Speakers also discussed the shift under health care reform toward primary care. "They will be the gatekeepers for any kind of imaging. Working with them is going to be important," said Sweeney.

At the same time, Muroff said hospital administrators are beginning to place less value on radiologists. "It's difficult to get them to consult with referring physicians, hospitals become less attached to them and turnover is common -- something unheard of 10 years ago."

While some may disagree that radiologists can be easily replaced, Muroff cautions that a dramatic workforce shift will occur. He said it's happening as hospitals become more comfortable outsourcing and advanced professionals like radiology assistants and radiology practitioner assistants play a greater role -- in part, to help facilities save money.

"Any study can be read by anyone at anytime in any place," he added, referring to inroads made by teleradiology.

National radiology entrepreneurial companies are also a reality. In Australia, for example, three to four companies already control the majority of radiology practices. And they are appealing to hospitals for many reasons, quality metrics foremost among them.

Who's going to lead the change?

Klepper said radiology staff members need to be fluent in data tools, which can help them prove the value of imaging and build a more competitive practice.

McKenzie said radiology administrators have the chance to step up to the plate.

"This is an opportunity to lead the change in the new paradigm," said McKenzie. "You're the leaders and the time is now."

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