The new health care reform law brings three challenges--more patients, new care guidelines and low payments--to all providers, says Christopher Buckle, M.D., a radiology resident at the University of Chicago.

A prime goal of reform is to provide health insurance to 30 million individuals currently not covered. But that will create pressure on accessibility of care because of the clinician shortage in radiology and many other specialties. And because many of the newly ensured will be covered under low-paying Medicaid, that will create pressure on payment for services. Consequently, practices have to become more efficient, while also adopting evidence-based care which insurers of all types will increasingly demand as a condition of payment.

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