Dr. Ansel’s credentials as a thought leader and endovascular “luminary” are widely recognized. Coming from a cardiology background, he was among the early pioneers who understood that excellence in vascular disease management and endovascular therapy could only be achieved through dedication and intense focus. He has contributed widely to the field, and continues to be a significant player in — essentially — all major areas of endovascular technology. I find his reflections and views most reasonable as they are grounded in the realities of vascular practice. Obviously, some aspects of practice development are unique to one’s specialty background and “tribal origins,” and some are universal to all — whether a cardiologist, vascular surgeon or vascular radiologist. At the end of the day, availability and communication with patients and referring physicians are the true pillars on which to build the foundations for a solid and growing clinical practice. And, of course, it would be difficult to sustain a busy practice without consistently good outcomes.