Tom Hoffman – American College of Radiology

As general counsel and executive vice president of governance and member services for the American College of Radiology (ACR), Tom Hoffman stands at the intersection of law, governance, and patient-centered advocacy. It’s a role that demands strategic foresight, practical problem-solving, and the ability to see issues from multiple perspectives.

“I want to make sure our decisions are grounded in evidence and designed to serve our members—and ultimately, their patients—for the long term,” Hoffman says.

His leadership helps ensure that the organization remains relevant and proactive as radiologists, radiation oncologists, medical physicists, interventional radiologists, and nuclear medicine physicians navigate an evolving healthcare landscape.

Founded more than 100 years ago, ACR’s 42,000-plus members share a mission to maximize the value of radiology and related specialties by advancing science, improving patient care, influencing the socioeconomics of practice, providing continuing education, and conducting research for the future. For Hoffman, that mission is personal—one he’s been helping to advance for more than 25 years.

“We recently updated our mission to state that our organization is the voice of our members, empowering them to serve patients and society by advancing the practice and science of radiological care,” Hoffman says. “It is a mission I truly believe in.”

Stepping into strategic leadership

Hoffman assumed his current dual role in January 2024 following the retirement of his longtime colleague and mentor, Bill Shields. By that time, he was already a fixture within ACR, having joined in 1997 as senior attorney and became associate general counsel in 2001 after five years in the general counsel’s office at the U.S. Department of Health and Human Services. His legal background—rooted in both government service and deep knowledge of healthcare law—positioned him to take on a broader leadership role as ACR welcomed new CEO, Dr. Dana Smetherman, in mid-2024.

The transition required a shift from legal and business counsel across ACR to an even more strategic, big-picture focus. Hoffman now directly oversees the governance and member services team, working to make ACR more practical and valuable to members dealing with rising imaging and therapy study volumes.

“You have to set priorities and learn when to step in,” he says. “We have a lot of stakeholders, so it’s about balance—being responsive to our CEO and staff without micromanaging.”

Succession planning, member recruitment, and retention have all become key priorities. Hoffman actively evaluates partnership opportunities with other medical societies, ensuring that ACR remains at the forefront of radiology advocacy and innovation. Weekly team meetings and near-daily check-ins with colleagues keep the work aligned and collaborative, even in the organization’s mostly remote environment.

Tackling policy, advocacy & AI

Hoffman’s legal and governance work is not confined to the boardroom—it extends into some of the most pressing issues in healthcare today. One example is ACR’s ongoing advocacy surrounding the No Surprises Act, a federal law designed to protect patients from unexpected medical bills. While supportive of the law’s intent, ACR and other physician groups are challenging aspects of the government’s reimbursement methodology for imaging services.

“We’re committed to ensuring our members can continue to provide high-quality care without facing reimbursement practices that undervalue their work,” Hoffman explains.

His responsibilities also include supporting ACR’s delegation to the American Medical Association House of Delegates, reviewing and advising on resolutions that shape the broader medical landscape. This work strengthens ACR’s connections across the healthcare community and reinforces its strategic position in policy discussions.

Hoffman has also been heavily involved in the development of ACR’s artificial intelligence usage policy. With AI rapidly transforming healthcare, the policy sets clear guidelines for staff and publications while exploring how the technology can be used responsibly to improve efficiency.

“We’re still learning what’s sensible and what protects the College’s brand,” Hoffman says. “AI has potential, but in healthcare, you have to think about not just what you can do legally—but what you should do.”

A career built on purpose

Hoffman’s legal journey has been shaped by a consistent thread: a desire to contribute to society in a meaningful way. Inspired by his father’s work in public hearings and policy—he served as a senior aide to a New York state legislator—he initially considered a government-focused legal path. After earning his degree from Le Moyne College and his JD from Georgetown University Law Center, he joined HHS, where he gained an in-depth understanding of Medicare and healthcare law.

When the opportunity to join ACR came in 1997, he recognized it as a chance to combine his legal skills with service to a professional community that directly impacts patient health. Over the years, he’s seen the organization evolve—expanding into AI, data science, and medical publishing—while maintaining its commitment to safe, effective, and accessible imaging.

For Hoffman, one of the most rewarding aspects of his career is mentorship. He advises young lawyers and residents visiting ACR headquarters, encouraging them to see healthcare law as a way to make a tangible difference.

“You can believe that you’re contributing to society,” he tells them, noting that his wife, a longtime schoolteacher, has shown him the power of work that benefits others.

In his current role, Hoffman sees himself as both a strategic leader and a trusted advisor.

“Part of being effective is staying current by reading, attending conferences to interact with members and other lawyers, and understanding the broader landscape,” he says. That mindset has allowed him to adapt as ACR’s needs have shifted, from legal compliance to governance innovation.

To the future

As ACR continues to face challenges ranging from technological disruption to changing healthcare policies, Hoffman’s role will remain critical. His focus on evidence-based decision-making, proactive problem-solving, and relationship-building ensures that the organization can adapt while staying true to its mission.

He understands that leadership in a nonprofit medical society is different from corporate law—it’s about balancing the needs of members, patients, and the profession as a whole.

“We have one client, but many stakeholders,” he says. That reality drives his commitment to transparency, trust, and collaboration at every level of the organization.

Whether advocating for fair reimbursement policies, shaping guidelines for emerging technologies, or fostering the next generation of legal and medical leaders, Hoffman’s work reflects a belief that law is more than rules—it’s a framework for making healthcare better. And as the American College of Radiology continues to evolve, he’s determined to ensure it remains the indispensable voice for radiology in the decades to come.