In this 2012 ISMRM Lauterbur Lecture, my goal is to challenge the members of the ISMRM to think critically about how we approach our research. From the perspective of a leader of an academic health sciences center, which is also a health care delivery system, I address three specific questions: Are we developing great technologies? Are we advancing scientific knowledge? Are we advancing human health? Specifically, with respect to increasing pressure in health care to improve patient outcomes and lower costs, I ask members to consider how we select the areas of research we focus on and whether we have sufficiently prioritized research that assesses the impact of our MR methods on patient outcomes. For imaging research to meet higher standards of evidence-based medicine, multicenter consortia should be developed, potentially under the auspices of the ISMRM, and priority should be given to developing investigators with expertise in health services research.