I believe in the future of our healthcare system and I believe that many changes are on the horizon. I think the system will strive to find new ways to save money while delivering the best possible care. This is by no means an easy feat. I do not know what the global answers will be but I plan to ride the wave. I do believe that part of it lies in medical imaging and truly believe we can do a better job for the patient while saving them, and the system as a whole, money. I believe in the AIUM's initiative to think "ultrasound first." Too many imaging needs are being sent directly to advanced imaging modalities. The first thought of any imaging need should not be MRI or CT. It should be X-ray or Ultrasound, in fact unless it is strictly a boney concern, then it should be ultrasound first. Remember ultrasound uses no harmful ionizing radiation, no nephrotoxic contrast agents, and no claustrophobia inducing apparatuses. It is quick, safe, effective, less costly and - in the right hands - more accurate than MRI and even MRA for MSK applications such as rotator cuff tears. Help AMUS and the AIUM to convince the healthcare world to think "Ultrasound First."