Newsletter AMERICAN ASSOCIATION
OF
PHYSICISTS
IN
VOLUM E 24 NO. 2
MEDICINE MARCH/APRIL 1999
AAPM President’s Column The AAPM as a National Influence By Geoffrey Ibbott Lexington, KY
vant, but instead defined the qualified individual as a Certified Nuclear Medicine Technologist. The AAPM responded promptly, as did a number of members in Indiana, emphasizing our belief that a qualified medical physicist has the correct c redentials to perf o rm this work, and that the SSRs should be consulted before new regulations are written. The legislation has been withdrawn, at least for now. However, members must
Our Presence and Influence on State and National Policymaking CRCPD In th e January issue, I described the AAPM’s opportunities to influence policymaking as one of the most important opportunities for our association. On a number of occasions during the past few months we have seized this opportunity to assert ourselves. Late last year, we submitted comments to a state radiological health department that was on the verge of adopting an AAPM report as a part of their regulations. We commented (through a letter written by Chairman of the Board Larry Rothenberg) that we felt this was an inappropriate use of an AAPM publication. Instead, we recommended that the state agency consider adopting the Suggested State Regulations (SSRs) published by the Council of Radiation Control Program Directors (CRCPD). The AAPM has invested considerable effort into the SSRs by attending the CRCPD annual meetings, presenting symposia, and participating on committees that draft the SSRs. In May, the AAPM will again
present a symposium immediately prior to the CRCPD annual meeting in Louisville. The AAPM’s effort is directed by our liaisons to the CRCPD, Chuck Kelsey, Keith Strauss, Dick Lane, Melissa Martin, and Frances Harshaw. Nurturing this relationship has been given a high priority by previous AAPM Presidents, and I will do the same, as I believe it represents one of our best opportunities to contribute to the development of realistic and useful regulations. More recently, I was alerted by several members in Indiana that legislation had been forwarded that would specify the credentials of individuals qualified to perform inspections of radiation sources and radiationproducing machines. Those credentials did not include qualifications we consider rele-
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INSIDE TABLE OF CONTENTS President’s Column………………p. 1 1999 Budget………………………p. 3 JCAHO/ACR Agreement…………p. 6 Strategic Planning…………………p. 6 Executive Director’s Column……p. 8 PACS/Electronic Imaging…………p. 9 Letters to Editor…………………p. 10 Chicago 2000……………………p. 11 Announcements…………………p. 12 Summer School……………….…p. 15
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MARCH/APRIL 1999
remain vigilant, as this issue seems to come up periodically.
Health Care Financing Administration Last fall, HCFA published a proposed rule for a Hospital Outpatient Prospective Payment System (HOPPS). This proposal would combine groups of CPT codes into Ambulatory Patient Classifications (APCs) for hospital outpatients. As patients seen in radiology and radiation oncology departments are generally outpatients, this proposal is very likely to affect our practices. The Professional Council, chaired by Mike Gillin, has examined the proposal carefully, and determined that there are a number of issues that not only threaten reimbursement in radiology and radiation oncology, but also violate HCFA’s own published criteria for APCs. For example APC 757 would combine all of the radiation therapy technical tre a t m e n t codes into a single code. As a result, all treatments, whether delivered by a linear accelerator, superficial x-ray machine, or Gammaknife stereotactic unit, would be reimbursed at the same rate. HCFA’s own estimates indicate that the proposal would reduce Medicare payments to hospitals by 3.8% overall, but that hospitals that treat large numbers of cancer patients would experience a reduction in reimbursement of nearly 30%. With the guidance of the Professional Council, the AAPM has sent three letters to HCFA (Chairman of the Board Larry Rothenberg sent the first at the end of last year). The letters escalated in specificity and intensity. All were submitted
prior to the HCFA deadline of January 8, although the deadline was subsequently extended until early March.
