The research, conducted in collaboration with the Society of Chairs of Academic Radiology Departments and the Society of Chairs of Academic Radiation Oncology Programs, took the form of an anonymous survey distributed to department chairs at academic radiology and radiation oncology programs across the United States between June and July 2025. By targeting the leaders who administer and interpret leave policies, the investigators aimed to capture a department-level picture of how paid family and medical leave, commonly abbreviated as PFML, is structured in the academic settings where radiologists and radiation oncologists are trained and employed.

The headline finding is one of broad availability but uneven execution. PFML policies were reported to exist in academic radiology and radiation oncology departments of every specialty, geographic region and department size, suggesting that the era in which physician parents or caregivers had no formal paid leave option at all has largely receded. Yet availability is only the first step. According to the study authors, a significant number of programs surveyed require faculty members to draw down vacation or sick time as part of their leave, a design choice that effectively reduces the total time off a physician can accumulate. The survey also documented wide variability in two structural features that can determine whether leave is genuinely usable: whether leave can be taken in noncontiguous blocks rather than one continuous stretch, and whether the promotion clock can be extended to compensate for time away.

These details matter because the structure of a leave policy shapes how it functions in practice. Requiring physicians to exhaust vacation and sick banks before accessing paid family leave can leave them with little discretionary time off in the years that follow a birth, adoption or serious illness. Restrictions on noncontiguous leave can force a recovering parent or a physician managing a chronic condition to take all protected time in a single block, even when a phased return or intermittent schedule would better serve their health and their family. And when promotion clock extension is inconsistent or unclear, faculty may face a hidden career penalty for taking leave that is nominally available to them, a concern that weighs heavily in specialties where the pathway to tenure and academic advancement is tightly calibrated to years of service.

Kirti Magudia, MD, PhD, assistant professor of radiology at Duke University and an author of the study, framed the results as evidence of a persistent gap between what policies promise and what physicians experience. Paid family and medical leave, she noted, is an important workplace benefit that all radiologists and radiation oncologists can be expected to use at some point during their careers. While the survey results are promising in showing how widespread formal policies have become, she expressed the hope that these policies will continue to improve to support the wellness of the workforce. That framing captures the study’s central tension: the infrastructure for leave exists almost everywhere, but its design and delivery have not converged on a standard that physicians can rely on as they move between institutions.

Perhaps the most striking utilization finding is that most survey respondents reported that fewer than 10 percent of faculty in their departments used leave during the previous year. On its face, such a low figure seems at odds with the demographic realities of a workforce that includes physicians in their childbearing and child-rearing years, as well as clinicians who inevitably face medical events and family caregiving responsibilities. The authors interpret this as another signal of the gap between policy and implementation. Low reported utilization may reflect genuine underuse, whether because physicians hesitate to take leave, because coverage constraints make it impractical, or because the administrative pathway is burdensome. It may also reflect how utilization is counted at the departmental level. Either way, a benefit that fewer than one in ten faculty members access in a given year is not functioning as the routine, expected support that its advocates envision.

Underlying much of the survey’s findings is the problem of clinical coverage. Substantial concerns about who will read the studies, deliver the treatments and staff the services when a physician steps away emerged as a recurring theme among respondents. In radiology, where coverage models are built around continuous interpretation of imaging studies, and in radiation oncology, where treatment courses cannot be paused without clinical consequences, the absence of a single faculty member creates a tangible workload that must be absorbed by colleagues or covered through temporary hiring. The survey suggests that in many departments, no robust system exists for absorbing this workload, which means the practical feasibility of leave often depends on informal goodwill rather than institutional design. That reliance on informal coverage is precisely the kind of structural weakness that makes leave policies feel precarious to the physicians considering them.

The study’s methodology, a chair-level survey rather than a review of written policies or an analysis of personnel records, carries both strengths and limitations worth noting. Chairs are uniquely positioned to describe how leave is administered in their departments, including the informal norms that never appear in an employee handbook. At the same time, self-reported perceptions of policy clarity and utilization may diverge from what faculty themselves experience, and the anonymous design, while encouraging candor, prevents follow-up with individual respondents. The survey period of June to July 2025 also captures a snapshot of a landscape that continues to evolve, as states expand their own paid family and medical leave programs and institutions adjust to a patchwork of federal, state and local requirements.

That patchwork is an important part of the context. In the United States, there is no comprehensive federal mandate for paid family leave, so the benefits available to a physician depend on a combination of institutional policy, state programs where they exist, and the federal Family and Medical Leave Act, which provides unpaid job-protected leave for eligible employees. Academic medical centers therefore occupy a policy space where generous departmental practices can coexist with minimal legal floors, and where a physician relocating from one state or one institution to another may encounter dramatically different entitlements. The variability documented in this survey is a window into that fragmented system, seen from the vantage point of the department leaders who must translate institutional rules into workable schedules.

