Roderic Pettigrew, MD, PhD, is director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH). He states his organization’s goal simply: developing technology that can detect disease early, even at the molecular level, long before physical symptoms begin to appear.

Idle hands are said to be the devil’s workshop; in 2012, government regulators proved the same to be true of hands that are busy, as evidenced by the new and modified rules that they churned out to address perceived problems in the delivery of radiology services. Many of these rules—brought forth by DHHS agencies—were unhelpful to radiology practices striving to keep their heads above water. In fairness, though, one or two rules were of the opposite character.

Imaging managers are being called upon to reduce costs significantly in their departments, so understanding the total cost of ownership is critical. All payors have targeted imaging as a high-cost, high-utilization service, over the past seven years, and now health-care reform will change the way that imaging does business forever—making it a cost center on the inpatient side.

There was a time, not long ago, when radiologists were either organized into private practices or employed by academic medical centers. Today, they have more options. Representatives of different practice models—from teleradiology to hospital employment to megapractice/multispecialty-practice membership—vary in their views of increasing service and performance demands (and their business, clinical, and lifestyle implications).

Every year, when we produce the ranking of the nation’s largest private practices, we are reminded of the contributions that radiology makes—not just to the health of the nation, but also to its economy. For a number of reasons, the profession has fostered many large and exceedingly complex organizations that employ—in the case of Radiological Associates of Sacramento in California—up to 900 people.

After countless hours and almost 10 years of Herculean effort from Society of Interventional Radiology (SIR) members and the American Board of Radiology (ABR), the American Board of Medical Specialties (ABMS)—the organization that oversees the 24 recognized medical-specialty boards—approved the ABR’s application for a dual primary certificate in interventional radiology and diagnostic radiology.

Digital health care gives patients a new opportunity to engage with their care providers on an unprecedented scale. With the electronic exchange of health information, consumers can access their medical records electronically, share them with providers, and make informed decisions. These advances in health IT make possible better consumer engagement, as well as more efficient and effective care.

In today’s health-care landscape, how can you expand your volume in the face of falling reimbursements, competition from larger health-care systems, and increasingly complex regulations? How do practiceas, imaging centers, and radiology departments increase revenue and margins—and address the challenges of patients’ tight budgets?

As a most tumultuous year comes to a close, let’s reflect a bit on what makes the people of the United States unique, what drives us toward achievement and success, and why the health-care institutions in this amazing country will continue to thrive—despite significant headwinds and uncertainty. Our cultural DNA is structured in a way that makes it certain that whatever it is that needs to get done, we will get it done.

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