How-To Guide: Becoming the Chief Medical Officer of a Radiology Practice

A practicing radiologist shares his career path and advice for success in the radiology industry

You could say I’ve been a physician leader for as long as I’ve been a radiologist. During my residency at the Cleveland Clinic, I was the chief resident in radiology and president of the house staff. In 1979, three years after I passed my lifetime boards (American Board of Radiology), I started my first radiology practice.

My first practice grew to become a large, multistate, multihospital radiology group. In addition to co-founding multiple practices, I have also owned several diagnostic centers and even helped start a leading radiology software company. Despite my experience launching and leading medical businesses, I have always considered myself a radiologist first and foremost, and I believe my success in business stems from the fact that I have never lost sight of my principles and aspirations as a physician.

Manage Your Career

The practice of medicine is constantly evolving, especially with fundamental changes transforming U.S. healthcare. One thing is certain during a radiology career: the longer it is, the more turns it will take. Thriving in your career will require managing it proactively. This means constantly staying abreast of emerging trends and technologies, developing expertise in areas that interest you and that you believe will be important, and looking for creative solutions to challenges and opportunities to innovate.

When I began my residency at the Cleveland Clinic in 1972, radiologists were just beginning to use and read CT scans. Our team had one of the first head CT scanners and the first whole body CT scanner. Early access to CT and ultrasound made me one of the first radiologists to work with cross-sectional imaging. We had to figure out for ourselves what the examinations were demonstrating, what was normal and what different types of pathologies looked like. It was exciting work that made me seek out other opportunities to expand my knowledge, skills and experience.

After passing my boards, I became a staff radiologist at the Cleveland Clinic and taught radiology at two university medical centers. I studied and practiced new subspecialties – mammography, genitourinary radiology, interventional radiology and ultrasound – to develop the highly specialized knowledge required to work with new imaging technologies. I also wrote dozens of peer-reviewed papers and contributed chapters to radiology books. These activities expanded both my knowledge and my professional credentials immensely.

My first foray into leading a practice was as co-founder of a community hospital group of radiologists. I continued to seek opportunities to learn and grow by serving as chairman of radiology at multiple hospitals covered by our group, participating in every hospital committee and even assisted in the writing of the bylaws of a new hospital.

Embrace Technology

As technology and imaging advanced, it became increasingly difficult (and eventually impossible) for a radiologist to provide expert interpretations of the entire body. To keep up with changes in the field, I narrowed my practice in the early 1990s, providing interventional radiology and MRI interpretations and then eventually focusing on MRI imaging interpretations.

Imaging wasn’t the only technology advancing radiology at the time; seeing an opportunity, I worked with a team to develop computer software designed to help imaging centers manage workflow and volume. This experience would later prove incredibly valuable for growing the healthcare practice where I still serve today.

In 1999, I launched my next practice, providing teleradiology subspecialty services to orthopedic practices with in-house MRI scanners. Two years later, I merged with another radiologist, Peter Franklin, MD, and we turned our focus solely to subspecialty radiology interpretations. We wanted to attract the best subspecialty radiologists nationwide, but we knew we couldn’t ask them to relocate to any single location. Our concept was to move the images to them, connecting everyone in an entirely new model: a distributed practice with teleradiology services, forming Franklin & Seidelmann Subspecialty Radiology.

To make our new model work, we needed to develop a network, find affordable technology, develop software, license radiologists in multiple states and obtain malpractice insurance across the country. The practice took off, and in 2007 we became a full-service radiology group, Radisphere National Radiology.

With our team of off-site distributed subspecialty radiologists and our overnight emergency department radiologists, Radisphere staffed hospitals with on-site facility radiologists, providing interpretations 24 hours per day. Our distributed teleradiology model gave small- to medium-size hospitals access to subspecialty expertise that rivaled academic centers, significantly improving diagnoses, reducing length of stay, increasing physician satisfaction and reducing turn-around-times for reporting of cases.

As Radisphere grew to become a multistate, nationwide hospital-based radiology group, with 120 radiologists supporting 60 facilities in 23 states, so did our technical demands. We realized we needed to hire a team of dedicated in-house engineers to develop our enterprise software. As it turns out, we anticipated and filled a need for enterprise integration for all radiology practices. In 2014, we split our professional and technology service lines to launch Candescent Health as an independent business offering enterprise management software not just to our group but for radiology practices around the country.

Invest in Your Physicians’ and Your Own Development

While I still provide consulting services to Candescent Health, my true passion is helping other radiologists grow as diagnosticians and physician leaders. In 2011, I became Radisphere’s chief medical officer and chief quality officer. One of my first priorities was to cultivate a positive, physician-led but also professionally managed culture for our radiologists.

To bolster the benefits we could offer our radiologists, Radisphere decided to seek a radiology service partner. We chose to partner with Sheridan Healthcare, which subsequently acquired Radisphere, because it offered our radiologists professional growth and leadership development, a wide variety of practice options, practice security and financial viability. Like all Sheridan physician leaders, I make decisions in the context of the quadruple aim: enhancing the patient experience and safety, improving population health, reducing costs and improving the work life of radiologists.

Even though my current role is focused on assisting in the growth and management of Sheridan’s radiology practice and developing our talented team, I have also maintained my credentials as a practicing radiologist. The ABR now only offers 10-year limited certifications, but when I first took my boards it awarded lifetime certificates, which are still honored today. Still, I have elected to recertify in neuroradiology three additional times to verify that I’m still competent.

My friends tell me I may be one of a limited number of radiologists to have certified four times, especially at my age. (Rather than retire in my late 60s, like some of my colleagues, I recertified this past March.) Although I have a lifetime certificate, I know that I must keep myself knowledgeable and up to date.

I love what I do and worked hard to become a radiologist. Until I am ready to slow down – which isn’t any time soon – I’ll continue to maintain and develop my skills and expertise.

Even after 40 years in the field, I can’t predict what the future holds. As others have said, the only thing I can be sure of is that the demands of my practice will continue to grow and change will remain a constant. However, four decades as a radiologist have taught me one important lesson: you will always have opportunities in this field if you are good at what you do and constantly strive to be better.

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