The implications extend beyond radiology and radiation oncology. Academic medicine has often served as a bellwether for physician workplace policy, and the patterns identified here, including mandatory depletion of vacation banks, unclear promotion protections, coverage anxieties and low utilization, are likely to resonate in other specialties grappling with the same structural questions. For a profession facing well-documented pressures on wellness, burnout and retention, the design of leave policy is not a peripheral administrative detail but a core element of workforce sustainability. The study’s authors, by documenting the extent of inconsistency with survey data rather than anecdote, have given departments and professional societies a concrete baseline against which future reform can be measured. Whether the next survey of academic chairs reports convergence on clear, usable, genuinely supportive leave policies will be one measure of how seriously academic medicine takes the wellness of the physicians it trains and employs.

Subject of Research: Paid family and medical leave policies in U.S. academic radiology and radiation oncology departments

Article Title: JACR study explores discrepancies among paid family and medical leave policies across U.S. academic and radiation oncology departments

Article References: JACR study explores discrepancies among paid family and medical leave policies across U.S. academic and radiation oncology departments. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: paid family leave, medical leave, radiology, radiation oncology, academic medicine, department chairs, survey research, physician wellness, workforce policy, Journal of the American College of Radiology, Duke University, clinical coverage

Harpham’s argument arrives at a moment when the technical demands on physicians have never been greater. Advances in diagnosis and treatment mean doctors have more to discuss with patients than ever before, yet the time available for each visit has not grown to match. In that compressed environment, she argues, brief expressions of compassion are not a luxury but a clinical tool. Words, she writes, have the power to comfort and inspire patients living on the front lines where the pain is felt and the pills are swallowed. No matter how medicine changes, nothing can diminish the healing potential of well-chosen words. This framing treats communication not as bedside manner in the decorative sense but as an active component of care, one that influences how patients understand their conditions, whether they adhere to treatment plans, and how they cope emotionally with uncertainty.

One of the most striking insights in her work concerns the ordinary greeting. For patients carrying a medical concern, the first visit to a doctor is never truly the first step. Many have already wrestled with fear, self-doubt, and decisional paralysis before they pick up the phone to make an appointment. By the time they sit in the waiting room, they are often managing a delicate psychological balance. Harpham recalls her own experience of being greeted by a nurse with a casual question about how she was feeling, and finding herself unable to answer. Should she report the exhaustion she felt with any exertion, or the anxiety and sadness she had been carrying? Or should she project confidence, hoping to be taken seriously and to appear a model patient? She describes stammering, frozen with uncertainty, as different sides of her competed to answer and left her tongue-tied.

That moment of paralysis, she suggests, captures the psychological tightrope that patients walk at every visit. They are balancing honest reporting against their need to maintain hope, to appear competent, and to avoid being seen as difficult or demanding. The stakes of this balancing act are not trivial. A patient who downplays symptoms in order to seem strong may withhold information that is essential to accurate diagnosis. A patient who fears being judged for delaying care may arrive late in the course of an illness. The solution Harpham offers to clinicians is specificity. Instead of an open-ended and ambiguous question about how a patient is doing, she recommends asking how the patient has been feeling since the last visit, or what brings them in today. Such phrasing removes the ambiguity that forces patients to guess what kind of answer is wanted. She also reminds patients themselves that doctor visits are not social visits, and that the clinical setting is precisely the place for candid reporting.

Harpham’s guidance extends to some of the most emotionally charged moments in medicine, including the arrival of patients who have delayed seeking care out of fear. Rather than expressing frustration, she suggests that doctors build connection with compassion, acknowledging that coming in is difficult and that trying to give a symptom time to resolve is understandable, while expressing genuine gladness that the patient has come. For false alarms, when a worrying symptom turns out to be benign, she recommends reassuring the patient that they did the right thing, and that a false alarm is better than a missed opportunity. The logic here is behavioral as much as emotional: a patient who is praised for prompt reporting is more likely to seek care quickly the next time, while one who feels embarrassed or foolish may hesitate longer in a future emergency. In this way, a single well-crafted sentence can shape health-seeking behavior long after the visit ends.

Perhaps the most delicate territory Harpham explores is the discussion of conditions with a poor prognosis. She argues that insights and tips for clinicians ultimately help patients as well, by guiding them toward healthy ways to process difficult truths and manage uncertainty. When breaking bad news, she valued the doctors who prepared her before delivering it, with phrases such as wishing she had better news, or warning that what was about to be said would be difficult for the doctor to say and, she expected, difficult for the patient to hear. Such warnings, delivered calmly, communicate two things at once: sorrow and competence. Patients whose world is changing in an instant need to see both, she suggests, because grief without competence feels chaotic, and competence without grief feels cold. The preparation itself becomes a form of care, giving the patient a moment to brace before the news lands.

