people have.

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Now, other people have said this as well,

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and I'm, I'm approaching this again from a medical

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and from a radiology point of view,

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but this is from a fairly famous, um, us, uh, writer

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and, uh, philosopher educator.

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Um, and, you know, I'll just, you know, quickly,

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I'm not gonna read the whole thing, but just, you know,

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again, this notion that leaders are born, not made,

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it's just not the case and it's nonsense.

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And you know, what they do is learned. It's not mysterious.

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It's possible to describe the tasks,

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and he's, he's saying it, you just break down the tasks.

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And you know what, it, this is not something

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that's one in 1% of the population.

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Now, there's may be 1% of the population

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that can compete in some events in the Olympics,

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but these are widely distributed.

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And so I think he's saying it very well.

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And I would just say that even if you don't think you can be

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a leader, if you are willing to try, you will probably be,

15:40

have the ability to become a good leader if you want to.

15:44

And if you ever have the privilege of talking

15:46

to somebody like this, um, they will, you know, tell you

15:50

that regardless of how much value they think

15:53

or other people think they bring to the organization,

15:56

they know that in a knowledge organization, like, you know,

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for those of you who dunno who this is, this is Bill Gates.

16:02

And you know, as he built Microsoft, you know,

16:05

he will tell you that he had to find really smart people to

16:10

take care of all the tasks

16:12

and to really, you know, bring the organization forward.

16:15

You can't possibly do this in a directed fashion from above.

16:19

And I think sometimes people think that, you know,

16:22

in the organization where they are,

16:23

that it's like the military

16:25

and the general just gives orders and then things get done.

16:27

Even in the military, at least effective militaries,

16:30

you have to have distributed leadership

16:32

to make it effective.

16:34

And I've talked to many people in technology sector

16:38

and the biomedical sector,

16:40

and they'll be the first to tell you

16:42

that they have leadership at many levels

16:44

in their organizations.

16:46

And so the alpha leader isn't the only leader.

16:48

So even if you expect that your chair

16:51

or your practice leader is the person in charge, he

16:55

or she really needs your help,

16:56

and I'm sure would be willing to help

16:58

with delegating tasks to you.

17:01

Um, and again, in successful organizations,

17:04

you have distributed leadership.

17:05

It means you have more creativity,

17:07

you can move faster than if you're relying on one person

17:11

or a small group of people to make the critical decisions.

17:14

In some sense, in most organizations, most of the employees,

17:19

uh, are, you know, knowledge workers

17:21

and have something that's a, a leadership role.

17:24

Now, why do people not go into leadership?

17:28

Or why do people look at leadership and then turn away?

17:33

Well, one is this notion that's, you know,

17:35

something we see a lot in STEM professionals,

17:37

and I first heard this from some engineers in Philadelphia

17:40

and a special program that we had at Wharton, four people

17:44

who were in, you know, engineering.

17:45

And in, um, it is this notion, well,

17:50

I'm really good at what I do.

17:51

I'm really good at coding, I'm really good at chemistry

17:54

and radiology.

17:55

I may be great grades,

17:56

and we're really good at taking standardized tests.

17:59

I've done great research. I've got the most publications

18:01

and the most grants of anybody my age.

18:03

So I need to be the chairman because I'm qualified.

18:06

Well, these are all good things

18:08

and they're all important things,

18:09

but it's not the same as saying that you're the right person

18:12

to lead other people and do the tasks

18:15

that we just looked at.

18:17

And, but there is this notion like,

18:19

why do I have to climb another mountain?

18:21

And I, I took my boards, I passed my boards,

18:23

I did all my call, I did this, and I did that.

18:25

But it's really about doing something a bit different.

18:28

So some of the answers to this are,

18:31

and leadership is different.

18:33

And in fact, traditionally in US medicine,

18:37

we weren't really doing a very good job,

18:39

at least in my generation

18:40

of teaching people leadership early on

18:43

and getting people involved in leadership roles.

18:46

It's sort of just stick to your, stick to your work,

18:48

get your work done, and, you know,

18:52

leadership is different

18:54

and you do need to study it, practice it,

18:57

and like riding a motorcycle and not just talk about it

19:00

and read about it, but actually start doing it.

19:03

And it, it's kind of silly.

19:05

But just because again, because you are very smart

19:08

and you did well on one thing, doesn't mean that you're,

19:10

you know, just gonna naturally be able to do something else.

19:13

You have to study it and master it the same way

19:15

you did the first task.

19:17

These, it's the wrong question, it's the wrong answer.

19:21

And part of the solution here is to understand

19:23

that it takes time and it takes effort.

19:26

You can't wing it.

19:27

And if you try to wing leadership, you'll probably fail.

19:31

Um, you'll certainly stumble a lot until you figure it out

19:33

and get it right and you'll get frustrated and angry.

19:36

I've seen people fail at this,

19:38

and sometimes I share with them something

19:39

that a Navy seal shared with me, which is this notion that,

19:43

you know, you start slow and the slow smooth

19:46

and then eventually smooth becomes fast.

19:49

And that in this case, you want to try to do that

19:52

and take your time and actually study this

19:56

and, you know, get it right.

19:58

I've seen many chairs fail

20:00

because they're very comfortable writing grants,

20:02

but they just don't have the background, they don't have

20:06

the interest, and they certainly don't have the training

20:09

to do the leadership that, uh, you know,

20:11

complex department requires.

