Data shows that supply-demand imbalance is driving changes in practice type, ownership models, compensation, technology and remote work.
Finding reliable data to accurately track trends in the radiology workforce is no easy lift. Since 2012, the ACR has conducted the ACR/RBMA Workforce Survey, a specialized annual survey to better understand the professional workforce in radiology — and where the specialty may be headed.
Until recently, only practice leaders were surveyed, with the focus being on quantifying the current number of radiologists and both recent and anticipated near-term hiring plans. After a successful first decade, the College’s survey was redesigned and broadened beyond practice leaders with the goal of being more representative of individual radiologists’ opinions. The intent in modifying the survey process was to identify factors underlying changes in the workforce and what they may mean to ACR members and the radiology community.
The 2026 ACR/RBMA Workforce Survey results are now available. The responses support and quantify what many radiologists report anecdotally — the workforce is under pressure and evolving in response to the strain. The data show rapid change in practice type, ownership models, technology adoption and remote work.
A deeper look suggests that these changes are not occurring in isolation. They are unfolding against the same backdrop: an imbalance between demand for radiology services and the supply of radiology professionals that is shaping radiologists’ current environment and our specialty’s future.
Radiology demand comes from many areas, all of which are increasing. The overall population in the United States has grown from 282 million to 343 million between 2000 and 2025. Compounding this, the oldest members of our population are the biggest users of healthcare services — and it is projected that those users will grow significantly in number over the coming decades. An ACR study shows that population segments ages 75–84, 85–94 and 95+ are estimated to grow by 52%, 150% and 282% between 2023 and 2055. Beyond population growth, demand is driven by physicians’ and non-physicians’ increasing reliance on imaging over physical examination for diagnosing patients. This trend has been observed over many years, likely affected by minimal time reserved for patient interactions and malpractice concerns — also exacerbated by a self-reinforcing erosion of physical exam skills because of ongoing reliance on imaging. Finally, ongoing technology advancements introducing new ways for medical imaging to diagnose and treat patients adds further imaging demand. All indications suggest that radiology’s ongoing, unrelenting demand will continue an upward trajectory.
Radiologist supply is not keeping pace with demand drivers, resulting in the imbalance we are seeing today. The Balanced Budget Act of 1997 has constrained the growth of federally supported physician training over the last three decades. Reacting to a projection of having trained too many physicians in the 1980s and 1990s, Congress capped the number of residency training slots the federal government would fund at 1996 levels. As CMS is by far the largest funding source for physician training, this law significantly affected the number of physicians and radiologists entering the training pipeline annually. Over three decades, this has severely constrained the single most important pathway for expanding the supply of practicing radiologists.
Radiologist supply is not keeping pace with demand drivers, resulting in the imbalance we are seeing today.
The 2026 ACR/RBMA Workforce Survey identifies and quantifies several ways the profession is adapting amid the supply-demand imbalance radiologists currently face. The market is responding in many ways, including changes in practice consolidation and ownership, technology adoption and remote work. While this is occurring across the profession, specific segments such as academic practices and early-career radiologists are experiencing slightly different challenges or outcomes [Future articles on Academics and YPS to follow].
Private practice remains the most commonly reported practice type, but its share of respondents fell significantly from 47% in 2024 to 35% in 2026. At the ownership level, hospital or health-system ownership is now the most commonly reported arrangement, accounting for 42% of respondents’ primary organizations in 2026, up from 33% in 2024. Physician-owned organizations were statistically flat over the same period, suggesting a changing mix rather than a simple transfer from one model to another.
Ownership and employment structure matter because they are tied to access to capital, operations and decision-making — including if and how radiologists participate in decisions about schedules, technology purchases and delivering clinical work. No model is necessarily inherently more or less capable of supporting radiologists. The consequential question is how physician influence is maintained as organizations grow larger, and decision-making increasingly includes non-physician administrators.
When radiologists were asked whether they have an ownership stake in their practice as a partner, shareholder or equity owner, only 25% responded “yes.” Three out of four respondents said they have no ownership stake. This is not telling us that only 25% of radiology practices are physician-owned — it tells us that only one in four individual radiologists reports personally holding equity.
