The Capacity Question Radiology Leaders Should Ask Before Hiring

October 26th, 2026

Radiology has a workforce problem.

Imaging demand continues to grow, recruiting remains difficult, and radiologists are leaving practice at higher rates than they did a decade ago. ACR’s Neiman Health Policy Institute reports that annual radiologist attrition more than doubled from 1.1% in 2014 to 2.5% in 2022. Its projections also show CT and MRI demand continuing to grow through 2055. (American College of Radiology)

The shortage is real.

But hiring cannot be the entire capacity strategy.

Before asking how many more radiologists your practice needs, ask another question:

How much of the radiologist capacity you already have is being spent on work that actually requires a radiologist?

 

Start with the work.

Look at what your radiologists actually do throughout the day and sort it into five categories:

• Must be done by a radiologist. Interpretation, clinical judgment and work requiring physician expertise.
• Should be done by a radiologist. Work where physician involvement adds meaningful value.
• Can be delegated. Protocoling, documentation, coordination, follow-up and administrative work may have opportunities for appropriate team support.
• Can be automated. Repetitive administrative work, information retrieval, follow-up tracking and portions of workflow management increasingly belong here.
• Shouldn’t be happening at all. Rework. Unnecessary handoffs. Duplicate processes. Manual steps that exist because they have always existed.

There is growing industry attention on redesigning the team around radiologists. RSNA recently highlighted the use of advanced practice providers for functions such as documentation, protocoling, patient follow-up and other support within radiologist-led teams. (RSNA)

The goal isn’t finding another way to ask physicians to do more.

It’s protecting an increasingly valuable resource: their time.

Then connect capacity to revenue.

Finding additional physician capacity sounds good.

But what is that capacity worth?

Could the practice absorb more volume? Support another hospital contract? Reduce outsourced reading expense? Improve turnaround times? Create a more sustainable physician schedule?

Then ask the other side of the equation:

What revenue does the practice need to support the capacity it already has and the capacity it plans to add?

That requires more than volume and RVUs.

Look at:

• Net revenue per study and modality
• Payer mix and reimbursement trends
• Revenue by site and contract
• Denials and reimbursement leakage
• Cost of incremental physician capacity
• Volume required to support that cost
• Economics of hospital coverage arrangements
• Revenue created by growth compared with the additional work growth creates

A practice can be busier every year without becoming financially stronger.

That’s why productivity, volume and revenue cannot be evaluated separately.

Your RCM partner should be looking beyond collections.

This is where revenue-cycle data should become business intelligence.

Your RCM partner sees what payers are actually paying. It sees shifts in reimbursement, modality and payer mix, denial patterns, volume, and where expected revenue isn’t becoming collected revenue.

That data should do more than explain last month’s collections.

It should help leadership answer:

• We’re reading more studies. Are we making more money?
• We need another radiologist. What revenue has to exist to support that position?
• A hospital wants expanded coverage. What does providing it actually require from the practice?
• Our payer mix changed. What did that do to the economics of our growth?
• Our physicians are producing more. Why isn’t margin following?

The data often already exists.

The value is having a partner who knows what to look at, connects the pieces, and helps leadership understand what the numbers mean for the business.

Start with the work before the headcount.

Practices still need to recruit. They need competitive compensation, strong retention strategies and sustainable expectations.

But hiring cannot be the only answer.

Look at the work.

Look at where physician time is going.

Understand the revenue required to support the organization you’re building.

Then make sure the partners looking at your data are helping you see the whole picture.

Every hour you give back to a radiologist is capacity you didn’t have to recruit.

Knowing what that hour is worth is where the business conversation begins.