20:13

Another one is, you know,

20:15

how do I balance my success in the group success?

20:18

Many times in my generation, people were promoted

20:20

because they were very good at writing papers

20:22

and very good at getting grants.

20:24

It was about them, and it was very hard,

20:28

and in some cases impossible for them to sort of stop,

20:31

take a deep breath and say,

20:33

now my successes should depend on

20:36

how the group is succeeding,

20:39

and I'm gonna be measured by the section department

20:41

or group that you're leading.

20:44

And yet, if you look at how we continue to promote people,

20:49

it becomes a balancing act and it can be very hard.

20:52

And in the end, to be a good leader, you have

20:56

to put the group ahead

20:58

and, uh, particularly if you're gonna lead in the kind

21:01

of challenging situations that we're in.

21:04

And this transition is hard, psychologically challenging.

21:08

Um, many people are just too narcissistic

21:12

or too self-absorbed to be able to pull this off.

21:16

And we saw one, one place where they went

21:19

through several chairs and they kept hiring the same kind

21:22

of person over and over again who wasn't, you know,

21:26

a good fit for a leadership role,

21:28

but they were very good at killing rats and doing research.

21:31

And, you know, it was just sort of like some

21:33

of your friends, when you get to be my age, you see friends

21:36

who keep marrying the wrong person

21:37

and they keep marrying the wrong man or woman.

21:40

And there's remarkable similarity between the three

21:43

or so who didn't work out.

21:44

Same thing can happen here,

21:46

and it's important that you understand

21:48

that great leaders should be judged

21:50

by the performance of their teams.

21:52

It's gonna take time away from stuff

21:53

that's about personal promotion.

21:56

You have to have some selflessness,

21:58

and it won't happen if you're a narcissist.

22:00

You have to delegate, you have

22:01

to let other people take the credit.

22:03

And if it's all about you, then, you know, being the leader

22:06

of an organization of 50, a hundred

22:08

or several hundred people probably isn't a good fit for you.

22:11

Another one that we all have,

22:13

and this can happen whether you're a leader or not,

22:15

but it's something that drives people out of leadership, is

22:19

that, you know, first of all, you get, get rid

22:22

of the illusion that even when you're a big leader,

22:24

you still answer to somebody.

22:26

And maybe Vladimir Putin doesn't answer to anyone,

22:29

but the rest of us are always in

22:31

kind of a sandwich or a vice.

22:32

No matter how much leadership, you know, you get

22:36

and you have, um, whatever number of people you have

22:40

underneath you, there's always somebody

22:41

above you that you're answering to.

22:44

And if you have a difficult boss,

22:46

somebody who's impossible makes your life miserable.

22:49

Um, first step in handling the situation is to make sure

22:53

that you're not the cause.

22:55

And if you're not the cause then understand

22:57

that it's their craziness.

22:59

But these are hard situations,

23:02

and if it helps you, there are people

23:04

who have written a lot about toxic bosses

23:07

and toxic situations, it's helpful to know

23:10

that you're not the only person.

23:11

There's even a taxonomy of this where you can look up

23:14

and, you know, there are, you know, five, 10

23:16

or more categories of kinds of people who are, you know,

23:20

not doing a good job as leaders,

23:22

but sometimes you have people

23:23

who are disorganized and decisive.

23:25

They waste people's time, they can't make a decision.

23:28

They undermine, they take credit for other people's work.

23:32

And at some point you have to figure out

23:35

and at least have sort of a, you know, moment of reflection

23:40

and understand that you at times can't solve these

23:43

situations by working harder.

23:46

Um, if you're not the problem, then you can't, you know,

23:51

and you, you the other part person has to be fixed, not you.

23:54

So working harder, working longer,

23:57

changing yourself isn't the answer.

23:59

You try to help them try to set limits.

24:02

But you know, I have at times advised people that it's time,

24:07

you know, you may need to move to a better situation.

24:10

One of the best books on strategy that I've ever read,

24:12

I think it's one of the best books on strategy ever written,

24:15

is by Sun Sue in the Art of War.

24:17

And he has a class of situations he calls deadly Ground,

24:20

and that's where the only solution is to withdraw.

24:24

Sometimes you cannot win,

24:27

and the best thing you can do is to move on

24:31

and move to a place where you can win.

24:34

And, you know, if you go to, to business school

24:37

and using different words,

24:38

they will describe exactly the situation.

24:41

And smart people, you know, don't stay at a place

24:44

and bang their head against the wall.

24:45

It's a form of insanity, and you just have to move on

24:49

and move to a different place.

24:51

Another thing that we run into a lot is this

24:53

culture of perfection.

24:55

And these are, you know, three fairly obvious, um, you know,

25:00

neuro radiologic exams.

25:02

Um, when I started in neuroradiology, we didn't do

25:06

what we do now, which is we welcome everybody into the

25:08

fellowship, tell 'em how smart they are

25:10

and how they're way smarter than we were when we, you know,

25:14

got, got neuro fellowships

25:17

and you know, throw a party for them and all that.

25:20

Um, I basically started,

25:22

and, you know, on the first day, um, one

25:25

of the attendings came over

25:27

and said, you know, if any of you miss any

25:29

of these three things, and these are actually the three

25:31

things that they mentioned and not the same pictures,

25:34

but you know, if you miss one of these,

25:37

then your continuance in the neuroradiology fellowship will

25:41

be in question kind of a, a little speech.

