AAPM Newsletter May/June 1998 Vol. 23 No. 3

Newsletter AMERICAN ASSOCIATION

OF

PHYSICISTS

IN

VOLUM E 23 NO. 3

MEDICINE MAY / JUNE 1998

AAPM President’s Column

by Lawrence Rothenberg New York, NY Spring Activities This has been a busy Spring for AAPM related activities.

You have all found our new electronic abstract submission f o r mat to your liking . We recei ved an increase in abstract submissions for the Annual Meeting of more than 15% and only about 6% of the total came in as hard copy.

Kudos to the program committee, led by Bob Gould, and to the AAPM Staff for opening cyberspace to our meeting attendees. Make sure to submit your meetin g re g i s t r a t i o n f o rms and room re s e r v a t i o n s for San Antonio, included in the packet with this newsletter, as soon as possible, since we a re anticipating a very larg e t u rnout. As the Local Arrangements Chairman J i m M a r b a c h points out in the accompanying announcement in this mailing for our 40th Ann ual Meeting in San Antonio, will be a celebration of the centenn ial of Marie Curie’s discovery of radium.

ABR Conference on Education Several AAPM Representatives, including Chuck

Wilson, Russ Ritenour, Jim Purdy, Geoff Ibbott and me, as well as our three ABR Trustees Guy Simmons, Bill Hendee, and Ed Chaney, participated in the ABR Conference on Graduate Medical Education in Radiology held early in March in Washington, DC. Radiology and Healthcare experts discussed the problems facing our medical institutions in providing funding and relevant education as we enter the new millennium in this era of managed care. G u y S i m m o n s will provide a detailed review of the meeting in the next newsletter.

AIP Assembly of Officers I was fortunate to represent AAPM along with G e o f f I b b o t t and two members of the AIP Board of Governors Ji m Smat hers and C h r i s M a r s h a l l, at the AIP

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Assembly of Scientific Officers.

Topics of discussion at that meeting were “Science and I n t e r national D iplo macy ,” “What is Physics at AIP?” and “Ascertaining the Public Image of Physics,” as well as a discussion of other current topics of interest. This annual meeting provides an opportunity for your leadership to interact with those from other member o rganizations as well as the AIP Staff. Geoff Ibbott will p rovide further discussion of this meeting elsewhere in the newsletter.

INSIDE TABLE OF CONTENTS President’s Column . . . . . . . . p. 1 Florida News . . . . . . . . . . . . p. 5 Medicare Fees . . . . . . . . . . . p. 6 AIP Officers. . . . . . . . . . . . . p. 7 Annual Meeting Update . . . . . p. 8 Executive Director’s Column . . p. 9 Medical Physics CD ROM . . . p. 10 Year 2000 Problem . . . . . . . p. 11 Announcements . . . . . . . . . p. 12 Award at Nice . . . . . . . . . . p. 13 ABMP News. . . . . . . . . . . . p. 14 Herbert Lecturer . . . . . . . . . p. 15

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MAY / JUNE 1998

NRC Communications We have had communications with the NRC concerning the revisions to Part 35.

With the assistance of Chuck Ke lsey , D ic k Lane , Mi ke Gillin, and others, I have put forth our re c o m m e n d a t i o n s along with a sincere plea that the r evis ion ef fo rt not be rushed, since we will all have to live with the resultant document for a long time. Yo u can read the AAPM response to NRC, as well as many other relevant and interesting documents on our web page: www.aapm.org.

Radiology Editorial An upc omi ng i ss ue of R a d i o l o g ywill contain an editori al f rom AA PM on future directions in imagin g re s e a rch entitled “A Per specti ve o n the New Millennium from the American Association of Physicists in Medicine.” Thanks to R o n Price, Ravi Nath, Tim Hall, Andy Karellas, Wlad Sobol, Mik e Ye s t e r , an d B o b Zimmerman for their participation in this effort.

Certification Boards We co nt inue to t ry to resolve the situation of duplication of certification examinations in the various subspecialties of radiological physics.

Chairman of the Board Steve T h o m a s, Pre s i d e n t - E l e c t G e o ff Ibbott, and I sent a letter late in February to both Sarah Donaldson, President of AB R, an d Fai z Kha n , Chairman of ABMP, requesting that they reestablish communication to resolve this issue.

Copies were sen t to t he AAPM EXCOM and Board, the

Executive Directors of ABMPSuntha and ABR-Paul Capp, the ABR Physics Trustees from AAPM, and the Chairmen of the ACMP-Alex Tu rn e r a n d A C R / C M P -Don To l b e r t. Dr. D on ald son and ABR h ave replied that ABR will work with AAPM in every way possible to resolve the issue, and ABMP and ACMP have given indications that they will soon be submitting a compro m i s e p roposal requesting stro n g AAPM Board support. Clearly AAPM must serve as the principal channel of communicat ion and su pp ort for this effort. The AAPM EXCOM and B o a rd are eager to find a compromise consistent with the diverse viewpoints of our membership. I have pers on ally met wi th both D rs. Do na ldso n and Khan during April to indicate our

s t rong interest in resolving this issue.

An Apology Finally, an apology to Paul F e l l e r fo r my inco rr ec tly identif ying To ny Sei be rt, rat her than P aul , as t he E du cat ion P ro g r a m C o o r di nat or o f the 1998 An nual M eet in g, in t he Jan/Feb N ewsletter. (To n y chairs the Annual Meeting and Refres her C ou rse Sub committee as well as t he Conti nu in g Educat ion Committee.) Both Paul and Tony are working diligently to i n s u re that our educational activities in San Antonio will be a great success.