That is a notable change from the traditional structure of radiology. Historically, the specialty developed around relatively small, physician-controlled groups. Around the turn of the century, when many of today’s senior radiologists were beginning their careers, many practices were small, independent organizations. Similar to many segments of our overall economy, the healthcare system has undergone a steady movement toward fewer, larger, more consolidated entities. Although it is slower to participate in consolidation than many other physician specialties (e.g., cardiology, orthopedics), radiology has more recently experienced this phenomenon too.
Radiologist ownership is closely tied to practice size. In practices with fewer than 50 employees, 61% of radiologists report having an ownership stake. That falls to 33% in practices with 50 to 99 employees, 42% in practices with 100 to 499 employees and 9% in organizations with 500 or more employees. The clearest contrast is between the smallest and largest organizations: ownership remains common in practices with fewer than 50 employees and is uncommon in organizations with 500 or more.
There is a myriad of reasons practices grow or consolidate. One school of thought is that the increasing regulatory, reimbursement and administrative complexities of running a practice often interfere with radiologists participating in the clinical work they trained for many years to do. Handing off time-consuming administrative tasks — even if it means no longer owning the practice — may free radiologists to spend more time on clinical work they enjoy/prefer.
Where work happens has changed even faster than practice type. In 2026, 71% of radiologists worked remotely at least some of the time, up significantly from 55% just two years earlier. Remote work is no longer a niche arrangement or a category confined to remote-only radiology groups; it has evolved to being standard-operating procedure and critically important for most practices. It allows organizations to distribute work across locations, assemble coverage by matching available radiologists with uncovered hours, recruit beyond a local market and offer flexibility to current or prospective employees in today’s competitive workforce.
But remote radiology’s potential effects extend beyond the radiologists working remotely and the groups using remote technology. Fewer hours spent commuting may leave more time for clinical work. Remote options may also allow some snowbird radiologists to work part-time rather than fully retire or help cover busy periods without committing to a full shift. For radiologists who find working from home less stressful, remote work may also offer a more sustainable arrangement. Although remote work will not resolve today’s supply-demand imbalance, its rapid adoption — 71% of radiologists now work remotely at least some of the time — may help practices improve efficiency, thus adding overall radiologist capacity with the same number of radiologists.
Artificial Intelligence’s (AI’s) arrival and anticipated effects on radiology have been widely discussed and studied. More than 75% of all FDA AI device approvals through 2025 were related to radiology. What AI will ultimately mean for radiology and radiologists is unknown, but its use is growing at a breakneck pace.
Among respondents familiar with their organization’s AI use, 89% said their practices deployed AI in some capacity in 2026, up from 46% in 2023. This rapid, broad adoption strongly suggests that the question is no longer simply whether AI will be adopted. A more useful and informative question is “what work is AI being asked to do already?” Survey findings show that much of the recent increase comes from non-interpretive applications, although part of that increase reflects a broader definition of non-interpretive AI.
Among the most prevalent non-interpretive applications are automated impressions and worklist prioritization and assignment. Such applications may help radiologists work more efficiently. In the current supply-demand environment, even modest productivity gains could prove valuable.
AI adoption differs from AI participation. Among respondents whose organizations use AI, 80% described their current or expected role as that of a user rather than a purchaser, clinical collaborator or developer. That distinction does not mean radiologists are excluded from decision-making; AI purchasing and governance typically involve institutional, IT and operational stakeholders as well. This tells us that for radiologists, using an AI system is much more common than selecting, evaluating or building one.
Taken together, the Survey findings give us more than a snapshot of the radiology workforce — they give us a detailed look at how the specialty is adapting to evolving work environments, coping with supply and demand challenges, putting new technologies to use, and understanding practice structures. As demand for imaging grows, the College continues to support workforce strategies that will put radiologists’ expertise to best use while providing the highest standard of care for patients.
If you are interested in a deeper dive into these and other topics, there are more Bulletin articles planned in 2027. Six specific “stories” in the 2026 Workforce Survey were selected as particularly timely and of interest to a large swath of members. They are: Remote Reading, AI technologies, Ownership and Consolidation, YPS (early career radiologists), Academics, and Gender.
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