25:44

And so everybody knows this is blood in the head,

25:46

a c-spine fracture

25:48

and, uh, pretty nasty form of herpes encephalitis,

25:51

but missing things is, you know, a big deal.

25:55

We don't want to be missing things,

25:57

but it also means that it can paralyze leaders.

26:00

Leaders are never perfect

26:01

and honest leaders will tell you

26:03

that they never get it completely right.

26:06

If you meet a leader who says they're always getting it

26:08

right, they're probably not trying to do very much.

26:11

Um, and they're probably not the kind of people

26:14

who can lead you through a difficult time,

26:16

because when things are changing, you have to take risks

26:19

and make difficult decisions.

26:21

But we feel like we need to be, if you feel that you need

26:24

to be perfect, and you know,

26:26

we certainly never wanna miss any of these things.

26:28

Um, we want to read perfectly,

26:31

but you cannot lead perfectly.

26:34

And we are are in a culture of perfection,

26:36

radiologists even more so

26:37

because there's always a permanent record of anything we do.

26:41

So it makes it a, a, you know, stressful, challenging job.

26:46

And it even is this kind of a strange thing.

26:49

And, you know, you can sort

26:50

of be like an air traffic controller

26:52

or some other, other people who are in this category of

26:55

that we're invisible until we have make a mistake, is what

26:58

that acronym's play more polite way of saying that acronym.

27:02

And because of that, it's stressful

27:05

and people are afraid to make mistakes,

27:08

but leaders will make mistakes.

27:11

And it, you know, we're, you know, we're don't want

27:15

to do anything wrong.

27:16

We don't want to be responsible for a mistake.

27:18

You know, our mistakes are serious.

27:22

We're always striving for perfection.

27:24

And they're like some of the engineers who I've worked with

27:26

where they'll say close enough isn't good enough,

27:29

and if they make mistakes, bridges fall down, cars crash,

27:32

airplanes come out of the sky,

27:34

and that bad things happen With leadership, it's even worse

27:38

because it's also not that easy to measure.

27:42

And whenever somebody tells me about, well,

27:45

what do you think about the leadership of so-and-so

27:47

and him or her?

27:49

Um, it's usually somebody in academics.

27:51

And I usually tell people I haven't walked in their shoes.

27:53

I don't know all the details

27:54

of why they made the decisions they made.

27:57

And I think you have to cut them some slack.

27:59

You also have to allow sort of a tincture of time, um,

28:03

because sometimes leaders have to make decisions

28:05

that in the short run are very difficult and hard,

28:08

but might have good long-term outcomes.

28:10

So be careful. Um, people tend to be very judgy.

28:14

And no matter what you do as a leader,

28:17

somebody's gonna criticize you.

28:19

And if you make the people above you happy,

28:21

you may be making decisions that hurt your radiologist.

28:24

So you're also, again, kind of, again, in that sandwich

28:27

where you have people above and below you.

28:31

And certainly the ways that I tell people

28:33

to push back on this is that, you know, understand

28:37

that you're gonna be judged

28:39

and you're gonna be judged harshly.

28:41

I've, you know, had people get mad at me about

28:43

decisions I've had to make.

28:45

Um, but part of the answer is, is to get good training so

28:48

that you know more about good leadership so

28:50

that you can justify your leadership.

28:52

You also need to get good mentors

28:54

and build a peer network so that you can rely on each other.

28:57

And perhaps in a future lecture we can talk about it.

29:00

I like Lincoln's quote, which is, you know,

29:02

focus on the outcomes rather than the decisions.

29:05

You know, and success forgive many mistakes.

29:07

And so if you succeed, um, you know,

29:11

people will let the small things go that, you know,

29:14

they thought were bad, things that you had done,

29:16

bad decisions you had made.

29:18

You're also, again, serving multiple masters.

29:20

And again, for many of us, the ability to just focus on

29:25

the cases in front of you is much, much simpler role

29:28

during the course of a day.

29:31

And I had the privilege of serving with, uh,

29:33

someone who's one of, I think one

29:35

of the best leaders in US radiology that worked.

29:38

And it was funny how sometimes he would say, um, Frank,

29:42

some days I'd rather not be a leader.

29:44

I'd rather just read the cases.

29:46

So when you're out out there,

29:48

you're serving multiple masters,

29:49

you gotta balance the needs of a lot of people.

29:52

And sometimes they're competing people in groups.

29:54

So you can't make everybody happy. But how do you do it?

29:57

Maintain your focus. That's one

29:58

of the key things in leadership.

30:00

First things first, and try to keep the long-term success

30:05

of the people you lead in mind.

30:06

Try to take the best care of your radiologists that you can

30:10

also take time to listen carefully.

30:11

Because sometimes if you listen to these other parties, many

30:14

of them are talking about short-sighted, um,

30:17

rather parochial ideas.

30:19

And maybe you can come up with ways to help all of 'em

30:22

and come up with more creative decisions.

30:25

And, you know, be clear

30:27

and transparent with your colleagues when you have

30:29

to make the hard decisions.

30:30

If you can tell people you're, we're gonna have

30:32

to work harder, we're gonna have to wait another year

30:33

before we get our new equipment.

30:35

Just be clear and transparent.

30:38

Um, also, you have to be able to manage up.

