ACR Bulletin

Covering topics relevant to the practice of radiology

The Exceptionalism of Radiology

As the ACR develops its new strategic plan, it is guiding the specialty and the broader community to work together to realize radiology’s potential.
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Consistently and overwhelmingly, the evidence showed that experts are made, not born.

August 31, 2021

Benjamin S. Bloom, a professor of educational psychology at the University of Chicago, published a landmark book in 1985, Developing Talent in Young People.1 According to Bloom, all the superb performers he investigated practiced intensively, studied with devoted teachers, and were supported enthusiastically by their families throughout their developing years. Later research building on Bloom’s pioneering study revealed that the amount and quality of practice were key factors in the level of expertise people achieved. Consistently and overwhelmingly, the evidence showed that experts are made, not born.

Many others claim to be experts in the skills that radiologists provide. There have been continuous attempts to commoditize medical imaging and discount the value of radiologists. Yet it is radiology and radiologists that remain exceptional in our commitment and devotion not only to the realized benefits of medical imaging today but to innovation and the promise of its impact on patients and future population medical management.

At times, we may be myopic in realizing the exceptionalism of our chosen profession. We focus on potential threats and commoditization of what we deliver to our patients and referring physicians. No doubt these are important concerns for us to identify and address, especially during our strategic plan development process. Yet, if we step back and look at the macro-environment, it is undeniable that radiology is in an incredible position. Imaging-based care is at the forefront of modern medicine. We are just at the infancy of detecting the information hidden in our digital data. Metabolic and functional imaging techniques are emerging and will be fundamental to how we consider diagnosis and therapeutic options. With emerging modern techniques such as AI, the integration with pathology, and population and personalized health management, the potential is limitless.

So many entities, including big tech, are looking at medical imaging and what we do — for very good reason. Healthcare has always been an attractive industry. Radiology is in an advantageous position to deliver essential data and micro-interventions for future healthcare paradigms. Embedded in our training and orientation are both short-term and longer-trajectory opportunities to utilize medical data and informatics. Imaging and data are going to be key for the objective assessment and planning of medical care, in whatever future payment systems develop.

As a science, the future is ours to realize. Radiologists are advancing the applications, science, and innovations of imaging, therapy, and interventions. We can reduce costs. We can take a leading role in population health management. As our predictive modeling evolves and matures, we can tell an individual what their risk factors are and guide them through a personalized medical care plan.

Radiology is in an advantageous position to deliver essential data and micro-interventions for future healthcare paradigms.

As a profession, we continue to attract the best and brightest. A brief glimpse at our literature will uncover the innovations that continue to evolve in our space. While some pundits had transiently focused on the potential negative impact of AI on our specialty, most population health management experts understand that imaging and informatics can shift healthcare paradigms to deliver better evidence-based care with greater efficiency and more value.

Exceptionalism does not end at our shores. The international interest and excitement in our specialty is inspiring. Working with international partners, radiologists are raising the profile and awareness of medical imaging — especially in countries where resources are scarce. We are learning best practices as medical imaging is being applied in multiple national delivery systems with various populations and demographics. As medical imaging is being primarily recognized in delivering even basic healthcare needs, we have the opportunity — if not the obligation — to impact global health. This is truly an exceptional time to be a radiologist.

Radiology continues to be an incredible profession — providing societal value, professional satisfaction, and intellectual curiosity. Our specialty is witnessing the explosion of technology and science amidst the promise of our future.

As I speak with residents and fellows across the country, I congratulate them for choosing radiology as a specialty. Despite all the distractions, they are entering the specialty at an exciting time. Yes, there will continue to be challenges. In an earlier era, the introduction of Medicare was thought to be the end of radiology. But radiology survived — and even thrived. The specialty looks very different from the time when we had rolloscopes. The promise is that radiology will look very different even ten years from now. We will continue to innovate, adapt, and serve our patients.

Radiology is indeed exceptional. We are well-positioned for continued success. The ACR is a crucial organization in guiding the specialty. As we develop our new strategic plan, we will focus on maximizing our collective potential. I encourage all of our members and the broader radiology community to work together to realize our future — for our specialty and our patients.


1. Bloom B. Developing talent in young people. Ballantine Books, 1985.

Author BOC Chair Howard B. Fleishon, MD, MMM, FACR