IT is often depicted as a force that will transform the production and delivery of healthcare services, promising lower costs and improvements in service quality. However, research on IT and organizational change emphasizes that the organizational consequences of new technology are not straightforward and easy to predict. In this paper we study why IT is framed as determining organizational consequences in the context of digital radiology implementation, showing that, contrary to the view of technological determinism as a case of repeated bad practice, the construction and enactment of technological determinism can be understood as an emergent strategy for coercive organizational change within a particular context of relationships between managers and professionals.