30:41

It's not enough to manage the people underneath you

30:44

or manage the people who are your peers.

30:46

You also, again, part of the answer

30:48

to a toxic boss sometimes, or somebody who's not so toxic,

30:51

but just somebody who can needs help is manage up

30:55

and you negotiate.

30:57

Try to understand the position that your leader's in be,

31:01

you know, share your challenges.

31:02

Um, here is why we need this. Here is why I need this.

31:07

Um, there's a colleague at Wharton

31:10

who wrote a whole book about saying no.

31:12

And sometimes, you know, you have to say no,

31:15

or sometimes you have to say, I would love to do

31:18

that project, but I have to wait

31:20

until I get these other three projects done

31:22

before I can do that.

31:23

Like, write that paper, do that research.

31:26

And you know, one of the things we do in the RI is we teach

31:28

people how to write a business case so that, again,

31:30

you can justify things

31:32

and things like, you know, how do we get people

31:35

to do their nonclinical tasks

31:36

and how do we, um, treat them fairly with time

31:40

and money when they're doing things that are just

31:41

as important than RVs,

31:43

but we're dealing with an administrator

31:45

who may only understand RVU and not the rest of what we do.

31:48

Now I'm gonna close by talking about how we do this.

31:52

Now, this is a great title for a book.

31:54

Unfortunately it was a terrible book, terrible idea.

31:58

It was basically a blueprint for the Soviet Union, one

32:00

of the worst ideas that humans have had in

32:03

the last couple hundred years.

32:04

But, um, it's a great title. So I'm gonna borrow it.

32:08

And if you ask me, well Frank, how do I do my first project?

32:13

Um, you know, we have a project here

32:15

where we're gonna change how we, you know,

32:18

are running our schedule, gonna change

32:21

how we manage our radiologists and that kind of thing.

32:25

I usually tell people first, build a good team.

32:28

Leadership by definition means you're leading other people.

32:32

And to really make significant good changes in an

32:35

organization, you usually need a team.

32:38

And if I'm sure

32:40

that everybody who's on this call could sit down in,

32:44

in 10 minutes, fill a couple pages with things

32:46

that could be better in your institution, if you can't do

32:50

that, then send me an email.

32:52

'cause I would love to come and work in your place if it

32:53

really doesn't have any issues.

32:55

'cause all of us, I think, see things that could be better,

32:59

but you're gonna need help.

33:01

And I like to have, you know, a elite team, kind

33:05

of like a mission impossible team where people have,

33:07

you know, lots of skills and can be helpful.

33:10

You want it to be a high functioning team

33:13

and you know, you certainly don't want a team

33:15

that's dysfunctional.

33:17

And also make sure that you work on important projects.

33:21

You know, life is short, so you should try

33:23

to do important significant things when

33:26

you're doing project work.

33:27

Project work is going to eat up some time.

33:29

So again, focus on things that are really important.

33:32

When you lead a group, you want to get the right people.

33:35

Every business book starts with

33:37

that in the first chapter is get the right people.

33:39

Pretty obvious. Um, one

33:42

of the books talked about getting the right people on the

33:44

bus, getting the wrong people off the bus.

33:46

Um, if you don't have choices, if you're sort

33:49

of having an assigned group of people to work with

33:51

and you're not getting to pick them, then certainly try

33:55

to fix and optimize the people you have and be a role model.

34:01

And that's part of what you do as a leader.

34:03

And whether it's safety, quality, operational excellence,

34:06

just be the leader.

34:08

Second, again, evaluate these projects for value.

34:13

And particularly when you have something

34:14

that's particularly challenging.

34:15

And right now we have a labor crisis.

34:18

Um, just focus on what's urgent and important.

34:21

You know, you know, limit, you know, you have limited time

34:24

and resources, so you may want to shelf some other things so

34:28

that you can figure out how you can recruit and retain.

34:32

Um, if you're going having the pleasure

34:34

of switching over a PAC system

34:36

or an EMR system, make sure that you have plenty of assets.

34:41

And, and don't underestimate how hard that can be.

34:45

I've lived through a couple of those and there are no fun.

34:47

So just make sure

34:48

that you're focusing on the things that matter most.

34:51

And then you have the, you know, resources that you need.

34:54

Um, and if you're gonna do a paradigm for this,

34:58

this is a little book.

34:59

It's not my book, but it's a very good book.

35:02

It's short, it's to the point.

35:04

Roger Fisher, they're, they're both great authors

35:06

and they're both very, very smart people.

35:09

But you know, here's a good way to sort

35:11

of do project leadership.

35:12

Now they, they put it in terms of sometimes of crisis,

35:15

and they have some examples from some crises.

35:17

Roger was a very famous negotiator, negotiated some

35:20

of the nuclear arms limitation talks

35:22

between the US and the Soviet Union.

35:24

But, um, you can do this with anything,

35:27

and it's starting with purpose

35:28

and then working through thinking, learning,

35:30

engagement and feedback.

35:32

Very simple, but very powerful.

35:33

If you follow the paradigm

35:35

and with purpose, it's really having a clear aim

35:38

that's specific and quantifiable.

35:40

One of the things from the business literature is,

35:42

is this acronyms, you know, specific, measurable,

35:45

attainable, realistic, and timely.

35:47

If you can make even most of these, let alone all of 'em,

35:51

then you've got a good project.

