I have visited some 40 radiology practices or imaging center organizations in the past six months, and a recurring theme in the questions that I am asked regarding business strategy relates to the somewhat elusive notion of leadership in this profession of ours. That is, leadership within these organizations themselves at the imaging center level, leadership at the state, regional, and national level from the various societies and organizations that represent the profession, and leadership from those national opinion and thought leaders whom we admire and aspire to emulate.

The bottom line is that we are in a profession under siege while at the same time facing a true leadership crisis. I sense a yearning for true industry leadership, and I intend to focus quite a bit of attention this year on the development and articulation of the type of leadership model that I believe we need in order to inspire, motivate, and challenge this entire profession to rally around a new level of positive activity—legislative, regulatory, payor, business and internal.

Citing Shakespeare, Winston Churchill once said "some are born great, some achieve greatness, and some have greatness thrust upon them." As we look around the landscape of the executive ranks in outpatient imaging today, it is clear that we are seeing an entirely new leadership model emerge, one that has the opportunity for greatness to be thrust upon it. No doubt there are many imaging executives who would just as soon pass the baton at such an opportunity, yet most seem more than willing to face the challenges ahead and lead their teams to new heights, despite the odds. What they need is some encouragement, direction, and a forum.

Leadership starts with building the team. The first thing that today's executives need to do is rally their organizations from the bottom up, creating within the practice a motivated staff headed in the same direction, challenged to succeed, inspired to do so, and with a clear direction based on mutual respect, communication, accountability to the team, and confident direction from the top. Vision, mission, and values need to align around just such a teambuilding effort.

Pools of these local leaders need to then join together in the pursuit of common goals, and they in turn need to pave the way for the profession itself. We have seen some of this begin to take shape as a handful of manufacturers such as GE Healthcare, Hitachi, and Berlex gather outpatient imaging executives at retreats in order to help them find solutions to the impact of the Deficit Reduction Act on their respective businesses. Additionally, there are various forums for the exchange of ideas at the practice level, with informal networks emerging as a means of building consensus around best practices. These are good as far as they go, but we need to do more.

Yes, the respective professional societies and associations such as the Radiology Business Management Association and others, do a laudable job of assembling their constituents at annual meetings, often focused on some of the topics related to specific elements of success, achievement, and alignment necessary to the emerging leadership model. Nonetheless, there is a void where different types of executives, some physicians, some business executives, some chiefs of functional units, seem to have no forum that crosses these association boundaries to find common ground.