Nominations for ABR Trustees For a number of years now, the AAPM has been a full sponsor of the American Board of Radiology. The January/February issue of the Newsletter contained articles describing the relationship of the ABR to the ABMS, and the role of the ABR physics trustees. (The same issue also contained an article discussing the American Board of Medical Physics, and the procedures by which physicists can become certified by that board.) As a sponsor of the ABR, the AAPM is entitled to thre e trustees; Ed Chaney, Bill Hendee, and Guy Simmons currently hold those positions. Dr. Chaney’s term of office ends in July, and last year, the AAPM was invited to submit three nominees, of whom one would be selected by the ABR to replace Dr. Chaney. When submitting nominees in the past, the AAPM has not followed any particular policy for developing the list of nominees; former presidents Ravi Nath and Bhudatt Paliwal each took responsibility for selecting and forwarding the nominees themselves. A somewhat different procedure was followed last summer. An ad-hoc committee was formed to develop the list of nominees, and the list was submitted to the AAPM Board for comment. After re c e i v i n g approval of the slate by a majority the Board, the list of three nominees was submitted to the ABR. Soon afterward, a letter was
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sent to the ABR from eleven well-known and re s p e c t e d AAPM members. All are radiation therapy physicists, two are members of the Board and two are members of Excom. The letter indicated that these members had concerns regarding the process for selecting the nominees and the qualifications of the nominees themselves. The letter had no letterhead, and was not represented to be the opinion of the AAPM. ABR President Wi l l i a m Casarella responded by writing to then-Pres ident L a r r y Rothenberg, acknowledging receipt of the letter, and asking if the AAPM wished to reconsider its nominees. After considerable discussion, and by a 4 to 1 vote, Excom decided to ask the ABR to postpone its consideration of the nominees to allow the AAPM to review the process. ABR President Casarella agreed to extend the deadline until May 1, and Excom decided to develop guidelines by which a list of nominees would be developed and forwarded to the ABR. By the time this Newsletter appears, the procedure will most likely be underway, and the AAPM Board will be in the process of developing a new list of nominees. I believe that developing a procedure for selecting nominees and casting it as AAPM policy gives us the opportunity to improve on the methods followed in the past, and will provide better guidance to future Presidents. But I am greatly concerned that the image of the AAPM and of medical physicists has been damaged by the events that led to our request for a postponement. The concerns should have been
AAPM NEWSLETTER
voiced within the AAPM, discussed by the Board, and handled internally. Even if a delay had been deemed appropriate, the request should have come from the AAPM Board of Directors, rather than from a group of individual members. However, given that these events have transpired, we will proceed onward from here, and I am confident that we will submit nominees that will be acceptable to the ABR.
Correction of errors from last column In the last issue of the Newsletter, I incorrectly identified some of the AAPM members holding leadership positions regarding the program at the annual meeting in Nashville. The scientific program director is Maryellen Giger, and the co-director is Eric Klein. The educational program director is Jerry Allison. Local Arrangements chair is Ronald Price, Continuing Education Committee chair is Tony Seibert and incoming Program Committee chair is Dave Pickens. My thanks go to those who identified the errors.
