Frank Lexa, MD, MBA, on Team Building: A Project Management Approach

Sometimes we take people who are so smart and so good at what they do, they don’t understand the need to build a team. Individual high performers sometimes damage teams.

Frank Lexa, MD, MBA, FACR
CMO, The Radiology Leadership Institute.
October 7, 2020

Back before the globe shut down on a balmy January weekend in La Jolla, Calif., radiology practice leaders gathered for the annual ACR–RBMA Practice Leaders Forum to explore subjects that ranged from physician burnout to adventures in clinical decision support implementation. One of the weekend treats was a session on Team Leadership featuring Frank Lexa, MD, MBA, FACR, professor, department of medical imaging, University of Arizona College of Medicine and  CMO, The Radiology Leadership Institute.

Dr. Lexa took a project management approach to the subject, focusing on building teams to accomplish objectives, leading those teams through a project, and common challenges encountered along the way, while Ms. Vaquez focused on the administrator’s role in building an effective team to support radiology practice mission.

At the outset, he disabused the group of the notion that smart people who excel in the STEM subjects are naturally good team members. “Sometimes we take people who are so smart and so good at what they do, they don’t understand the need to build a team,” he said. “Individual high performers sometimes damage teams.”

He recommends that teams be made up of a variety of people who possess the skills you need to accomplish a goal. Furthermore, he urges leaders to think in terms of building a variety of teams—not just one team—because most failures are based on system failures. The three keys to building a great team is, first, understanding the goal of the team; second, making sure the members have the right skill sets, a diverse range of views, and subject matter domain expertise; and third, ensuring they have team skills.

Leaders who manage teams through projects should approach project leadership in five phases:

Phase 1: Purpose. Have a clear aim and make it SMART—specific, measurable, attainable, realistic, and timely.  “If you can get just three of those, you have a great project,” Dr. Lexa said, offering good and bad examples. “A ‘bad’ purpose would be to have ‘better’ stroke service—it’s not specific,” he said. A “good” purpose would be to have all head CTs read in the centaur fashion (utilizing AI and human interpretation) to improve care.

Phase 2: Thinking. “Don’t just do something,” he said, “think about it for the moment.” Answer the following questions:

  1. Who can help you do this?
  2. How will you form and manage the team?
  3. How will you quantify results?
  4. How will you implement the project?
  5. Do you have the expertise you need, such as operations and IT?

Phase 3: Learning. After implementing the project changes, pay close attention to what happens next. What are the expected and unexpected results of the project implementation? For instance, if the centaur fashion of head CT interpretation was implemented, did you gain or lose radiologists? What is the best way to implement AI? What happens a year after implementation? Five years after implementation? 

Phase 4: Engagement. The project will not succeed without engagement, and that is the leader’s responsibility. “Management is about getting a group involved in doing the right thing,” he said. In some settings, you don’t have the luxury of choosing your team members, but if you do, choose the right people, and that doesn’t necessarily mean people who agree with you. “Some presidents have succeeded because they are willing to have dissenting voices in room,” he noted. If you can’t choose your team, help the people you have do the right thing.

Phase 5: Feedback. Take time to analyze the project at its conclusion by soliciting 360-degree feedback from participants. Don’t forget to include stakeholders.

Having led many projects during his academic and consulting career, Dr. Lexa shared a list of common challenges leaders face in leading teams:

  • Too many like minds
  • Rigid thinking—no creativity or flexibility
  • Living in past
  • Baggage—emotional or otherwise
  • Cliques
  • Hidden agendas

He closed by sharing a best practice that may seem obvious but is frequently overlooked in the rush to implement. Consider beginning with a pilot to make sure it works before rolling it out on a larger scale, especially if your project is complex or faces strong headwinds. 

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