It is the contention of Arl Van Moore, MD, who spent a good deal of his 10 years in the Navy powering through the world’s oceans in a nuclear submarine, that leaders are made, not born. In the military, people do not get to issue orders until they demonstrate that they are capable of following orders. This is what Moore calls followership, the fundamental way that people learn to lead in the military.
The culture in the U.S. Navy is a direct outgrowth of the culture of the British Navy in the 18th century, Moore says, in which midshipmen were eligible to become officers only after two years at sea learning skills from the captain and other officers on the ship.
“Medical schools have deemphasized the need to have strong physician leaders,” says Moore (pictured). “They are training a lot of Marcus Welbys, but they are not looking at the entire process. We need to focus on leadership, individual thinking, and problem solving.”
There has been little emphasis by the American Board of Radiology until recently on anything other than interpretive skills, notes Moore, and residency programs have not spent much time on fostering and developing leadership, followership, teamwork, and team-building skills in their trainees. The end result is that as a specialty, radiology is under-resourced when it comes to leadership.
Moore believes that medicine in general and radiology in particular need to start teaching good leadership and followership from the outset, because to truly know one it is essential to know the other.
Moore’s rules of good followership include the following:
• Support do not undermine the leader.
• Disagree, when necessary, in private.
• Use initiative, make decisions clear with the leader.
• Accept responsibility whenever offered.
• Tell the truth, don’t quibble
• Do your homework, anticipate possible questions
• Remember your limitations when making recommendations.
• Keep the leader informed.
• If you see a problem, fix it.
• Put in more than an honest day’s work.
Far from being yes-men and yes-women, good followers understand self-management, commitment, focus, and courage. Knowing good followership is essential to building leaders, but it also is the bedrock of high functioning teams, the ultimate goal of leadership.
As the long-time president of one of the highest functioning teams in radiology, Charlotte Radiology, Moore says that radiology must begin instituting leadership training immediately, “and we need to start at the entry point of the process, not the at the end of the process.”
Why? “Without our efforts the status quo will remain, inertia will prevail, and where will this leave us?”