Advocacy efforts in radiology succeeded on both federal and state levels, reinforcing the importance of radiologists getting involved early in their careers.
YPS: EARLY TO RISE
Advocacy is often something we intend to “get to later” after boards, fellowship and when our first job feels stable. But the reality is politics shape our daily work, how we are reimbursed, our patients’ access to care and the future of radiology. If we want informed lawmakers to vote on the policy issues driving the future of our profession, it is critical that we make our voices heard. As Amy K. Patel, MD, chair of ACR Radiology Advocacy Network (RAN) and RADPAC®, said in the most recent Radvocacy newsletter, “Responding to Calls-to-Action and contributing to RADPAC are two of the most powerful ways you can show your support to our patients and profession.”
Thanks to sustained efforts by the ACR, RAN and RADPAC, 2025 was a remarkably active year on federal and state advocacy fronts. These efforts happened because radiologists showed up by maintaining ACR membership, responding to Calls to Action, supporting RADPAC, and lending their voices to policy conversations that directly affect patient care.
At the federal level, advocacy by ACR and others has helped avert meaningful harm. After the longest government shutdown in U.S. history, legislation restored critical policies that impact radiology practice, including telehealth flexibilities, the Medicare Geographic Price Cost Index (GPCI) floor and funding for implementation of the No Surprises Act. In addition, advocacy was critically important in stopping automatic PAYGO cuts that would have triggered a 2% across-the-board reduction in Medicare reimbursement. These wins resulted in tangible protections for both patients and physicians.
ACR continues to urge Congress to pass the Radiology Outpatient Ordering Transmission (ROOT) Act, which would decrease unnecessary imaging, lower patient radiation exposure save the Medicare program an estimated $700 million annually and decreasing out of pocket expenses for patients. To ensure the timely and efficient implementation of the Appropriate Use Criteria (AUC) program, which stalled under the Protecting Access to Medicare Act (PAMA) of 2014, ROOT aims to ease AUC implementation requirements. These changes include replacing the “real-time” claims processing requirement with a provider attestation of AUC consultation, providing exclusions for providers participating in clinical trials and for small or rural practices, and establishing a review study of collected data to inform future improvements.
For early-career radiologists and trainees, it is easy to assume advocacy is reserved for or the responsibility of senior leaders. That assumption is wrong, as advocacy relies on broad participation at all career levels.
Workforce issues have taken center stage as well. The ACR’s advocacy portfolio includes support for increasing Medicare-funded residency positions, improving visa pathways for international medical graduates and incentivizing specialty physicians to practice in underserved and rural areas. These efforts recognize that access to imaging depends on maintaining a robust, well-supported radiology workforce — and that policy decisions made today will determine who is available to provide imaging services tomorrow.
At the state level, ACR chapters across the country fought — and often successfully stopped — harmful scope of practice expansion bills that could compromise patient safety. Strategic use of advocacy grants, grassroots mobilization and digital outreach helped prevent dangerous legislation in states like Texas, Michigan, Mississippi, New York and Iowa. The outcomes in states where these unfavorable laws passed further underscore why sustained engagement is essential.
State advocacy also delivered meaningful patient-centered victories, particularly in breast health and AI oversight. Multiple states enacted laws eliminating cost-sharing (the portion the patient pays for medical bills) for diagnostic and supplemental breast imaging, directly improving access to life-saving care. Others passed legislation ensuring that AI cannot independently deny medical care — requiring physician oversight and transparency in utilization review. These laws reflect something powerful: when radiologists help shape policy, our patient’s health and safety are greatly improved.
For early-career radiologists and trainees, it is easy to assume advocacy is reserved for or the responsibility of senior leaders. That assumption is wrong, as advocacy relies on broad participation at all career levels. We need to respond to calls to action and support RADPAC to amplify our collective influence.
Participation in advocacy is how we protect our patients, our profession and the future of radiology. Advocacy is a team effort. It requires persistence, especially in moments when progress feels slow or political climates feel discouraging. The successes of 2025 show that advocacy works when we stay engaged. Now is not the time to step back, it is time to lean in.
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