Prof. Jarl A. Jakobsen
Department of Radiology
A solid grounding in management and business administration is a crucial asset to healthcare leaders who want to manage their departments in the best way, and to create growth and consolidation for our profession. Management is particularly demanding for radiologists, who are not only leaders of diagnostic functions, but also of technology and IT activities in the hospital. This is belied by the paucity of radiologists in Norway acquiring MBAs or striving for positions of higher responsibility, something this article will delve further into. The Faculty of Medicine in the city of Trondheim is closely connected to the technical university in the city, which has a focus on developing amongst other things, medical technology. The research and teaching institution in medicine and health, St. Olav’s Hospital, is closely linked with the technology part, giving possibilities for exciting developments in imaging. However, there has not been a radiologist as faculty head of department since many years. This is characteristic of the culture amongst radiologists in Norway, of ignoring management education and avoiding positions that make administrative demands on them they are ill-equipped to deal with. This lack of faith in the merits of management training will have a serious impact on the future development of our professional interests on a national and international level.
Current Management Training Facilities
In Norway, radiographers tend to take positions of leadership in imaging departments, with the radiologist reporting to them. Presently, in two of our six university hospitals, the head of the department is a radiographer who has undergone approximately one year of administration training. Current education requirements for all medical specialists in Norway necessitates just one short, compulsory week of intensive management training, consisting mainly of lectures concluded by a final exam. This focuses not only on basic administrative issues, such as organising workflow and quality control, but also leadership skills. The brevity of this training is compounded by the trend for radiologists working in the healthcare system here, not to seek positions of responsibility in their career path. It is a matter of great concern as to how we can challenge this lack of interest through MBAs or supplementary courses.
In fact, out of the six university hospital facilities in this country, I am the only Chair of a radiological department with formal management training at university level, holding an International Masters degree in Health Administration. The University of Oslo offers this course, designed for all healthcare professionals, in which 28 students attend full-time during half a year, taking six or seven exams which they must pass. Then they must be part-time students until they have finished, which takes between six months and two years, and finally write a thesis. It covers essential management training areas such as leadership, psychology, quality management, economy, methodology, statistics and project management. The Norwegian Medical Association also offers a three week course in management which is carried out over a yearwhereby students must hand in reports periodically. Fortunately, many hospitals have management training in-house for all managers, though it is seldom a full and comprehensive programme.
A good management training course, in order to properly educate leaders of the future, must cover:
'Administrative tasks such as organising schedules and rotas
'Leadership skills, learning how to handle and lead people, as well as yourself
'Managing phases of development (project management), including both competence and technology projects
'Professional, economic and financial strategies
The most paramount management skill that underpins each of these is the psychology behind true leadership skills.
Clearly, a leader that attempts to complete each single task themselves without learning to rely on the appropriate team members will not do his department justice. Learning how to manage your team in the most efficient way can have a significant impact on the success of professional goals, from areas such as time management to staff productivity. Also, being conscious of the competence and skills you lack, and strengthening your leadership by recruiting and relying on people that have them, is mandatory. The question remains, how can we convince radiologists in Norway that these are essential skills necessary for the development of a long-term career, and that they should strive to climb the ladder as in other Western countries?
Learning to Delegate
The role of Chair of a modern radiology department is unrecognisable from how it was ten years ago, particularly in the field of IT. The implementation of RIS/PACS systems has been the biggest revolution faced by department heads in recent years. However, now that 100% of radiology departments in Norway are ‘PACSified’, coping with the exponential increase in demand for advanced imaging techniques (e.g., multislice CT, 3D imaging, MR, spectroscopy and minimally invasive therapy), has replaced this as the primary concern of a department head. In our department, I have created an internal ‘Technology Operations’ team responsible for radiological IT issues as well as space and equipment management. The leader reports directly to me. One of the reasons I am so emphatic in my belief in the fundamental need for management training for radiologists, is that to effectively address rising demands such as those described above, which stretch the traditional definitions of what a department leader should be beyond recognition, the psychological as well as the practical elements of good leadership as part of holistic management training are a fundamental skill. Without a good grounding in management skills, radiologists miss out on the opportunity to claim their role as leaders of the imaging departments of the future and to have the satisfaction of leading a good and effective department of radiology.