We are practicing medicine in an era of economic revolution and find ourselves re-examining virtually all of our beliefs, practices, rituals, habits, and ethics. This revolution is not driven by the government but--in large part--by economic factors that work to lower costs by restricting access to the health care system. Re-thinking all that we do and formulating responses in this new era should be viewed in a positive light; opportunities abound for radiologists to revive enthusiasm, stimulate creativity, deepen their involvement, and intensify their commitment. Are we capable of identifying what is valuable in our specialty and of safeguarding its stature? Can we develop a vision of what our future should be? Can we convince the majority of radiologists that change is inevitable and that a reshaping of our profession is critical? Can we develop a consensus about what we value most? Can we continue to entice bright individuals into our field? Can we identify our sundry missions and use them as guideposts? Can we create effective strategies for dealing with discontinuous change? Our rich heritage of innovation and our skills as consummate managers of medical information suggest that we can. The challenges will be great but the rewards are worth our best efforts.