Interventional radiology (IR) is transforming itself into a fully fledged clinical specialty. Successful practices will have to adapt to this environment by developing the requisite clinical skills and acquiring the associated privileges. To thrive, an IR physician will have to develop strong clinical skills, be intimately familiar with the relevant disease, IR procedure, its possible complications and how to address them effectively. From an administrative point of view, successful practices will have to follow a multidisciplinary approach to treatment that involves other physician-specialists and develop a diverse IR group that can provide appropriate pre- and post-intervention clinical care. The above are especially necessary in order to offer interventions such as arterial embolizations and percutaneous ablations which are rapidly becoming the mainstay of treatment for non-surgical patients (and increasingly surgical patients as well) with cancer.