Medical Physics on Line As you learned recently by Email from AAPM Headquarters, the Association’s journal, Med ical Physics, is now available on-line. Editor Colin Orton and Journal Business Management Committee chair Chris Marshall, along with past chair John Boone, are to be congratulated for bringing this project to completion. Should you need them, details and instructions are available at the journal’s web address: http://www.medicalphysics.org. ■
MARCH/APRIL 1999
1999 AAPM Budget by Melissa Martin AAPM Treasurer Bellflower, CA This is the final pro g r a mmatic budget for 1999, as a p p roved by the Board of D i rectors at the RSNA meeting in Chicago. Thanks to the efforts of the Budget Subcommittee consisting of Herb Mower, Mike Tkacik, Jim Smathers, Geoff Ibbott, Sal Trofi and Melissa Martin who met in early October 1998 to put this together. The 1999 budget is the first to implement all of the re commended changes in the budgeting process made by t he H ead qu ar te rs Sit e Review Committee. Following these re c o m m e n d a t i o n s , some significant changes in philosophy were used in developing this budget. We a re now using best actual es t ima te s, base d on o ur experience and anticipated expenses, to develop projec ted prof its from th e annual meeting and other operations which generate revenue to support the many a ct ivi t ie s of our members. A significant change in the budget you may notice is that the we are now re cog nizing that the annual meeting generates almost 30% of our annual operating expenses. This change accurately reflects past experience and the tre m e ndous support that we are getting from our corporate ex h ib it ors . E ach of us
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should support our exhibitors whenever possible. Another great contribution to ou r ve ry busy, almost $4.0 million budget, i s o ur jo ur n a l, M e d i c a l P h y s i c s , wh ic h is n ow available on line. The Journal Business Management Committee, chaired by Chris Marshall, alo ng with th e leadership of Colin Orton as e d i t o r, has developed a very successful operation for the j o u rnal, even incorporating the added expenses of taking it “On Line in 99.” Additional income for our association is from our educational programs, although these are budgeted to make m a rginal profits. Vi e w i n g educational activities as one of the primary goals of the o rganization, these activities are budgeted to be succes sf ul , b ut w e ar e n ot dependent on them for the maj ori ty of our re v e n u e . Don Frey, Education Council Chairman, is certainly active in developing many avenues of providing educational opportunities for our members. The ultimate goal given to continued on page 5
AAPM 1999 Programmatic Budget Revenue
Net
Expenses Direct
Overhead
Total
Membership Dues Dues Renewal Notices Applications and Reinstatements
$676,312
Subtotal
11,000 $687,312
$152,560 11,000 3,000 $166,560
2,058 16,651 $18,709
$152,560 13,058 19,651 $185,269
$523,752 (13,058) (8,651) $502,043
$118,965 (37,977) (62,812) (49,979) (12,775) (10,000) (67,578) ($122,155)
Membership Services Placement Bulletin Membership Directory Monthly Mailings Newsletter Salary Survey AAPM Brochures AAPM Web Site
$200,000 5,100 25,000 600
Subtotal
$230,700
$80,000 25,600 77,300 44,650 12,500 10,000 3,000 $253,050
$1,035 17,477 10,512 5,929 275 64,578 $99,805
$81,035 43,077 87,812 50,579 12,775 10,000 67,578 $352,855
$12,000 44,000 9,000 $65,000
$4,826 55,936 6,433 $67,194
$16,826 99,936 15,433 $132,194
($16,826) (99,936) (15,433) ($132,194)
$27,659 15,550 30,800 111,485 32,000 60,840 $278,334
$11,143 2,962 1,533 105,603 1,854 1,952 $125,047
$38,802 18,512 32,333 217,088 33,854 62,792 $403,381
($20,002) (18,512) (32,333) (201,188) (33,854) (62,792) ($368,681)
$25,000
$134,512 1,414 63,148 8,218 73,921 67,590
($159,512) (1,414) (63,148) (24,318) (73,921) (76,590) (21,000) (50,337) ($470,239)
$513 22,946 5,500 3,500 2,500 16,100 $51,059
Organizational Board of Directors Executive Committee Elections & Society Votes Subtotal
Councils and Committees Education Council Professional Council Science Council Administrative Committees Ad Hoc Committees Liaisons with other Organizations
$18,800
15,900
Subtotal
$34,700
Administrative Professional Services Investment Management Telephone and Mail Headquarters Travel General Operations AAPM Database Credit Card (Processing Costs) AIP Services
