Leading in a Hot Zone

ACR-18Dana H. Smetherman, MD, MPH, MBA, FACR, chair of the American College of Radiology® (ACR®) Commission on Breast Imaging, contributed this post.

The first Louisiana patient with COVID-19 was identified on March 9. By April 28, there were 27,286 cases and 1,758 deaths from the disease in our state. While these statistics pale in comparison to states like New York and New Jersey, Louisiana is ranked sixth in the nation for number of cases at 585 and fifth for number of deaths at 38 per 100,000. Although the prevalence of COVID-19 is now declining, when cases peaked in Louisiana, the hospitals in our system, Ochsner Health, were caring for more than 60% of COVID-19 inpatients in New Orleans and more than 30% in the state.

As chair of the radiology department at Ochsner Medical Center in New Orleans, my leadership team and I have employed several strategies to lead during this crisis.

  • Communicate — In-person conversations, phone calls, texts, emails, virtual staff meetings, social media and picture archive and communication system (PACS) chat functions have all been part of our approach to departmental communication. In this rapidly evolving situation, we have also encouraged our colleagues to use virtual tools to facilitate interactions with residents, referring providers and technologists. In-person rounding by department leaders has enabled rapid identification and resolution of issues, including the emotional support needs of our colleagues.
  • Prioritize the safety of our colleagues, employees and patients — Social distancing in the workplace (including physically separating physicians in reading rooms and deploying home workstations where appropriate) and providing adequate, readily available personal protective equipment are some of the most important methods to ensure the safety of our physicians, advanced practice providers and employees.
  • Highlight positive achievements and express gratitude — Though all of us are facing unprecedented uncertainty, we are striving to highlight positive outcomes, such as the number of patients extubated and discharged, the development of abundant, readily available in-house polymerase chain reaction and antibody testing and successful recruitment to COVID-19 clinical trials. At Ochsner, we have also celebrated our “health care heroes” in internal and external communications, including social media.

As we transition to the next phase of this pandemic and develop strategies to reopen imaging services, new challenges will undoubtedly arise, as will the need to adopt different leadership strategies. Nonetheless, I am optimistic that the lessons learned and knowledge gained in this first skirmish of our battle with COVID-19 will serve us well as our specialty and community navigate the uncharted waters ahead.

  • This blog post expands upon Dr. Smetherman’s remarks during the ACR Radiology Leadership Institute® Leadership Town Hall: Leading in Times of Crisis. If you missed the livestream event, you can catch the replay and access additional resources at acr.org/covid19.

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Navigating a Pandemic Through Advocacy

Nicola, GregGregory N. Nicola, MD, FACR, ACR Council Steering Committee member, contributed this post.

Navigating the COVID-19 pandemic means navigating its profound effects on all of us, from our personal health to our medical practices, friends and family. While different regions around the country are facing their own unique challenges, we have seen one common trend — a serious reduction in imaging volume and revenue. Radiologists are sounding the alarm on the economic impact of this pandemic.

Over the course of the past few weeks, my practice and I have experienced drastic fiscal alterations forcing us to make difficult decisions affecting our families, employees and employee families. We hope these decisions have a short shelf life and allow us to support our work force near the level prior to COVID-19, yet the natural course of this tragedy is still uncertain.

This economic impact is also seen and felt by practices around the country. As such, the American College of Radiology® (ACR®) and the Radiology Advocacy Network are supporting us through countless advocacy-related efforts. The ACR has created a collection of COVID-19 radiology-specific resources which include clinical, economic and regulatory, state, well-being, and leadership updates.

Whether you’re in a small practice or on the front lines of a large health care system, the ACR is working tirelessly to safeguard the field of radiology throughout this pandemic and beyond. The ACR’s advocacy efforts have resulted in firsthand information on loan programs and other relief measures to help support practices and hospitals just like mine. Many practices have received relief fund payments from the Department of Health & Human Services, which may not have been otherwise possible. These relief funds provide us time, delaying further complex fiscal decisions all of our practices may need to make.

  • How has COVID-19 affected your practice or hospital? What does your day-to-day look like now? Join the conversation with me! The Radiology Advocacy Network encourages you to share your COVID-19 story on social media. Post a video on Twitter or Facebook sharing your experience, and don’t forget to use #radvocacy and #myCOVID19story.

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Managing Burnout One Step at a Time

Johnson, TatumTatum Simon Johnson, MD, diagnostic radiologist at Wake Forest Baptist Health in Winston-Salem, NC, contributed this post.

I am burnt out on the word “burnout.” Burnout can be defined as a long-term stress reaction characterized by depersonalization, emotional exhaustion, a feeling of decreased personal achievement and a lack of empathy for patients. For many, it evokes feelings of frustration and hopelessness. Others may feel it’s a sign of weakness and dismiss the idea altogether. After all, our medical training teaches us to “tough it out.” It may be easier for some, rather than others, but we must talk about it. Can burnout be addressed proactively, before a physician reaches their breaking point?  As we find ourselves on the front lines of a global pandemic, it’s time to take action.

Analogies can be drawn between our reaction to burnout and our reaction to the COVID-19 pandemic. We are human beings first, and physicians second. I’ll bet that some of you bought extra toilet paper last week! None of us are immune to the very normal reactions to threat or perceived threat: fight, flight or freeze is our primitive physiologic sympathetic nervous system response. But what if there is no tiger to outrun? What if our tigers include fearing loss of income, poor outcomes or loss of respect from colleagues if we make a mistake, failure to produce high volumes or to keep up with publications?

According to the 2019 Medscape Radiologist Lifestyle, Happiness & Burnout Report, 45% of radiologists report being burned out, 14% colloquially depressed and 3% clinically depressed.

I find that regular exercise, practicing mindfulness and laughing with colleagues, whenever possible, keep me in check. Nurturing positive connections with technologists, nurses and other providers sustains me. Our profession can be highly competitive; find those you can trust and remember to be kind.

While we can all get back to the basics of self-care by maintaining a balanced diet, exercising and sleeping properly, and nurturing positive connections, we must also remember that the solution to burnout is not a one-size-fits-all approach. I encourage you to take action now and seek out the tools and resources available. Many organizations are offering free burnout toolkits that you can access online.

The ACR has curated a selection of well-being tools, activities, webinars, podcasts and more to help improve your well-being throughout this pandemic and beyond. Check out Combating the COVID-19 Pandemic: A Collection of Well-Being Resources for Radiologists for all the latest information.

Now, more than ever, we must take control so that we can give our best to our patients, colleagues and institutions.

  • Does your institution offer well-being resources? What tools are most beneficial to you?

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