Diagnostic Confidence: Practical Steps Imaging Centers Can Take to Manage Medical Malpractice Risk

Diagnostic imaging plays a critical role in modern healthcare, with the global market expected to reach 76.69 billion in U.S. dollars by 2034. In Canada, the diagnostic imaging market is projected to grow from USD 1,061.20 million in 2024 to an estimated USD 1,387.37 million by 2032. This growing demand also heightens medical malpractice exposures, particularly related to diagnostic accuracy, patient communication and procedural safety.

“As demand for imaging services grows, so does the complexity of managing malpractice risk. Centers that take a proactive approach to operational consistency are better positioned for favorable coverage outcomes,” says Michael Brennan, Director – Healthcare & Life Science at CNA Canada.

From an underwriting perspective, these risks are often manageable when imaging centers adopt consistent, well-documented operational practices, such as quality assurance cycles, credentialing, and disclosure and consent.

Quality Assurance Cycles
The most common imaging center malpractice risks relate to diagnostic accuracy, patient safety, and communication of diagnostic results. Regular quality assurance (QA) cycles can help mitigate each of these risk areas by promoting consistency and identifying issues before they develop into claims.

Effective QA programs go beyond compliance; they create a culture of continuous improvement. Structured and well-documented processes typically include incident reporting, peer review or double-reading, alignment with accreditation standards, and ongoing staff training. Centers are also encouraged to track near misses and emerging trends, not just incidents. This proactive approach demonstrates strong risk management and builds underwriting confidence.

“Effective QA programs aren’t just about compliance; they’re fostering continuous improvement,” notes Michael. “Tracking near misses and emerging trends shows underwriters that a center is committed to proactive risk management.”

Credentialing

Credentialing is a foundational component of risk management for imaging centers. Ensuring that physicians, technologists and the facility itself meet appropriate professional and regulatory standards helps support quality of care and strengthens defensibility in the event of a claim. “Credentialing is more than a checklist; it’s a cornerstone of patient safety and legal defensibility,” says Michael.

While both are essential members of a patient care team, technologists and radiologists have distinctly different pathways to practice.

• Medical radiation and imaging technologists typically complete a two‑ to three‑year diploma or other approved program in radiography, MRI, nuclear medicine, or radiation therapy, depending on their discipline. Their certification and regulatory requirements vary by province, and in many jurisdictions, employers expect or require national certification through the Canadian Association of Medical Radiation Technologists (CAMRT).
• Radiologists, by contrast, are physicians who complete medical school followed by specialty residency training in diagnostic radiology or nuclear medicine. To practice, they must be licensed by their provincial medical regulatory authority and typically obtain national specialty certification through the Royal College of Physicians and Surgeons of Canada (RCPSC).

In Ontario, for example:

Medical radiation and imaging technologists must be registered with the College of Medical Radiation and Imaging Technologists of Ontario (CMRITO) to legally practice in their specialty, and many employers also look for national CAMRT certification. Radiologists, meanwhile, must be licensed by the College of Physicians and Surgeons of Ontario (CPSO) and are generally certified by the Royal College of Physicians and Surgeons of Canada in diagnostic radiology or nuclear medicine before entering independent practice.

Additionally, facilities are generally accredited through recognized bodies relevant to their modalities and services, including Accreditation Canada, the Canadian Association of Radiologists (CAR) for diagnostic imaging standards, and the Canadian Nuclear Safety Commission (CNSC) for facilities offering nuclear medicine services. “From an underwriting standpoint, clear documentation of these credentials and maintenance processes can make a meaningful difference when evaluating coverage,” says Michael.

Disclosure & Consent

Informed consent is both a patient care requirement and an important component of malpractice risk management. In imaging settings, consent is most effective when it is treated as a plain-language conversation rather than a one-time form, with engagement taking place before, during and after any services.

“We often see consent-related claims that arise from everyday situations, such as language barriers, procedure changes or misunderstandings about risk,” Michael explains. “Robust documentation practices, which should be reinforced through regular QA reviews, can help imaging centers manage these exposures. Patients should be given the opportunity to review and acknowledge disclosures and consent forms, including instances where they decline a recommended procedure.”

Provincial frameworks further define patient rights and consent requirements. For example, in Ontario, the Health Care Consent Act (HCCA) sets out the elements of valid, informed consent, capacity and emergency exceptions, and CPSO’s practice guidance provides practical expectations for physicians. Familiarity with these frameworks can help imaging centers establish clear, compliant processes.

Benefits for Imaging Centers

“Imaging centers that invest in these practices are often better positioned to manage risk over the long term,” Michael emphasized. “From our perspective at CNA, clear evidence of thoughtful quality assurance, credentialing and consent processes can support broader coverage considerations and more flexible program structures.”

Ultimately, these safeguards not only help protect patients, but also demonstrate a center’s commitment to consistent, well-managed care; an approach that benefits operators, brokers and insurers alike.