35:53

Some examples, you know, be a good radiology department.

35:57

It's actually a bad purpose

35:59

because what do you mean by good?

36:01

And how are you gonna measure good?

36:03

What are you gonna do to be good?

36:05

It's, it's not formed

36:07

and you really need to go back

36:08

to the whiteboard and work on that one.

36:10

Improve our IT systems still not great.

36:12

Um, at least you're focused a little bit more,

36:15

but you really need measurable, you know, elements.

36:18

Get the stroke alert readings in line

36:20

with national time standards, that's a lot better.

36:23

And improve the retention of radiologists. That's good.

36:26

That's also critical.

36:28

So, but you wanna make sure that you meet as many

36:30

of these attributes as you can then think,

36:35

and that is not a misprint up there.

36:37

The first couple times I had this slide up,

36:39

people kept wanting to correct it.

36:41

Um, but that's from, uh, an attending,

36:43

a nephrology attending I had when I was working in the ICU

36:46

as an intern in the Brigham.

36:49

And he just said, don't just do something stand there

36:52

because we get into these algorithmic responses,

36:54

these reflexes,

36:56

and it's what, uh,

36:58

Nobel laureate called the fast thinking form of

37:01

how we use our brains.

37:03

And sometimes you need to use the slow pathway

37:06

and really rethink this.

37:07

Uh, do we really understand what's going on here?

37:10

And think carefully.

37:11

Don't just come up with easy solutions,

37:14

but think hard about better solutions.

37:15

Things. Who, who's gonna help you think

37:18

how you're gonna do the measurable part of the work,

37:21

how you're gonna implement it

37:23

and think if you have the right expertise,

37:25

do you have the right people understand operations

37:28

and it to really do what you need to do?

37:32

Um, any project you do in leadership should

37:35

have a learning component.

37:36

And by this I mean that you pay attention

37:38

as you implement the changes in the project

37:41

and look really carefully.

37:43

One of the things that happened with an early project

37:44

that I did in Philadelphia where we were trying

37:47

to get our stroke, um, turnaround time under control,

37:51

is we did a great job of streamlining

37:54

and transport and communication.

37:57

Um, what we didn't expect was

37:59

that once we were really doing strokes very quickly, um,

38:03

the incidence of stroke in Philadelphia skyrocketed

38:06

because people in the ED said, well,

38:08

we'll just make everything a stroke,

38:09

or at least we'll make a lot more things strokes.

38:11

So you wanna watch out for that, watch out for expected,

38:14

unexpected results

38:16

and make sure that you're not, you know,

38:18

having any unexpected, um, types of outcomes

38:22

where the re we're tying up resources.

38:24

So now we're slowing down things elsewhere.

38:27

And many times the answers to these projects aren't

38:30

so much in the radiologists.

38:31

You know, telling the radiologists just to read faster,

38:34

giving them rewards for read faster, reading faster.

38:37

Many times it's about communication, it's about transport,

38:41

it's about, uh, technologists, um, being in a, you know,

38:45

aligning with what we're trying to do.

38:47

So just think widely.

38:48

Don't just, you know, come up with a simplistic solution

38:51

that only addresses a tiny part of the matrix.

38:55

Uh, with regard to engagement, you really want

38:57

to get your team engaged.

38:59

If you need help from good people,

39:00

you need to get them excited.

39:02

Try to get the right people again, try to get them motivated

39:07

and assign roles and tasks to them.

39:10

Finally, in every one of these projects,

39:12

if you're gonna be a leader, um, your leadership job,

39:16

your leadership role will be to do more things.

39:20

You're not just gonna do one project and then call it quits.

39:23

So always do something afterwards to analyze what you did

39:27

and figure out what worked and what didn't.

39:30

And the military, they call this an after action analysis.

39:33

Um, did you have the right people?

39:36

Um, and if you did, then make sure you try to keep them

39:40

and get them involved in the next project.

39:43

Figure out what you did well and figure out what went wrong.

39:48

Um, if you're honest, you know, projects, sometimes you kind

39:51

of bump along and you figure it out.

39:55

And don't be afraid to use 360 degree feedback,

39:57

because many times, again,

40:00

it's not just the radiologists who are gonna be involved.

40:02

And in the very first leadership project that I did

40:05

as a young faculty person, um, the,

40:10

the team was actually very diverse.

40:12

And some of the best stuff

40:13

that we got came from the ICU nurses

40:15

for a project we were doing on, uh,

40:17

carotid Endarterectomies of Penn.

40:20

So just, you know, make sure

40:22

that you're looking at everybody and listening to everybody

40:24

and looking widely now how to succeed as a leader.

40:28

And I'm gonna, you know, close things up

40:30

so we can turn it over to you

40:31

for questions in a couple minutes.

40:33

But always, you know, be willing to start leading

40:36

before you have to, and to really start with leadership

40:40

and start thinking like a leader and acting like a leader.

40:43

Even if you're not not really interested in ever having like

40:48

an alpha role, like being the the chair,

40:50

um, you'll be happier.

40:52

You'll get your department to work better.

40:54

Um, make sure you manage yourself first

40:56

in challenging situations.

40:58

Um, if you're being told you have to produce more RVs

41:02

and you, you know, you're upset, um, figure it out

41:07

before you talk to your team about it.

41:08

Uh, 'cause you have to manage yourself and stay focused.

