Re-recognizing the importance of radiology's professional community

The medical association landscape is changing. Declining memberships, increasing member disengagement and duplication of efforts continue to threaten these organizations that established our professional sovereignty and ability to self-govern.  Physicians are part of unique professional community--a community that wasn't established by accident. Within radiology, organizations such as the American College of Radiology, the Radiologic Society of North America, the American Board of Radiology and the American Roentgen Ray Society were integral in building a specialty that thrived throughout the 20TH century.

Whether leading in advocacy, policy, imaging technology, or education, these organizations assembled the platform on which our specialty (and all subspecialties) are built.

But now radiologists are showing a reluctance to join organizations.

Don't get me wrong. I agree that our radiology organizations have struggled to define the value received from paying membership. Even when there is tremendous inherent value for potential members, the message sometimes is poorly conveyed and poorly received. And when the value in membership is not clear, it becomes hard to shell out thousands of dollars in membership dues.

Solutions to this problem can be viewed from two separate perspectives, though. First, the various radiology organizations need to understand what is professionally important to potential members. Younger radiologists have a different expectation from membership than our elders. Social media and our hyper-interconnectedness have changed the way we evaluate organizations and altered the type of expectations we have for them. 

In addition, the persistently changing employed-physician landscape--as well as the shift from private physician practices--alters (and arguably eliminates) many of the reasons physicians traditionally join professional organizations.

Fortunately, I think that the brilliant, diligent staff members and physician leaders in each of our membership organizations realize that "membership value" needs to be repackaged. I believe each respective organization will continue to improve their efforts on this front.

But there is another angle from which radiology membership organizations can be rebuilt. 

Currently, most potential members take a "What's in it for me?" approach. Self-centric, if you will. Why is professional membership worth this many dollars to me?

Instead, I submit to you that the onus is on us to seek and understand the deeper importance of professional membership.  It is up to us to realize that professional organizations represent the key cog in our ability to professionally organize and function. 

Physicians have been--in this country at least--organized with community principles. These principles promote knowledge creation and socially-beneficial dissemination of that knowledge. Community principles promote trust between colleagues, as well as from the general public and government. These principles are in contradistinction to hierarchical and market principles that dictate how other professions function and organize. 

Hierarchical principles do not promote new knowledge discovery. Hierarchical organizations cannot handle or tolerate dissemination of tacit knowledge (that knowledge gained by personal experience and beliefs). Market-driven organizations, while superior in incentivizing knowledge creation, do not promote socially-appropriate dissemination of that knowledge. Our physician community is threatened by the increasing prevalence of hierarchical and market forces. Forces such as employment models, RVU measurement, turn-around-time tracking, PQRS, ICD-10, vendor incompatability and service commoditization all threaten and weaken our professional community.

Community principles are not perfect, either. Community organizing principles are susceptible to insularity and closure. Our reluctance to have our performance measured, to make our prices transparent and to recognize the multi-specialty interdependence essential to future care-delivery models render our professional community even weaker. In order to counter-balance the rise of hierarchical and market forces, we need to change the way we organize. We have to change, refine and rebuild our communities. We need to re-establish the inherent belief that our professional community and our professional sovereignty are important to us. 

And I believe that our professional organizations are central to this concept. They need our resources--some combination of time, money and intelligence. If they do not persist and thrive, so will be the fate of our professional community.

We can't just expect our professional organizations to meet our needs. The onus is on us to help them succeed in that regard.

Matt Hawkins, M.D., is a vascular interventional radiology fellow at the University of Washington/Seattle Children's Hospital. Follow him on Twitter at @MattHawkinsMD.

Prior articles by the author:
H.R. 4302: Duct tape, delays and decision support
Reimbursement in medicine: One radiologist's perspective
Keeping score with revenue: The 2-step-back feedback
It's time to end diagnosis fragmentation
RSNA13: Business analytics, clinical decision support take center stage for radiologists

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