A key theme that I've noticed at the Society of Interventional Radiology (SIR) 2013 meeting is an ongoing attempt to define the interventional radiologist (IR) specialty. What does the future hold for IRs?'

From the beginning, a driving principle of interventional radiology has been innovation. These physicians are always looking for the next big thing? and trying to find solutions to unmet needs. This drive for innovation is what makes the IR specialty important to the medtech industry. The industry needs IRs to be their early adopters, to champion the devices and new procedures that manufacturers have put their R&D dollars toward. On the flip side, IRs need the industry to fund and commercialize innovative devices to drive their profession forward. Accordingly, of all physicians, IRs have one of the closest relationships with the medtech industry.

Interventional oncology is an example of how successful this relationship can be this is the current big thing in interventional radiology, representing a huge dedicated client base for these physicians, as well as an extremely attractive market potential for medtech manufacturers.

Unfortunately, a focus on innovation has not always been a successful model for interventional radiologists; this group has a history of losing procedures to other physician groups. The major example of this is peripheral vascular (PV) procedures, the majority of which are now performed by vascular surgeons and interventional cardiologists. So while PV remains a profitable growth market for the industry, the physicians that pioneered it are no longer reaping the benefits of its success.

This history is the reason that the SIR is concerned about their current M.O. of being so innovation-focused. As Dr. Ziv Haskal put it: We've been here for 40 years. Maybe we have to stop acting like we're a start-up company constantly innovating and spinning off procedures. Maybe we're a $50 million company that needs to grow to be a $200 million company.

Maybe, instead of the next big thing, IRs should be focused on owning what they do.

But what does this mean for the industry? Will they lose their partners in innovation? The take-home for the industry is that the current issues they face are the same as the issues faced by IRs. The climate of government regulation and cost-containment strategies is a defining feature of medtech right now. What IRs need to do to own their procedures is fully aligned with what medtech has to do to remain profitable in today's health care landscape; both must prove the value proposition of their procedures to government bodies. Medicare and payers need outcome data to clearly see that interventional radiology procedures are both medically effective and cost-effective. IRs need to show that they can perform procedures quicker, cheaper, and more cost-effectively than the status quo. THAT, rather than a new procedure, indication, or device, is going to be the "next big thing" in interventional radiology.

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