Farzaneh Rahmani, MD
On Saturday, Nov. 1, 2025, Americans watched the Los Angeles Dodgers clinch the 2025 World Series, pulling off their first back-to-back championship since 2000 through a seven-game series. Who was the 2025 World Series MVP? Not the player who hit the most home runs. Rather, it was their star pitcher, Yoshinobu Yamamoto.
In radiology, we often default to thinking in terms of volume and revenue — much like baseball teams that focus only on developing and paying for the players who hit the most home runs. In baseball, this is tracked with the runs batted in (RBI), which may as well be the relative value unit (RVU) that is tracked so closely in radiology.
But just as the Dodgers won the World Series by relying heavily on their pitcher, who quite literally changed the trajectory of the series, academic radiology cannot thrive on clinical throughput alone. What made the difference for the Dodgers this year was their pitching. In academic radiology departments, clinician-scientists are our baseball pitchers.
Like a baseball team that does not have many pitchers, a typical academic radiology department does not have many clinician-scientists — less than 2% of the field. But for those who’ve spent years developing their skills and their passion — they’re the ones who need the most support.
What can a pitcher do that a home-run hitter cannot? They can shut out the other team and limit the runs from opposing hitters at bat. They can win the game using a completely different but incredibly important set of skills that aren’t easy to find but are vital for the win. The same is true for clinician-scientists in radiology. There aren’t many of them, but the few who exist carry enormous strategic value for departments that want to innovate the advances tomorrow.
The ACR Center for Research and Innovation™ connects radiologists, academic partners and industry leaders to accelerate scientific progress and transform patient care through advancements in clinical trial design and management, precision diagnostics, imaging-based therapy, AI validation and real-world evidence.
Academic radiology risks losing sight of this important priority. Years of anxiety about NIH cuts — real or perceived — and the relentless pressure to prioritize clinical revenue have made it harder to defend and invest in clinician-scientist roles. Departments have come to see themselves as single-skill enterprises when, in reality, they should operate like full, balanced teams. A baseball team with only home run hitters cannot win. A radiology department with only work RVUs cannot lead innovation and advancements.
Academic radiology departments are at risk today due to the seemingly unending clinical expansions to increase revenue and complete declining reimbursements as well as private equity competition. This is an example of how the larger healthcare landscape bleeds into our field.
A recent Lancet review put it plainly: “Money has become the mission …” in American healthcare, where insurance companies are positioned as the profit centers. It is no surprise that in such a culture, clinicians are increasingly seen as cost centers — units to be trimmed, not talents to be nurtured. The data speak for themselves: Between 2019 and 2023, 127,700 physicians — about 15% of all patient-care doctors — abandoned private practice to become corporate employees.
Nearly four out of 10 physicians now work side gigs just to sustain the lives they want. As you can imagine, this system is not only problematic for patients and doesn’t support the well-being of physicians, but it also completely overlooks the aspirations of academic physicians whose goals exceed what the current structure is built to serve.
In a home–run-obsessed environment, clinician-scientists are the pitchers. The mantra that “research doesn’t make money” is no more valid for leading-edge academic radiology departments than for the LA Dodgers to say that “pitchers don’t hit home runs” while trying to win the World Series.
Clinician-scientists develop the tools, techniques and science that can cure diseases, transform practices, spin off successful companies and win entirely new kinds of victories. Yet, great pitchers aren’t encountered by accident. We need early investment, protected time and sufficient resources. Radiology chairs in conjunction with institutional deans and leaders need to invest in clinician-scientists, the same way baseball general managers invest in great pitchers and not just home-run hitters.
Real success comes from balancing different skill sets, not relying on only one. Without that balance, we’re just swinging for home runs — and hoping that will be enough while we risk taking a swing and a miss.
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