‘Leading from the front with a clear organizational vision and shared values’ by Farzana Rahman

As a team of radiologists who also lead a teleradiology start-up, we spend a lot of time thinking about what learnings we can take away from each role, especially when it comes to leadership. We often get asked, is there a difference between the leadership needed in the NHS and the leadership needed for running a start-up? Five years after starting our company, Hexarad, we feel like we are getting closer to an answer.

We decided to create the company when we were still registrars at St George’s Hospital in London. We didn’t have a lightbulb moment; all we knew was that we wanted to try to solve the problems we saw in Radiology whilst working with people we liked. If we were going to summarize this in corporate start-up speak, we would say that we shared a ‘vision’ and had common ‘values’. But we didn’t know that then; we were junior doctors, too busy recovering from long on-call shifts whilst studying for exams.

Another thing we didn’t realise was that, as we grew and matured as clinicians, we were also building the leadership skills we would need to take our company forwards. Building a start-up is not dissimilar to being a new junior doctor; there are a mountain of tasks to complete, there’s new information to assimilate and it’s often hard to find someone to answer a question. In the end you have to trust your instincts, learn as you go, and know when you’re out of your depth. Reid Hoffman, the founder of LinkedIn, has said that building a start-up is ‘like jumping off a cliff and assembling a plane on the way down[i],’ a sensation that many junior doctors will recognise!

Five years on, it still feels like we’re assembling that plane. But one of the most important lessons we’ve learnt is that defining and living a set of values is fundamental to any organization.  Creating a strong company culture is hard – precisely because it’s not black and white. Everyone who’s part of our organisation has to understand the culture we’re trying to create and live the values that define our company.

Our core values were something that the Hexarad senior leadership team developed together, and we have taken active steps to ensure that we use them to inform any decisions that we make as a company. Our values are: teamwork, collaborating for a common goal; innovation, always finding better ways to work; equality, promoting fairness in everything we do; quality and excellence, committing to providing the highest quality in everything we do; integrity, acting in accordance with our values; and patient-centred thinking, always putting the patient first.

We all wanted to make sure that we were truly using our values to define Hexarad as a company, so after much trial and error, we settled on using a ‘living the values’ exercise at the beginning of management meetings. This involves one person giving an example of how they’ve lived one of our six company values recently. When we started it felt a little forced, but now it’s part of what we do and gives us an opportunity to reflect. Working together as junior doctors really brought home the importance of value-based leadership and the cohesion you can achieve as a team when you are all aligned behind those key values.

Some people might scoff at the idea of taking time out to reflect on how we are living our company values, but we have found that this exercise has real-world benefits, and those who skate over this side of leadership are creating more work for themselves and their teams.

Defining our values has helped us to make decisions faster – whether that’s about how we recruit, whether we pursue a commercial opportunity or if we spend time working on a social responsibility project, as we did recently with the Hexarad scholarship (https://www.rcr.ac.uk/posts/new-social-mobility-and-diversity-scholarship-award-radiology-opens). Inspired by the Black Lives Matter movement and our own experiences as medical students, we were able to launch our scholarship in less than a year, partnering with the Royal College of Radiologists and St George’s University of London Afro-Caribbean society. This unique scholarship provides mentorship and research project financial assistance to UK-based Black, Asian, and Minority Ethnic (BAME) medical students looking to explore a career in radiology.

The Hexarad scholarship is a perfect example of an initiative that wouldn’t have been possible at an organisation without value-driven leadership. It is easy to say that you care about social responsibility, but if you aren’t taking the time to think about what you are doing as a company to be responsible, then it is too easy to get distracted by other things.

So, to come back to our original question, five years into running our start-up we have realised that the value-driven leadership skills we learned and honed in the NHS are at the heart of the success of our start-up. Working as a clinician, and sharing so many core values with your colleagues, teaches you invaluable lessons about how to build and lead a successful team. Taking that forward, we have been able to work together with a clear understanding of our shared values to take on the challenges facing Radiology with innovative solutions.


[i] https://www.cnbc.com/2018/11/02/linkedin-co-founder-reid-hoffman-says-starting-a-company-is-like-jumping-off-a-cliff.html


Dr Farzana Rahman

Farzana is a radiologist with expertise in digital healthcare. She has worked in the health strategy and policy space both Nationally and Internationally, focusing on digital transformation and AI in healthcare. She holds a Masters Degree in Health Economics from the London School of Economics.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.

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