The most common approach to succession planning among radiology practices is no approach at all, according to David Myrice, CPA, MBA, director of practice management for Zotec Partners. “The reality is that most of the radiology groups out there have no plan in place for when their leadership retires,” he says. “Like most professional corporations, the owners also are the workers, which makes planning more complex and emotional. As a result, too many radiology groups are just operating on the fly.”
A widely held misperception regarding succession planning is that it focuses solely on new leadership, when, in fact, incoming leadership represents just half of the equation. “Succession planning is both how you train your future leaders and how you treat your departing leaders,” Myrice says. “Do you have the ability to accommodate older members of your practice as they are winding down? When it comes to your younger people, how do you address the disparities between your goals? Deciding on an exit strategy for departing leadership is as important as how you groom new leadership coming up. You want to establish processes and policies while everyone is happy, and stick to them.”
Disparities in Goals
The disparities in goals referenced above include both generational differences and differences inherent to radiologists’ professional timelines, Myrice says. Generational differences are well-trod territory: younger radiologists tend to be more invested in maintaining work-life balance, making them more amenable to lifestyle-enhancing decisions like outsourcing night and weekend call or even moving to hospital employment.
“A lot of your younger radiologists coming out of medical school are very lifestyle-structured,” Myrice says. “They want to make the same income as their older colleagues, but they never had that experience of having to work all night long. They also never had to deal with everyone sitting in the reading room together, popping films up onto the viewer. Technology has changed a lot of perceptions of where the profession is going.”
Lest the blame for disparities be placed solely on the shoulders of the younger generation, Myrice stresses that the older generation also can be tempted to put its priorities ahead of the good of the group. For instance, he says, “Traditionally, your more senior radiologists are running the group, and they have the experience and the knowledge, but their goals have changed over time. They are willing to ride things out—they do not want to rock the boat. The younger generation is looking at the future and feeling nervous.”
In short, Myrice says, there is a Catch-22 inherent to handing over the leadership reins, caused in no small part by healthcare’s current instability. “The older people have to be willing to step down and train the younger people to come forward, but the younger people have to keep in mind that their long-term goals will not always match up with the older generation’s goals,” he says. “There is no easy answer for it.”
For that reason, Myrice advises radiology groups to take a formal, structured approach to succession planning, setting policies and procedures in advance and sticking to them. First, he says, current leadership should identify the type of leader they believe the group needs in the future based on their experience and knowledge. “Who are the people who seem to be the right fit for what you need down the line?” he says. “Identify them, and then talk to them as quickly as you can, because if they are not interested then you are wasting your time. You have to assess their level of interest first.”
Most radiologists did not set out on careers in medicine with the intention of becoming business leaders, he stresses, so practices should invest in supplementary training for their future leaders. “You want to mentor them, test their capabilities, even send them to a few leadership courses on the corporation’s dime,” Myrice advises. “Involve them over time and groom them for their future roles. As opportunities present themselves to involve them on a more formal basis—becoming a member of the board, accompanying current leadership during hospital administration meetings—take advantage of them.” The specialty of radiology is recognizing the need to develop leaders in the challenging environment of healthcare management. The ACR recently implemented the Radiology Leadership Institute (RLI) to prepare radiologists with critical leadership skills for advancing in practice leadership and strengthening the radiology profession.
Meanwhile, the group should decide on a policy for outgoing members. An example offered by Myrice is the older radiologist who wants to transition to working part-time. “Most groups really cannot afford to maintain a partner on a part-time basis,” he notes. “On the other hand, the older members of the group are the ones with the relationships with hospital administration, so there is a value to transitioning them out slowly. Maybe the group will decide that radiologists can work part-time, but lose their voting rights. The ideal scenario is the group comes together before the question is raised to decide whether they will allow people to slowly taper off, or whether their retirements will be abrupt endings.”
In initiating the succession planning process, members of radiology groups would be well advised to remember that every vote they take will be taken personally, Myrice says. “Any vote you take, most people are looking at it from the perspective of how it will affect them,” he notes. “If you want good leaders, you need to groom them to be good leaders, but you also want to show how well you treat the people who were leaders when they are on the way out. If you decide in advance what the rules are and stick to them, you will have an easier time down the line.”