Chapter 12: Leadership Lessons Learned with Growing the Department

Chapter 12: Leadership Lessons Learned with Growing the Department



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In this chapter, Dr. Hicks summarizes what he learned from serving in this first major leadership role as department chair of Diagnostic Radiology. He begins by saying that his role required him to become “reacquainted with the broad field of radiology” in order to be able to properly understand issues in each of the sections. He also talks about gaining the confidence to elicit information and the challenge of creating an environment that fosters sharing of information.||Reflecting on his leadership style, Dr. Hicks explains that he allows others to air their views fully, often not sharing his own perspective in order to allow free flow of discussion. He notes that some colleagues have criticized him for being too slow to voice his own views and make decisions, but feels his slower style has served him well.||Dr. Hicks also comments on the importance of admitting when something didn’t go right, giving an example of the department’s inefficient first attempt to address effort allocation.



Publication Date



The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center


Houston, Texas

Topics Covered

The Interview Subject's Story - Overview; Leadership; On Leadership; Professional Path; Evolution of Career; Professional Values, Ethics, Purpose

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.


History of Science, Technology, and Medicine | Oncology | Oral History


Tacey A. Rosolowski, PhD:

What was the process like for you, what did you kind of take away as a new leader playing with this new chemistry set?

Marshall Hicks, MD:

Every role I’ve had has been different and being a section chief in a field that you already spent ten years, plus another four years, three years maybe in dedicated training for that, I knew interventional radiology pretty well. I was learning how to be a leader as a section chief, but then you step away from everything you know technically --you know the field-- into something that’s broader. Even though I was a trained as a radiologist, practiced in interventional radiology, which is more of a narrow field, so I was going back to a broader field where I wasn’t as familiar with some of the issues that are dealt with on the pure imaging side, on the pure diagnostic side. So relearning a little bit of diagnostic radiology and understanding some of the uniqueness of their problems. Even though interventional radiology was a part of radiology at the time, and diagnostic radiology, it’s a more narrow field, just like breast imaging is or some of the other fields, neuro, but still they’re all Diagnostic Imaging. Neuroradiology, breast imaging is still looking at images and interpreting them. Interventional radiology is much more procedurally oriented, and there were some procedure areas in the breast imaging, has some, and neuro has some. There were some similarities, but by and large, it was getting reacquainted with the issues of diagnostic imaging and some of the challenges in the electronic medical records that we had at the time. The challenges of timely reading. One of the issues we had, it was longstanding, but we imaged from seven in the morning until eleven at night, but we didn’t have radiology coverage that entire time. It ended at five. So we’d get this huge amount of studies that would be created in the evening and then that would create a backlog first thing in the morning. So just figuring out how we’re going to staff more appropriately to the workload and balance that. Some of those issues were things that we didn’t have to deal with interventional radiology. It was more unique to the diagnostic side, and it was great for the institution because we provided service. Great for the patients so they could get their studies done before their clinic appointments the next day. Just keeping up with that in a timely manner was a challenge, so we had to think differently.

Tacey A. Rosolowski, PhD:

How did you grow as a leader during this time?

Marshall Hicks, MD:

One thing I recall was that unfamiliarity with the area and learning that leadership is still leadership and it’s a lot about relationships, a lot about personalities, and having the confidence to say, okay let’s take a step back and let’s get the information. Let’s go through the process for learning and understanding and then developing solutions for the challenges, as opposed to thinking that I had to know all the answers or just depending --it was more creating an environment where people were sharing information and working together, was the most critical thing. That was the lesson I learned pretty quickly about it, is that you’re not going to be an expert in everything. Interventional radiology, I pretty much knew the field. Here you’re into things that you can’t really know everything and trusting the leaders and empowering them to help you, advise you, make decisions, help collectively come up with solutions. I learned that it was leadership applications in a broader sense. And that was at every level beyond that. A valuable lesson to know: that it’s more about the confidence in your abilities to help bring people together and create solutions than it is about the technical expertise.

Tacey A. Rosolowski, PhD:

I’m also hearing you say that when you talked about creating that environment for sharing, it’s letting go of ego and allowing other people to be legitimate authorities to speak about their arena of practice and experience, and to bring that out so it’s creating that culture of transparency.

