President's column

Have you ever sat across the table from hospital leadership, trying to make the case for the value IR provides—only to watch the conversation default to relative value units and procedure volumes? Have you found yourself explaining to a diagnostic radiology colleague why IR's future depends on longitudinal clinical care and periprocedural management, not just the technical skill in the angiosuite or the imaging volumes? If either sounds familiar, you're exactly who this column is for.

Interventional radiology has long understood its value: solving complex clinical problems with less invasive treatment and improved outcomes and cost of care. Yet our value is too often understood anecdotally, measured incompletely or framed by others. As healthcare continues to evolve, SIR has an opportunity and responsibility to define IR’s future on behalf of the patients, practices and systems we serve.

To meet this moment, SIR has partnered with triLumen Health Partners to develop a strategic roadmap for identifying, quantifying and supporting the value of IR. The project is designed to help SIR articulate what makes IR essential today, anticipate how the market is changing, and build the infrastructure members need to thrive across diverse practice settings now and in the future.

Why this work matters now

IR’s identity has always been both procedural and clinical. We are both indispensable proceduralists and longitudinal clinicians. The challenge is that many stakeholders still measure IR primarily through the first lens. That incomplete model affects reimbursement, resource allocation, service-line planning and institutional influence.

This project asks foundational questions: What is IR’s unique value proposition? How does it distinguish itself from diagnostic radiology and across clinical practice? Where is the market heading, and how will technology, regulation, competition, workforce dynamics and practice patterns shape the specialty over the next decade?

Surveying stakeholders

To answer those questions, the project includes interviews with payers, health system leaders, IR and DR physicians, trainees and other stakeholders.

The findings are encouraging. According to market interviews, stakeholders already believe IR is valuable—87% of payers rate IR superior on total episode cost; 90% of health system leaders rate IR as good or excellent; 73% of payers rate IR as superior on outcomes and safety; and 94% of practicing IRs describe IR as delivering significant value to their department.

At the same time, the findings reveal a critical gap: IR may be viewed as strategically important while still being treated operationally as a support function. That distinction matters. If IR is recognized for its value but not positioned as a service line, growth engine or clinical partner, then the specialty’s contributions may not translate into reimbursement, resources, autonomy or influence.

Building the infrastructure

SIR’s role is to build the infrastructure that converts belief in IR’s value into measurable action. We have identified a roadmap organized around five pillars and prioritized several key initiatives within each.

1. Enable members to win in their local markets.

Members need tools that help them make the case for IR with external decision-makers. This includes stakeholder-specific value-articulation playbooks, economic forecasting and value quantification tools, and balanced scorecard templates that define the outcomes, processes, patient experience measures and financial contributions by which IR should be evaluated.

2. Build the data foundation.

IR must be able to support its value with rigorous, scalable evidence. Economic and value research, registry infrastructure, claims data capabilities and analytics will help generate the evidence needed to demonstrate IR’s clinical and economic impact in terms that administrators, payers and policymakers can act on.

3. Advance national advocacy.

Evidence must be deployed through coordinated advocacy. This includes defending existing codes against valuation pressure, creating new codes for complex and evolving procedures, engaging payers, protecting reimbursement integrity, preserving IR-specific coverage and ensuring that IR physician leadership remains central to the delivery of image-guided care.

4. Shape technology adoption on IR’s terms.

AI and adjacent technologies will change how care is delivered, but the value created by innovation must strengthen patient care and IR practice—not simply be absorbed as reimbursement cuts. SIR can help define technology governance, quality standards, adoption playbooks and certification approaches that position IR as the specialty best equipped to turn innovation into clinical outcomes.

5. Develop the workforce of the future.

The future of IR depends on recruitment, training, leadership development and early-career support. Enhanced residency and fellowship models, longitudinal patient management experience, multidisciplinary service-line exposure and training in team-based supervision will help prepare IRs to lead across academic, community and outpatient practice settings.

A roadmap for every practice model

Not every pillar will affect every practice in the same way. The needs of an IR section in a large academic medical center differ from those of IRs in community hospitals or outpatient-based labs and ambulatory surgery centers. That is why the project includes practice-specific blueprints. Each blueprint will identify the actions, resources and strategic priorities most relevant to that environment, while ensuring that all members are represented in SIR’s long-term strategy.

What comes next

The SIR Executive Committee has identified key actions for 2026 and 2027, but this effort is designed to carry SIR through 2029 and beyond. In the months ahead, future columns will explore the pillars in greater detail, including the role of VIRTEX, the impact of AI on practice and how we can support the future of IR education.

The value of IR is not in question. The work ahead is to define it clearly, measure it consistently and communicate it persuasively, so that the specialty’s proven value is reflected in the decisions that shape patient access, practice sustainability and the future of medicine.