41:12

Build a great team. Um, when you have a plan, use it,

41:16

but also improve it.

41:17

Um, most people will tell you people

41:19

who do high level planning that plans are a starting point,

41:23

but they're not an end point.

41:25

And having, you know, having a plan isn't as important

41:29

as doing the planning.

41:30

And I think it was Eisenhower who said that,

41:33

and I am obviously a great planner, one

41:35

of the great strategists in US history.

41:38

Um, but he said that the plan itself wasn't what was useful.

41:42

What was useful was the planning

41:44

and the process so that when things go wrong,

41:46

you've thought about it.

41:48

And yeah, the plan has to be changed,

41:50

but you change it quickly and you move forward quickly.

41:54

Uh, don't be afraid to lose a small fight again.

41:57

Like Lincoln's quote, what matters is succeeding.

42:00

Another quote from US history from a different US president

42:04

is, it's a, you know, good bar bet.

42:07

Um, George Washington lost more

42:12

battles than he won.

42:14

So, you know, if you look at him like a sports figure,

42:18

he was actually a loser.

42:19

But what mattered is that he won the war.

42:22

And, uh, that's what you remember,

42:24

but you don't remember that he lost a lot

42:26

of battles along the way.

42:29

And as a leader, this will be,

42:34

you know, again, not something

42:36

that works in a culture of perfection.

42:38

If you are afraid to lose, you're not gonna win.

42:41

And you have to be willing to take risks in order to win.

42:45

And you should plan to lead and you should learn to lead.

42:49

And and my conclusions, uh, here, understand

42:53

that you can and should be a leader.

42:55

And I really hope that most of you, all of you decide

42:59

that you know, you'll get interested in doing leadership.

43:02

We need you, um, us radiology needs you.

43:05

Um, it is not something that you were born

43:08

with that is an illusion.

43:09

Now, some people are born wanting

43:11

to be leaders without getting into the details,

43:14

you can already imagine what I'm about to say.

43:16

And sometimes the people who want

43:18

to be leaders aren't the people we want as leaders.

43:20

And that many people around the world

43:22

who are currently leaders are terrible leaders

43:25

in some cases, awful.

43:27

And that, you know, this is something that you can do

43:30

and you can be a good leader

43:31

with the right training and experiences.

43:34

And if people want to be leaders, the ROI can help you.

43:38

Um, projects are opportunities

43:41

and these are ways to get involved in leadership,

43:44

make things better, and develop leadership skills.

43:47

So that's why I included that as a paradigm

43:50

for what to do next.

43:51

It's not just to read a book,

43:53

it's to go out and do something.

43:55

And with all of this, and I I say this to my residents

43:58

and fellows regularly.

44:00

I occasionally use this in my RLI talks.

44:02

Just remember the oath you took

44:05

and I, I said the Geneva, uh,

44:07

declaration when I graduated from medical school,

44:10

Hippocratic Oath, whatever you said, make sure

44:13

that your plans for leading are true to that

44:17

and you take good care of your patients, take care

44:20

of yourself and your team.

44:22

And with that, I'm out of time

44:24

and uh, that's me at Wharton with the person

44:27

who invented my computer.

44:28

That's Steve Wozniak. That's my personal email.

44:32

And again, thank you for your attention.

44:33

Thank you to modality

44:34

and thank you to the ROI for putting this together.

44:37

So thank you. And I'm gonna stop the screen

44:39

sharing at this point.

44:42

Excellent. Thank you so much Dr. Alexa for that lecture.

44:44

We will now open up the floor for some questions.

44:48

As a reminder, you can submit your questions through that q

44:51

and a feature so that we can get through as many as we can

44:55

before we need to close.

44:58

Dr. Alexa, can you see the q and a box

45:00

or would you like me to read them

45:02

to You got a couple in there already.

45:04

Um, I would ask you to, um, read them to me

45:08

because I just see the, um, materials

45:11

that were in there before we started.

45:13

I'm not seeing what's coming up that's new, so, gotcha.

45:16

Yeah, please go ahead and start. Yeah,

45:17

No problem. Okay.

45:18

Um, how do you deal with a younger immature supervisor

45:23

who is impolite disrespectful towards you?

45:29

Well, I guess it first depends on whether

45:31

or not they're a radiologist or not,

45:34

but certainly understand that,

45:37

you know, whatever age you are.

45:39

And, and in my position, I'm older than most of the people

45:42

who I interact with and work with.

45:44

'cause I think I'm officially the oldest person in the group

45:48

that where I'm working is you.

45:51

I guess you have to be patient.

45:53

Um, if they're being difficult with you, I would,

45:58

you know, be slow to anger with that.

46:00

If they're being difficult with other people, then I might

46:06

talk to them about it and or escalate it.

46:09

If I had to, as an example, we had somebody

46:13

who was immature who was not a radiologist.

46:16

And this is what I'm visualizing here, who told

46:19

my chief resident that she thought that

46:25

the residency program at the place

46:27

where I was at the time was kind of a, a waste of time

46:30

and money and we should get rid of it.

46:33

Um, I did not hold back

46:36

and I took that person aside

46:38

and explained how important it was that we have a residency

46:41

and that you shouldn't say things like that to,

46:44

you know, our residents.

46:47

And you know, if you, if you don't, you know,

46:51

become more mature

46:53

and you don't learn how to be professional,

46:55

I think is the term that I used.

