By attempting to shatter the status quo and shift toward value-based care, the radiology industry is, in a way, sacrificing today’s monetary gains for a better tomorrow. It’s a smart, impressively noble move, but one that hasn’t been easy—and likely won’t get much easier in the immediate future.

Marco D. Huesch, MBBS, PhD, of the Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania, wrote about this topic recently in the Journal of the American College of Radiology, and it’s a captivating read. What I loved about Huesch’s editorial—besides the wonderful Game of Thrones reference he used as a headline, of course—is that he speaks very matter-of-factly about radiology’s current situation: the industry is at a significant turning point right now, and it’s going to take a lot of hard work to properly fix things.

Huesch wrote that high healthcare spending in the United States is “unsustainable,” especially since it “is not reflected in better population outcomes, quality, safety, service, and patient experience compared with other advanced countries.” Emphasizing value to lower wasteful spending is a wise way for radiology to address this, but numerous challenges exist. Radiologists could potentially experience lower compensation in the immediate future, for instance, and the same is true for the many providers who partner with those radiologists.

Perhaps the biggest challenge radiologists face is that large changes take a lot of time and effort, and providers across the board already have their hands full. Patients that need care now can’t wait until tomorrow—so when, exactly, are facility-wide or system-wide changes going to be implemented? Did we gain an extra few hours in the day while nobody was looking?   

In his editorial, Huesch pointed to various initiatives developed by the American College of Radiology and said they must be “reiterated and reinforced.” He also painted a picture of what the future could look like if radiology fails to adapt during these hard times: “Without serious efforts and innovation in what we do, imaging could well become a standardized, commoditized industry offered by salaried, in-house specialists or national-scale teleradiology groups. Digitization and modern telecommunication facilitate, and the compelling logic of economies of scale and scope could dictate, a potential race to the bottom of an average industry cost curve.”

Yikes! Huesch may not necessarily paint the rosiest picture, but his message is clear. Battle on, radiology. Battle on and do not give up.

For the sake of patients throughout this country, I hope the industry takes his words seriously.