Albert Alan, MD

The most important implication of this graph may be for people who aren’t radiologists. If you refer imaging or own scanners, choose your radiology model deliberately. When price, turnaround time, and RVUs dominate the equation, work that doesn’t generate RVUs gets squeezed: consultation, protocoling, reviewing priors, discussing difficult cases, simply being available. Use your local independent imaging centers. Know the radiologists. Build relationships with them. If you own imaging, get a radiologist on site where practical. Where lawful, consider structures that genuinely align the radiologist with the imaging service rather than treating interpretation as a lowest-bid commodity. If your radiology must be remote, don’t shop on price alone. Demand availability, continuity, consultation, and quality. Then be willing to pay for them. And if you run a hospital: for God’s sake, keep radiologists on site. Make yours a place they want to work, and staff beyond the bare minimum when you can. A little extra capacity buys far more than extra reports. It buys attention, availability, and the margin to catch problems before they become bigger ones. You aren’t just buying a report. You’re choosing what kind of radiologist you want involved in your patients’ care.