Title: Associate Professor
Residency: Naval Medical Center, San Diego
Medical School: Dartmouth Medical School
Timothy Rooney, MD, is the division lead of breast imaging in the UVA Department of Radiology and Medical Imaging. He is a board-certified diagnostic radiologist with fellowship training in breast imaging. He comes to UVA after a long career in the military and at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
Q&A: Timothy Rooney, MD
Why did you choose your specialty?
I thought about becoming a doctor for many years before I acted on it. Even though I was having a successful career flying in the Navy, I felt like I was called to medicine. Radiology was a neat mix of forward-thinking medicine and caring for patients. In many ways, we’re a hub of many spokes within the hospital and in the outpatient setting; pretty much everyone goes through imaging at some point. That crossroads of technology and patient care, the robust ability to consult with other physicians, combined with a really great radiology department where I was training in the Navy, led me to radiology.
For breast radiology, specifically, I had an early exposure to this patient population during my residency. It was clear this was not what people typically envision for a radiologist; you aren’t hiding in a dark room. You are front and center, seeing patients and creatively managing their care. It’s a great opportunity to be part of a team.
What was unique about practicing medicine in the military?
When I began practicing medicine in the military, I was able to see patients who experienced trauma in Iraq and Afghanistan, which was really interesting. After retiring, I stayed in Germany. I ran the breast program there and cared for this far-flung patient population. We were trying to screen and diagnose patients, from active military to family members across Europe and all the way into Africa. The logistics of this were interesting; it felt like an underserved population because they had very special needs. I was fortunate to have the credibility of my prior line officer service as a pilot so I could understand their experience. Working with active-duty folks was rewarding because I used to be one of them.
What are your goals as head of the Division of Breast Imaging in the UVA Department of Radiology and Medical Imaging.?
I want the patient experience to be exceptional and personalized all the time. I want patients to feel like we are their allies, that we are part of their team and we’re there for them all the time, 24/7. My leadership style is customer-focused. I focus on how I can best support my customer: the patient, the oncologist and the surgeon. This also includes our trainees. We have fellows, residents and a plethora of folks here. I strive to make this a user-friendly environment, where we’re all on a level playing field, where every team member is empowered to be part of the solution, from the tech and the front desk person to myself and the med student. I’m trying to really be the leader without any top-down feel at all. To empower everyone to be part of the solution — that’s really important to me and that’s how I want to support my colleagues, trainees, patients, surgeons and referrers.
Did you have a mentor who inspired your approach to leadership?
My inspiration was the commanding officer of my fighter squadron. Hollywood has lots of stereotypes of military leadership, but he was a surprising example of thoughtful leadership. I was a young fighter pilot and my squadron was crossing the Atlantic in a huge storm; this is when I was first exposed to the customer-based leadership model. It’s not a top-down approach. It’s using a team concept, relying on others, lifting others up. To this day, I remember, he launched my leadership style and I haven’t varied from that since. He was an amazing advocate of that leadership philosophy and I was able to work thorough that with him in a real environment with a bunch of underpaid sailors on deployment on a carrier in the middle of nowhere.
What will be your clinical and research focus?
My clinical focus is breast MRI, 3D breast imaging and breast MRI-guided biopsy. My most recent research interest has been in breast MRI. I’ve been doing a lot of work with surgeons, developing novel ideas on how to do breast MRI in a surgical position; this is called supine breast MRI. It has to do with optimizing surgeons’ visualization and optimizing breast surgery using breast MRI.
I am also focused on global health and outreach. I teach over in East Africa. I’ve led training programs there for many years. Caring for the underserved internationally is a focus I’ve tried to thread throughout my career.
What’s the most exciting thing happening in your field right now?
There is super exciting stuff going on with 3D mammography and digital mammography. We’ve made leaps and bounds with this technology. There are things that are now ready for prime time, such as fast MRI and contrast-enhanced mammography. These will allow us to find a whole new reservoir of breast cancers that are not seen on a traditional breast mammogram.
What would you say is a common barrier for breast cancer screening?
There is still some confusion around the screening recommendations for women with dense breasts. Most would refer these women for an ultrasound, and that’s not a bad test. But more recent surveys show there are better tests that provide better sensitivity and specificity, such as fast MRI and contrast mammography. Both are equally excellent.
However, referring providers and patients don’t always know about these options. Our goal is to educate them. For intermediate-risk patients — those who don’t meet the criteria of having a 20% lifetime risk but do have dense breasts or another risk factor — who want to do adjunct screening, we have excellent offerings for them. There’s more than just the addition of ultrasound; there are other tests available.
What were your first impressions of your team at UVA?
The six of us faculty here [in the breast imaging department] really are on the same playing field. We have the ability to ask tough questions, to put ourselves out there, to be vulnerable and maintain that mutual respect. It’s noticeable, and I really have to give credit to my colleagues and also the interim director and division head, Dr. Carrie Rochman, who really has done such a great job and presents that personal approach. For me, that meant I was welcomed with open arms and that is not something everyone can count on. Our chairman is also amazing; he fosters that collegial attitude.
To refer a patient to UVA Health, call UVA Physician Direct at 800.552.3723.