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DON’T FORGET You can send revisions for your directory address, as well as your address(es) for mailings, billings, and correspondence, at any time through the AAPM Web Page:

http://www.aapm.org NOTE: These are not automatic changes to your file. Your submission will enter a queue and will be processed as quickly as possible.

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AAPM NEWSLETTER

MAY / JUNE 1998

A Review of AAPM Headquarter’s Services

By Bhudatt Paliwal Madison, WI In accordance with the established policies and guid eli nes of the AAPM, President L a w re n c e R o t h e n b e r g a p po in ted a Headq uarters (HQ) Site Vis it team. Durin g the review process, a significant amount of data was collecte d, an d a r ep o rt is be i ng p re p a red to submit to the P resident and the Board of D i rectors. The objective of this article is to share with the membership the type of services the HQ staff provides, and more importantly, how some of these services have grown since the move of the HQ to its current location at College Park, Maryland. The data presented foll ows fou r years of stable operation of the HQ at the current site; it also follows a period of s i g n i f ic a n t g r o wt h i n t h e activities of th e AAPM. T he As s oc ia t i on w as a l so fortunate to have the continu ity of support from a highly professional, qualif ie d a n d d e d i c a t e d s ta f f .

T h e p ri m ar y f un c t i o ns o f the HQ may be categorized under the following bro a d titles: • Financial Accounting functions, budget control, investment management, placement bulletin invoicing, collection of dues and meeting registrations.

• Membership Services Membership directory (production and advertising), monthly mailings, AAPM web page, various brochures.

• Meetings Support Summer school, RSNA, and annual meeting logistics which includes the scientific abstracts process, hotel and convention bureau negotiations, exhibits management, etc.

• Publications Medical Physics Journal manuscript submission administration, Journal Business Management Committee support, books and reports inventory control.

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• Councils, Committees and Liaisons Support Committee assignment process, awards program, support of executive committees and the AAPM Board in various matters.

• Other Major Services CAMPEP CEC process, residency and fellowship programs, World Congress meeting in 2000, development funds.

Assuming the HQ workload in each o f th e above categ or i es cor rel a te s w it h t he number of AAPM members, a tt end anc e a t t he a n nua l meeting, number of abstracts, exhibitors and booths at the annual meeting, the Site Visit

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MAY / JUNE 1998

Committee requested compilation of this data, shown in graphs 1-5. Depending upon t he ca te g or y, th e re l a t i v e growth over a period of five years (1993-97) ranges fro m 3% t o a s m u ch as 60 % .

T hi s increase i n w orkl oad does imp a ct the s ta f f i n g nee d s of t he H Q an d t he re s o u r ce s it t ake s to provide the services.

Th e HQ Site Visit C omm itt ee is cu rre nt l y in the process of comp leting i ts r e p o r t . Th e f i n al i ze d report will be submitted to th e Pres ident and the Board of Directo rs for further consideration. â–

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AAPM NEWSLETTER

MAY / JUNE 1998

Florida AAPM Elects New Officers

by John Cameron Florida/Wisconsin The Florida Chapter of the AAPM held its annual meeti ng i n s ou th wes t Ta m p a M a rch 20 - 21, 1998. AAPM P resident-elect G o e ff Ibbott spoke after the Friday lunch on the “State of the AAPM,” and gave a favorable report.

A t t he a nn ual b us in ess meeting, outgoing pre s i d e n t Frank Bova from Gainesville t u r ned over t he ga vel to inc omi ng pr esident B r i a n N o r i e g a f ro m Tampa. The t h ree new ch ap ter off i c e r s chosen in the recent mail ballot are: President-elect M a r y E llen Master son-McG ary f rom Melbourne, FL, secretary-treasurer Gloria Mazzara of Tam pa an d Boa rd R e p resentative David Miller from Orlando.

T he Cha pt er ap pr o v e d sponsoring a one-day workshop on medical instrumentation for physics teachers in January 2000 when the AAPT meets in Orlando. The chapter discussed the desirability o f h avin g a web page and w o n d e r ed i f i t co ul d b e a sub-page of the AAPM webpage. (It can.) There was a brief discussion of ways to provide opportunities for continuing education credits to meet the need created by the Fl or ida r e q u i re me nt f or licensed medical physicists. It is anticipated that the chapter wi ll i ni ti a te a n an nu a l newsletter.

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AAPM NEWSLETTER

MAY / JUNE 1998

AAPM Supports ACR Objections to Proposed Changes to Medicare Fee Schedule

by Geoffrey Ibbott Lexington, KY Over the last three years, the H ealth Care Financing Administration (HCFA) contracted with Abt Associates to conduct a study of physician practice expense. This study c o v e red all 6,000 CPT codes and all medical specialties.

Abt Associates set up expert panels to estimate these pract ice e xp ens e s, wh ic h ar e essentially the technical component of an office practice.

One of these expert panels dealt with the radiology and ra di at i on o nc ol ogy CP T codes, and was composed of a nu mbe r of p hysi c ian s, in clud ing radi ologi sts and one radiation oncologist. I represented medical physics.

Th e ex pert pan e ls wer e expected to derive practice expense costs by estimating the time spent by non-physici an staf f, and t he cost o f typical medical equipment. At the same time, Abt Associates t ried to e stim at e in di re c t practice costs by conducting a survey of 5,000 physicians.

