Politics of a Director of Radiology

In my formative years as a radiologist working at the Lysholm Department of Neuroradiology in London, I committed the cardinal sin of injecting air into the subdural space when performing a pneumoencephalogram. The consultant supervising the procedure considered the examination a failure. I was embarrassed yet annoyed because the quality of the radiographs was quite satisfactory. At a reporting session the following day, Dr. James Bull, the world-renowned Head of our Department, concluded that my 'failed' pneumoencephalogram was normal. This incident in 1967 gave me a glimpse of my chief's exemplary character — someone who stood by his trainee in his hour of need. Dr. Bull's immense intellect and strong personality brought his department worldwide fame; his staff were loyal and happy, a clear case of a Director operating in an ideal world. Technological advances in recent decades have revolutionised the practice of radiology. The computer manager and clerical coordinator have moved into the core of departmental management. Time and personnel resources are demanded of radiology because of the growing numbers of clinical interface. Society's move towards egalitarianism means it is acceptable to put a young and industrious person in charge. Such a Director might be a novice but may have been appointed by the higher echelon of administration for political reasons. Of the many unseen agenda items waiting at the Director's office, none are as crucial as the politics of running a department. Indeed, 'politicking' is a prime if unspecified job specification of the Director. There is no guaranteed crash course in people management in radiology. Much like a round of golf, politics in radiology is a learn-as-you-go thinking process. The talented are quicker to succeed; the journeyman takes a little longer. Regardless of age or experience, the Director of radiology is the public face of the department. Patients, the media and clinical colleagues perceive the department through the actions or inactions of its Head. The various facets of the Director's personality are reflected by his or her compassion, coolness under fire and willingness to go first on-call for interventional procedures — a leader by example. Yet in the odd instance, a Director might enjoy patrolling the reporting room, making sure all radiographs are reported. Small wonder then that this person is remembered not only as a competent radiologist, but also as a policeman. Loyalty is a cherished quality that works both ways. An astute Director shows loyalty, respect …