46:57

Um, you know, I'll, you know, you know, discuss this

47:00

with people who you work for.

47:02

And that helped 'cause I, I think nobody had stood up to her

47:06

and she was kind of bullying other people,

47:08

including our chief resident.

47:10

But I think with many of these people,

47:11

it's a matter of education.

47:13

You have to understand that some people in hospital

47:15

administration really care about medicine

47:17

and care about the health and the patients

47:21

and some people don't.

47:23

And if you're stuck with one of those people,

47:25

I would say try to bring them up to speed, try to be patient

47:30

and you might talk to your supervisor

47:33

and have that person talk to that other person's supervisor

47:38

in the sort of diadic relationship

47:39

that we have in hospitals.

47:41

You can do that, but I would certainly make people aware

47:44

that this is going on.

47:45

I talk to maybe the person who supervises you.

47:50

Excellent. Um, this might be a steamy question.

47:53

As a leader, how do you suggest dealing with

47:57

romantic relationships in the department

47:59

or conflicts of interest

48:01

or any of those other sticky situations?

48:03

Oh gosh.

48:05

Well first I guess you have to ask like

48:08

what are your local HR rules?

48:10

Um, and as a leader you have to follow the rules

48:15

and guidelines of your institution.

48:17

If you disagree with them,

48:18

then you need to get them changed.

48:20

So part of it is, you know, I don't agree

48:23

with every law in the United States, but I follow 'em

48:26

and then I try to vote for people who will change 'em.

48:29

Um, in this case, romantic relationships in some places have

48:33

to be openly declared in some places.

48:36

Some of them are illegal

48:37

or at least you will get into trouble if you get involved

48:40

with people who are in different parts of the organization.

48:44

And some of the places where I've worked, if you are a paid,

48:48

um, healthcare provider, you're not allowed

48:52

to have a romantic relationship with somebody

48:54

who is paying tuition to the institution.

48:58

So I would, you know, check that.

49:00

Um, I would also look at what policies are in place

49:04

and then ask yourself if you agree with 'em, if you disagree

49:09

with 'em, whether it's romance

49:11

or other sticky things, um, then I would suggest

49:15

that you work to get them changed.

49:18

Because to be honest,

49:19

in many places people don't know these things.

49:22

And in one place we had to tell somebody, you know, the fact

49:25

that you two are dating, you have to go and tell hr.

49:30

Um, it's not me telling you to do it.

49:32

It's that that's just the rules here.

49:34

Those are the rules here. Um,

49:36

and it certainly does make things sticky

49:38

because if you're in a position to grade someone,

49:41

if you're in a position to promote someone

49:45

in your institution, there are all kinds of, you know,

49:49

there's all kinds of scrutiny that you have to abide by.

49:52

But, you know, perhaps if there's another example

49:54

of a different situation, I can expand on that.

49:59

Excellent. Okay.

50:03

How would you approach leadership teaching

50:05

and personal career development as a junior radiologist

50:08

and a busy practice in the public sector?

50:13

Okay. Um, well it sounds like you're, you're very busy.

50:18

So I would say that I would look for ways to

50:24

lead at work so that it's part of your job description

50:27

because it sounds like you don't have a lot of free time

50:30

and you're pretty busy and you're junior.

50:33

Um, if you're asking about education, I would certainly

50:37

shamelessly promote the RLI here

50:39

because one of our missions is to try to make this as easy

50:44

for time starved individuals like you as we can,

50:47

and also make it as inexpensive as we can.

50:50

'cause we know that you're probably juggling a lot of things

50:52

and working hard and you might have even have some

50:55

educational debt that you're still dealing with.

50:58

Um, but I would try to actually start leading at work

51:01

and try to take on roles.

51:03

One of the things I didn't mention in the talk,

51:05

but I'll mention it here, is that for many radiologists

51:09

being told to be on a committee is about as much fun

51:12

as finding out you need root canal.

51:14

They don't want to serve on committees, they want

51:16

to be on the hospital committee that does this

51:18

or that, uh, don't want to be part

51:20

of an institutional wide promotion committee

51:22

or that kind of thing in an academic center.

51:25

But if you talk to my Wharton students

51:27

and I, I taught there for 17 years, the one

51:30

of the first things they do when they arrive

51:33

in a new job is they find out when the meetings are

51:37

and they make sure they get invited to the meetings

51:39

and they make sure that they're seen in the meetings

51:42

and they make sure sometimes to a fault

51:44

that they say something in the meeting so

51:46

that they will be remembered

51:48

because they understand that meetings are how humans

51:51

do leadership work and strategy and things like that.

51:54

So I would encourage you to get involved with committees,

51:58

get involved in projects, um,

52:03

get more visibility so

52:05

that your leadership starts where you are.

52:09

So it's not, you go off for two years to a, a,

52:11

a fly in MBA program, but you start learning where you are.

52:15

And again, some of the resources that the RLI have are about

52:19

as easy as it can be to at least get your toe in the,

52:22

in the pool and get started.

52:28

Thank you. Okay.

52:33

Alright. This is a good one.

52:36

How do you lead and build yourself

52:37

to become someone people can look up to without

52:41

being portrayed or feeling arrogant by the team?

52:47

Well, I guess it depends a bit on you and on the team,

52:50

but I think that there's several things you can do

52:55

to quietly build confidence, you

53:00

know, from other people.

