The radiologist in the 1990s: new practice expectations and management responsibilities

Radiology has enjoyed an enviable position among medical specialties during the past two decades. Unprecedented developments in new technology expanded its horizons, and the volume of radiologic procedures increased far more than overall growth in health care services. The attendant increase in relative and absolute health care spending on radiologic services has cast radiology as a prime target for restrictions, cutbacks, and limitations in an era of managed care and national concern for reining in the growth of health care spending. A strategic response by radiologists requires an understanding of the implications of structural change in health care delivery systems and payment systems. To meet the imperatives of the 1990s, radiologists must do far more than perform and interpret imaging procedures: they must learn to work as efficient managers of health care imaging resources and to organize their practices for effective contracting and service delivery for patients in managed care systems.