President’s column By Robert A. Lookstein, MD, FSIR
The Independent IR practice T
here is a massive shift emerging in the practice paradigms of interventional radiology: the independent
practice. This is not just a momentary fad but instead a larger movement. It reflects the evolving healthcare environment and a tectonic shift that SIR and the wider global IR community should pay close attention to.
When talking about this shift toward independent practice, I do not simply mention the many IRs who have chosen to open offi ce-based laboratories or ambulatory surgery centers. I am referring to the increasing number of IRs who feel that the existing historic practice model of being embedded in a larger diagnostic radiology group is no longer able to address the need for continued clinical growth.
This shift is not just occurring at an individual level but is also catching hold among healthcare delivery administrators and academic leaders, who are beginning to recognize that IR can not only survive as an independent practice, but instead grow and thrive.
Evolution and change are natural for any medical specialty, especially one as diverse and innovative as IR. A major driver for this paradigm change is a severe workforce shortage for diagnostic radiologists, as well as the migration from in-hospital services to teleradiology. There is growing consensus that the intense focus on work RVUs as a metric for productivity often fails to recognize the value and success of robust, comprehensive clinical IR practices. Exacerbating the situation is the observation that IRs are increasingly being asked to subsidize or compromise their clinical practice to support the needs of a larger DR practice. Faced with these intense
6 IRQ | FALL 2025
constraints, many IRs are choosing to create a diff erent blueprint for success.
As a result, our members—across geographies and demographics—are beginning to think about, plan for and ultimately achieve independence.
It’s an important moment in the history of our specialty to reflect our evolution and appreciate that independence has become not only a viable option, but a successful one for the clinically minded practitioner.
Like any movement, there are stories of both success and hardship, and it’s important that these experiences are shared broadly, so that we can all learn from them. We create the next chapter of IR by being humble, open-minded and data driven.
Leaders within the specialty must ensure that members who are going through the planning process for independence not only have their support, but also the resources needed for their next steps. SIR provides many crucial resources that support practice development, fi scal and economic literacy, operational excellence and clinical value. Our Business Institute, Business Center and Business of IR resources are designed to support the modern IR clinical practice. With these resources, we at SIR aim to provide members with the greatest likelihood for success, no matter what practice model they choose.
SIR was established to help, educate and enfranchise IRs, and serve as our professional network. As we identify more providers choosing independence, I would ask all of them to share their stories, educate their colleagues and empower the next generation. With this, we are not just helping ourselves, but shaping the legacy of our specialty and creating a brighter future for ourselves and our patients.
SIR was established to help, educate and enfranchise IRs, and serve as our professional network.
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