53:03

So part of it is leading by example, as I mentioned earlier.

53:07

So if you want to be trusted with, let's say,

53:10

doing a project that involves quality and safety.

53:13

So these are important projects, they're sensitive projects

53:17

and they're projects with trade-offs.

53:20

Um, first of all, I, I think you should be a good listener.

53:25

Listen to the people who you want to respect you.

53:30

Um, be a good listener, talk to them, understand

53:36

what their issues are.

53:38

Um, I think one of the worst things you can do,

53:40

and it's kind of one, one of the advantages

53:42

of being an introvert is that introverts tend

53:45

to be better at listening.

53:47

Um, even though e and extroverts can be very good at

53:50

pretending to listen to you, they're often the people

53:52

who are just sort of waiting until you stop talking.

53:57

And then they want to tell you,

53:58

well, lemme tell you about me.

54:00

And I think that if you want to build, you know,

54:02

build yourself up without looking arrogant versus you don't

54:06

need to be arrogant and arrogance is, is off-putting,

54:09

particularly to radiologists and other STEM people.

54:13

It's one of the things that turns us off to leaders,

54:15

but listening is important.

54:17

I think, you know, strong coherence, you know, if

54:22

if everybody's gonna have to work harder, then

54:25

you should be one of those people.

54:26

If we're all gonna have to pitch in more,

54:28

then you should be pitching in, um, leading by example.

54:33

In one military situation, I don't know,

54:37

I don't wanna mention which one it is,

54:38

but one of the mottos of that military is

54:42

that leaders say, follow me.

54:44

You know, they go first

54:47

and you know, you follow them, they lead by example.

54:51

So I think that's part of it.

54:52

I think it's also showing an interest in the project,

54:56

showing an interest in the people who are on the team.

55:00

I think that's how you can be a leader

55:01

without being arrogant.

55:02

And I don't think that arrogance really has much of a role.

55:06

Um, it, it's very off-putting.

55:08

And I think that if you, you know, follow these other ideas,

55:12

these other things I just suggested.

55:15

That's a way where people will just sort of,

55:17

you'll become the person they gravitate to,

55:20

that you'll be the person they confide in,

55:22

you'll be the person they can trust to be a leader.

55:26

And one of the issues that many

55:27

of us have in the hospital situations we're in

55:30

is lack of trust.

55:31

So I would start with some of those things.

55:34

So I hope that answers your question.

55:36

That's a great answer. Alright, let me do one more here.

55:43

Um, oh, this is a good one.

55:46

If you work remotely as a tele radiologist

55:49

and wanna gain leadership skills, what are the ways

55:51

to build more confidence for leadership, you know,

55:53

when you're just by yourself at home?

55:57

Oh, that's a, that's a great one

55:59

because in the midst of COVID,

56:01

I started doing more work from home

56:03

and I found it very hard to be disconnected.

56:06

Um, but, you know, you can do many

56:10

of the things we just said remotely

56:12

and during COVID we had to learn how to do that a bit.

56:16

Um, I would certainly encourage you as a tele radiologist

56:22

to, and, and we had a tele radiologist

56:24

who won our teaching award at Pitt.

56:27

Um, even though she was, most

56:29

of the time she was in Seattle.

56:31

So, but she's a great teacher

56:33

and she really learned how, you know,

56:35

and really made an effort to do great teaching remotely.

56:39

Same thing. Um, if meetings are still being held remotely in

56:43

your hospital or they're mixed, they're hybrid.

56:45

So some people are in a room, other people are remote.

56:48

Just make sure you're on those meetings,

56:50

make sure you're contributing, make sure you make an effort

56:53

to get to know the people.

56:55

And these are all challenging. I, I find it very hard

56:58

to be remote and do the Neurotrauma conference

57:01

because I'd much rather be in the room hanging out

57:04

with the people who are there and having coffee with them.

57:07

But at least make telework as much as you can

57:11

if it's possible in your job situation,

57:14

if you can even be a little bit hybrid instead

57:17

of fully remote.

57:19

But just occasionally, occasionally be there in person, um,

57:24

that will, you know, help you tremendously.

57:26

But if you are fully remote, I would just, again,

57:30

do the 110%, try to be at more conferences, try

57:34

to really work the system so

57:36

that it works well in conferences

57:38

and teaching and that kind of stuff.

57:41

And there's no reason why you can't be on a board

57:44

or be on a committee and be remote as long

57:47

as you're not the only one who's remote.

57:49

And in these days, even the people

57:51

who are three miles away from the hospital may be

57:53

doing it on Zoom or teams.

57:57

Well, thank you Dr. Alexa.

57:58

I think we'll wrap, wrap up with that one.

58:00

Thank you so much for your lecture

58:01

and for answering all those questions.

58:04

Well, thanks to everyone who is on. Thanks for learning.

58:07

Yeah. Appreciate it.

58:08

Yes, and thanks for everyone for asking such

58:10

great questions and participating.

58:12

Be sure to join us next week on September 18th at 12:00 PM

58:15

Eastern, where Dr.

58:17

Jonathan Alis will deliver a lecture entitled Mastering

58:19

HRCT, the Radiologist Pivotal role in Fibrosing

58:23

ILD Management.

58:24

You can register for that@modality.com

58:26

and follow us on social media

58:27

for updates on future NOOM conferences.

58:30

Thanks again and have a great day.