Challenges and Strategies in Radiology Management

Bryan Alexander is an experienced Imaging Director with over 26 years in radiology, 22 of those in leadership roles. He currently serves as the Administrative Director of Radiology at OU Health, where he has worked for the past 17 years. Bryan has a robust background in healthcare and hospital management, demonstrating expertise in enrollment management, healthcare leadership, and accreditation. Throughout his career, he has cultivated skills in team empowerment, operational efficiency, regulatory compliance, and workforce development to address challenges in radiology.

Through this article, Alexander highlights the critical issue of workforce shortages in radiology and the impact it has on the department's efficiency and ability to deliver high-quality patient care.

I began my career in Radiology over 26 years ago, with the last 22 years spent in leadership. Early on, I was fortunate to cross-train in multiple modalities, which broadened my expertise and prepared me for future opportunities. When a door of opportunity cracked open, I kicked it open and ran through it. As I grew in leadership, I sought a place where I could make a greater impact, which ultimately led me to OU Health, where I have been for the past 17 years. In my current role, I am grateful for the opportunity to create positive impacts on my team, community, and across the state.

Challenges in Radiology Management

One of the biggest challenges is workforce shortages, which are compounded by increased demand for imaging and lower enrollment in radiology programs. Like many healthcare facilities, we are competing for a small pool of qualified candidates, both technologists and radiologists. We are also seeing a trend where new graduates go directly into travel positions, which reduces the pool of candidates for our core staff and places additional strain on existing team members who are constantly in training mode. As an academic facility, we handle some of the most complex cases in the state, which requires highly skilled staff. With more new grads going into travel roles, the contingent labor pool has shifted, requiring more extensive training for temporary staff to meet our standards for complex imaging. This trend presents both operational and quality challenges in delivering the high level of care our patients need.

Strategies for Department Efficiency and Operational Metrics

Empowering and engaging the team is essential to running the department effectively. My role is to support my team by ensuring they have the tools and resources needed to provide excellent patient care. I believe in staying humble and recognizing that I don’t have all the answers. We have talented leaders and experts in each modality, and fostering their growth is crucial to our success. Interdisciplinary collaboration is also key; working closely with other departments enhances both efficiency and patient outcomes. I am fortunate to partner with physician leaders who share a commitment to common goals. Together, we focus on optimizing inpatient imaging utilization, particularly with high-demand modalities like PET and MRI. By shifting inappropriate inpatient imaging to the outpatient setting, when possible, we free up resources for inpatients who need urgent imaging.

"It is easy to feel discouraged at times, so it is essential to remember the “why”: we are here to improve lives. Though I may not see the direct impact as I did when working hands-on, my experience in the trenches reminds me of the difference we make every day"

Regulatory Compliance and Oversight

As our organization grows and integrates, one key challenge is maintaining oversight across all areas with imaging equipment, especially as clinics are brought under the hospital license. This often means managing compliance in locations where imaging personnel may not report directly through my organizational structure. Ensuring these sites adhere to policies and have access to the necessary education and resources for regulatory compliance requires proactive coordination. Establishing an Imaging Governance structure has been essential in addressing these challenges. This structure helps standardize procedures across the enterprise, providing a consistent framework for compliance and quality that aligns all areas with regulatory requirements. We are in the initial stages of the Governance structure and are already seeing the benefits.

Impactful Technologies and Innovations in Radiology

We are in the early stages of rolling out new technology that will have a transformative impact on OU Health and the entire state. We are building a mobile fleet equipped with mammography and CT capabilities, allowing us to bring essential imaging services directly to patients to detect diseases at earlier stages to improve outcomes. In addition, we have a dedicated health economist who provides invaluable insight into the broader impact of these initiatives. Being situated on a campus with seven health professional colleges – College of Allied Health, College of Dentistry, College of Medicine, College of Pharmacy, College of Nursing, College of Public Health, and the Graduate College – offers unique opportunities for collaboration and innovation. Having an on-campus Nuclear Pharmacy further enhances our capacity to deliver comprehensive radiology services.

Advice for Aspiring Healthcare Administrators

Go for it. We need more people in healthcare and more people dedicated to serving others. Healthcare administration, especially in a specialized field like radiology, can be challenging – particularly in today’s landscape – but it is incredibly rewarding. It is easy to feel discouraged at times, so it is essential to remember the “why”: we are here to improve lives. Though I may not see the direct impact as I did when working hands-on, my experience in the trenches reminds me of the difference we make every day. My advice is to surround yourself with great people and leaders. Healthcare is a team sport, and having a strong team amplifies the impact we can have on patients. Finally, prioritize work-life balance and make time for yourself. Maintaining a healthy relief valve is essential for sustainability in this field.

In the face of the workforce shortages, focusing on education and workforce development is essential. To address this, we are creating a student life-cycle model that supports students from high school through their radiology career journey. This initiative includes several key roles that enable us to employ students before they enroll in a radiology program, support them during training, and offer core positions post-graduation. Engaging with young students early on is crucial to developing the next generation of healthcare providers, ensuring a sustainable workforce for the future.