RSNA Explores Role of APPs to Address Workforce Challenges
APP integration emerges as a strategy to ease radiology strain
As radiology workforce pressures continue to affect capacity and patient access, the RSNA Board of Directors has identified advanced practice providers (APPs) as an important component of a broader strategy to support radiologist-led care teams.
“Radiology-based APP practice and utilization vary greatly across the nation,” said Leslie E. Partridge, RRA, MS, RT(R), a registered radiologist assistant at The Ohio State University Wexner Medical Center in Columbus. “Greater role alignment will increase understanding about how APPs can work as part of a radiologist-led team, clarify misconceptions about APP practice, and strengthen and unify radiology-based education and training of APPs.”
“APPs can help optimize workflow in many ways, by helping with documentation, protocoling studies and patient follow-up,” said Anne M. Covey, MD, RSNA Board liaison for public information and professionalism.
In 2024, the Board established its Task Force on Advanced Practice Providers in Radiology to examine the potential role of APPs, including nurse practitioners (NP), physician assistants (PA) and radiologist assistants (RA), in addressing ongoing workforce challenges. Dr. Covey said APPs may also expand capacity in underserved areas by supporting onsite care and teleradiology models.
At its June 2025 meeting, the Board received and accepted the task force’s final report, formally concluding the group’s work.
Dr. Covey said variability can create uncertainty in practice. “Challenges can arise from confusion regarding inherent differences in education and scope of practice among diverse types of APPs that are employed in imaging,” she said.
At the same time, Partridge said those differences can be addressed by aligning APP roles with specific practice needs. “It is important for radiologists or prospective employers to evaluate what needs or gaps they have within their imaging departments and use that information to determine how APPs can best meet those needs,” she said. “I feel that there will always be variability in how APPs are integrated.”
Christopher Davis, DMSc, PA-C, RT(R), a physician assistant at Radiology Partners in Phoenix, said that a practice-specific approach depends on clearly defining roles and expectations of the team.
Davis is co-founder of Physician Associates in Radiology (PAIR), the first national organization founded by PAs practicing across the field of radiology. PAIR received official designation by the American Academy of Physician Associates as a specialty organization in 2026.
“APPs can be invaluable members of a radiologist-led team,” Davis said. “As no radiology practice is exactly the same, each radiology group will benefit from developing a specific scope of practice, which is best developed with clear goals and open communication from each team member.”
While the RSNA task force outlined several potential engagement areas, the Board prioritized opportunities to make immediate impact using RSNA’s strengths of convening and educating. That focus reflects the need to better integrate APPs into radiology care teams.
“Thoughtful integration of APPs into a radiology practice can free up radiologists to work at the top of their licenses,” Dr. Covey said.
Partridge underscored the importance of collaboration in achieving that goal. “It is not about competition, but it is about how we can work together to balance daily workflows and best fulfill the needs of our patients and radiology departments,” she said.
Early Efforts Underway
Early efforts are translating into programming and partnerships. At RSNA 2025, a dedicated RSNA Connect session created space for APPs and radiologists to engage directly and share perspectives.
“What stood out to me was the need for a better understanding of APP roles within radiology,” Partridge said. “There are misconceptions and misinformation that lead to confusion which can exacerbate the lack of support for APPs.”
Education remains central to addressing those gaps, particularly in radiologist-led care models. “A successful radiologist-led care model requires a commitment to education,” Dr. Covey said. “The radiologist leading the team has to understand the capabilities of each team member to ensure an efficient workflow, prioritizing patient care.”
Partridge noted training differences across APP roles, highlighting the scope of training and work already handled by RAs. “RAs play a critical role in delivering high-quality, efficient patient care by conducting comprehensive pre- and post-procedure assessments, performing designated fluoroscopic and interventional procedures, and administering contrast agents and intrathecal chemotherapy as prescribed,” she said. “They support exam protocoling, ensure the appropriateness of imaging orders, and serve as a key communication link between radiologists and ordering providers.
