Dr. Richard Wiggins Interviewed by Michelle Jiyoung White, BS

Dr. Richard Wiggins is the Associate Dean of CME of the University of Utah School of Medicine, and Professor of Radiology and Imaging Sciences at the University of Utah Health Sciences Center in Salt Lake City, Utah. He is an Adjunct Professor in the Departments of Otolaryngology, Head and Neck Surgery, and BioMedical Informatics. He served as the program chair of the Society of Imaging Informatics in Medicine (SIIM) from 2014-2020 and was the past president of the Western Neuroradiological Society (WNRS) and the American Society of Head and Neck Radiology (ASHNR). Dr. Wiggins has more than 60 peer-reviewed scientific papers, 11 books, over 100 book chapters, and presented more than 600 national and international lectures on Neuroradiology, Informatics, and Teaching and Education.
What do you look for in future leaders?
Someone who has vision, who has their own drive and passion for their interests, who has ambition, and is able to accomplish all this while keeping their ego in check. There’s a difference between “managers” and “leaders.” There are a lot of managers, especially in academic medicine, whose job is to keep the basic work schedule. And then there are leaders, people who inspire you, fuel your interests, and make you want to show up every day and do those things you’re passionate about. Medical students may recognize leaders as those who inspire them to go into a specific specialty because they want to someday do what that “leader” is doing.
There are also the “soft sciences” that are important, and the concepts of empathy, communication, collaboration, and creative and critical thinking, that further set leaders apart. Such qualities are what allow leaders to be better respected and distinguished, and give them the mentalilty of knowing that a ‘rising tide lifts all boats’ – the willingness and humility to understand that success comes with each team member.
How did you get involved with ASNR and what was your path?
My path to ASNR is a perfect example of “showing up is half the battle.” In 1999 or 2000 I was at an ASNR conference (I think I was just looking for the bathroom), when I saw a sign that said Education Committee. Having come from a family of educators, I was immediately interested and went inside. After a while we started talking about technology, which I knew a lot about and just started sharing my knowledge in programming. At the end of the meeting, a senior ASNR member came up to me and asked which sub-committee I was with, to which I responded that I wasn’t and had simply joined because I had been intrigued. He then proceeded to put me in a sub-committee and pretty soon, within a couple of years, I found myself in charge of this Education Committee. We then quickly got involved with a lot of new programs for ASNR such as the Electronic Learning Center, where we would give workshops on how to incorporate technology into radiology teaching, PowerPoint, digital teaching files, and how to create web pages. These interactive learning sessions became very popular, especially in the early 2000s which were a transition time in radiology where we were moving from hardcopy slides to digital PowerPoint for conference lectures. With the Electronic Learning Center team, we continued to identify needs in radiology, and helped grow many of these experiences, some of which evolved into successful digital teaching files systems, such as STATdx. That’s kind of my unconventional story of how I got involved with ASNR.
What is your advice to Young Professionals who are hoping to become more involved?
Similar to my story, a lot of it is just “showing up.” I’m a big proponent of being open and asking people for opportunities to get involved. Website and social media, especially, is a great opportunity for YPS and younger members in training to get involved, because often, the senior members aren’t as familiar with such new online and SoMe platforms. These are huge opportunities for younger professionals to find their niche and get involved. Of course, you can also submit abstracts, give presentations, attend conferences and help moderate a session, and then over the years, eventually advance to giving lectures and more. However, there are things like Case of the Week, TweetChats, recording videos and audio for archivable content, and identifying needs in technology and education that are ow-hanging but great ways for Young Professionals to get involved, just like I did when I first started. To summarize, just be willing and show up, ask to get involved, join committees, identify needs, and find a mentor who is willing to guide you through your path.
You’re a huge proponent of incorporating technology into education. What online and technological resources or programs do you wish were available or see a need to improve?
It’s true – I am definitely a big proponent of technology in education, how we can use technology to learn and teach better, and there’s certainly a lot to improve within this field. Interestingly, technology and this recent pandemic flattened the earth and made it a lot smaller. For myself personally, it has been great to be involved in various group chats and discussions with radiologists, referring providers, and students from all over the world and share cases and learn on a broader level. It has allowed us to gain a greater appreciation for these different perspectives and see how everyone incorporates technology into education. There are several relatively newer concepts in education and technology that I see a big need for improvement. The idea of “edutainment”, where it’s educational but also engaging and entertaining. The “gamification” of teaching, such as game shows we often do at conferences such as Jeopardy and College Bowl. These are all very popular and well attended, and seem to hold the most engagement for learners.
