Virginia Pappas, CAE
Johannes Czernin, MD, editor-in-chief of The Journal of Nuclear Medicine and a professor at the David Geffen School of Medicine at UCLA, talked with Virginia Pappas, CAE, chief executive officer (CEO) of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), about her career in professional society leadership. For more than 45 years she has worked in various capacities to advance the society’s mission and the interests of its diverse membership. Her involvement in multiple efforts to make the wider medical community aware of the evolving roles of nuclear medicine has resulted in authorship of more than 50 peer-reviewed publications. In June 2023 she was recognized as an honorary SNMMI Fellow for her many years of service to the society.
Dr. Czernin: Virginia, you have been an SNMMI leader for quite some time. How did you enter the field of nuclear medicine?
Ms. Pappas: In 1978 I was working for a hematologist at Cabrini Health in Manhattan in the blood bank, but I looked for a change. I applied for an open position at the (then) Society of Nuclear Medicine. I knew nothing about association management or nuclear medicine, and the proposed position paid less than another job that I was offered at Cornell. But I liked the opportunity and started out as assistant to the director of administration, working directly with the executive director. What it brought to me was not only work in nuclear medicine and medicine in general but also association management, which turned into a career. A few years later I became first the director of administration and then the deputy executive director, and over the course of time, I have held just about every director position. My time at the society has always been creative, always doing something different. And that’s how I ended up in my current position.
Dr. Czernin: When did you become the CEO?
Ms. Pappas: March 1, 2002.
Dr. Czernin: How many members did SNMMI have when you started?
Ms. Pappas: The society had 17,000–18,000 members. Membership has decreased slightly over time, because not enough nuclear medicine physicians and technologists have entered the field to replace those who have retired.
Dr. Czernin: With the emergence of theranostics as the major driving force in nuclear medicine, do you already see a change? Are physicians coming back?
Ms. Pappas: Not yet, but we do anticipate growth. I see a resurgence of interest and enthusiasm, especially among younger nuclear medicine practitioners. We’re developing programs for them, such as the SNMMI Future Leaders Academy. We are also actively reaching out to residents and medical students to attract them to the field.
Dr. Czernin: Eli Lilly and Company recently acquired POINT Biopharma Global, Inc., and the Novartis acquisition of Advanced Accelerator Applications is a well-known story. The National Institutes of Health offer various funding mechanisms to foster industry–academia collaborations, thus suggesting that these collaborations are no longer considered immoral. The same awareness has emerged in academic institutions that need the support of industry to create startup companies to monetize intellectual property they create. Are you creating a home for smaller biotech as well as major pharmaceutical companies in SNMMI, so that they can become corporate or individual members?
Ms. Pappas: Yes and no. As a specialty society, we have to follow very strict rules about the involvement of industry in our programs and education. We don’t have an industry membership category, but we do have affiliate memberships for individuals who work for industry. Although these members can’t serve on committees or influence our strategic plan directly or indirectly, we offer a lot of advantages for companies. Through the Industry Partners Circle of our Center for Molecular Imaging Innovation and Translation, we invite industry and academia to come together to improve scientific collaborations. They meet at least once a year to tackle issues in this area.
Dr. Czernin: SNMMI now has around 15,000 members. This year’s hybrid annual meeting had a high attendance of around 7,000. Do you see the European Association of Nuclear Medicine (EANM) as the major competitor? Is such competition actually good, in that it creates a larger market?
Ms. Pappas: We have a very friendly competition with the EANM. Both our meetings attract attendees from around the world, and membership is international for both societies. We compete mainly on the format of meetings and types of programming, and as you mention, competition is actually good for both organizations. In the United States, our biggest competition comes from the radiology societies, since many of our physician members are now dual boarded in radiology and nuclear medicine.
Dr. Czernin: You have made significant progress in selecting more attractive meeting sites, which makes the meeting more competitive. Sites such as Washington, DC, Toronto, Vancouver, Chicago, and New Orleans are really attractive. This helps to increase in-person attendance.