Indirect costs included equipment service, QA procedures, and overhead. They conducted the first phase of this survey by surveying 1,700 physic ia ns . T he s urv ey re s u l t s w e r e not s uc ce s sful , an d t he r es t o f th e surve y was cancelled.

While acknowledging that th eir analysis was fl awed, H C FA ultimately published t hei r m eth od ol ogy and

impact figures in the June 18, 1997 Federal Register. The overall impact on radiology wa s to re d uce r e i m b u r s ements by between -5 to -9%.

For radiation oncology, the revised figures showed an increase in reimbursement of bet w een + 1 0 an d + 1 1%.

However, this average figure o b s c u red the fact that there were dramatic and inexplicab le vari ation s am ong CPT codes. ACR’s analysis of the H C FA p r opo s ed p ra ct i ce ex pe ns e RV Us (PE RVU s ) indicated that payment for ho spi ta l b as ed ra d iat io n oncology services would be reduced by -11% while payment for office based proced u re s wo ul d go up + 2 3% on average.

The reductions to the professional component are significant in light of the fact that the majority of radiation o ncol og ist s an d ra di ati on oncology procedures are hospital based. Furthermore, not all radiation oncology technica l c om pon e nt s w oul d r e ce i ve t he pr o j e c t e d increase. For example, while radiation treatment delivery ( co des 774 xx) w oul d s ee increases nearing +90%, payment for treatment devices (codes 7733x) an d re m o t e afterloading brachytherapy (codes 7778x) would be cut as much as -40% and -70% respectively. Moreover, many office based radiation oncologists would not benefit from the projected increases since the facility often retains the

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technical component; thus paym ent to t he ra di at io n oncologist is based on the professional component.

The ACR determined that the best solution to the HCFA proposal within both radiology and radiation oncology wou ld be t o ma in ta i n the re la t io nsh ip am ong C P T cod e s c urr en tl y in th e M e d i c a re RBRVS. Relativity can be maintained through a budget-neutrality calculation.

The ACR recommends that a s in g l e ad jus t me nt to th e P E RVUs of -2.2% be applied across all radiological modaliti e s.

Be cau se p ra ct i ce expense is approximately one half of total re i m b u r s e m e n t , the radiation oncology total payments would be re d u c e d -1 .0 7% . T he s e re d u c t i o n s would be negligible when s p rea d over a th r ee y ear transition period.

The AAPM, through a decision made by EXCOM, notified the ACR and ASTRO of AAPM’s support for this proposal. The AAPM b elieves that the changes proposed by HCFA are based on a flawed analysis, and result in unwarranted and unjustifiable shifts in payment, and should not be implemented. At pre s e n t , the implementation o f the H C FA pr o po sal ha s b ee n delayed until January 1, 1999.

It is not known at this time how the ACR re c o m m e n d ation has been received.

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AAPM NEWSLETTER

Assembly of AIP Society Officers

by Geoffrey Ibbott Lexington, KY The AAPM is a member of th e Amer ican Inst itute of Physics, and periodically the AIP holds an Assembly of AIP Society Officers. This year’s assemb ly was held at the American Center for Physics (home of the AAPM and AIP headquarters) in College Park on March 26-27. The purpose of the Assembly of Society Officers is to enable member and affiliated society representatives to become better acquainted with each other and to share ideas on common problems. In addition, th e assembly sessions are intended to provide information of general interest on a number of selected topics.

This year, the assembly was attend ed by four AAPM re p resentatives; Larry Rothenberg (President) and I ( P resident-elect) attended as s ociety officers; J a m e s S m a t h e r s and C h r i s t o p h e r M a r s h a l l attended in their roles as members of the AIP Governing Board.

The initial session of the meeting consisted of a series of reports by influential members of the scientific community. First was Rodney Nichols, P resident and CEO of the N ew York Academy of Sciences. He spoke about the federal government’s poor record of attention to science initiatives, an d prosp ects for the future. He criticized th e federal go ver n m e n t ’ s response as being withou t

strategy and su ff i c i e n t re s o u rces. Our ambassadors apparently spend a considerable amount of time on science-related issues, but communication with the State Department is poor, and leadership is weak. H e said the US tend s to make decisions without suff i c i e n t investigation of the issues, and then announces pro g r a m s with out maki ng suff i c i e n t resources available.

Th e next speaker was Admiral James Watkins, former S e c r etary o f E nergy and p resentl y Presid ent of the Cons ortium for Oceanographic Research and Education. Admiral Wa t k i n s recently testified before the US House of R epre s e n t a t i v e s Committee on Science that the State Department has little knowledge of or interest in science and technology and their i mp act on American i n t e rests abro ad. Admiral Watkins went on to site specific examples of the rather poor track record of the US in sustaining announced commitments and the lack of follow t h ro ugh on agre e m e n t s .

Admiral Watkins was followed

by Peter Humphrey, a Foreign Service officer at the State Department. Mr. Humphre y recently wrote an article in the Foreign Service journal stating that the State Department has decided to phase out the science and technology officers by 2004, moving their function to econ omics of fices, or regional environmental hubs.

He decried this move, and

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provided a number of examples in which the Foreign Service science and technology officers made major contributions throughout the world.

