Humans resist change: This is the bane of leaders, both seasoned and new to the game—particularly, at the moment, in health care. N. Reed Dunnick, MD, says, “We have many things going on, in our field, that require us to change.”

It’s the assumption at the core of GE, IKEA, and Unilever’s strategies; its presence, or lack thereof, guides the investments of billionaire Warren Buffett, among others. Sustainable competitive advantage sounds like something that every business, in every industry, would want to secure. With the advent of digitization and globalization, however, along with continual emergence of disruptors from every corner, is focusing on sustainable advantage still the best way to achieve success?

Welcome to the results of the sixth annual radiology-group survey. Recently, I had lunch (at a conference on health care’s future) with the former CEO of a large teleradiology company, and he asked how radiology groups were responding to changes in the marketplace. Over the years, we had discussed that we both felt that radiology groups would get larger and that we would see national radiology groups, in the future. The question was never whether this would happen—but rather, when. I think that the answer is either soon or now.

Alignment increasingly occupies the thoughts of health-care stakeholders—insurers, legislators, and regulators, but especially hospitals and physician groups. Because alignment sets the stage for service and quality improvements, as well as for the implementation of cost-control mechanisms, the interest is warranted. Hospitals have sought to employ both primary-care and specialty physician practices for the ability to impose quality and cost uniformity through top-down policies, procedures, and cultural mandates.

When hospital executives express dissatisfaction with professional radiology services, local radiology practices should put on their nimble-response shoes and communicate. If they don’t, national teleradiology companies will, and the experience at Stamford Hospital in Connecticut is a case in point.

With the rapid changes in health care, radiology (like other specialties) has had to adapt to survive. Smaller practices have been acquired or consolidated with larger practices. This allows greater emphasis on efficiency, shared risk, and economies of scale. There is also a perceived sense of security that comes with the size of the organization. Larger organizations, in addition, have greater negotiating power with both providers and insurers. These practices have the ability to attract top-level management and administrative talent as well.

In a fast-paced market, the ability to defend a business against (and to take advantage of) disruption is crucial for staying ahead of the competition. Disruptions have traditionally altered the trajectory of many industries: Digital photography has rendered film obsolete, music downloads have diminished CD sales, and tablets have largely replaced netbooks

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.