You have to appreciate the irony: there are physician shortages in most specialties, department administrators have reached levels of unprecedented stress, technologists and nurses are so scarce they are earning signing bonuses, and yet the New York Times has pronounced that health care will be the engine to drive the $10 trillion US economy through its next expansion. 1

What are the reasons for the optimism among financial observers? Among the reasons cited in the article are: Congress has cut back on health care as much as the market and its practitioners will bear; HMOs have backed off from gatekeeping; the mapping of the humane genome has resulted in increased research budgets at pharmaceutical companies; and the aging Baby Boom generation is expected to inflate spending on health care in this country from its current 13% to in excess of 20% in 2040.

What a difference a few years make. Just 2 years ago, health care organizations were decidedly unwelcome on Wall Street, making it difficult to raise much-needed capital, but, last year, 20% of all initial public offerings happened on behalf of health care companies. 1 And witness the example of Radiologix, subject of our comeback cover story, a company that briefly tasted the tail end of the go-go days of physician practice management before those stocks collapsed. It was sound management practices, strategic growth, and the ability to reinvent itself, that enabled Radiologix (albeit few other PPMs) to climb back to a figure close to its precrash high this past year. Radiologix was one of the many public health care companies, including pharmaceutical companies, equipment manufacturers, hospitals, and insurers, that have provided a fiscal beacon in an otherwise dreary 2001.

With the volume of radiological procedures increasing and health care spending on the rise, it stands to reason that radiology and its practitioners could be in a position to benefit. However, the challenges that loom appear just as large: the man and womanpower shortage in medicine; limited capital budgets in health care organizations for the informatics solutions that could help improve efficiency; and, alas, the lack of radiologists willing to serve in leadership positions. How big a problem is the leadership vacuum? It is big. According to Richard Miller, PhD, director of education, Radiological Society of North America, Oak Brook, Ill, the American College of Radiology has identified nearly 600 vacant radiology department chairmanships, directorships, and section leadership positions nationwide. The society has organized a conference on “Radiology Business and Management Issues,” Feb. 8-10, Phoenix, AZ, to address strategic planning, contracting, marketing, compliance, cost-effectiveness analysis, and technology acquisition, among other management topics. The course is designed for radiologist leaders and would-be leaders, and administrators.

What Wall Street sees in health care is a glass half full. Health care professionals and executives are more likely to see a glass half empty. Clearly, there are many challenges and opportunities ahead. But we need the leaders to ensure that, for radiology and its practitioners, the challenges are met and the opportunities do not go undiscovered.

Cheryl Proval

[email protected]


  1. Leonhardt D. Health care as main engine: is that so bad? New York Times. November 11, 2001.