The next session re v i e w e d the role of the AIP in supporting physics societies. One of the speakers was Roman Czujko of AIP who presented a talk on un derg r a d u a t e degrees of AIP society members and discussed the undergraduate fields and departments that are the sources of f u t u r e professionals to be served by the AIP and its member societies. He provided a number of useful statistics demonstrating the recent declin e in the n umber of bachelor’s degrees award e d annually in physics and mathematics. This is in stark contrast to the significant increase in the number of bachelor’s degrees awarded annually in all fields; the number has doubled since 1968 to nearly 1.2 million last year.

T he f irs t s ess ion on Friday morning attempted to as cert ain the publi c ima ge of sci ence. Arthur Spilhaus, P resident o f the American Geophysical Union, discussed the res ults of a focus group put together by the AGU to determine th e public image of geoscientists.

Among other specifics, he stated that the public perception is that while preservation of the environment is an important public issue, scientists are

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MAY / JUNE 1998

not capable of much influence. Another speaker, Judy Franz of the American Physical Society, explained that the APS has hired a public re l a t i o n s firm to improve the image of physicists and publicize their role. The APS has created a number of short radio segments highlighting the influence of physicists in issues of public interest, and has developed press releases in response to public events in which physicists had a ro l e .

Several other speakers made presentations and led discussions on improving the public image of physicists.

The assembly ended with a roundtable discussion of current issues, during which the o fficers of member societies di scus sed the s uccess es, trends, and concerns of their societies. Several of the societies revealed concerns regarding their membership requirements, involvement of their members in society activities, participation in elections, and payment of dues.

This assembly was a worthwhile event for the AAPM to participate in, and it is my opinion that the four AAPM re p resentatives benefited by being able to interact with officers of other member societies. Our pres ence there helped to increase the awareness of the member societies of the role and influence of the AAPM and its members.

Our continued involvement in the AIP assembly of society o f ficers will continue to enhance our relationship with other, more traditional physics societies.

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New Features of Annual Meeting

San Antonio’s Alamo

T h e re will be s om e ne w f e a t u res for the August 9-13, 1998 meeting.

• Early in June of this year, the 1998 Annual Meeting Program will be posted on AAPM’s web page, http://www.aapm.org.

You will also be able to view all accepted abstracts and search on them by title, author, category, and keywords.

• Refresher Course speakers have been encouraged to provide session handouts and Continuing Education Course speakers are required to provide handouts. As part of your Annual Meeting registration, you will receive a binder of all handouts provided by speakers. The handouts will also be available on the AAPM’s web

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page http://www.aapm.org

by August 1.

• Plan to dress comfortably for the San Antonio climate. The “official” dress code is CASUAL. Men, leave your ties at home.

Women, likewise with your high heels.

• All committee meetings will take place at the Convention Center, so active AAPM members will not have to run back and forth from committee meetings at the hotel to sessions at the center.

We are anticipating a great meeting. Exhibit booth sales have already surpassed 1997 s a le s , an d the in c rea sed number o f abstracts could indicate a larger attendance.

Don’t miss it.

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AAPM NEWSLETTER

MAY / JUNE 1998

Executive Director’s Column

By Sal Trofi College Park, MD Abstract Submission Process The electronic abstract submission process for the 1998 A nn ua l Me et i ng w a s w ell received by the membership due in large part to the herculean ef forts of members Bob Gould, Mary Martel, Maryellen Giger and Bruce C u r r a n and staff Lisa Rose Sullivan, Mike Wo o d w a rd and Angela Keyser. A total of 540 abstracts were submitted 508 electronically and 32 via hardcopy. This is a 17% i n c re as e fro m th e 4 63 abstracts submitted for the 1997Annual Meeting.

We were expecting more h a rdcopy submissions, but attribute the low perc e n t a g e (6%) in part to the fact that the deadline for hard c o p y submissions was two weeks earlier than that for electronic su bmi ss ion s.

Th e lo ca l F ede ral Exp r ess (F edE x) o ffice here in College Park m us t b e wo nd er in g wh a t h app ene d to th e 4 00 + o v e rnight packets norm a l l y r ec ei v ed at AA P M H e adq ua rt er s o n th e f irs t Friday in February.

E ach member submitting electronically saved between $12 to $15 and conversely FedEx lost between $6,000 to $8,000.

At the time of this re p o r t , the on-line review process is complete. Scientific Pro g r a m D i re c t o r, Mary Martel, and

S cie n tif i c P r ogra m C oD i re c t o r, Maryellen Giger, are assigning sessions on-line, and invited speakers are subm i tt i ng t he ir a bstr ac ts .

Au thors wi ll be c on tacted e l e c t ronically re g a rding the disposition of their abstract.

As wi t h mos t n ew pr ograms of this magnitude, we had some rough spots along the way. A few segments of the program were not working by the original deadline dates. The delays were not long in duration and did not ca use s evere hardshi ps to members submitting. We did receive suggestions from the m em bers hi p on how to i m p r ove t h e p r oce s s and have surveyed the reviewers f or t hei r com me nt s. Th is information will be forwarded to the P rogram Committee f or t he ir c on si dera t io n of possible upgrades for 1999.

Remotely Directed Continuing Education (RDCE) Update At the time of writing this column, the RDCE program is continuing to be developed.

The process should be ready for use during the 3rd quarter of this year. The back end of the program (re c o rd keeping, et c.) is fi nis hed .

The front end of the program ( s c reens that the users will s e e and u se) ar e bei ng reviewed by Chuck Kelsey a n d the R DCE com mi tt ee .

