The SIR 2025 Annual Scientific Meeting in Nashville was a humbling opportunity to revisit our specialty’s past and reflect on its origins. As we gathered to celebrate 50 years of our society, we were joined by some of the earliest IRs, as well as those who were taught, mentored and inspired by them. By revisiting our past, I was struck not only by how far we have come, but by the common themes that guide our constant evolution.
The specialty emerged to provide image-guided therapy for hospitalized patients who were not surgical candidates. The original providers of what we now call IR services were frequently called upon by internists and surgeons to treat patients that needed the benefit of incredible diagnostic skills and an expanding toolkit of therapies. It was in this environment that new concepts and techniques were born: endovascular therapy for peripheral arterial disease, transcatheter embolization for gastrointestinal hemorrhage, managing urinary obstructions with percutaneous nephrostomy tubes, placing transhepatic biliary drains to manage sepsis—just to name a small few. There were countless therapeutic options that revolutionized the field of medicine—but an unfortunate aspect of these therapies was that IR’s scope of practice was entirely predicated on taking care of patients that were in the hospital.
As we all know, healthcare has evolved dramatically in the United States—and by extension, the global healthcare delivery system. Medicine is radically different today than it was in the 1970s; a large amount of clinical work that was previously performed in high frequency is either no longer relevant or has been replaced by alternate treatments. We are also seeing a shift in the care environment, with increasingly large swaths of the population pursuing care in the outpatient setting rather than inpatient. This evolution has taken place over the last 25–30 years, and IR has transformed itself radically to accommodate.
In 2025, most of our specialty provides patient-directed services in the outpatient setting, and many of our members—both in the United States and globally—are providing comprehensive clinical services to patients with a variety of different diagnoses and conditions. The therapeutic options that we offer have also multiplied. It is truly the case now that a modern IR practice can offer services related to cardiovascular care, cancer care, pain management, back pain, pelvic health, hypertension, infertility, kidney disease and liver disease—and that is just scratching the surface.
Increasingly, the future of medicine will be provided by clinical experts utilizing technical skills to provide minimally invasive procedures, which means that IR is poised to have a profound impact on the healthcare system in the coming years. However, while there are immense opportunities, there are also difficulties. The SIR and SIR Foundation Board of Directors, with our new CEO, have worked together to create a strategic plan that we believe reflects not only our current member needs but gives us a glimpse into the future. We are committed to empowering our members by strengthening their ability to provide comprehensive clinical practice for the patients they serve while addressing the healthcare challenges that our members, patients and delivery systems are facing. In addition, we feel that this strategic plan may serve as a template upon which to create partnerships with our global colleagues to elevate the specialty worldwide.
As we continue to grow, it is clearer than ever that our specialty has an incredible opportunity and a humbling responsibility. I am so optimistic and excited to see what IR can accomplish in its continued pursuit to transform healthcare delivery—not just in the United States, but around the globe.
