Imaging Demand Outpaces Radiologists

Author Kathie Ragsdale

Business NH Magazine Issue: September 2026

Faced with an aging population requiring ever more diagnostic imaging and a shortage of radiologists to read results, NH medical facilities are finding creative ways to meet patient care needs.

Building new or expanded diagnostic units, using more “teleradiology” for remote test interpretation, relying on temporary workers to help administer tests, and experimenting with budding AI technologies are among the strategies helping to meet the demand.

New Hampshire has the second-oldest population in the country, with nearly 22% of its residents over the age of 65, according to the NH Commission on Aging. Projected growth rates through 2050 show the fastest-growing age groups to be 70 and over. Meanwhile, the Radiological Society of North America reports that those 65 and older account for about 30% of all annual imaging.

“The longer people live, the more likely they’re going to be having some disease,” says Rob Glew, executive director of Southern NH Radiology Consultants.  This increase in disease leads to an increasing demand for radiology services such as PET imaging to diagnose several conditions, including Alzheimer’s, and MRIs. PET scans show functions and metabolism, while MRI scans show structure and anatomy.  “Similar to MRI, this is partly due to aging populations and some advances in imaging. Many types of disease cases that would benefit from an MRI are more prevalent in the older population.”

The global market share for PET (positron emission tomography) technology, which uses radioactive substances to view organs and tissues at a cellular level, and can be combined with MRI and CT scanners, is expected to grow from $2.96 billion in 2026 to $4.37 billion by 2034, according to Fortune Business Insights.

At the same time, NH, like the rest of the nation, has a shortage of radiologists, due to post-COVID retirements, training bottlenecks, burnout, among other factors. Technologists to administer imaging tests are also in short supply.

Investing for the Future
Nationally, imaging use is increasing 3% to 4% annually, primarily due to aging populations, while the number of practicing radiologists is growing less than 1%, according to a 2025 study by the Harvey L. Neiman Health Policy Institute.

To address the double whammy of an aging population and a shortage of radiology specialists, hospitals and diagnostic imaging centers are investing in newer, better facilities and equipment, as well as using teleradiology and outsourcing as ways to address the staffing shortage.

Wentworth-Douglass Hospital in Dover recently introduced a new interventional radiology suite that includes new care bays, procedure rooms and a new imaging system that has both a CT scan and a fluoroscopy device, which functions like an X-ray movie, in the same unit. A new MRI machine was installed at the hospital’s Lee location earlier this year to allow for quieter scanning and faster scan times.

Huggins Hospital in Wolfeboro opened a new $4 million MRI facility in April, driven by an increase in demand, according to Monika O’Clair, chief strategy officer. “We definitely needed it,” she says. “Now patients are able to get in within a week where they formerly had to wait three to four weeks.” New MRI technology also reduces movement in the images, reducing the need to take more images.

“As new technologies come up, scans are often shorter,” points out Kirk Perry, director of cardiovascular services and diagnostic imaging at St. Joseph Hospital in Nashua. One procedure that used to take an hour and a half now takes four minutes, he adds. A new cardiac catheterization lab that was put in two years ago has increased image quality by 300%. It uses a Philips Azurion 7M20 high-tech imaging platform that delivers high-resolution vascular and cardiac imagery while cutting radiation exposure by up to 75%.

St. Joseph Hospital in Nashua recently invested more than $3 million in imaging technology upgrades, including a state-of-the-art CT scanner at its Milford Medical Center. It is also planning to upgrade its MRI units over the next two years, according to Perry. “Our radiologists read everything we throw at them within a day,” Perry says. “If you need an MRI, the longest you wait is a week.”

Teleradiology, or remote image interpretation, is helping to streamline the process and some hospitals are also using independent imaging centers to augment or replace in-house radiologists.

For example, Elliot Health System in Manchester employs its own breast imaging radiologists but uses Southern NH Radiology Consultants to read imaging studies, according to Beverly Primeau, vice president of surgical and diagnostic integration at Elliot Hospital. St. Joseph Hospital uses a company called vRad to do “soft reads” after hours, with its own radiologists following up.

“My phone rings probably three times a month from a hospital looking for our help,” says Glew of Southern NH Radiology Consultants. “Either the team they have is overwhelmed or isn’t meeting contractual obligations, so hospitals are looking at other teams willing to help.”

Southern NH Radiology Consultants has 30 radiologists, two physician assistants, and serves seven hospitals and two imaging centers, one of which it owns.