Ms. Pappas: The SNMMI meeting has grown over the years, and we have specific space requirements for our meeting. The scientific program committee decided to rotate through a few large cities, thus making the meeting more attractive and competitive.
Dr. Czernin: SNMMI has created the Value Initiative. Could you describe its purpose and the targeted outcomes?
Ms. Pappas: Satoshi Minoshima, MD, PhD, created the idea for the SNMMI Value Initiative, which seeks to educate and promote the value of nuclear medicine to the community at large, including industry and government. This initiative focuses on quality of practice, research and discovery, advocacy, workforce pipeline and lifelong learning, outreach, and organizational strength and stability. We have raised more than $10 million in 6 years, which has enabled SNMMI to increase programming and activities in every single domain. It has increased the enthusiasm of industry participants at our meetings for supporting SNMMI in other areas, including exhibits, advertising, and sponsorship.
The society’s core values are innovation, education, and research. Our number 1 goal (as it has been for many years) is to continue the growth of the profession and help our members with resources and education. The SNMMI Mars Shot for Nuclear Medicine, Molecular Imaging, and Molecularly Targeted Radiopharmaceutical Therapy, created by Richard Wahl, MD, is an example of the ways in which we’re working to enhance research in the profession.
“SNMMI is a wonderful source of innovation and vision. Nuclear medicine and theranostics are among the most exciting fields in medicine. The patient-centric creativity and innovation keep us all engaged. New therapies have turned around the visibility and image of nuclear medicine and are making extraordinary differences in the lives of our patients.”
Dr. Czernin: One initiative that was talked about was attracting young people to join the field, even involving high school students by offering educational opportunities. Is that something that is still being pursued in terms of making the field better known?
Ms. Pappas: Yes. We’re working with science teacher organizations and with medical student organizations to increase awareness of the field, as well as actively engaging with the American Medical Association in their medical student and resident sections. We also just created a video series, “Jobs of Tomorrow,” to educate young people on the career opportunities available for physicians, scientists, and technologists within the profession. The workforce pipeline domain’s goals are to develop programs and find ways to encourage physician–scientists and technologists to enter the field.
Dr. Czernin: Let me get back to the SNMMI annual meeting. Heather Jacene, MD, is doing an excellent job as chair of the scientific program committee. Of course, professional scientific meetings are always works in progress, but what areas of improvement would you like to see for the meeting?
Ms. Pappas: One of the main goals of the new SNMMI strategic plan is to reimagine the annual meeting. Dr. Jacene and the scientific program committee are doing a wonderful job. Changes will be made over the next several years to make the annual meeting more entertaining and interactive, as well as adding more meeting spaces where people can network. Simplifying the meeting is also a consideration, by streamlining the sessions, avoiding duplication in programming, and improving the poster sessions. This is a heavy lift, since SNMMI has so many constituents.
Dr. Czernin: That was my next question. The EANM website lists 15 major committees. SNMMI has innumerable committees and subcommittees. The meeting design should be led by a small leadership group that then recruits people who know about specific areas. They can then help with recruiting the best national and international speakers. Do you agree that we have too many committees at SNMMI?
Ms. Pappas: Another major goal of the SNMMI strategic plan is to redesign the governance structure. Yes, there are too many committees, and we just keep adding more. We find it difficult to eliminate committees once they are created, even when they no longer have significant roles. The redesign task force is looking very critically at duplication and whether some committees are still needed. However, we have 3 distinct constituents in our membership, each with its own foci and needs: the technologist component, the practicing physicians, and the scientists. The redesign task force is currently working on this and has completed a survey looking at every single committee to ask, “What is your goal? What are your objectives? Have these been met? Are you still current? Are you still needed today?”
Dr. Czernin: Isn’t it difficult for a committee to say, “We’re no longer needed”?
Ms. Pappas: Yes.
Dr. Czernin: Wouldn’t it be more efficient to ask leadership to decide whether a committee is still needed? I asked that once of a previous program chair, and the response was, “But I cannot disenfranchise the committees.” I replied, “Oh, you have to. There’s no way around it. You have to disenfranchise the committees.”
