CHICAGO — The Peter Principle – that people rise to their highest level of incompetence – was first introduced in 1969. But according to three radiologists speaking about success in a leadership role at RSNA, the concept is alive and well in medical leadership.

It matters, they said, because a failure of leadership is a detriment to the modern goals of health care to control costs and improve quality in a value-based, MIPS world.

The panel was on hand to spread the word about RSNA, American College of Radiologists (ACR) and other leadership training programs to help radiologists successfully lead their departments, hospitals and ACOs. The Academy of Radiology and Leadership Management (ARLM) program, for example has, to date, had exactly 1,000 radiologists participate in its leadership training and issued 123 certificates.

In brief, the radiologists said that too often in imaging leadership selection of department chairs and other leaders are based on clinical skills and not qualities key to being in charge. Such qualities, they deemed, often seem counterintuitive.

“You have to invert the [chain-of-command] pyramid ... so that leaders serve the people they manage,” said Dr. Jonathan Lewin, FACR, president, CEO and chairman of the board at Emory Healthcare. “You have to make sure that your people are successful in doing their jobs.”

He cited several guiding “postulates” on his journey to become a leader. These included:

• Too much managing can undermine your leadership effectiveness. Instead, set a clear direction, communicate it clearly, empower your people and let them fly.


• Effective leadership is a set of behaviors and beliefs that place the good of the organization above self-interest. As President Harry Truman said, added Lewin: "It's amazing what you [an organization] can accomplish when you do not care who gets the credit."


• If you need regular proof of gratitude and appreciation, get a dog. Leadership is about inspiring others, not yourself.


• As weather shapes mountains, problems shape leaders. But, to quote Winston Churchill: "A pessimist sees the difficulty in every opportunity while an optimist sees the opportunity in every problem." Leaders have to be up for the challenge every day.

Lewin said the four top qualities of leadership are honesty, forward thinking, competency and to inspire others. These characteristics are rated higher than intelligence, being fair-minded and cooperative.

Another speaker, Dr. N. Reed Dunnick, chair of Radiology at Michigan Medicine, University of Michigan, positioned good leadership as an imperative to fix the major challenges of the U.S. health care system. He presented data that indicates the country’s health system is too expensive, with less quality, characterized by shorter lifespans and higher infant mortality than the rest of the first world. Much of the remedy, he believes, is in good leadership to inspire necessary change.

The third speaker, Dr. James Brink, FACR, Radiologist-in-Chief at Massachusetts General Hospital and a professor of radiology at Harvard Medical School, noted there is a difference between a boss and a leader. Leaders, he told the audience, are selfless, empathetic and respectful - not commanding and demanding like bosses. Leaders, he said, possess good skills for gathering emotional intelligence from others.