Among her most surprising insights as a patient involves the agonizing interval spent waiting for test results. Conventional wisdom frames this wait as a hope for good news, but Harpham argues that this framing sets up a damaging binary in which results are either good or bad. She instead encourages patients and doctors alike to hope for accurate news. Accurate news, whatever it contains, provides the information needed to make wise decisions and respond in helpful ways. It honors the complexity of medical reality, in which partial responses to treatment, stable disease, and ambiguous findings all carry meaning that a simple good-versus-bad dichotomy erases. It also helps patients manage the uncertainty of the waiting period itself, because the goal is no longer a lottery win but a truthful picture. More than she hopes for good news, she says, she hopes for accurate news, however long she has to wait.

Throughout the book, Harpham models specific phrases for a wide range of common clinical scenarios, each designed to show compassion and to foster the trust on which effective communication depends. To encourage candid descriptions of symptoms, she suggests telling patients that reporting symptoms is not complaining but rather providing information that helps their care, a reassurance that removes the fear of being judged. To prepare patients for the toll of adhering to demanding regimens, she recommends acknowledging openly that tests and treatments demand a great deal of time and effort, and inviting patients to report any difficulties following through so that adjustments can be made without compromising the chance of the best outcome. This framing acknowledges the stress and grief that accompany therapies and helps clinicians personalize prescriptions to the realities of a patient’s life. To reframe the use of mobility aids, she suggests that choosing to use a cane is choosing to make life the best it can be, presenting the aid as an instrument of empowerment rather than a badge of decline.

What unites these examples is a view of language as a clinical instrument with measurable effects on patient behavior and wellbeing. Harpham’s authority on the subject comes not only from her medical training but from her long apprenticeship as a patient, during which she experienced firsthand how clinicians’ words could lift her or unwittingly cause distress. Her book gathers personal stories to illustrate the patient’s perspective on phrases that help and phrases that hurt, offering clinicians a rare window into how their sentences land on the receiving end. In an era of time-limited visits and expanding medical knowledge, her message is that the healing potential of well-chosen words remains one of the most powerful and least expensive tools available to medicine, and that learning to use it deliberately is a skill every clinician can practice, one conversation at a time.

Subject of Research: Clinical communication between doctors and patients and its impact on patient wellbeing and care

Article Title: What doctors say can be as powerful as what they prescribe, physician-turned-patient warns

Article References: What doctors say can be as powerful as what they prescribe, physician-turned-patient warns. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: clinical communication, doctor-patient relationship, Wendy Harpham, cancer, patient experience, medical empathy, breaking bad news, healthcare, physician wellness, medical humanities, patient advocacy, Routledge

The commentary, written by Rama Ayyala of Cincinnati Children’s Hospital Medical Center and the University of Cincinnati Medical Center, proposes a framework for wellness-centered leadership that reframes leadership itself as a primary wellness intervention. Its central premise is drawn from a growing body of evidence: burnout is driven less by deficiencies in individual resilience than by chronic workplace stressors, including excessive workload, inefficient workflows, staffing shortages, communication failures, and organizational culture. If that is true, then the people with the most influence over those conditions are not wellness officers offering yoga classes, but the department chairs, medical directors, and team leads who design the daily work environment.

The scale of the problem in pediatric imaging is well documented. Previous surveys of the Society for Pediatric Radiology have found substantial burnout prevalence among pediatric radiologists, alongside identifiable stressors ranging from workload to administrative burden. The specialty faces a paradox familiar across medicine: professionals describe their work as highly rewarding, citing meaningful patient interactions, multidisciplinary collaboration, teaching, mentorship, and research, while simultaneously reporting symptoms of exhaustion and disengagement. Imaging volume and complexity continue to climb, demanding greater subspecialized knowledge and faster, more accurate interpretations. The author describes this as a growing functional burden, one that extends beyond raw case counts to encompass the mental effort of synthesizing complex clinical information, communicating findings, and making high-stakes decisions under time pressure.

Operational friction compounds the cognitive load. Inappropriate or unclear imaging requests, competing clinical priorities, and frequent interruptions create inefficiencies that frustrate physicians, technologists, and nursing staff alike. Workforce shortages force individuals to meet rising demands with fewer resources, and caring for critically ill children adds a significant element of emotional labor. Crucially, the commentary emphasizes that these stressors do not erase the meaning of the work; fulfillment and stress can coexist, and clinicians can remain deeply engaged while experiencing significant burnout symptoms. That distinction matters because it shifts the diagnosis: burnout may reflect not a lack of meaning or personal grit, but systems that erect unnecessary barriers to meaningful work.

