Leadership & Workforce Management
Essential Negotiating Skills Every Imaging Leader Needs to Master
March 03, 2026 - Joshua N. Weiss
Over the years, I’ve worked with people from many different disciplines. In the world of medical imaging, I often hear this refrain: “I’m very good at what I do technically, but when you put another person in front of me — particularly someone who’s difficult — I’m at a loss for how to handle the situation.”
If that sounds like you, you’re not alone.
It’s important to understand that being a great negotiator takes time and effort, but the rewards are worthwhile. This is not a destination, but a journey, and everyone can improve with time, knowledge, and experience. If you invest in this knowledge and skill set, it will enhance your career on many levels.
Types of Negotiations Imaging Leaders Face Regularly
Imaging leaders are negotiating constantly. While it may not be in a formal setting, like a board room, you’re flexing these skills all around the hospital or facility regularly. Here are just a few examples of this in action:
- In conversation with emergency physicians, surgeons, and internists when departments need quick reads or a sequence of cases must be addressed.
- Through interdepartmental discussions, negotiating with other specialists about imaging appropriateness, protocols across departments, and scheduling.
- With resources and budgets, focusing on equipment purchases, staffing issues, and space allocations with administration and doctors.
- When managing contracts and employment agreements, whether for yourself or your employees.
- In handling patient-facing decisions around issues of consent, dealing with anxiety, and sharing the risks of image guided procedures.
- Meeting with vendors and other external entities around equipment and maintenance agreements, as well as training and other service arrangements.
- Within your imaging group over call coverage, vacation schedules, and subspecialty workload levels.
Addressing 4 Myths of Negotiation
Before you can become a better negotiator, it’s important to understand a few myths. These misconceptions can be a barrier to improving your skills, so it’s important to understand the truth about this critical skill.
Myth No. 1: Negotiation is a zero-sum game with winners and losers. If you negotiate with the same people and groups over time, seeing the other side as an adversary is a failing strategy. Instead, view them as a problem-solving partner and find ways to meet both your needs as best as possible. This will assist you in the short term with your needs; in the long term, you’ll build relationships — the lifeblood of effective negotiation.
Myth No. 2: Negotiation is all about compromise and giving up something of importance in order to get where you want to go. Negotiation is much more focused on creative thinking and understanding what motivates people. Sometimes when you figure out what people need, compromise is not necessary. Take this example from a friend of mine who works in the operating room (OR):
“In the OR, it’s easy for people to dig their heels in. You’ll hear things like, ‘I need this room,’ or ‘I can’t start until that tray is here.’ Those are positions, but the underlying interest is where progress happens. I remember a morning when a surgeon demanded to keep two rooms open just for his cases. I did not try to compromise and offer one room. Instead, I asked why he needed two rooms. He explained one of his patients was high-risk and he wanted a backup room ready in case something went wrong. Once I understood his ‘why’ we worked out a plan. Anesthesia kept a standby room open until the patient was stable, then we released the room for the next case.”
That scenario was not about compromise, but about grasping needs and finding a creative solution.
Myth No. 3: The mark of success in negotiation is reaching agreement. People can give away all kinds of important things in order to reach agreement, but that’s not what success is about. It’s about meeting your objective as best as possible. If a proposed agreement doesn’t do that, you should walk away and find a better alternative. If you take this new view of success in negotiation it will help you greatly.
Myth No. 4: You have to keep emotions out of negotiation. It’s unprofessional. Human beings are logical and emotional creatures. We wouldn’t keep logic out of our negotiations, so why remove emotion? When we care about something, emotions will play a role whether we openly express them or not. A better strategy is to become emotionally intelligent and bring your emotions into the process with control.
3 Tips for Better Negotiations
With a few misunderstandings out of the way, we can focus on best practices for better negotiating. Here are three tips to help you in any scenario.
1. Separate positions from interests.
Positions are what people say they want; interests are why they want them. The why is key, but here’s the kicker: People often hide their interests when negotiating, out of fear it will be used against them. This is why trust and solid relationships are essential. People will open up if they think you’ll address their why.
Interests can be thought of in two buckets. The first is tangible interests, which is anything you can touch — money, rooms for patients, etc. The second is intangible interests, or things you can’t touch. These are what make us human and connect to our identity. If your why is that you feel disrespected by a colleague as part of the process, that intangible interest has to be addressed or no solution will be forthcoming.
2. Think creatively when it comes to finding solutions.
The best negotiators see this process as a problem-solving endeavor where they need to use creativity to find the best way forward. Let’s go back to my friend from the OR as an example:
“In the OR during a busy trauma week, we were short on anesthesia technology coverage and the surgeons were frustrated that cases weren’t turning over fast enough. The techs were exhausted and felt underappreciated. I had to find a way forward. My position was to stick to the schedule and avoid adding non-urgent cases until we had proper staffing. My interest was in protecting my team from burnout, maintaining patient safety, and preserving trust between departments. The surgeons wanted their cases done as scheduled. Their interest wasn’t control or ego, but about patient care and keeping their workflow steady so outcomes wouldn’t suffer. Instead of arguing about the schedule, we discussed shared goals, safety, efficiency, and teamwork. Through creative thinking, we agreed on a plan that prioritized urgent cases and staggered elective ones, giving the techs recovery time while keeping the OR moving.”
3. Know your best alternative to a negotiated agreement (BATNA).
Simply put, your BATNA is your plan B. Before you go into any negotiation, you must understand how good or bad this is. If you can walk away with a decent alternative that still meets your interests and objectives, you’re in good shape.
Imagine you’re negotiating with a vendor and there are three other companies with comparable pricing and equally good service. You don’t have to reach an agreement with a vendor who is pushing hard on price. You can walk away to the next one.
But let’s flip that challenge. Consider negotiating with a vendor for a specialized service that only they provide; you have no other option. In that case, you have a bad BATNA and they have the power. This is where you need to think creatively about how to meet your needs, or you may have to accept a less-than-optimal agreement.
Before accepting a less ideal outcome, ask yourself if there are ways to improve your BATNA. In the scenario with the specialized vendor, maybe that means doing more research or talking to others about lesser-known solutions.
Go Forth and Negotiate
Your training may be in medical imaging and team management, but you’re more of a negotiator than you realize. If you embrace this reality, understand the truths behind this skill, and follow these negotiation tips, you’ll begin to feel more confident in your work. As a leader, building this skill is essential, and you have the tools and experience to be successful. Go forth, negotiate, and reap the benefits!
Ready to go deeper on negotiating tips and tactics? Tune in to this episode of Medical Imaging Matters, featuring Dr. Joshua Weiss and AHRA Past President Mario Pistilli, CRA, FAHRA.