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Radiation oncology has evolved as a discipline and the physicians who practice radiation oncology are adapting to the changing landscape of oncology management. The skill set for the modern radiation oncologist has matured as the requirements for modern patient care have become increasingly complex both in patient evaluation and treatment execution. Radiation oncology interacts with all medical and surgical subspecialties and advanced radiation therapy treatment plans require nimble use of volumetric anatomic and metabolic image sets and applied pathology to contour targets for successful treatment. Although multidisciplinary care management can serve to confirm and validate a treatment plan among providers, the number of providers involved with an individual patient management plan can also generate confusion and mixed messaging for the patient and their family. Because radiation oncologists work with every discipline and see patients weekly on treatment, often the relationship between the radiation oncologist and the patient can serve as a bridge between disciplines and radiation oncologists can serve to align the disciplines with the patient to re-affirm the care plan, limit confusion, and generate confidence for the patient with the plan and the providers. In this article, we will review the changing role of the radiation oncologist as we continually move directly into the mainstream of patient care, in equal partnership to medical oncology with highly advanced tools for modern therapy. Survivorships models of care will mature as radiation oncologists become more integrated into primary and follow up management of each cancer patient. The article has relevance as modern radiation therapy programs will need to adjust to meet the needs of modern patient care as radiation oncologists assume more primary responsibility for the longitudinal care of the oncology patient.