This is where the critique of conventional wellness programs becomes sharp. The author argues that many organizational initiatives amount to what has been called performative wellness, or carewashing: pizza parties, resilience workshops, meditation sessions, and wellness newsletters that create the appearance of institutional concern while leaving the structural drivers of distress untouched. Worse, such programs can subtly transfer responsibility for coping onto individuals, implying that those who struggle simply lack resilience. This framing risks stigmatizing distressed employees and discouraging honest conversations about workplace problems. Decades of occupational psychology research, including the influential work of Christina Maslach and colleagues, points instead to chronic mismatches between job demands and available resources, lack of control over work, and toxic organizational cultures as the true engines of burnout.

The proposed alternative is a three-pillar framework for wellness-centered leadership, adapted from work by Tait Shanafelt and colleagues at Stanford. The first pillar is caring about people. Leaders build trust by deliberately fostering psychological safety, the shared belief that employees can speak up, ask questions, report concerns, and admit mistakes without fear of embarrassment or punishment. That requires consistent humility, transparency, curiosity, and visible follow-up on feedback, not just invitations to share ideas. Behaviors such as active listening, transparent communication during change, recognition and gratitude, stay interviews, and leaders modeling healthy work-life boundaries all reinforce the message that employees matter. The familiar observation that people leave leaders rather than organizations, the author suggests, is a warning worth heeding.

The second pillar is cultivating relationships. Pediatric radiology depends on a diverse team of physicians, technologists, nurses, child life specialists, administrators, researchers, IT professionals, and trainees, and community across those silos does not develop automatically. Leaders must engineer opportunities for connection through inclusive decision-making, multidisciplinary workgroups, shared quality initiatives, mentorship, and cross-professional recognition. Remote and hybrid work adds friction, reducing informal interaction and professional visibility, so leaders must ensure that visibility reflects contribution rather than physical presence and that access to information, recognition, and development opportunities is equitable regardless of work location. Shared purpose is protective as well: prior research shows that physicians who spend at least 20 percent of their professional effort on the activities they find most meaningful experience substantially lower burnout, giving leaders a concrete lever for fulfillment.

The third pillar, and arguably the hardest, is inspiring change by fixing the work itself. Even without new staff or budgets, leaders can target modifiable sources of distress: inappropriate STAT requests, inefficient workflows, unnecessary administrative tasks, scheduling inequities, and communication failures. Engaging frontline teams to identify low-value work, simplify processes, and clarify priorities turns prioritization into a core leadership responsibility. Expanding imaging access into evenings and weekends supports patient-centered care but risks overburdening a constrained workforce unless staffing and interpretation capacity expand in parallel. The author argues that operational excellence should be treated as an essential wellness strategy, and that when problems cannot be solved, transparent communication about limitations and meaningful employee involvement in decisions can preserve trust.

Measurement is the thread that ties the framework together. Departments rigorously track turnaround time, productivity, quality, and patient experience, yet rarely measure employee well-being with the same discipline. The commentary calls for professional fulfillment, psychological safety, trust, workplace inclusion, and retention risk to be added to routine departmental dashboards alongside traditional metrics, with repeated climate and pulse surveys to monitor progress. Measurement, however, must be the beginning of improvement, not the end: surveys without visible action erode trust and discourage future participation. For leaders unsure where to start, the commentary offers a practical roadmap: ask employees directly what makes their work harder than it should be, hold role-specific listening sessions, fix one operational pain point to build credibility with a small win, follow up visibly and transparently, and protect time for meaningful work while recognizing contributions across every professional role.

The ultimate message is blunt and, for many healthcare organizations, uncomfortable. The goal is not to make healthcare professionals more resilient to broken systems but to build better systems that support the people who provide care. Leadership, the author concludes, is not adjacent to workforce well-being; it is the intervention itself. In a field where burnout is increasingly understood as an organizational disease rather than a personal failing, the departments that thrive will be those whose leaders shape culture, foster community, dismantle unnecessary barriers, and treat the employee experience with the same rigor they apply to any clinical metric. For the children and families who depend on pediatric imaging, the sustainability of that workforce may be one of the most consequential health interventions of all.

Subject of Research: Wellness-centered leadership as an organizational intervention to reduce burnout in pediatric radiology

Article Title: Empowering leaders, empowering teams: fostering wellness through leadership

Article References: Ayyala, R. (2026). Empowering leaders, empowering teams: fostering wellness through leadership. Pediatric Radiology. https://doi.org/10.1007/s00247-026-06774-0

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06774-0

Keywords: burnout, leadership, pediatric radiology, physician wellness, psychological safety, organizational culture, workforce retention, healthcare leadership, professional fulfillment, wellness-centered leadership, workplace stress, employee experience