Hard Lessons to Navigate Leadership: Insights from the Radiology Department

Pr Hans Blickman delves into the pivotal lessons learned throughout a distinguished career in radiology. He highlights the importance of trusting one's instincts, understanding the limits of one's influence, and recognising the significance of leadership compatibility. Through personal anecdotes and reflective insights, he underscores the necessity of aligning personal values with professional aspirations to achieve lasting fulfilment and effectiveness in one's career.

Key Points

• Trust your instincts: Even when receiving overwhelmingly positive advice, it's crucial to heed your own instincts and evaluate the full context of a career opportunity.
• Beware of the 'saviour' complex: Understanding one's limitations as a change agent is vital, especially when transitioning to a different cultural or professional environment.
• Leadership compatibility: Recognise the importance of aligning your leadership style with the organisational culture and existing leadership dynamics.
• Self-awareness in career roles: Be mindful of your strengths and preferences in leadership roles, avoiding positions that may not align with your natural inclinations and expertise.
• Align personal values with professional aspirations: Ensure that career decisions align with your values and long-term goals for sustained professional fulfilment and effectiveness.

Navigating the labyrinth of professional advancement often entails grappling with the stark realities of decision-making and leadership dynamics. This narrative of hard-learned lessons underscores the crucial importance of trusting one's instincts, understanding one's limitations as a change agent, and recognising the significance of leadership compatibility. Through a series of pivotal career experiences, I have come to appreciate the profound impact of these elements on professional fulfilment and effectiveness. The following recounts these defining moments, each offering valuable insights that have shaped my approach to career decisions and leadership roles.

Trust Your Instincts, Not the Advice Of Others, Even When Laudatory

As a highly driven professional, I found great satisfaction in the rapid advancement of my career within the radiology department. In my early 40s, while holding a leadership position for several years, I was approached for an attractive opportunity by a headhunter. At that particular time in my life, my plate was full, juggling the responsibilities of caring for young children, meeting articles and books writing commitments, and managing a heavy workload due to understaffing. The prospect of taking on a prestigious role and leading a project that aligned closely with my expertise was alluring, as it held the promise of potentially lightening my workload and making a significant impact.

After consulting with mentors and family, I distilled the offered task into a clear plan: to lead the paediatric radiology department's expansion, doubling the faculty to nine or ten members and establishing it within a new Children’s Hospital building. The consensus was largely in favour of seizing the opportunity, especially considering it could be a potential stepping stone towards a future leadership position at the prestigious (Boston) Children's Hospital in 5 to 10 years. Despite the overwhelmingly positive advice, I had moments of hesitation, especially during several late-night walks with my dog. Nevertheless, I ultimately disregarded these doubts.

After making the move for the new role, it swiftly became evident that the working environment in the South was markedly different from what I had been accustomed to in the ‘north’. This was something I had failed to fully take into account during my interviews and pre-acceptance assessment of the job. There were discrepancies in promises, timelines, budgets, and the overall work culture. Consequently, the position did not unfold as anticipated. In hindsight, it became clear that my initial instincts were correct: the faculty at that location is still relatively small over 20 years later, the Children’s Hospital remains unbuilt, and there has been limited academic achievement.

Do Not Delude Yourself Thinking You Can Be ‘the’ Change Agent

As a native of the Netherlands, I received from time to time inquiries from Academic Medical Centres about my interest in returning to the Netherlands to serve as chairman of an academic radiology department. The persuasive, likeable, and engaged dean of a medical faculty finally convinced me by appealing to my sense of 'giving back' after spending so many years in the American medical system. Blinded by this notion of being a 'saviour' of sorts, I conveniently forgot that I had been away from the Netherlands since graduating high school almost 30 years earlier. I lacked the network that was a natural product of the Dutch University system and had minimal experience with the so-called 'polder model' or consensus method of leadership in the Netherlands. Nevertheless, my enthusiasm(again!) overruled the caution I should have exercised. I believed the recruiters who assured me that I could be the change agent their department and Medical Centre needed.

Upon accepting the position, I immersed myself in my new role, determined to bring about positive change. We made significant strides in modernising the department and improving its operations, but, over time, the cultural differences and my approach to change began to clash with the deeply ingrained consensus-driven culture. While my 'crazy American can-do attitude' was initially seen as refreshing, innovative, and overall very successful, it eventually started to wear thin, and after two five-year terms, I returned to the US, quite disillusioned.

If You Know You are Better ‘At the Wheel’, Do Not Settle for a ‘Next to’ Role.

Upon leaving the Netherlands, I was recruited to an upstate New York Medical Center by the chairman of Imaging Sciences, who needed assistance revitalising the pediatric radiology section and building a new Children’s Hospital. He also expressed particular interest in my quality assurance experience for the entire imaging department. After my stint as chairman of a department, I convinced myself that I would be fine as the vice chairman (the ‘wise’ man behind the chair) as well as the section chief of pediatric radiology. However, I failed to consider that my personality might not align well with that of the chairman, who had fallen into the position and was very protective of it.

While I did not mesh well with the chairman, I found that I got along well with the department's rank and file, the board chair, and others. This led to predictably uncomfortable tensions. From my extensive sailboat racing experience, I knew that I performed best at the wheel of the boat, not as a crew member. How I wished I had heeded my own advice. The clash in personalities and leadership styles between the chairman and me became increasingly apparent, causing friction within the department.

Despite my best efforts to adapt and contribute positively, the mismatched dynamics ultimately hindered my effectiveness and satisfaction in the role. This experience reinforced the importance of self-awareness and the need to carefully evaluate not just the professional opportunities but also the interpersonal dynamics and leadership structures when considering new roles.

Conclusion

Reflecting on these experiences, the key takeaways are clear: trust your instincts, recognise the limits of your influence, and understand your strengths in leadership roles. Each chapter of my career has taught me invaluable lessons about navigating complex professional landscapes. These insights have not only shaped my approach to career decisions but have also underscored the importance of aligning personal values with professional aspirations. At this almost-retired stage of my career  I do look back on having had many positive contributions, serious lasting impact and I hope these lessons may be of some benefit to younger professionals contemplating similar career paths.

Conflict of Interest

None