In Search of Leaders

May/June 2022 RBMA Bulletin

You’ve no doubt met a few people you’d follow to the ends of the earth and others you wouldn’t follow to the end of the driveway.  If you stop to think about leaders you’ve known, there will be those who inspired and uplifted, helped you achieve aspirational goals and who picked you up on the day everything went wrong and you wanted to give up.  In contrast, you may also have toiled with people who blatantly lied without flinching, focused mainly on building their empires and promoted those who produced mediocre work but excelled in flattery. How did these types of leaders make you feel about coming to work each day?  Can you actually be a leader if you don’t have followers?  

While the list of leadership qualities is much longer than this, let’s look at a few characteristics of both good and “other” leaders, with the idea that behaviors clearly illustrate our values and values provide the foundation for leadership effectiveness.  What are some of the values we see in effective leaders?  On the other hand, how do people in leadership positions let bad behavior undermine them?   


Ever notice how a great leader shows respect for the “little people” while not making them feel like little people?  She enlists them in solving problems, thereby showing appreciation for their skills and knowledge.  She knows the company will be successful if everyone is competent and committed—and then works to set the environment where that can happen.  There is honesty in her communications, she knows everyone’s name and makes them feel their work is appreciated. 

Then we have the opposite in a leader.  He seems to see everyone he manages as a form of currency that can help him achieve status and recognition.  People, then, are valued in terms of how much they can advance his cause and discarded when they are no longer perceived as useful or when they are viewed as posing a threat.  Respect for coworkers and colleagues is superficially given and they know they can easily be the next scapegoat. 


In its simplest definition, integrity is measured by the ability to do the right thing, even when no one is watching and is the foundation for making difficult decisions.  It is when what you say matches what you do. 

For example, the leader with integrity demonstrates consistency of action.  If he emphasizes high service levels to clients or patients, he works to ensure necessary support functions are coordinated to reliably perform.  He responds to questions and/or e-mail quickly so operational processes can continue without interruption.  He personally responds to problems promptly and authorizes others to do so as well, removing the risk of them being punished for not asking permission before assisting a customer. 

In contrast, we have the leader who promises accuracy and transparency to physicians in the group and then manipulates write-offs and adjustments to show improved net collections on monthly reports.  She hopes nobody asks questions and then lectures her staff about honesty and setting a good example.  Her staff takes note, however.


The leader presents the results of a recent process improvement initiative and compliments the imaging center technologists and administrative staff, who recommended workflow changes resulting in improved throughput and reduced costs.  At the same time, she openly accepts responsibility for an error calculating physician productivity last month, which impacted reports for the quarter.  Her staff is confident she will be responsible for decisions made and not blame them if something beyond their control goes wrong. 

Our other leader takes credit for an intensive project handled by his billing manager and leading to the recovery of more than $100,000 for improperly paid insurance claims.  The billing manager in fact identified the problem, assembled an extensive amount of documentation and worked with the insurance company for weeks regarding resolution.  Her boss previously blamed her in front of the Board of Directors for a revenue decline that was not her fault, but due to an error with hospital downloads.  His staff is certain they will take the fall for any problems that arise and they are fearful of making decisions.


He arrives at work nearly a half-hour before the administrative office opens, starts the pot of coffee and begins working.  He meets with the group’s Executive Committee over lunch, reviews the status of a credentialing problem with staff during the afternoon and is back at his desk, often working for an hour or so after everyone else has left for the day.  While he isn’t unfriendly, he is focused and the atmosphere in the office is one of productivity.  They feel like he sets an example with his work ethic and while he doesn’t force it outwardly on others in the office, they don’t want to let him down by not taking work seriously.  He works hard so they work hard. 

Our other leader strolls in at varying times in the morning, usually on a personal phone call as she enters the office.  She checks time clock punches with rigid determination and is quick to discipline the person several minutes late one day last week due congestion caused by a traffic accident.  She leaves the office for long lunch hours and instructs the staff to tell physicians asking for her that she is at a meeting any time she is out.  Because she is also disorganized and has trouble prioritizing her work, she is chronically stressed and short-tempered.  When she makes mistakes, especially if they involve one of the physicians in the group, she lashes out at others in the office. The entire staff dreads the flurry of activity preparing for monthly board meetings and there is a constant tension in the office. 

Which of these leaders would you rather work for?

As a leader, you are being watched and those watching are always learning and evaluating.  Even scarier is the fact that an office will reflect the personality of its leadership.  There are dysfunctional offices where employees barely dare to look up from their computer screens and say “everything is fine” when there are obvious performance issues impacting revenue.  There is a palpable tension and an unnatural level of quiet as employees often try to ignore problems due to the risk of wrath if issues are reported.  On the other hand, productive offices tend to feel more relaxed, the employees more open with communications and suggestions and while professional in demeanor, you can tell that laughter is not a foreign concept.  This office knows the faster a problem is identified, the more quickly it can be resolved and there is an emphasis on involvement and improvement.

Becoming a leader others want to follow is a continuous challenge and everyone slips up now and then.  While life is a school where you can learn from others, you will still have to develop and refine your own leadership style.  Recognizing how the behaviors of others reveal their values can provide an important guidepost for all of us as we try to adhere to our own value systems.  There are certain observed behaviors you can adopt as you work with effective leaders but it can also be evident when you’re trying to “be” someone else, so it is important to separate behavior from style. 

There is much to be learned from both good and bad extremes and a title alone does not confer leadership competence.  You can find leaders at every level in an organization and developing leadership skills doesn’t have to wait for a promotion.  We can all lead right now.             

headshot of Pat Kroken Director of Education and Corporate communications, MSN Healthcare Solutions

Patricia Kroken, FACMPE, CRA, FRBMA,
has an extensive background in radiology practice management and directs education and corporate communications for MSN Healthcare Solutions

She worked as a consultant for radiology practices, billing companies, software developers, and hospital radiology departments for 20 years before joining MSN.

She is a regular contributor to the RBMA Bulletin and a frequent speaker on topics related to radiology practice management. 
Pat can be reached at
or 505-856-6128