AAPM medical physics practice guideline 7.a.: Supervision of medical physicist assistants

Abstract

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: • Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. • Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

COMP Report: An updated algorithm to estimate medical physics staffing levels for radiation oncology

“…This is a slightly higher physics assistant compliment compared to the recent recommendations of the American Association of Physicists in Medicine, where a maximum of 0.25 physics assistants per medical physicist was proposed. 15 In regions where physics assistants are not employed, the algorithm's physics assistant FTE should be combined with the physicist FTE total.…”

“…Quality control measurements and other specific tasks under the supervision of medical physicists. [13][14][15] MSc or BSc emerging techniques that require more time during the early stages of clinical implementation. Based on the experience in Ontario, default values of 25% and 1% of total cases were found to be reasonable estimates for complex and highly specialized procedures.…”

AAPM Medical physics practice guideline 15.A: Peer review in clinical physics

“… The reviewer must determine whether instruments (appropriate to the clinical scope) are readily available, with instrument calibrations consistent with current AAPM recommendations and/or applicable regulations. Staffing levels and schedules must be carefully assessed, with consideration for the scope of clinical services, frequency of special procedures requiring physicist support, and other physicist duties such as radiation safety and administrative tasks. The staffing assessment should consider support staff such as medical physicist assistants, 13 medical dosimetrists, administrative support, and information technology. Equipment access for quality control and quality assurance must be assessed, including flexibility of scheduling relative to the incumbent physicist's availability. This is particularly important when the physicist is responsible for multiple clinic locations or is contracted for less than full‐time coverage. …”

“…Key QC templates should be evaluated for accuracy and clarity. The reviewer must assess whether clinical physics quality assurance (e.g., radiation oncology treatment plan reviews, 14 fluoroscopy dose, and pregnant patient radiation safety evaluations) is appropriate to the clinical services being provided, whether the incumbent physicist has conducted risk assessments to justify the existing QA procedures, and whether appropriate tools exist to ensure that such QA is consistently performed. The review must evaluate the program's safety culture and patient safety initiatives (e.g., incident learning, open communication, safety checklists). The review must evaluate the incumbent's supervision of clinical operations and leadership in process improvement, such as overseeing the dosimetric planning process in therapy or overseeing the development and management of imaging protocols and patient shielding practices in imaging. For QC work delegated to support staff, the reviewer must ascertain that instructions and tolerances are unambiguous, that the results are reviewed and co‐signed by the incumbent physicist, and that the work is performed under appropriate supervision 13 …”

“…The review must evaluate the incumbent's supervision of clinical operations and leadership in process improvement, such as overseeing the dosimetric planning process in therapy or overseeing the development and management of imaging protocols and patient shielding practices in imaging. For QC work delegated to support staff, the reviewer must ascertain that instructions and tolerances are unambiguous, that the results are reviewed and co‐signed by the incumbent physicist, and that the work is performed under appropriate supervision 13 …”