Ms. Pappas: The redesign task force will spend the next year performing surveys and interviewing other organizations to be able to make recommendations to SNMMI leadership and the board of directors. The goal is to simplify the governance structure. I really believe that with a redesign, we will eliminate a large number of committees and improve our structure and function. We have more than 100 committees right now and more than 700 associated volunteers, not including speakers and editorial board members.
Dr. Czernin: That’s a nightmare!
Ms. Pappas: Yes, and we have limited staff resources to manage them.
Dr. Czernin: The structure of governance and leadership of SNMMI is also different from that of other organizations, where presidents may be in office for 2 or 3 years to get work done. SNMMI has 1-year terms.
Ms. Pappas: There have been some discussions about increasing the SNMMI presidential term to 2 years. But the 1-year term has not been a problem, because SNMMI leadership members work closely together, beginning with the vice-president-elect term. So before assuming office, our presidents have 2 years of active preparation in understanding the issues, meeting international leaders, etc.
Dr. Czernin: Fairly recently you initiated a survey of the SNMMI membership. What were the key outcomes? What were the membership’s most important and relevant concerns or suggestions?
Ms. Pappas: We conducted several surveys, including one for the website and another for the SNMMI strategic plan. Regarding the website, a redesign is absolutely necessary to create a more modern site to which members can come to locate essential information for professional needs and to answer questions about SNMMI. Our new website is planned to be up and running in June 2024.
The survey of our members identified several opportunities and challenges, including the need to focus on theranostics and capacity building, improve communication and messaging so that members know what we are doing for them, follow through with organizational redesign and restructuring of the society, and address workforce pipeline and reimbursement issues.
Dr. Czernin: Based on the strategic initiatives, what are the priorities for the next 3–5 years?
Ms. Pappas: Radiopharmaceutical therapy (RPT) is obviously at the top of the list, including creating educational programs in RPT, advancing our Therapy Center of Excellence program, and establishing productive relationships with referring physicians. Improving patient access to high-quality treatment centers is another important priority. As mentioned before, target efforts also include redesigning the annual meeting and society governance structure, improving and increasing communication, enhancing educational opportunities, and creating a platform for a new and more user-friendly learning management system. We would also like to become more integrated and established within the National Comprehensive Cancer Network and similar alliances. All these are priorities.
Dr. Czernin: All these future goals will cost money. Are new finance models under consideration? Is it allowed to ask industry for support?
Ms. Pappas: If the Value Initiative continues to be strong, we’re raising more than $2 million/year. If this continues at the current level, it’s more than enough to help us do the work we need to do.
Dr. Czernin: Who is supporting the Value Initiative?
Ms. Pappas: Around 35 companies contribute to the Value Initiative. This may grow significantly with the growing industry interest in theranostics. The funds raised are used to further the goals of the Value Initiative domains. We have many meetings with industry, including in one-on-one settings, as part of the Value Initiative and via industry advisory board meetings. Companies can share information, provide feedback, and give us suggestions about areas in which we could improve. Often strategies of the society align with those of these companies.
Dr. Czernin: Any good enterprise must have a leadership succession plan, whether short- or long-term. What is your succession plan at SNMMI?
Ms. Pappas: A good association will conduct a search via a search company, and the succession can be from within or from the outside. The good news about SNMMI is that we have a strong leadership team. If needed, our leadership team and the board could step up and assign an interim CEO. I was the interim director 3 times during periods when the society searched for a new executive director. The society will run very competently with or without me. To handpick someone would not be the best way to go about succession.
Dr. Czernin: We usually end this discussion by asking the interviewee for a special message about our field for young people. What would be your message for the next generation, either the administrative leaders or people joining the field of nuclear medicine?
Ms. Pappas: SNMMI is a wonderful source of innovation and vision. Nuclear medicine and theranostics are among the most exciting fields in medicine. The patient-centric creativity and innovation keep us all engaged. New therapies have turned around the visibility and image of nuclear medicine and are making extraordinary differences in the lives of our patients.
Dr. Czernin: With this I thank you for your service and contributions and for sharing your views with our readers.
- © 2024 by the Society of Nuclear Medicine and Molecular Imaging.
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