From Imposter to Expert:
Charting Your Course

By: Patricia (Pat) Kroken, FACMPE, CRA, FRBMA
Originally Published in RBMA Bulletin March/April 2023

Brandy, the newly appointed Vice President of Operations for Quality Radiology, was dreading her afternoon meeting about a new imaging center.  She felt comfortable with parts of her current job but overall, was concerned she would be seen as an unqualified imposter when looking at the full scope of her assigned responsibilities and expectations of the radiologists.  Her experience in revenue cycle management improved financial performance as she tightened down processes and implemented productivity goals.  With the benefit of increased cash flow, the group seemed pleased with her performance so far.  But opening an imaging center?  Her stomach tightened at the thought of the upcoming conversation, since the group/s leadership would be attending. 

Brandy’s predecessor was an “ops guy” and obviously comfortable with business expansion efforts.  He had developed the group’s billing/administrative office, organized a joint venture outpatient interventional center and introduced new modalities to the current imaging center.  His knowledge of billing/collections was weak, however, and the group suffered financially as the new entities failed to meet projections.  Brandy’s mastery of radiology billing made her an attractive candidate and she presented herself confidently during a series of interviews.  But now she was the one who had to work outside her comfort zone and she didn’t want to appear an imposter who oversold her qualifications and was about to be found out. 

Fortunately, the group’s CEO was also attending the meeting and maybe Brandy wouldn’t be put on the hot seat just yet.  Still, she envisioned them all looking at her and saying, “What do you think we should do next?” 

The Meeting

Brandy was the only woman at the meeting, which included the President of the group, a mammographer, the architect, lead technologist and contractor.  Bart, the CEO, asked if she would take minutes and organize a task list for actions needed prior to the next organizational session.  She then learned she would be tasked with managing the center as it opened and Bart handed her several thick files from a previous venture for reference.

Bart reviewed the proposed timeline for construction and set the meeting schedule for the group to report progress.  They discussed several issues related to construction and approvals by the city, which were expected to be resolved by the contractor prior to the next meeting.  Brandy was still overwhelmed at the scope of the project but felt better as it began to break down into logical steps.  She was assigned to follow up on the progress of assigned tasks and report problems to Bart.

Before we go further with the education of Brandy, should she have been offended at being the scribe for the meeting?  Was it just because she was the only woman there?  Was Bart treating her as his secretary rather than respecting her role as VP of Operations? 

For too many younger professionals, there can be a tendency to overthink situations and identify insults and discrimination where none are intended.  Let’s look more closely at the situation before leaping to conclusions. 

  1. Bart handed her several reference files at the beginning of the meeting. He trusted her to learn what was involved in an imaging center project.  The mature outlook would be to assume she would be able to play an important role in project development based on the fact he was giving her materials with which to educate herself.

  2. With the exception of Brandy and Bart, each of the other attendees was involved in a narrower aspect of the project. She had the opportunity to develop her organizational skills while learning from the other participants and building her knowledge base.  This enabled others in the meeting the ability to focus on their specific responsibilities.  Who else would logically be expected to take notes?  Would it be more appropriate for the CEO to be responsible for this task?

  3. Bart could have set her up and made her look foolish if he decided to ask her to discuss how she planned to make the project successful. Instead, he assigned her an important role that allowed her to be in a listening and learning mode while building her expertise. And it enabled him to stay on track with the agenda and running the meeting. 

  4. Since she was informed she would be managing the center as it opened, it was beneficial to be involved in the early stages of development.

Radiology Management Is Lifelong Learning

The situation described reflects the type of challenge radiology managers will meet throughout their careers.  Sometimes we find ourselves fortunate to have the necessary skill base to tackle a new project but sometimes our skills are outdated or the project represents something totally new. 

How might Brandy educate herself as she tackles the imaging center project?

  1. Review the files Bart provided regarding the previous project and take notes. What can she learn from checklists, correspondence and documentation?  Where did problems occur and how were they resolved?  The files should be able to provide an overview of steps taken and decisions made, as well as identifying potential landmines.

  2. Ask to meet with the technologist who was part of the kickoff meeting to identify his priorities and concerns. She should be able to ask about workflow and learn functional information about imaging center operations. Techs can be excellent resources for information, especially if she asks how she can best help make sure the project comes off effectively.

  3. Request a meeting with Bart for his input and concerns about the imaging center. Clarify questions raised during the review of the previous project folders. Again, she can ask how to best assist him as the project rolls out and can also ask him to identify his priorities and concerns.

  4. Learn from fellow RBMA members. She may not find someone who has been in exactly the same situation but general project management experience can translate well. The RBMA offers a rich set of resources in articles, presentations, webinars, specialized seminars, the various forums and from the network of members. Ask questions and let “Progress Through Sharing” become more than a slogan. 

Lifelong Learning As A Way Of Life

The successful people you meet in radiology management represent diverse backgrounds but have one thing in common: they learned radiology-specific management on the job. There isn’t a specialized degree program to teach the basics so each person pulls together their own resources and applies knowledge from other parts of their lives. The “faculty” for self-learning is all around us, the range of challenges keeps boredom at bay and there are seemingly endless opportunities to grow professionally. It means we each accept responsibility for our own growth as professionals, but it can also be an adventure. And each capability added to your resume is an investment in your future. 

Will Brandy be paid more for taking on the imaging center project? She shouldn’t count on it.  However, successful completion of the project will result in equity in her capabilities “file” and adding new expertise will help her be worth more eventually. Again, this is a growth opportunity and an investment in her future.

Patricia Kroken, MSN Healthcare Solutions Director of Education and Corporate Communications

FACMPE, CRA, FRBMA

Prior to joining MSN Healthcare Solutions as Director of Education and Corporate Communications, Pat Kroken had nearly 30 years of experience in radiology management as both a practice manager and consultant to radiology groups, billing companies, software vendors and hospital radiology departments.

Pat has had more than 200 articles published, is a regular contributor to the Radiology Business Management Association (RBMA) Bulletin and a frequent speaker on practice management topics. She served two terms as President of the RBMA, is Editorial Advisor for the national RBMA publication, The Bulletin, and represented the “business side of radiology” as RBMA Liaison to the Radiological Society of North America (RSNA) Associated Sciences Consortium for 7 years. 

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