LETTERS TO THE EDITOR
Re: “Careerism in
Radiology”
We read Gunderman and Lexa’s [1]
opinion piece “Careerism in Radi-
ology” (published online, June 30,
2017) with great interest. Although
we have both encountered those in-
dividuals whose loyalty to their cur-
rent organizations seem to last only
as long as their ability to leverage the
relationships for personal gain, we
find far less convincing the posited
causal relationship between this
phenotype and the acquisition of
formal business or management
training.
The article disparages those who,
in the opinion of the authors, take
the “simplistic approach” to adding
value by learning accounting,
finance, and strategic planning.
Robust measures are equated with
“meeting the bottom line,” and these
“MBA-toting careerists” are accused
of knowing the world only through
case studies written by “business
school professors with an ax to
grind.”
We would like to counter this
rather dystopian view of the value of
physicians who pursue training in
the business aspects of medicine.
The ACR has, through its invest-
ment in and continued support of
the Radiology Leadership Institute,
taken the position that physicians
who can learn to speak the language
of strategy, finance, and operations
add to their ability to positively
affect the lives and outcomes of the
patients they serve.
It is true that business schools
may measure success in terms of the
financial or status achievements of
graduating students. However, we
have been consistently impressed by
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the commitment of the business
school faculty members who have
taught at Radiology Leadership
Institute meetings to a definition of
successful leadership focused on
health care: one that puts our re-
sponsibility to serve our patients at
the center.
In short, we could not disagree
more with Gunderman and Lexa
that an MBA or other formal busi-
ness training is a “biomarker” for
careerist behavior. We do, however,
agree that our success as a profession
will continue to depend on “people
who operate with a wider, deeper,
and longer-term commitment.”
Those people will, of necessity, bring
a range of skills and areas of focus,
and we will do better if some of
them can speak the language of
business.
James A. Brink, MD
Chair, ACR Board of Chancellors
Massachusetts General Hospital
Harvard Medical School
Boston, Massachusetts
Geraldine McGinty, MD, MBA
Vice Chair, ACR Board of
Chancellors
Weill Cornell Medicine
1300 York Avenue
New York, NY 10009
e-mail: geraldinemcginty@gmail.com
The authors have no conflicts of interest
related to the material discussed in this
article.
REFERENCE
1. Gunderman RB, Lexa FJ. Careerism in
radiology. J Am Coll Radiol. http://dx.doi.
org/10.1016/j.jacr.2017.05.011.
http://dx.doi.org/10.1016/j.jacr.2017.07.015
S1546-1440(17)30880-3
Re: “Careerism in
Radiology”
We thank the editor for the oppor-
tunity to respond to several impor-
tant issues raised by Drs Brink and
McGinty in their letter regarding our
recent JACR article. First, we agree
that careerism and an MBA are not
directly overlapping phenomena. We
have met many toxic careerists
without MBAs, and one of us has
taught many MBA students who
work for nongovernmental, reli-
gious, and military organizations
that contrast sharply with the
careerism we describe.
Second, we emphasize that our
article describes a risk, a possible
outcome, rather than a foregone
conclusion. Traditional MBA pro-
grams and particularly some portions
of their content cannot be directly
applied to professionals, let alone to
medical professionals or, more spe-
cifically, radiologists. The cultures
are not aligned. That is one reason
that physicians take an oath to serve
our patients. The corporate world
does not have anything to do with
what we swear to do in our oaths.
The factors for success in investment
banking and many other sectors are
quite different than those in medi-
cine and in science. Careerist
behavior often works in the corpo-
rate world, at least in some in-
stitutions and in some sectors. This
is not a deep, dark secret. It not only
works, but it is also something that is
taught in some MBA programs. This
is why we raised the issue for
discussion.
Third, both authors have worked
many hours as volunteers to help the
ACR Radiology Leadership Insti-
n
tute, the house of radiology, and the
ª 2017 American College of Radiology
1546-1440/17/$36.00 n http://dx.doi.org/10.1016/j.jacr.2017.07.015