Their comments and suggestions will be implemented a nd th e n t est in g of t he

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system will take place. The system will allow a member to query the RDCE system via the WWW for a display of their RDCE credits at any time. The process includes c o m p r eh en siv e f ee db ack about the testing process to enable the question writers to bu il d be tt e r te st s i n the future. â–

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Medical Physics CD ROM

by Christopher Marshall New York, NY The April mailing to AAPM members included a CD ROM with the full text and illustrations from the 1997 volume of Medical Physics. The CD also has the article titles and authors of all the papers from al l vo lu m es of M e d i c a l P h y s i c s since inception, and the f ul l ab st ra ct s o f mor e recent volumes which have been preserved in digital forma t. Nex t ye ar, me mb e rs should receive a replacement CD ROM which will add the 1998 volume to the pre v i o u s contents, and we can continue to add incrementally to the contents each year for the foreseeable future by eventually switch ing to wh atever technology replaces the CD ROM as a standard.

This significant step towards e l e c t ronic publication of the J o u rnal is being taken with the enthusiastic support of the Edi tor o f M e di c al P hys i cs, Colin Orton, based on the rec om mend ati on s of th e Journal Business Management Committee (JBMC), chaired by John Boone, and in partnership w i th th e A me r ica n Institute of Physics (AIP). We have also received some welcome financial support fro m advertisers. You can link to th e ir h om e pag es dir e c t l y f r om t he C D i f you h av e access to the Internet fro m the ma chi ne you us e fo r the CD. The CD R O M, lik e th e pri nted c opies of M e d i c a l P h y s i c swhich are supplied to

members, is strictly for personal use, and should not be pl ac ed i n libr ar ie s. T h e f i n an c i a l v i a b i l i t y o f Medical Physics rests in part on library subscript i on i n c o m e , w h i ch i s e n d a n g e r e d i f m e m b er copies are used improperl y . The C D R OM i s bei ng issued to members only, as a benefit of membership, and not as a product for sale at t hi s t ime . One i mme d iat e advantage over the print version can be measured by the s hel f sp ac e t hat c an be re c o v e r ed by mem b er s if paper copies are discard e d .

Another is that the CD ROM text can be reliably searched using the tools provided with the product. Finally, it gives all of us a vehicle to explore the advantages and disadvantages of the digital age as it applies to the Journal .

This article is intended to encourage members to use t his n ew p rodu c t a nd bec ome f a mi li ar wi th t he advan tages and d is advant age s o f a n e le ct r o n i c J o u rn a l, to p rovi de s om e b a c k g round to the general issues related to electro n i c publications, and to stimulate discussion within the AAPM about its future actions in the area of electronic publications. Members are theref o re encouraged to access and participate in the discuss io n on th is CD pr o d u c t t h rough a forum which may b e ac c ess ed f rom t he Medical Physics home page (http://www.medphys.org) or through the J o u rn a l ’ s link on

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the A APM ho m e pa ge ( h t t p : / / w w w . a a p m . o rg). The for u m is a ls o in t end ed to assi st m em bers w ho h a ve tec hnica l ques tion s abo ut using this product. The JBMC opted not to pay the significant additional costs for providing telephone support for users. If you post the question, someone should have the answer.

The AIP, which pro d u c e d the CD and which pro d u c e s the J o u rn a l on behalf of the AAPM, converted to a fully digital compositional system several years ago and uses th is for all t he jo ur n al s i t p rod uc es u nder i ts own i mpri nt , and o n be h alf of member societies, like AAPM. The AIP has the technology to produce both print and digital publications from this digital source material and also to deliver digital publications to subscribers using the I n t e rnet. It is pro g re s s i v e l y enhancing the utility of the web-based publications in a series of steps; for example by p rovi di ng h ot li nk s f rom re f e rences to the original articles.

T h e re are several re a s o n s why the JBMC has taken the approach of producing a CD ROM at this time, while also ensuring that all necessary coding is done to permit current and future volumes of the J o u rn a l to be published via the Inter net whenever that is deemed to be appropriate. One reason is that the Co m mit t ee is not ye t convinced that the membership as a whole has conve-

AAPM NEWSLETTER

nient access to the Intern e t , al th ou gh thi s si t uat io n i s clearly changing rapidly and the amount of inform a t i o n available to members through the Internet is likely to make access indispensable in the near future. Another reason is concern that it is less convenient to read articles on a m o n i t o r, although the technology used on the CD ROM and with the web-based publications is designed to minimize this disadvantage, and r e ma rk a bl y goo d qu al i ty copies of pages and articles can also be printed locally on a laser printer.

The main reason for this a p p roach, however, is conc e r n abo ut th e ec ono m ic risks of full electronic publication. The JBMC must weigh t hes e a gain st th e g ener al belief that any serious scientific publication must soon be ma de av ai la b le v i a t h e I n t e rnet to retain its author base and its re s e a rch re a d e r b ase , an d t hu s i ts libr ar y base. At the current time, the J o u rnal is very dependent

upon inc o me fro m li br ary subscriptions and from advertising revenue to cover costs.

