Fast 5 Speakers Touch on Some of Radiology’s Most Pressing Challenges

Owning the Business Side of Radiology 

From declining Medicare payments to emerging technologies, and through increasing hospital consolidation, and private equity involvement, radiology is evolving rapidly.

To navigate this shifting landscape, radiologists must engage with administrators, understand business drivers and take part in strategic decision-making. 

“Business fluency is no longer optional—it is critical to safeguarding patient care, professional autonomy, and the value of our specialty,” said physician-executive Mariam Moshiri, MD, MBA.

In her presentation, Dr. Moshiri emphasized that mastering finance, operations, and strategy empowers radiologists to move from passive observers to active leaders. “We must own the business side of radiology if we want to own the future of radiology,” she said.

Building Culture at Scale

From RVUs to staffing shortages, for many radiologists the pressure keeps mounting. “We risk turning individualized patient care and radiologist identity into an assembly line,” said Andrew Moriarity, MD, MBA, a diagnostic radiologist and the executive vice president at Advanced Radiology Services PC in Grand Rapids, MI. 

Two ways to counter this drift are culture and shared ownership. “Remember, radiologists aren’t interchangeable parts in a system—they are essential leaders in delivering personalized, meaningful care and connections,” Dr. Moriarity said.

For multi-site radiology practices, Dr. Moriarity suggests building culture at scale through intentional investment, governance redesign and peer-learning initiatives. These can help build a sense of ownership, engagement and connection across a distributed team. “Radiologists deserve to feel connected to patients and to each other, whether locally or across the broader health system,” he concluded.

Sustainable Imaging, Sustainable Careers

Radiology is facing a crisis of motivation. “The trend towards incentivizing speed, productivity and RVUs runs counter to what motivates people to excel at tasks requiring complex thinking,” explained Rachel Gerson, MD, MBA, a radiologist specializing in MSK and women’s imaging at Mt. Baker Imaging in Bellingham, WA.  

Not only can this trend cause burnout, it’s also unsustainable. “Low-value imaging is rising and the consequences are serious; it adds to radiology’s environmental impact and accelerates burnout and attrition,” Dr. Gerson said.

The key to reducing both: sustainable imaging. “Sustainable imaging can help us find meaning in our work, contribute to healthy communities and combat some of what drives burnout,” Dr. Gerson explained.   

Let’s Raise our Collective Voices

Our health care system often fails to meet the needs of both patients and clinicians. “Too many critical decisions about our patients and our careers are made behind closed doors, without our input,” said Alexander Podlaski, MD, a radiologist at Newark Beth Israel Medical Center in New Jersey. “The consequences of these decisions can be far-reaching. ”The solution lies in advocacy.

“Advocacy is an essential, non-interpretive skill that every radiologist must master,” Dr. Podlaski said. “When we speak with a unified voice—not just as radiologists, but as advocates—we don’t merely influence policy. We shape the future of health care itself.”

Home Field Advantage

With radiologists being asked to address health disparities, patient engagement and access, Matthew Miller, MD, said it’s time radiology embraced community partnerships. “We need to think beyond the technology and consider how culture, geography and community pride intersect with care,” he said.

A radiologist at Drexel University College of Medicine, in Philadelphia, Dr. Miller highlighted how collaborations with sports teams can help bridge barriers to cancer screening.

By engaging with patients at community sporting events, radiologists can raise awareness, visibility and screening participation. “This is a chance for radiologists to be architects of outreach and not just interpreters of imaging,” Dr. Miller concluded.

Access the Fast 5 session (M7-RCP01) at RSNA.org/MeetingCentral