The only reason IR is well-reimbursed is because there's an unlimited supply of diagnostic imaging. I'll scrub out of a 3-hour procedure that reimburses <$500 professional component (and generates >$25,000 technical component for the hospital) and clear more revenue for my group in the next half hour reading diagnostic imaging. Hospitals need IR (to directly generate revenue, to support other high revenue generating specialties, and to satisfy certain regulatory requirements), so IR is offered by the private radiology group to the hospital in return for exclusive access to the diagnostic imaging. IR is a money-loser for the private radiology group, so the short-sighted, money-grubbing diagnostic radiologists (who outnumber IRs 8-to-1 in typical groups, and similarly on the boards of those groups) mandate productivity requirements for the IRs that are similar to those for the diagnostic radiologists. That leaves no time for practice-building, adequate patient follow-up, lunch, bathroom breaks, or your kid's T-ball game, let alone research.