The session on regrets at the Management in Radiology congress of the European Society of Radiologists produced some very interesting scenarios which I am sure strikes a chord for many in senior management positions. However one of the themes that emerged from the sessions emphasised the pitfalls in managing people. Radiologists who take up management posts will understand the business of delivering good images and accurate reports in a cost and clinically effective way but are generally poorly trained and equipped to deal with poor performing or disruptive members of staff and inter-personnel conflicts. They are also rarely involved in negotiating terms and conditions of service and pay with unions as this is often done on a hospital, regional or national basis and yet these issues are fundamental to the successful management of a department of radiology. Human resources legislation is complex even at a national level but is often driven by European legislation even up to the European courts. It is therefore impossible for a radiologist in a management positions to be knowledgeable about all the nuances. However it is important to understand some basics to assist through the day to day running of a department. The session highlighted two key areas.
The first involves the process of removing a poor performing and disruptive individual who is dragging down the performance and morale of other members of the staff. This needs to be handled carefully and proactively in order to avoid the need for industrial tribunals and costly settlements. The key is to ensure that all members of staff are given very clear objectives and performance targets which can be easily measured and monitored on a regular basis with face to face discussions held to understand reasons for underachievement. Regular appraisal of staff allows a structures means of reviewing in detail an individual's overall performance as long as proper and relevant outcome measures are available. The views of other staff should also be included in the appraisal process preferably through a formal multisource feedback process within the department. All these will assist in the process of performance managing an individual who is not delivering or who is disruptive. This is a slow tedious and time consuming process but is essential if you wish to avoid compensation claims. It is important to keep very careful notes of all events through out this process. Consideration also needs to be give to the fact that a negotiated payoff may be less time consuming and disruptive if reasonable terms can be achieved.
The second issue links to the first in relation to the initial employment of staff. There is now considerable legislation in place to ensure a level playing field for all applicants for a job and as a result it increases the pressure on the selection process. As indicated in the presentations it is often easier to promote internally as the individuals are known to the organisation and there should be no surprises. However this may result in individuals being promoted beyond their capability or a lack of insight into the inefficiencies of the organisation which may be obvious to an outsider.
Bringing in new blood is therefore essential but a robust selection process needs to be in place with the individuals shortlisted spending time in the organisation talking to as many people as possible and being assessed by them. In too many situations the choices for key positions are made on the basis of a short interview although psychometric and other tests of ability may also be included. As is suggested careful private conversations may take place with outside individuals and bodies but these should be fair to all candidates and should recognise and exclude interpersonal bias. A robust system for appointments will usually negate the need for performance managing someone out of the organisation at a later date.
Prof. Iain McCall