Like a POW on rice and water eating his first rib eye, an editor of a certain age finds no greater pleasure than getting her hands on 60-pound–paper stock after spending a year in the ether of electronic media. If you are reading this, I sincerely hope you are holding it. In the world of publishing, e-media do have intrinsic, unique values. A part of me would like to be linking, right now, to one of my favorite Web videos, Shift Happens [http://www.glumbert.com/media/shift], to illustrate that—as surely as the earth turns on its axis, spinning a worldwide web of infinite change—I do understand the need to adapt and relinquish. If I did link you out right now, though, there would be no assurance that you would come back, and I would not want you to miss a reading experience to savor. It was conceived, designed, and built that way. Radiology Business Journal is the third launch by the Imaging Center Institute, headed by radiology consultant, publisher, and—yes—visionary Curtis Kauffman- Pickelle. First came ImagingBiz.com, and if you are not receiving this free monthly ejournal, I urge you to tune in to its coverage of the news, trends, and business proceedings in outpatient imaging. Just a few months ago, we launched the first edition of the quarterly e-journal.RadInformatics.com, where we explore the daily business, clinical, and IT challenges of operating a digital radiology enterprise. The vision behind Radiology Business Journal is loftier: to foster leadership in the specialty by growing the shared business intelligence necessary for radiology to maintain its unique position as command central of medicine. All stakeholders in radiology have worked hard and smart to achieve this position through continuous innovation that resulted in ever-greater improvements in patient care. You have earned your rewards. The ability to interrogate the human body tomographically, slice by slice, has all but eliminated exploratory surgery, accelerating the ability to view the extent of trauma or diagnose a suspected pathology. Functional imaging modalities have taken us even further with the ability to image actual disease processes, including infection, angiogenesis, and impaired blood flow, paving the way for radiology to assume a more central role not just in the diagnosis, but in the treatment of those disorders. In addition, no other specialty has more effectively leveraged information technology for efficiency. These successes, however, have not come without cost. Much has been said about the crude assault on radiology reimbursement launched through the Deficit Reduction Act (DRA) of 2005 and the fact that this blunt trauma occurred outside the established process for arriving at a fair reimbursement for a given procedure: namely, the resource-based relative value scale. Rather than viewing the DRA as a mere injustice, however, recognize this action as a clarion call to radiology to sit up, suit up, and get into the game, be it in Washington, DC; Albany, NY; or the political landscape of your local hospital. While the current economic uncertainty and the crisis in the financial markets will pass, the unsustainable Medicare program will continue to be a problem for everyone in the United States. It has already become a problem for many in radiology. How can radiology become part of the solution? Where should radiology go for protection from future arbitrary cuts? What can radiology do to keep the specialty vital, to continue to attract the brightest minds, and to generate the investment dollars necessary to perpetuate the innovation? Who are the thought leaders who can provide the answers? We do not pretend to have the answers to the big questions, but we vow that, in every issue of Radiology Business Journal (four, this year), you will meet people who are struggling with these questions and looking for solutions. We caution that you might not always like what you read, but we promise that it will always be relevant. Pour yourself a cup of something hot, sit back, and open the 60-pound–paper pages of Radiology Business Journal. Imagine that the world has stopped spinning. We look forward to building this new dialogue with you.