A large increase in the current member dues allocation to th e J o u rn a l wo ul d b e needed to cover costs in the absence of these sources of revenue. Full electronic publication will have impact on both of these sources of reven u e, a nd wh ile t her e i s potential to build new re l ationships with advertisers and libraries (for example by linki ng t he el ec tro ni c a d s t o advertising home pages, or by p er mit t in g li bra ri es t o r ed is t rib ute o ver a lo c al intranet) such possibilities do not currently represent a riskfree base for economic modeling. There are some potentially significant economic advantages from full electronic publication, such as eliminating the large costs associated with paper and mailing, but it is most unlikely that any journal such as M e d i c a l P h y s i c s co uld simply stop publishing a paper edition in the immediate future. Th e

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ne ed to pr o du ce p a ra ll e l paper and electronic versions has significant cost implications. This suggests that we should not leap pre m a t u re l y into electronic publishing, but since we must also be posit io ned to s ati sfy l ib ra ry demands for electronic public at i on s as the y ar i se, we potentially face some difficult e co nom i c ch oi ce s in the future.

Please join in the debate by accessing the forum from the Me dica l P hysi cs h o m e page. You will also find links to many of the advertis ers who support the J o u rnal o n its home page. If these links are used enough, advertisers will recognize that this is a viable way to reach AAPM members, and we can begin to develop the re l a t i o n s h i p s w e n ee d t o su st a in our J o u rna l in an exciting but rapidly changing future.

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Medical Physics and the Year 2000 Date Problem

by Thomas Shope Rockville, MD Unless you have been totally isolated from the media for the last six months, you no doubt have heard about the “Year 2000 Date Problem” or the “Millennium Bug” or the “Y2K Problem,” or whatever you wish to call it, and the d i re predictions which have bee n asso c iat e d wit h t his

issue. Unfortunately, much of the concern is well-founded, a s th is pr o bl em , re s u l t i n g from the use of two digits to represent the year in computer dat e r e p resen tat ions or calculations, can have impact on m an y as pe ct s o f l ife , in c lu d ing t he de l i ver y of m edi c al c a re or me di ca l physics services.

Anyone who has developed or otherwise obtained soft-

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ware, such as radiation treatm ent pl anni ng s of t wa re , which could impact patient care should give careful attent io n t o t hi s is su e and the status of the software.

The Federal Govern m e n t has established a World Wide Web site to provide inform ation on the “Year 2000” status of medical devices and scient ifi c l aboratory equi pment (b iom edi c al eq ui pme nt ).

AAPM NEWSLETTER

MAY / JUNE 1998

T h e re is a chance so me of these products will experienc e pro bl e ms ass oc iat ed with the use of date information on January 1, 2000 if the computer systems, software a ppl ic at io ns o r imb e dd ed chips used in these devices and equipment contain twodigit fields for representation of the year. In such a circumstance, the software program will not be able to distinguish the year 2000 from the year 1900. When the device needs to calculate a date to work, this can potentially lead to the product’s failing to function as expected. Analysis of the year 2000 problem shows the m ost li kel y errors wi ll result in printed test re s u l t s that are incorrectly dated or self-evidently wrong but some ma y mor e di re ct ly pu t patients at risk.

The website, administere d by the U.S. Food and Drug Administration for the governme nt ’s C hie f Inf or m a t i o n O f fi c er s Co u ncil S ub committee on the Year 2000, is intended to give pro d u c t users in healthcare facilities and research laboratories and other interested parties one c o m p rehensive re s o u rce for i n f o rmation about the “Ye a r 2000 compliance” of biomedical equipment. “Year 2000 compliance” means that the p roduct accurately pro c e s s e s and stores date and time data du rin g , f ro m , i nt o and between the 20th and 21st centuries, and the years 1999 and 2000. (Pr ocessin g and storing data may include calculating, comparing, displaying, recording and sequencing operations involving date and time data, including corre c t

processing of leap year data.)

To be Year 2000 compliant, p r odu c ts must f un ct ion as intended or expected, regardless of the date.

Should they not be corrected in time, Year 2000 date p roblems potentially could pose serious health and safety c ons equ e nce s. A medi cal de vi c e f u nct io n w hi ch de p ends on a ca l cu la tio n involving a date, and which is performed incorrectly as a r esu lt of a da t e pr o b l e m , co uld le ad to a risk to t he pat i ent. O ne exa mp le i s a product used for planning the delivery of radiation treatment using a radioactive isotope as the radiation source. An error in the calculation of the radiation source strength on the da y t he t her ap y is t o b e d e l i v e red could result in an i n c o r rect treatment and have a d ve rse con se q uenc es f o r the patient.

While the website was originally planned to aid the several agencies in the federal government that use and purchase medical devices and laboratory equipment, it was q ui ck ly re al ize d tha t t he p r iv at e sec to r ha s th e same needs for this inform at io n. Man uf ac tu rer s w ill b e nef i t t oo , as th e y can r efe r inq ui ries t o t he website instead of answering them repeatedly.

D e pu ty Se cr et ar y K evin T h u rm of the Department of Health and Human Services, i n a let t er on Jan uar y 21, 1 998 , a s ked b io medi cal equipment manufacturers to p rovide information on the Year 2000 compliance status of their products. The information received from manu-

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facturers will be made available on the World Wide Web p age ma int ai ned b y FDA .

Th e we b si te w i ll cont a in i n f o rmation only for those p roducts identified by their m a n u f a c t u rer as not being “Year 2000 compliant.”

The website is located at: http://www.fda.gov/cdrh/yr 2000/year2000.html.

