The field of interventional radiology is currently at a crossroads. The position and role of the future interventionalist will be defined by the direction taken by the current generation of practitioners. There are four key issues that must be dealt with: (i) the dichotomous relationship between diagnostic and interventional radiology, (ii) the idea of the "hired gun" interventionalist versus that of the clinician interventionalist, (iii) the public's image of the interventional radiologist, and (iv) "turf wars" with other specialties.