Recruiting in Radiology 2026: What Doctors Actually Want (And How to Give It to Them)

As an independent recruiter with 17+ years in this industry, I’ve watched the cycles. The feast years, the drought years, the shifts from fellowship-based pipelines to nationwide talent wars. I’ve seen what works and, more importantly, what quietly kills a deal before it ever starts.

This past spring I had the opportunity to speak on a panel alongside two fellow industry experts, and the conversation kept coming back to the same three things: marketing, identification, and transparency. Not as buzzwords but as genuine gaps. For practices and physicians alike, the thread running through every challenge we discussed was the same: are you being intentional and are you being honest? The more I sit with that framing, the more I think it’s the right lens for everything happening in this market right now.
Here’s what I know: recruiting in radiology is no longer a local problem. It’s a macro problem. And the practices still treating it like a local one are losing.

No longer can a group in the South lean on regional relationships and word of mouth. No longer can a northeastern academic program count on Fellows choosing to stay. Online presence, brand clarity, and demonstrated value have become core parts of the decision-making process, right alongside compensation and call schedules. Work-life balance isn’t a perk anymore. It’s a filter. Doctors are screening you before you even know they exist.

I spend hours in conversations getting to the real question, not “what’s the RVU structure,” but what does the life you want look like? And almost every time, when we get past the surface, the answer is some version of the same thing: I want to feel valued for the work I do. Not a novel concept. But in this market, where physicians hold leverage they haven’t held in years, it’s the groups that understand that and act on it that are winning.

The Market

The shortage is real and well-documented. The JACR has projected workforce growth of roughly 25 to 40% by 2055, trailing imaging volume growth by a meaningful margin. Attrition is up, new training slots aren’t keeping pace, and the average radiologist practices for 35 years, meaning the pipeline doesn’t self-correct quickly. We’re not solving this anytime soon. The question isn’t whether the shortage exists. It’s what you’re going to do inside of it.

And yes, reimbursement is declining. That’s not a secret and I’m not going to pretend otherwise. I can’t grow money on trees and neither can the practices I work with. That pressure is real and it affects every conversation in this space. But I’m not here to talk about what we can’t control. I’m here to talk about what we can. Because there is plenty we can do, and most of it starts with how we show up.

For the Practice: Marketing With Intent

Scroll any major job board, this one, ACR, Aunt Minnie, etc.. and you’ll see the same thing: post after post competing for the same shrinking pool of physicians. Long. Wordy. Dense with benefits language that sounds like it was written by a compliance team. There is no magic formula. But I treat this work like a matchmaker, and good matchmaking starts with authenticity. If your listing reads like a form letter, if your first call feels like a screening rather than a conversation, if you’re not willing to talk honestly about the real challenges inside your practice, you’ve likely lost them before the second contact.

The groups doing it right are telling their story clearly. Why did you build this practice the way you did? Why do your hospital partners choose you over the group down the road? What does partnership look like in three to five years, not in theory, but in writing? If you can answer those questions with specificity and honesty, you are immediately differentiated from most of your competition.

And then there’s compensation. I’ll say it plainly: don’t avoid it.

A candidate I worked with recently had spoken to more than 30 groups. He kept a spreadsheet. His single elimination criterion: any practice that didn’t discuss compensation within the first two conversations was automatically cut from the list. No second chances, no follow-up. He wasn’t being unreasonable. He was being efficient. He’d learned that groups who avoided the number early almost always had something to obscure. He was right more often than he was wrong. Thirty groups. Gone before a site visit was ever scheduled, not because of the number, but because of the silence around it.
Being cagey creates uneasiness with candidates. The silence, the deflection, the vague answers to direct questions. Candidates notice all of it and they are drawing conclusions in real time. It’s worth remembering that you are both interviewing each other. The physician is evaluating your culture, your honesty, and how you handle the uncomfortable moments just as much as you are evaluating their experience and fit. The practices that understand this show up to every conversation differently. And it shows.

The other piece is geography of reach. If you’re only marketing regionally, you have already narrowed your pool before the search begins. The market for radiology talent is national now. Teleradiology, hybrid models, and flexible scheduling have fundamentally changed where doctors are willing to consider. Widening your net with intentional, consistent brand presence in national forums, social communities, and recruiter relationships is no longer optional strategy. It’s table stakes.

Time is always a constraint. I hear it constantly: we’re already doing more with less, we can’t add a full recruiting process on top of everything else. That’s real. But the cost of a long vacancy, a wrong hire, or a physician who felt like a number during the process is far more expensive than the investment in doing it right.

What Transparency Looks Like

Transparency has become something of a buzzword in this industry. Every group claims it. Few practice it. Real transparency is uncomfortable sometimes. It means telling a candidate the truth about a difficult hospital relationship before they join. It means explaining what a partnership track realistically looks like, not just what it looks like in the best-case scenario. It means having an honest conversation about compensation rather than presenting a ceiling number and obscuring the variables.