Marshall Hicks, MD:

Exactly, and it’s not always easy, because people do have strong opinions, strong egos, and some of that was a learning experience for me. I came from a situation in interventional radiology where I was fairly senior to most everybody else, so there’s that differential that people have deference there. But when you get into a situation where it’s more your peers that you’re now leading, truly in terms of experience, it’s a learning experience in terms of letting people express their opinions, maintaining the order, the calmness of letting people express their views. Asking people for their opinion. Understanding different personality types and making sure that you could engage everyone, but setting a tone as well about professionalism and civility within a discussion, and making sure that that’s pretty clear how we’re going to treat each other and how we’re going to make decisions and work together. People can give pretty strong emotions about certain things they feel strongly about or close to, passionate about. Clearly, a lot of people are passionate about our mission areas of clinical care and education and research, prevention.

Tacey A. Rosolowski, PhD:

What are some strategies, because what’s working under the surface is just conflict. What are some of your strategies, are some of your strategies for working with people who come into powerful conflict about something?

Marshall Hicks, MD:

I think more often than not, it seems like people beneath that surface and beneath the emotions still kind of want the same thing. They really—sometimes they have more emotions about how to get it done or maybe are even just blinded to listening to somebody else. Some of it is just making sure things are aired, that points of view are put out on the table in a calm, professional way. But sometimes you have to leave it for another day, too. You have to get the discussion out there, let people vent, let the emotions calm down and bring it back another day, as opposed to trying to force something in that day. Unless it’s critical obviously, unless it’s something urgent. Often things are not, not that urgent that you can’t bring it back for another day. Sometimes it takes two or three times of discussing something to where you actually get a breakthrough. So I think it’s being patient and being resilient and understanding that you’re not afraid to talk about it, to bring it back, to get resolution on it. But it is important to let people be heard but also understanding that amygdala, that emotional basement that people are in sometimes, isn’t where you can have rational thinking, so you have to let that tone down. Sometimes it takes a conversation on the side but often it’s just a couple of discussions around it that people start to realize –particularly, say here are the points of view that maybe I need to be a little more compromising or accepting that they’re not always going to get everything they want every time. But it’s working together and what do we really want to accomplish. Resetting those goals saying this is our principles, this is what we really want to aspire to. Is it that far off from what everybody is saying? A lot of times it’s not.

Tacey A. Rosolowski, PhD:

I think too, with allowing time to elapse and not being too impulsive about having to fix the situation, allows sometimes the conflict behind the conflict to come out. Because sometimes what people are arguing about is just the surface, and there are really sub-textural issues that are at work, that are probably more important.

Marshall Hicks, MD:

That’s a great point and sometimes side conversations happen in the interim, where things get talked through and resolved, or understood better. One of the criticisms people make of me is that sometimes I’m too slow for making those decisions, because I’ll let things get discussed, embedded, as opposed—and that I’m not always the first one to express my opinion. I generally like other people to express it, so people can sometimes interpret that two ways. One is that they will be hesitant to express their opinion because they don’t want to come across as something different than me, or they may read into what I’m not saying. It’s a risk either way, and I like to be able to hear what other people say because sometimes I change my mind or sometimes I’m of a different opinion. So I’ll often qualify it if I’m going to speak early, but I usually like to hear what people say, but sometimes it takes time and it’s a process and I’d rather make the right decision to take a little longer than be impulsive, like you said. That said, you have to understand that in leadership, you have to be willing to revisit, to admit something maybe didn’t go as you wanted and maybe it was a mistake. Maybe it was a wrong decision, and have the courage to go back. Most things are reversible. Not everything is, but I think for the things that are reversible, having that willingness sets an example for others to say it’s okay to make a mistake. It’s okay to try something, to be bold, to do something and then modify it. The risk there is you don’t want to be revisiting decisions over and over again, but just the willingness to say hey, let’s revisit this in three months, six months, and make sure we’ve made the right decision, make sure that things are going as we thought.

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Chapter 12: Leadership Lessons Learned with Growing the Department