There’s also Case of the Week, which are ways for us [radiologists and professionals] to continue the education. For a lot of societies, the one-time annual conferences are the only times for connection and education, and nothing else really happens until the next year’s conference. However, social media is a great way to continue the education after the conference and stay connected. There are things like ‘transmedia story telling’, where, for example, if you like Star Wars there’s opportunities to stay in touch through games, books, and other story-lines and tracks that parallel the original story. Transmedia story telling, gamification, edutainment – how we use technology in education, especially with audience response systems is all very interesting and is an area for growth.
In today’s society, the smartest person is no longer the person who knows the greatest number of facts. We have access to all the information we need in our electronic devices. Rather, it’s how we use that technology for education. It’s more important to teach people how to use logic and rationality for problem solving and how to incorporate technology in education. This is a critical area for improvement that I see and I’m excited to see how we do that in the future.
What do you foresee as the biggest challenges facing our profession in the near future?
For us in radiology, there are two big things. One is machine learning, AI and deep learning, and second is the onslaught of cases. Thirty years ago, I was looking at 2,000 images a day, and now I’m looking at 200,000 images a day! So how we deal with these big image data sets is a big problem. And that kind of goes into the idea of machine learning and AI. In the radiology world, there are about 200 FDA-approved radiology machine learning companies out right now. But most of them are focused on interpreting the images and replacing the radiologists, which is very complex, and not focused on the low-hanging fruit which I think we’re going to see with machine learning much faster. In the imaging informatics world, a lot of people talk about AI not as ‘artificial intelligence’ but as ‘augmented intelligence’. It’s like having a “good fellow” sitting next to you all the time. Many studies have shown that machine algorithms and AI won’t be replacing radiologists completely but rather would be assisting us. It would be like having a “good fellow” who preps all the data and assists us in going through the big data sets much faster than what we’re able to accomplish now.
So when we think about the commoditization of radiology, I think the machine learning algorithms won’t be replacing radiologists any time soon. Rather, with the commoditization of radiology, it is more likely that radiologists who are using machine learning and incorporating it into their practice may replace the radiologists who refuse to adapt and use it – it’s one of those ‘resistance is futile’ things. Therefore, for us [radiologists] moving forward, we need to think about how to incorporate this into our practice, otherwise, the radiologists who are actually using it may end up replacing those who refuse to use it.
Lastly, what do you wish you knew when you first transitioned to practice, and what is your advice to others?
Hm, well, I started in surgery, so one of the things I wish I had known is that I wish I had looked into radiology in medical school. It might have saved me 3 or 5 years. But in another way, I think that experience [doing Head and Neck surgery and working in the ERs] was a good learning opportunity because now I can better talk to surgeons and ER doctors and understand the clinical relevance that makes what I do so important. I have conferences almost every day of the week with some division of the Head and Neck surgeons, and my past experience with them has taught me what’s important to the surgeons and what I need to include in the report.
Additionally, as painful as it is, the more cases you look at, the better you get at radiology. Be willing to go through cases and look up stuff you don’t understand. Ask around and listen to others and learn from their experiences.
I would also get comfortable with being able to say “I don’t know.” Nobody knows everything. I tell my residents and students all the time that I don’t expect them to know everything. I think in some ways the people who can’t say “I don’t know” are dangerous. You need to understand in radiology that everybody misses stuff. But it’s a great opportunity as it highlights areas we can improve in. Try not to let your misses get you down but recognize that it’s an opportunity for learning; we learn a lot more from our misses than the things we get right.
To summarize, 1). talk to your referring doctors and find out what’s important to them so you know what to put in your reports. 2). Listen to everybody. Even though I have been doing this for a long time, I still have something to learn from someone. 3). Get comfortable with saying “I don’t know” and understand that everybody misses stuff. Failing is a learning opportunity to embrace and recognize what we can do better.