I think the fundamental question IRs need to reconcile is: can we obtain our own referrals or do we need to depend on other sub specialties to exist? I feel strongly that it is possible to build stand-alone IR practices and appropriately collaborate with other specialties by engaging in a strong clinical models not unlike like other surgical subspecialties. My perspective is a minority and likely has to do with the culture of our specialty being tethered to radiology and the associated doctor’s doctor mindset. I’m hopeful the next generation of IRs sees these issues and acts accordingly.

Very astute observation. When urologists find out they can bill for the procedure by hiring their own IR they all of a sudden become very interested. It coincidentally is the highest paying procedure in an office setting for BPH and happens to be the one procedure urologists do not have the training to do (excluding the small handful who are dual trained in IR and urology). When this phenomenon is packaged as “collaboration” it can sold to private equity investors at a hefty multiple. Those who raise concerns will be labeled as anti collaborative and anti innovation. The devil is in the details, but the repercussions of this model will be long lasting and negative for the specialty when it comes to independence.