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Tender documents from Health New Zealand Te Whatu Ora (HNZ) obtained by the Otago Daily Times said several health districts, including the southern district, did not "have the capacity to provide all the radiology services needed to meet the demand for their population".
The southern district expects to outsource 89,589 radiology procedures, more than elsewhere in New Zealand.
Of the procedures expected to be outsourced, 80,146 are classified as "reporting only", which includes assessing the results of imaging tests.
The outsourcing plan comes after HNZ Southern has previously acknowledged it has struggled to find radiology staff.
In November, there was a 40.1% shortage of radiologists and a 26% shortage of medical imaging technologists.
Association of Salaried Medical Specialists (ASMS) chief executive Sarah Dalton said "outsourcing radiology is expensive and, ultimately, degrades capacity within the public system".
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The Royal Australian & New Zealand College of Radiologists (RANZCR), which is holding its annual meeting in Queenstown from August 2-4, was also disappointed.
RANZCR president Prof John Slavotinek said it was "crucial that our patients receive treatment in a timely fashion and are not made to wait any longer than necessary for any diagnosis".
"The most appropriate long-term solution to easing radiological workforce shortages in New Zealand is simply to train more radiologists.
"We are committed to working with the New Zealand government to increase the number of trainee radiologists and develop strategies to keep them in the country once fully qualified."
The tender documents outlined an array of possible options.
"The participating districts have, therefore, identified a need to outsource radiology services for an initial period of one year, with two rights of renewal of one year each.
"The objective of this request for proposal response process is to facilitate the establishment of a panel to deliver options for best public value for participating districts, which is consistent with the expectations of both the Office of the Auditor-general and district obligations to balance ethical and sound commercial practices, within a robust, transparent and fair process," the documents said.
They also said while it was "preferable that patients be treated without the need to travel too far", consideration might be given to service providers who could provide services "outside the participating district catchment areas where necessary".
Depending on the proposal, outsourced services could range from reporting-only to full radiology services, while procedure volumes would be distributed based on locations and provider capacity.
Last year, the Dunedin Hospital’s radiology department was given a high-risk score in a report by the International Accreditation New Zealand (IANZ).
This was due to aspects such as no nuclear medicine-trained radiologist at the hospital, meaning medical-imaging technology staff were under high stress, making decisions they were not trained to do or comfortable making.
Applicants have until the end of this week to submit their proposals, and a HNZ panel will make a decision before the end of August.
HNZ has been approached for comment.