Just in time, radiology providers are arriving at an understanding of their unique branding propositions. Are we almost there? That refrain is familiar to anyone who has ever taken young children on a long road trip. The kids get anxious and are easily bored, you get a bit cranky, and the trip seems to take a lot longer than you remember it taking, back when you took the same route unencumbered by responsibility for the necessities of others. Ironically, in retrospect, the travelers can recall only the fun parts of the journey, remembering the highlights of shared experiences, challenges overcome, and interesting sites visited. Such is the situation we find ourselves in with the current state of the medical imaging profession, as it morphs into something other than what we remember it being. The journey has been long and hard, but we seem to recall, with nostalgia, the good old days of radiology, as we face even more difficult paths ahead. I sometimes feel like that proverbial driver, as I help radiology groups and imaging executives navigate the roads on their respective journeys toward the full realization that their practices have, in fact, become businesses, in every sense of the word. It seems that we have been talking about it for years, and yet we are only just finishing our first round of singing 99 Bottles of Beer on the Wall. A major difference, of course, is that I never lose my enthusiasm for this journey, and I cherish the relationships that I have developed while being a guide and supporter for these fellow travelers. I guess I really am a true road warrior. The good news is that we’re getting close to being there. There is much more of a realization today that the road signs signaling key milestones are pointing clearly in the right direction, making it obvious to most that a renewed attention to the principles of business is the best way to ensure success in today’s crowded imaging marketplace. In years past, it was a lot easier to make it up as one went along on the journey, but that is no longer acceptable. Now, one needs definite guideposts and data points with which to measure progress. How is radiology a business, and why does it matter? As more information becomes available to patients and payors about costs, outcomes, quality, methods, turf issues, and other determinants of success, it becomes increasingly clear that patients/consumers will demand more from tomorrow’s providers of care. They will not be content with subpar customer service. They will not be content to wait for access to the system. They will not be content with indefensible costs and vague descriptions. Consumerdriven health care is arriving, and although it is not quite here yet, it is destined to become a reality with which the business of radiology will need to come to terms. Successful businesses are governed by fundamental principles that relate to how best to differentiate themselves in the hearts and minds of their constituents and stakeholders. These customer groups can and do build loyalty to brands, organizations, service groups, and other enterprises based on the entity’s ability to articulate these differences in terms that the customer understands (and to which he or she can relate). Typically, this means finding the benefit to the customer, rather than the service feature that the entity is proud to describe. The fundamental business proposition for today's—and tomorrow's—successful radiology practice, imaging center, or hospital outpatient group is to identify, and to articulate persuasively, the benefit to the customer of doing business with it. Why should customers come to you? In what way will they benefit? How are you different? In other words, what is in it for them? The groups that figure out how best to deliver on these basic tenets of business will be those that thrive in a consumer-driven health care arena. Where is your organization on the journey to achieving this ability? Are you there yet?