Over the past115 years,radiologistshavebeen blessed by thetechnological advancesof our specialty. In eachnew era of health-care delivery, some newtechnology has captured the hearts andminds of physicians and patients. Ourreliance on that technical propagation has,in part, contributed to a sense that radiologyand radiologists are in such a centralposition because that is the natural order ofhealth-care evolution. In today’s world, noone would argue that excellent health carecould be delivered without imaging.However, storm clouds that were onthe horizon are now directly overhead.Health-care expenditures have reached anunsustainable percentage of the nationalgross domestic product; new paymentsystems are being implemented; theNational Cancer Institute is proposing aconsolidation of collaborative researchprograms; and proof of competence,proof of outcomes, and value-orientedmedicine are being demanded across theboard by society.Despite this seemingly unfavorableclimate, there is little debate that imagingwill maintain a central and indispensablerole in future health-care delivery. Scientificprogress will not abate, and futuregenerations will experience personalizedmedicine, genomic molecular imaging,and personal biomarkers to predict riskof disease and response to treatment. Thefuture of radiology will be secured byscientific and technological progress. Thefuture of radiologists, however, will not besecure unless true added value is generatedand proven.Lest radiologists become marginalized,we must think in new terms about ourplace in health-care delivery systems. Iwould advocate we create the concept of“radiology-centric medicine” as a meansof recapturing and securing the center ofthe enterprise. A necessary component ofradiology-centric medicine is “radiologistcentricmedicine.”If we continue to perpetuate behaviorand practice patterns through which weare perceived as ancillary, we will neverachieve our goal. Leaders in radiologyhave told us for decades that we need toemerge from our darkened reading rooms.That advice has never been more importantthan it is now.With a grass-roots commitment to recapturethe center, our collective, creativestorehouse will be able to produce a broadarray of concepts that can be applied tothe development of radiologist-centricmedicine. The spectrum of these conceptsshould include practical applications ofa renewed commitment to service, goodcitizenship, professionalism, introspection,and innovation. Longstanding models ofpractice business and staffing will need tobe re-evaluated and revised to accommodatethe process of recapturing the center.In this issue of the ACR Bulletin, threesuch concepts are described. For decades,the traditional radiology reportingsystem involved a radiologist dictatinga report, a report being transcribed,the radiologist checking the report forerrors, and finally, a printed copy of thereport being sent to the medical recordand the referring physician. This processwas progressively streamlined to thepoint where it became an extremelyefficient component of the radiologist’sworkflow. However, depending onclerical resources, report distributioncould be unduly delayed. The article onpage 17, “Loud and Clear,” discusses theadvantages and challenges of voicerecognitionreporting systems — a toolthat clearly can facilitate the enhancementof radiologist-centric medicineby proclaiming that the interests ofthe patient, through immediate reportavailability, are of primary concern to theradiologists central to their care.The article on page 11, “Right toSpeak?” reinforces the radiologist-centricconcept by exploring the process ofradiologists delivering imaging resultsdirectly to patients. This would have beenunacceptable to referring physicians40 years ago, but their appreciation ofradiologists’ ability to interact directlywith patients has evolved through theefforts of mammographers and interventionalradiologists. Direct reporting topatients is another opportunity to createradiologist-centric medicine.Imaging is also central and criticalto the diagnosis and management oftrauma. The article on page 14, “TacklingTrauma,” discusses the need to effectivelymanage trauma through streamlinedcare. Here is another area in which thepersonal involvement of radiologists cansolidify our role in radiologist-centricmedicine. Stepping up in our role as trueconsultants and not mere followers oforders will enhance our stature in theminds of our medical colleagues andour patients.The opportunities to create a brighterfuture for radiologists are there. It’s up toeach of us to use them.