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Announcements June 14-19, 1998 1998 American Association of Medical Dosimetrists 23rd Annual Meeting “Avenues in Dosimetry” Sheraton Meadowlands Hotel East Rutherford, New Jersey For mor e inf o r mat i on , contact: Karen Episcopia, CMD Phone (718) 558-2050 FAX (718) 558-2022 Oaks Travel Agency (800) 284-0679 for hotel and airline reservations.

MDCB and ASRT continuing educations credits have been applied for.

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AAPM NEWSLETTER

MAY / JUNE 1998

Letter to the Editor Medical Physics Award at Nice

by John Cameron Florida/Wisconsin T he I UP ESM esta bl is hed two awards to be given at the World Congress, one for a n o u t s ta n d i n g m e d i c a l physicist and the other for an outstanding bio medical engineer. Previous recipients o f med ic a l ph y si cs awa rd a re John Mallard of the UK a nd R u n e Wa l s t a m o f S we d e n. I n 1 9 9 6 D r.

Madhvanath, former pre s ident of IOMP was made chair of th e IUPESM committee to choose the re c i p ie n t s o f th e a w a r d s . H e established two subcommittees - one for each field to select the recipients. John C a m e ron, former Secre t a r y General of IOMP was chair o f t h e s u b c o m m it t e e to choose the medical physicist a w a rdee. He chose Phillip D e n d y o f t h e U K an d Gudrun Alm-Carlsson of S we d e n a s t h e o t h e r t w o members of the subcommittee. The choice of these two distinguished medical physicists was influenced by the fact that the previous recipients of the Medical Physics Aw a r d w e r e f r o m t h e U K and Sweden A condition of the award was that the a w a r de e m u s t ha v e m a de significant contributions in medical physics in their own country and intern a t i o n a l l y .

The subcommittee solicited

nominations from all IOMP a f f i li a t e d o r g a n i z a t i o n s .

About ten candidates were n o m i n at e d b y v a r i o us national organizations aff i l iated with the IOMP. The subcommittee decided t h a t e a c h m e m b e r w o u ld choose their top three candidates among the nominees.

The results of this pro c e s s w e re used to select the top t h ree overall. T hese were : John Cunningham, nominate d b y C O M P o f C a n ad a , A n d ree Dutreix nominated

by SFPH of France and John Laughlin nominated by the AAPM of the US. The subcommittee agre e d t h a t e a c h o f t h e se c a nd i dates were were well qualified to be the awardee.

In their final voting they c h o s e L a u g h l i n a s fi r s t , Cunningham as second and D u t r eix as third. The s ub committees submitted their r e c o m m e n d a t i o n s t o D r.

M ad hva nat h a t th e e nd o f 1996. Laughlin was informed of his selection and agre e d t o ac c e p t t h e a w a r d a n d give a talk at t he o pen ing c e remonies in Nice. A coup le o f m o n t h s b e f o r e t h e C o n g r es s, Lau ghlin devel o p e d a m e di c a l p r o b l e m involving his eyes and was advised not to travel. He w a s t o l d h e co u l d h a v e someone else read his talk at the opening cere m o n i e s .

He learned that Jack

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Cu n n i n g h a m , t h e s e c o n d choice of the selection committee planned to attend the Congress. He felt that it would be more appro p r i a t e to have the awardee present a t t h e op en in g c e r e m o n y and suggested that Professor Cu nningh am be given t he a w a rd. This seemed to be a good solution and was approved by the IUPESM. Professor Cunningham had previously agreed to give an invited talk at the Historical session on the contributions of Harold Johns. I suggested that he give that talk at the opening ceremonies, which he did. He also chaired the Historical session that was dedicated to Professor Johns.

P ro f esso r J ohn s w ho is re t i red and lives in To ro n t o Canada was appreciative of the recognition. â–

AAPM NEWSLETTER

MAY / JUNE 1998

ABMP News 1998 Exams

by Faiz Khan Minneapolis, MN New Sponsor Th e A merica n Board of Medical Physics, which has been solely sponsored by the American College of Medical Physics since 1987, now has a new sponsor: The American Academy of Health Physics.

The ABMP is now govern e d by eight Dir ector s – six appointed by the ACMP and two by the AAHP. The new members appointed by the A AHP t o t h e A BM P Bo ar d a r e: R ich ard Vetter (May o Clinic, Rochester, Minnesota) and Kenneth Miller (Hershey Med ic al Cen te r, H ershe y, Pennsylvania).

101 candidates have re g i stered for the 1998 Oral (Part III) exam which were held in Chicago (O’Hare Hilton) on April 23-26, 1998.

184 candidates have re g i st e red for t he 1998 Wr i t t e n Exams (Part I and II) which will be held in San Antonio, August 8-9, 1998.

T he fi r st Wr i t t e n Examination in MRI Physics is being off e red in 1998 on the dates specified above for the Written Exams.

The ABMP Web page can be accessed from the ACMP web site: w w w . a c m p . ogr o r f r om the AA PM We b site : www.aapm.org.

the ABR and the ABMP is of c o n c e r n to man y AAP M members. While efforts are still underway to unify both B o a r ds , I ho pe med ic al physicists will maintain prof essi on a l u nit y a nd a voi d actions that can further polarize the medical physics community on this issue. Until a workable solution is agre e d up on, m edi ca l p hysi c is ts should be supportive of both Boards. Both Boards are duly incorporated, pro f e s s i o n a l l y sponsored and nationally recognized. We should leave it to the candidates to choose the board certification exam they prefer to take. What is important is the certification p rogram and the cre d e n t i a ling of medical physicists to help maintain a standard of clinical practice.