Partridge added that RAs can also contribute to departmental and resident education efforts and collaborate closely with imaging and multidisciplinary care teams to streamline workflow, enhance coordination and optimize patient outcomes. She noted that further access to training would benefit both APPs and the radiologists who mentor them. “Radiologists who are willing to serve as clinical preceptors or mentors to APPs are essential,” she said.
“For PAs and NPs entering radiology, education often has to build on a generalist foundation,” Davis said, noting that during formal training, procedural exposure is often limited.
He said APPs benefit from radiology-specific education, including conferences, web-based cross-sectional anatomy modules, and continuing medical education in radiation safety. He also pointed to US fundamentals, mentorship under supervising or collaborating radiologists or interventional radiologists, and self-directed learning from case-based radiology texts and procedural manuals as important pathways for developing radiology-specific knowledge.
Davis said practices that include APPs should anticipate a learning curve, particularly when they are transitioning from general medicine into procedural radiology roles. “Structured onboarding, individual support and clearly identified mentors can help make that transition more successful,” he said. “Thoughtfully developing a systematic approach to teaching these skills will improve the experience of both the practice and the new PA/NP.”
The focus on education also extends to RSNA’s broader partnerships. The Society recently strengthened its relationship with the American Society of Radiologic Technologists (ASRT), which now partners with RSNA and the American College of Radiology on the RadiologyInfo.org patient education platform.“Excellent patient care is only possible when all team members work together for a common goal.”
— ANNE M. COVEY, MD
A Deliberate Path Forward
For RSNA, efforts continue to center on education and collaboration. “Excellent patient care is only possible when all team members work together for a common goal,” Dr. Covey said, emphasizing the importance of coordinated, team-based care.
“With the extensive reach and resources RSNA provides, the organization facilitates conversations and programming to foster collaboration between radiologists and APPs,” Partridge said. “RSNA can develop educational courses and materials to support high-quality radiology-based training of APPs.“
She added that those efforts depend on greater visibility for APPs within the field. “I believe the most immediate opportunities for impact revolve around the inclusion of APPs in RSNA meetings and materials to support radiology-based education,” Partridge said.
Partridge chairs the Advanced Practice Providers subcommittee of the RSNA Annual Meeting Program Planning Committee, and Davis is a member. Development of APP-targeted programming is ongoing.
Davis said organizations like RSNA can support APPs by helping identify opportunities in available education and working with the APP community to address them. He noted that topics like radiation safety, diagnostic fluoroscopy, US physics and knobology, cross-sectional anatomy and appropriate use of contrast media are some areas where online or module-based education could be helpful. “RSNA is well positioned to provide this education,” Davis said. “The Society could also consider developing structured learning pathways or a certificate program for PAs and NPs.”
At the same time, Dr. Covey noted that additional areas identified by the task force, such as standards-setting and public advocacy, will require additional evaluation given differing perspectives across the field and globally. “Scope of practice is different for NPs, PAs and radiologist assistants. Regulations differ between states, and credentialling is unique to each hospital system,” she said.
For now, RSNA leadership is taking a measured approach as it evaluates next steps. “RSNA is committed to providing educational resources to all members of the radiology team caring for patients,” Dr. Covey said.
As the Society continues to gather feedback from early initiatives, those insights will help guide how RSNA supports the evolving radiology workforce.
For More Information
Access RSNA 2026 Meeting Central to view targeted programming for APPs.
Learn more about the Medicare Access to Radiology Care Act and efforts to support its passage.
Read previous RSNA News articles on the radiology workforce:
MARCA and the Radiology Workforce
As RSNA explores how APPs can support radiologist-led care teams, federal legislation could affect how one APP role, the registered radiologist assistant (RRA), is utilized in practice.
Recently reintroduced in the House and Senate, the Medicare Access to Radiology Care Act (MARCA) would allow Medicare reimbursement for certain hospital-based services performed by registered radiologist assistants under radiologist supervision. The bill aims to improve patient access and address workforce shortages.
Watch for advocacy opportunities and contact your members of Congress to share your views.