Private radiology practices were especially impacted by the COVID-19 pandemic, and the ways they mitigated the impact of the pandemic on their practice will shape the future of radiology. Key Results: 1. The coronavirus disease 2019 (COVID-19) pandemic has resulted in dramatic decreases in examination volumes, of up to 80% in some cases, for private radiology practices that solely depend on revenues from examination interpretation. 2. To survive the pandemic, private radiology practices reflected on their values and priorities to decide which levers to pull to reduce costs, such as decreasing compensation, paid time off, benefits, and hours of work, while increasing work responsibilities. In many cases it is unclear when or if these measures may be returned to the pre-COVID-19 state. 3. The future of private radiology practices will be impacted by the pandemic in that practices are likely to restructure operational policies and business risks to account for potential sudden volume decreases, as were experienced during the pandemic.