This session will cover the range of affiliations that radiology practices might pursue. The benefits and issues related to 'growing larger' will be covered, and strategies to protect one's practice and improve patient care will be discussed. Hospital administrators and referring physicians are demanding longer hours of onsite coverage, greater availability of radiologists, and more subspecialty expertise. Newer payment models will require greater geographic access. Entrepreneurial radiology companies are becoming more aggressive in their competitive initiatives. To respond to these pressures, radiology groups will need to develop innovative strategies, including a variety of affiliations such as mergers and alliances.