APDR PRESIDENT – 1992-1994

Jerome H. Arndt, MDThe story of the Association of Program Directors in Radiology is a positive story. It is the story of how competitors put competition behind them. It is the story of how university-based program directors, seemingly comfortable in a world of the AUR, suddenly became willing to risk discomfort in a venture that ended an era, gave birth to an audacious offspring and a vibrant new spirit of unity that seemed to retain from the old all of the strengths and none of the frailties. That spirit invigorated the AUR affiliates, jump-started lethargic private/community hospital program directors and even attracted cooperative proposals from the larger, more broadly based radiological organizations. The APDR had sprung from a notion, picked up a broad base of support, and then grew beyond anything its founders anticipated.

For program directors, the story of the APDR might also be titled “Up From Obscurity”. They were saddled with myriad roles and tasks, most un-appreciated and none compensated, then suddenly found themselves listened to, not just by compatriots but also by the RRC and the ABR. They began receiving cherished invitations to examine on the Oral Boards.

How did this all begin?

One could say it began by chance at the 1985 meeting of the AUR in Nashville, TN, when William M. Thompson, MD, then at Duke and soon to be chairman and program director at the U. of Minnesota, and Jerome H. Arndt, MD, a 20-year veteran program director at Baylor University Medical Center (a private/community hospital in Dallas, TX) met at the tennis tournament hosted by the Department of Radiology at Vanderbilt.

The two men shared little by way of background. The former went straight through college and academic training into academia. The latter only decided on medical school after spending 3 years as a roughneck and then a Mud Engineer in the oil fields of Texas, Kansas and Oklahoma. They did however, share a passion. Both firmly believed that all programs that trained residents in radiology, university, private, and military were not much different, and would benefit by coming together in some manner. Dr. Thompson was a determined advocate of the AUR, his logic was compelling, and he saw no insurmountable problems. As AUR President in 1989-90 he began to “plow Main Street” for his new friend.

The “AUR Program Directors Symposium” traditionally a three-hour marathon on Thursday afternoons was the only meeting time then allotted to program directors. Dr. Arndt was asked to participate representing private directors. His presentation, emphasizing the need for, and potential benefits of, a coalition of all program directors, received a rousing ovation. It seemed that Thompson and Arndt were not the only people thinking that way.

But thinking and accomplishing are not the same thing, and although Dr. Arndt had by then been made chairman of the Symposium Committee and implemented a number of innovations designed to entice program directors to join the AUR and attend the meetings, these efforts had produced only a blip. Nothing approached the broad surge that was needed.

As it happened, the Symposium Chairman was also looked upon as the representative of program director-members of the AUR, and as such was invited to Executive Committee meetings. At the interim EC meeting in November 1991 during the presidency of Albert Moss, MD, Dr. Moss asked Dr. Arndt for suggestions that might attract program directors, (particularly the seemingly recalcitrant private directors) in the greater numbers that the EC had in mind. Dr. Arndt replied that if the AUR was committed to such an effort, it might be accomplished by authorizing the formation of a separate program directors organization under the aegis of the AUR, an organization with its own bylaws, officers, committees, agendas and finances, but firmly committed to meeting with the AUR. The idea seemed to strike a chord with the EC members, and to Dr. Arndt’s surprise, a motion to that effect was passed without a single dissenting vote. He was authorized to proceed, and did so.

During the early formation process, bi-weekly telephone conferences kept Dr. Moss informed, and in late January during one of their conversations, Dr. Moss said, “Jerry, are you sure everyone is as enthusiastic about this idea as you are?”v

Dr. Arndt replied, “Al, are you changing your mind?”

“Oh no no! I was just thinking maybe you could call a few of your friends and get their opinions”.

This was of course, the equivalent of a large wrench thrown into moving gears. There weren’t enough “friends” to constitute a valid survey, and even if there had been, an advocate conducting a telephone survey could certainly create a bias that invalidated any result. And the annual meeting was less than three months away.

During the next weekend Dr. Arndt and his wife formulated, assembled, stuffed, sealed and mailed out a survey with return envelopes to every program director listed in the green book under “Radiology, Diagnosis” that year, all 210 of them. Those knowledgeable in surveys opined that a single-mailing could reasonably expect no more than a 25% return rate even with stamped return-envelopes enclosed. Ultimately 78% were returned, and 85% were “in favor” or “strongly in favor” of the concept, 8% were neutral and 8% “against” or “strongly against”. We had a tiger by the tail! And Dr. Moss was convinced.

In the ensuing weeks the essential ingredients of a new organization were assembled. A name, bylaws, a logo, stationery, a membership database, and list of candidates for officers and committees were developed. Here again, Bill Thompson played a key role, as did another past AUR president, Tom Harle. The knowledge of these men, together with that of Drs. Joe Sackett and Charles Rohrmann added greatly to the pool of outstanding, qualified people, a factor of critical importance in the embryonic years of any organization.

Discussions with the ACR regarding an administrative contract were begun. The College already provided administrative services for the AUR as well as for other organizations. Tom Greeson, Chief Counsel for the ACR provided, or arranged for, essentially all of our legal guidance, and did so at no charge to us. We could soon be ready to begin operation as a 501 C-3 corporation registered in the state of Illinois.

There were still a few lingering reservations amongst key members of the AUR and SCARD. M. Paul Capp, MD, the newly appointed Executive Director of the ABR, and Kaye Vydareny, MD the incoming President of the AUR, were both concerned over the need for a separate organization because of the possibility of a potential breakup if the APDR became too successful. Their concerns were probably shared by others, but not voiced. In Dr. Arndt’s mind, a break-up was not even a remote possibility. He argued, “The academic organizations are by nature a family and together are strong, appreciated and respected. The AUR is the parent.”

Dr. Vydareny retorted, “And what happens when children grow up? They leave home! That’s exactly what I’m talking about!” We laughed and eventually Dr. Vydareny either changed her mind or put her reservations on hold, which was fortunate since it was she, as the President of the AUR, who would guide the formal approval process through the membership at the business meeting.

The first part of the first meeting of the newly formed APDR was a plenary session designed to bring out problems, expectations, and priorities. Then, with a “round-table” format (there were about 20 tables with approximately 8 persons/table) each table was assigned and asked to address, 1, 2, or 3 issues with solutions if possible. Each table briefly summarized its efforts for the assembly’s comment and those records were preserved and served as the basis of ad hoc committees and later actions. The meeting format also helped us meet each other, discouraged anonymity, left members with the feeling that they were being listened to and could, if so inclined, become committee members or chairs or officers. They knew it was their organization, and the energy derived from that knowledge was palpable.

Whatever the successes of this organization, they are the result of the combined efforts and imaginations of many, and an affirmation of the words of a man who died 40 years ago:

“Few will have the greatness to bend history itself; but each of us can work to change a small portion of events, and in the total of all those acts will be written the history of this generation.” --- Robert F. Kennedy