I sincerely thank the Radiological Society of North America (RSNA) for extending me the privilege and honor of delivering this Annual Oration on such an auspicious occasion—the centennial of this great meeting. One hundred years ago, radiology was in its infancy, and the technologic changes that have occurred since then are truly breathtaking. However, many challenges face our specialty, and one of them is to transition from volume-based practice to value-based practice. All branches of medicine are being admonished to do this, but I believe the challenge to us in radiology is especially urgent. One reason for this is that we are often not viewed favorably by others in the health care industry. They feel radiologists are overpaid, overly interested in their lifestyle, not “real doctors,” and unnecessary middlemen. They feel we do not care much about our patients and that we do not provide much value to the patient care continuum, other than churning out our reports. Many of them feel imaging is easy and that they themselves can go ahead and do it without benefit of rigorous training.