Road to Leadership continued from p. 13
How do you come to grips with that? How do you sleep with
that? What is the best way of presenting it? The chair of psychiatry agreed that it was a big responsibility, but that it was something I needed to do. He gave me tips about the best way and even
the best day for presenting it. It turns out that it’s not best to let
someone go on a Friday afternoon because you don’t want them
to be alone all weekend. I think that was one of the biggest challenges, knowing that you have to do something, knowing that it’s
the right decision, but knowing that it’s going to be hard for
somebody and it’s going to negatively affect someone else’s life.
Fessell: You recently published a paper about burnout for radiologists. Does that come from your role as chair and seeing
how people and different institutions deal with it? Is it something
personal you’ve experienced?
Recht: It’s really from listening and talking with people.
There is no question that everybody’s workload is harder, and
people feel it.
I think one of my responsibilities is to find a way of making
people’s jobs as easy as possible, knowing that we’re asking people to do more. We did a survey in our department and asked
people how we could make their jobs easier.
As a result of this, we hired a team that we call “reading room
coordinators” to contact physicians about important findings. We
developed an electronic system so people can electronically contact reading room coordinators to let them know when they need
to call somebody or when they have an IT problem. Getting referring doctors on the phone quicker and more easily is one of the
things radiologists in the department have felt most satisfied about.
Our departmental survey also asked about whether people
wanted televisions in the lounges. Do we want to put in treadmills? Do we want to have ping pong tables? What’s interesting is
that uniformly nobody wanted those additions. What they wanted were improvements that were very simple and really inexpensive. People wanted small refrigerators in reading rooms stocked
with snacks and drinks. This was something really easy that
made people feel like we cared about them.
Another thing people really appreciated was clean reading
rooms. To be honest with you, it was something that I never
thought about because a lot of our reading rooms were in the
hospital. We didn’t really control the cleaning crew, and we didn’t
really pay attention to that in the past. We looked and it was true.
We worked with the hospital and said, “We need to fix this so
people have a nice, clean area.” We worked out the ergonomics of
reading rooms, soundproofing some of the reading rooms, and
getting workstations that move up and down so people can stand
up and read.
In terms of burnout, one of our innovations that has gotten the
greatest praise is what we call the “radiology pathology feedback
module.” When you read a case, you always intend to get the follow-up and find out what the actual answer was, but it’s hard to
do. Now we automatically get an e-mail with both the radiology
report and either the pathology report or the operative note. So
you know whether you were right or wrong. It sounds like something very simple, but it creates a feedback loop. It allows our radiologists to continue to grow and to learn, and people love that.
It gives us a chance to say, “How can we improve our algorithms? How can we improve our rules for saying something is or
is not aggressive? Can we look at 50 cases and see what is common
among those 50 cases?” Maybe there were two or three findings
that individually don’t mean anything, but when they’re together
they really indicate whether this is aggressive or nonaggressive.
We also started something called the Rising Star Program—
Radiology Ideas Stimulating Innovation and New Growth. People
submit ideas, safety ideas, changes in workflow, or things that
would make life better for them and our patients. We’ve had approximately 500 ideas submitted, and we actually implemented
150 of those ideas. Every time a person’s idea is implemented,
they get a “Rising Star” pin to show that they have helped improve our department. It’s really empowered staff and helped
them to feel like they have a say in how the department’s run. It’s
been great for the department.
Supporting people’s growth also helps avoid burnout. We
have several people in our department who are getting advanced
degrees supported by the department. We have people who have
completed MBAs and master’s degrees in quality assurance,
public health, and informatics. I think that allows people to build
another room or two on their house. We also ask them to show
how it’s going to benefit to the department.
I think that’s helped prevent burnout because you’re not doing
the same thing every day. It doesn’t become a rote activity. We’re
not an assembly line. If we just become assembly line readers of
film and pattern recognizers, we’re not going to survive very
long. You want to be doing new things and learning new skills. I
think that’s how we prevent burnout and motivate people.
Fessell: Wow—I can feel your energy as you talk about this,
giving people opportunities for growth and empowering them.
Part of your business strategy is to merge with outpatient imaging centers and help provide financial backing to pay for some of
these innovative improvements, correct?
Recht: Yes, that is absolutely correct. The dean has given us
a lot of freedom to go out, find new revenue sources, and reinvest
the money into the development of our faculty. I think it’s a great
opportunity. When I first did some of that, when we merged with
some of these outpatient imaging centers, the question was why
are we doing that? I think people now understand that it allows us
to extend the brand of N YU Langone. We’re really building what
we’d like to call an “academic private practice.” It’s the same level
of subspecialty radiology that we practice at our main campus,
except without the research responsibilities. I used to say that
those sites didn’t have any teaching, but it’s interesting that our
residents have asked us to create a rotation in these outpatient
imaging centers so they can see what it’s like to be in a more private practice environment.
We stream our conferences to those outpatient sites so the
radiologists who are not physically here are still able to participate in the subspecialty conferences, like the musculoskeletal
and the body conferences. Sometimes they come in and spend a
day reading here. Sometimes they give lectures to our residents.
It achieves the best of both worlds and we’re able to take advantage of the best of both private practice and academics. It certainly helps financially to allow us to do things that otherwise we
would not be able to do as an academic department.n