ACR presidential address: with change inevitable, can we survive?

The universe of medical practice is changing at an ever increasing rate, an exponentially increasing rate. In examining Earth's history from the beginning of time, it is not necessarily change per se that has threatened countless species but the rate of change that has challenged species survival. Darwin's thesis indicates that those who are most able to adapt to change will be more likely to survive. Medical technology, especially imaging technology, has been on a exponential growth curve for the past 2 decades, dramatically changing not only the field of medical imaging but the environment of all of medicine. Change in our practice environment represents both threats and opportunities to medical specialties to adapt and survive in the context of radiology and remain relevant to the future practice of medicine. Can we as radiologists survive and remain relevant in the future practice of medicine? What is the path to survival? The approach to survival will be multifactorial. We must continue to put our patients first, maintaining high-quality patient care in our adaptation strategy. We must do a better job of developing and investing in leaders, not only within radiology, but within all of medicine. We will need to hypersubspecialize within our profession and with that hypersubspecialization develop an integrated team concept, working together like a well-oiled Swiss watch. Last, we must as a profession invest in ourselves vigorously, supporting imaging research in a number of arenas, searching for the next imaging breakthrough, and exploring and adapting nanotechnology applications in both imaging and therapy.