Of its 30 radiologists, 11 are local and the rest are remote, according to Glew. His group invested in a cloud-based system, Intelerad, that allows them to hire radiologists from anywhere in the country. Three of his radiologists live in Hawaii and a couple are in New York.

“When I joined the group in 2019, all of our radiologists were local,” he says. “Technology has helped us. Internet transmission times are faster and the imaging equipment required for viewing in a hospital can easily be replicated in a radiologist’s home office … Your conversation with an ordering provider may be on the phone, but you’re able to look at the same images.”

His current “pain point,” Glew says, is trying to find an interventional radiologist willing to move to to do the in-person procedures and administrative work.

Glew acknowledges that he is understaffed but says his radiology team puts in the hours to meet the demand. The average inpatient and urgent cases are read in under an hour, he says, and all other cases are read on average within 24 hours “so each day we start fresh.”

New Partnerships and Strategies
Dr. Randy Tauro, lead radiologist for Derry Imaging, calls the radiologist shortage “massive” and raises concerns over the quality of new candidates. He blames hospitals trying to increase profits by eliminating radiologists, a change in the American Board of Radiology (ABR) certification tests that eliminated oral exams, and concerns over AI taking over, keeping some from entering the field. The ABR is bringing back oral exams starting in 2008, and Tauro celebrates that as a way of raising standards so that more new radiologists are qualified to work in a variety of settings.

A year ago, Tauro says he placed an ad at a career center at a college focused on radiology, “and I didn’t get one response in a year.” So, he wooed radiologists away from three NH hospitals and continues to recruit that way.

“I gave up on general searches and just make phone calls to the radiologists around us to see if they want to come work for us, and usually I don’t even have to finish the conversation,” he says. “We pay more.” Derry Imaging, with seven locations, has seven radiologists and Tauro considers it fully staffed.

Independent imaging centers, like Derry Imaging, lack the overhead that hospitals have and don’t have the fixed hours that some radiologists dislike, Tauro says. They can also charge less and see patients more quickly.

Tauro says his prices are 25% to 50% less than those of a hospital, and the short turnaround time for procedures draws people from as far away as Boston, where he says they sometimes have to wait a month. Patients are usually seen within five days and the typical turnaround time for him to read a case is less than 24 hours, he says.

Radiologic technologists—the people who administer tests—are also in short supply, according to Allyson Worthington, treasurer of the NH Society of Radiologic Technologists and an MRI technologist at Southern NH Medical Center in Nashua.

In response, many medical facilities are turning to radiologic technology “travelers,” temporary workers who stay for a specific period, often 13 weeks. At Southern NH Medical Center, three of seven technologists are travelers (two from California and one from Texas).

New online programs, such as Tesla MR Institute, are shortening the time it takes to get certified as a technologist, Worthington says. The Tesla MR Institute offers online MRI technologist training featuring self-paced didactic courses, virtual scan simulation, and hands-on clinical rotations, according to its website. The program helps students prepare for certification without requiring prior X-ray or healthcare credentials.

On-the-job training is also helping to fill critical positions. Danielle Anibal, MRI supervisor at St. Joseph Hospital, started in the X-ray department and worked with other staff members to move up the ladder, taking the required boards, to become supervisor.

Primeau says Elliot has partnerships with local colleges to help train prospective technologists “but when it comes to advanced imaging like MRIs, fewer are going into that field so we’ve developed some cross-training opportunities to provide a clinical ladder for advancement.”

AI is further helping by automating repetitive tasks and improving efficiency, freeing up radiologists to spend more time reading results. Some AI technology is already being used in MRIs themselves, reducing the time it takes for a procedure so more patients can be seen.

Southern NH Radiology Consultants uses AI tools to help with dictation and identifying some common diseases, augmenting the radiologists’ work. Elliot is in the process of implementing Aidoc, AI technology that performs preliminary reads, flags areas of concern “and raises them to the top of the radiologist’s task list for review,” Primeau says.

Glew also foresees using more mid-level practitioners to assist radiologists in the future. His group now uses advanced practice providers (APPs), including physician assistants and soon-to-be nurse practitioners, to assist with diagnostic radiology procedures.

As for the future, “I think organizations are going to have to be nimble and flexible and implement strategies that insure they have ongoing service provision,” says Primeau.

Click here to see the Imaging Demand_Business NH Magazine_Sept 2026.