I had a physician fly out for a site visit with a group that did everything right on paper. Dinner, tours, genuine hospitality. But no one at the table was willing to talk honestly about the culture. No one addressed the things that mattered most. What he did get came from the side conversations. The honest moments at happy hour. A colleague who pulled him aside and quietly told him what to ask for on a signing bonus, information that wasn’t anywhere in the job posting. He left with more clarity from those informal moments than from anything official in the process.

That’s not a recruiting strategy. That’s a leak. And it’s more common than most groups realize. When the most useful information a candidate receives comes from whispered conversations at dinner, it means the formal process failed them. Candidates will find the truth one way or another. The only question is whether you’re the one giving it to them, or whether they’re piecing it together from hallway conversations and reading between the lines.

I’ve watched practices lose excellent candidates not because of their offer, but because the candidate felt like they were being sold to rather than talked with. In a buyer’s market, that impression is decisive.

For the Physician: Your Side of This

Every doctor I work with has some version of the same fatigue. Sifting through ad after ad, trying to read between the lines of what a practice is really like versus how they’ve packaged themselves. Narrowing to a short list and then waiting, sometimes weeks, to hear whether anyone on the other side is equally invested.

Here’s what I’d offer: honesty about your own intent matters too.

If you know you won’t relocate, say so early. If remote flexibility is non-negotiable, name it. If you’re genuinely interested in partnership track and ownership, bring that up in the first conversation, not after an offer. Practices that are serious about the right match want that clarity. And when you’re clear, the conversations that aren’t right end faster, and the ones that are right go deeper.

Specificity is not a liability in this process. It’s a gift to yourself and to the right practice.

One of the cases I’m most proud of involved a radiologist who came to me with a very specific schedule in mind. Not a rough preference but a specific one. Most people would have talked her out of it or quietly set it aside. Instead we took it seriously. It took many conversations, a lot of back and forth between her and the practice, and genuine willingness on both sides to problem-solve rather than posture. They got there. It took longer than a standard placement. It was worth every hour. She got exactly what she needed. The practice got someone fully committed from day one.

I rarely get the chance to meet my doctors in person. But when I do, it’s never transactional. I sat down for coffee recently with a physician I had placed and we barely talked shop. He told me about finding the right home, moving closer to family, getting back to his roots. That conversation is exactly what the recruiting process should feel like from the very first interaction. The first impression, the follow-up, the way you show up when nothing is required of you. That’s what people remember. That’s what builds trust. And trust is what this whole thing runs on.

Negotiating: Read the Fine Print

For physicians in active negotiation, a few things I’ve learned from being on the inside of hundreds of these conversations:

Before you ever get to the offer stage, start asking questions about the agreement. Not in a combative way but in a curious one.

Are there commonly asked questions around your contracts?

Are there items I should be aware of before we get to that stage?

This kind of early inquiry signals that you’re serious, and it also gives you a preview of how the practice handles directness. The things worth understanding before you sign are rarely the ones being highlighted in the job posting. The non-competes, the tail coverage, the buy-in timeline if partnership is on the table. These are the terms that shape your life for years, and getting ahead of them early is always the right move.

Ask direct questions and don’t lead anyone on, but don’t stay quiet about what you need either. Practices often don’t know the full picture of your priorities, and they can’t solve for what they don’t know. Creative solutions exist. I’ve seen schedules rebuilt, compensation structures renegotiated, and geographic constraints accommodated, but only because someone said out loud what they truly needed.

Groups sometimes can’t meet every ask. That’s honest. But the conversation must happen for anyone to find out. In a constrained market, the only way through is honest problem-solving from both sides. That’s not idealism. It’s the only approach that produces good long-term outcomes for everyone involved.

The Bigger Picture

The practices that will recruit well over the next several years share a few things in common. They know who they are. They can articulate it clearly. They market nationally with consistency. And they treat the recruiting process as the beginning of a relationship rather than a transaction to close.

The physicians who will navigate this market well know themselves clearly enough to filter quickly, engage honestly, and trust the signals when something doesn’t feel right.

This is a complicated market. But the fundamentals aren’t. People want to be valued. Practices want physicians who are invested. The gap between those two things is almost always a transparency problem, and transparency is fixable.

That’s the work.

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Raquel Roman

Raquel Roman is an independent, bespoke recruiter specializing in radiology placement. Known for her agent-style approach, she takes the time to understand both sides of every match, going beyond the resume to find the right fit for physicians and practices alike. Raquel is an active volunteer with the Radiology Business Management Association and was recognized as a Global Ambassador in April 2026.

Whether you are exploring your options or just want to talk through what the market looks like right now, Raquel is always open to a conversation. Find her on LinkedIn or at radmatchinfo@gmail.com.