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Personal Note Duplication of certification of medical physics by both

Exam Results Written Examinations Parts I and II Specialty Number of Examinees No. (%) Passed Part I: General Medical Physics 101 73 (73%) Part II: Radiation Oncology Physics 81 48 (59%) Diagnostic Imaging Physics 18 9 (50%) Medical Health Physics 5 2 (40%) Total: 205 123 (60%) Oral Examination Part III Specialty Number of Examinees No. (%) Passed Radiation Oncology Physics 72 31 (43%) Diagnostic Imaging Physics 14 6 (43%) Medical Health Physics 4 3 (75%) Total: 90 40 (44%)

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No. Condition 20 3 1 24 (27%)

AAPM NEWSLETTER

Herbert Chosen as AAPM/IPEM Visiting Lecturer

by John Cameron Florida/Wisconsin Donald Herbert, an AAPM Fellow with a mathematical ben t, wa s ch os en by t he AAPM Aw a rds and Hono rs C omm itt ee to be an AAPM/IPEM Visiting Lecturer.

He will give a total of seven f o r mal l e ct ure s at fi v e Universities and medical centers in the UK from April 13 to May 8, 1998.

The centers he is scheduled t o v is it a re : T he R oy al M ars de n N HS Tru st ; T he University College (both in Lo nd on) ; Ca mbr idg e University Teaching Hospitals (C am bri dge ); t he Uni t ed Bristol Health Care NHS Trust (Bristol); the Western General H os pi ta l NHS Tr u s t ( E d i n b u rgh ); an d t he Paterson Institute for Cancer Research (Manchester).

The titles of his lecture s are: 1) “What Works in Medicine.

A n I nt ro duc t io n to Technology Assessment and Outcomes Analysis in Radiology.”

2) “T he Ne w Ph y si cs : C a t a s t r oph es, Frac ta ls, Chaos, and Solitons. An I n t r od ucti on wit h Applications in Medicine.”

3) “Does the Model ‘Fit?’ An I n t roduction to Modern Sta ti st ica l Mo de l in g o f Radiobiological Data.”

These lectures were selected b y t h e r e spe cti ve ins tit ut ions fr om a me nu o f l e ct ur es s ub m it ted by Herbert that inc lud ed t wo additional lectures: 4) “Be yon d Mol e cul a r Biology: An Intro d u c t i o n to the Strange and Violent Worl d o f N onl i nea r Dynamics.”

5) “Combining Inform a t i o n .

An I n tr o duc ti on to Meta-Analysis.”

The three lectures selected provide a perspective on the current interests and concerns of British medical physicists.

(I hope that the abstracts for h is le ct ure s w i ll be m ade available on the AAPM web page with their references.)

Dr. Herbert was the second chair of the AAPM Biological E f fe cts Co m mit t ee (B EC ) founded by Harvard pro f e ssor (and past AAPM President and F ell ow ) E. W. (Te d ) Webster. Dr. Herbert was the chair of its first task gro u p , TG1, “Evaluation of Models for Do se- R esp ons e in Radiation Oncology” that prod uce d A APM Re p ort 4 3, Qu a li ty As se s sme nt a nd I m p rove me n t of Dos e Res po nse M o del s: S o me E ffects of Study We a k n e s s e s o n St udy F ind in gs. ‘C ’es t Ma gn if ique ?’ ” He wa s the principal author of this erudite and voluminous re p o r t .

He is currently the chair of the BEC TG7 on Complexity

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MAY / JUNE 1998

Th eory in B io lo g y. H e is als o c ha ir of th e A APM Statistics Committee.

Don’s fee lings about the impo rt an ce of sta ti sti cs is summarized in his paraphrase of Rutherford’s famous quotation that “All Science is either Physics or it’s Stamp-collecting.” Don replaces “physics” with “statistics.” I didn’t used to think so but I have fallen under Don’s spell and rather a g ree with him. I think he might allow me to modify it to “the proper use of statistics.” In science neither sloppy physics nor improper use of statistics are appro p r i a t e .

Unfortunately the latter is still all too common - as demonstrated in AAPM Report 43.

This report provides many examples of disastrous inferences and estimates resulting f rom inappropriate uses of statistics in major published studies. Unfortunately, this report has not received the acclaim it deserves. I have no idea how many AAPM members have read Report 43 and agree with me.

My minor contribution to Don ’s t ri p w a s t o s ugg es t that he open some of his lectures with the joke about the physics professor who had a d ream. In the dream he was gi ving a lecture. Whe n he woke up h e found he was giving a lecture! I didn’t suggest the statistics joke about the ma rri ed c ou pl e w ho w e re b oth sta t is ti c ia n s.

Co in ci den t al l y th e y ha d twins. They naturally had one baptized and kept the other as the control.

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AAPM NEWSLETTER MANAGING EDITOR Marsha Dixon

EDITOR-IN-RESIDENCE Robert Dixon Send information to: Marsha Dixon Broadcast News Public Relations 201 Knollwood Street Winston-Salem, North Carolina 27104 (336) 721-9171 Phone (336) 721-0833 Fax Internet: brdcst@aol.com The AAPM newsletter is printed bi-monthly. Deadline to receive material for consideration is four to six weeks before mailing date. We welcome your entries, and encourage authors of articles to supply a photo.

Please send material via e-mail, disks or mail. Faxes are encouraged as back-up, and are acceptable alone.

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