Want to see consolidation in action? Look anywhere. Across the globe, mergers and acquisitions are upending the established order at a pace not seen since just before the entire U.S. economy went over the falls in 2008. One hopes the same doesn’t happen on the back end of the present M&A frenzy. 

Either way, now as then, business leaders who proactively take charge of change will be better positioned than their passive wait-and-see peers to ride out the rapids till the water calms again. That’s assuming it ever does. 

How intense is the activity? The Financial Times reports that deals worth almost $3.3 trillion were in the works as of late September. This eye-popping figure represents a spike of very close to 40 percent over the same period last year. 

FT singles out as a primary cause “sweeping technological change,” which has companies “racing to remake themselves.” And the influential outlet names healthcare among the three economic sectors consolidating the fastest. (The others are energy and technology.)

Here’s where else to look for consolidation’s creative disruption at work: on many pages, in black & white or between the lines, inside this issue of RBJ. 

For starters, the results of the 2018 Radiology 100—not only the list but also its associated survey responses—deliver a fresh testament to the constancy of change wrought by consolidation across the private-practice landscape. 

Further inside, Randy Young’s excellent reporting on survival strategies for small practices builds on the theme. Here’s a taste: “If more and more independent radiologists find themselves at a disruptive crossroads, the choice does not always boil down to ‘sell’ or ‘don’t sell.’” 

And guest columnist Barbara Perez Deppman draws from firsthand experience to offer tips on due diligence, with an emphasis on communications, for practices that are either facing consolidation now or may find themselves in that spot sooner rather than later. 

Of course, all of this comes on the eve of RSNA 2018. We’ve got a what-to-look-for interview with 2018 RSNA president Vijay Rao, MD. And Dr. Rao graciously took our questions on not just the conference but also what’s on radiology’s collective mind heading into one of the largest annual powwows convened by any industry in the U.S. (Yes, AI comes up early and often in the conversation.) 

Meanwhile, Washington is right now debating the effects of hospital mergers and acquisitions on the price patients pay for consolidated care. The second week of September, three members of the House’s Energy and Commerce Committee sent a letter to MedPAC, the Medicare Payment Advisory Commission, asking for a study to “help improve our understanding of the impact of consolidation in the hospital industry.” 

As of presstime, MedPAC hadn’t yet responded to the request. Sigh. Consolidation’s creative disruption of radiology may be just getting warmed up. 

Dave Pearson, Editor

dpearson@trimedmedia.com