Consolidation in Radiology: Perspectives and Insights

Jared Christensen, MD, MBA, Professor and Vice Chair, Radiology at Duke University Medical Center; Andrew Moriarity, MD, MBA, Executive Vice President of Advanced Radiology Services, PC, and Associate Professor at the Michigan State University College of Human Medicine; and Richard Duszak Jr., MD, FACR, Chair and Professor of Radiology at the University of Mississippi Medical Center, contributed this piece.

Consolidation is rapidly reshaping the radiology landscape, bringing new partnerships, larger practice structures and shifting definitions of autonomy and leadership. For some, it’s a path toward greater stability and shared resources; for others, it raises concerns about independence and identity within an evolving health care system.

To capture a range of perspectives, we invited three radiologists from different practice settings to share how consolidation impacts their work and the profession as a whole. Here’s what they said

From your perspective, what are the most significant drivers behind the current wave of consolidation in radiology?

Dr. Moriarity: Consolidation in radiology reflects broader forces across healthcare — declining reimbursement, workforce shortages, and the escalating costs of technology, compliance, and capital investment. Hospitals and private groups alike are seeking stability and leverage to navigate these pressures while maintaining quality and access.

Consolidation can be a double-edged sword. What are some of the most promising benefits and the most concerning drawbacks you’ve observed?

Dr. Moriarity: When done well, consolidation can enable subspecialized coverage, shared quality infrastructure, and the ability to invest in technology that smaller groups could not accomplish alone. It can enhance reliability, resilience, and patient access across large networks. But consolidation done poorly erodes culture—creating distance between physicians and patients, reducing autonomy, and undermining the sense of shared ownership that sustains excellence in radiology.

What do you think is the most misunderstood aspect of consolidation in radiology today?

Dr. Duszak: The term “consolidation” is often used interchangeably with private-equity driven corporatization but that isn’t always the case. Many independent practices, not-for-profit health systems, and academic health systems are increasingly merging and acquiring so it’s a trend all across healthcare. 

Can you share a brief story or example from your own experience that illustrates how consolidation has impacted your practice?

Dr. Christensen: I have experienced consolidation in a way that few anticipated would reach academic medicine. Until 2022, Duke radiologists belonged to a large independent physician group contracting with the university health system. We are now health system employees. Through the transition, several benefits of integration have materialized, but some have not yet been realized, and we have lost a degree of autonomy under a centralized administrative structure. It remains a work in progress that requires consistent physician engagement to strengthen our ties to the broader health system and to define our evolving role within it.

One key lesson from my experience is that consolidation is everyone’s concern, affecting private and academic practices alike. This underscores why conversations about consolidation and other practice trends, such as those at the ACR-RBMA Practice Leadership Forum, are so critical for our specialty.

How is the ACR supporting radiologists who feel they are losing autonomy or influence in consolidated environments?

Dr. Duszak: Over my career, I’ve seen radiology groups get bigger and bigger, making it harder for radiologists to feel personally engaged in their practices. Many of our old work families have morphed into impersonal corporate entities and have left many feeling like they have no autonomy and agency. The American College of Radiology® (ACR®) recently launched a task force, co-led by me and Dr. Eric Rubin, on how we can best support radiologists in the increasingly consolidated environments in which we practice. The ACR Radiology Leadership Institute® (RLI) will be a big part of that, offering leadership training and networking to help radiologists navigate bigger systems and maintain influence.  It will be a focus of a number of upcoming meetings and sessions. We will be highlighting different practice models, stories of what works (and likely what doesn’t work), and challenge both staff and volunteer leaders at the ACR to think about our consolidating marketplace in all the ACR does and offers.

What is one piece of advice you would give to someone who is actively or recently affected by consolidation?

Dr. Christensen: Be an active participant in defining your future, not a passive recipient of change.

Approach consolidation as a negotiation about values, not just compensation. Before signing anything, ask yourself and your potential partners critical questions: What happens to clinical autonomy? How are quality standards maintained? What voice do physicians have in operational decisions? What is the plan for preserving culture and mission?

It is important to remember that concerns arise from consolidation gone wrong, not consolidation itself. The difference lies in whether radiologists maintain meaningful influence.

As consolidation continues to evolve, radiology leaders are finding new ways to adapt, advocate and strengthen their practices. The conversation is far from over, and it’s one that will be explored in greater depth at the 2026 ACR–RBMA Practice Leadership Forum, where experts will dive deeper into the challenges, opportunities and real-world strategies for navigating radiology’s changing practice environment. Join us Jan. 30 to Feb. 1 to learn practical insights and strategies for leading through change.