9,000 21,000 38,910 $110,010
11,427 $360,229
$159,512 1,414 63,148 24,318 73,921 76,590 21,000 50,337 $470,239
$5,000 1,500
$9,487 2,554
$14,487 4,054
2,400 $8,900
$12,041
2,400 $20,941
16,100
Subtotal
Other Income CAMPEP AAPM Mailing Lists Credit Card Royalties Computers in Physics, Royalties WWW Host Services and Advertising Malpractice Insurance Program Subtotal
$15,000 27,000 5,500 3,500 2,500 18,500 $72,000
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Page 4 AAPM 1999 Programmatic Budget Revenue
Net
Expenses Direct
Overhead
Total
Meetings Annual RSNA World Congress
$1,161,377
Subtotal
$1,161,377
$699,591 20,800 24,000 $744,391
Subtotal
$159,400 17,500 $176,900
$119,262 12,470 $131,732
$1,133,630
$852,010 13,200
$128,002 33,455 60,720 $222,177
$827,593 54,255 84,720 $966,568
$333,784 (54,255) (84,720) $194,809
$20,138 313 $20,451
$139,400 12,783 $152,183
$20,000 4,717 $24,717
$852,010 20,228 90,647 $962,885
$281,620 (20,228) (90,647) $170,745
$5,999 12,756 $18,756
Education Programs Summer School Review Courses, Medical Physics
Medical Physics Journal Journal Production Journal Business Management Headquarters Support Subtotal
$1,133,630
$865,210
7,028 90,647 $97,675
Subtotal
$6,045 12,783 $18,828
$3,600 11,400 $15,000
$2,399 1,356 $3,756
Publications Books Reports
$46 27 $72
Other Organizations Contributions and Donations Dues and other payments
$16,600 14,950 $31,550
Subtotal
$16,600 14,950 $31,550
($16,600) (14,950) ($31,550)
Sponsored Residencies Varian RSNA ASTRO Elekta Subtotal
Totals before Investment Revenue Investment Revenue from operations
Grand Total, Accrual Basis
$30,000 30,000 30,000 15,000 $105,000
$30,000 30,000 30,000 15,000 $105,000
$351 351 351 351 $1,406
$30,351 30,351 30,351 15,351 $106,406
($351) (351) (351) (351) ($1,406)
$3,620,447
$2,774,737
$1,028,489
$3,803,226
($182,779)
200,000
2,000
$3,820,447
$2,776,737
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$1,028,489
2,000
198,000
$3,805,226
$15,221
AAPM AAPMNEWSLETTER NEWSLETTER MARCH/APRIL MARCH/APRIL1999 1999
the Finance Committee six years ago was to develop budgets that would allow the AAPM t o have one year’ s operating funds in reserve. This goal, thanks to the leadership of Jim Smathers, Sal Trofi, Angela Keyser and Lisa Rose Sullivan, is now within sight. After the 1998 accounting is finalized, we should have approximately 90% of this target achieved. As you can see, the headquarters operations which provide membership support is very busy. We
have many of our members involved in liaison activities with other organizations and regulatory bodies in addition to the many scientific and educational committees of our association which now utilize our head-quarters staff. A great deal of appreciation is due from all of us to the support we get from our staff at College Park. To achieve this approved budget we will need the continued participation of all our
members in the coming year in our annual meeting, educational activities, and other activities that generate revenue, and therefore, encourage the use of the AAPM sponsored credit card and insurance policies. It has been a pleasure to serve as your treasurer this past year and now having survived the first year in this office, I will continue to be as diligent as possible in providing information to you as needed. â–
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MARCH/APRIL 1999
Joint Commission, ACR Enter Into Cooperative Agreement The American College of Radiology (ACR) and the Joint Commission on A c c reditation of Healthcare O rganizations have signed a cooperative agreement to reduce duplicative on-site e v a l ua t io n s o f r a d ia t io n oncology programs. U n de r t h i s a g r e e m e n t , the Joint Commission will accept ACR accre d i t a t i o n decisions for radiation oncology programs that are p ar t of h e a lt h p la n s o r i nt e g r a t e d d e l i v e r y n e t works seeki ng accre d i t ati on und er th e J oint Co mmission’s Network A c c reditation Program. It is anticipated that Joint Commission recogn ition of A C R - a c c re d it e d ra d iat io n oncology programs will be exp and ed to in clu de a ll Joint Commission accre d itation programs during the next year. â–
1995 Ad Hoc Strategic Planning Committee Recommendations by Stephen Thomas Cincinnati, OH An Overview of Item Implementation and/or Disposition Forewod r : The AAPM Executive Committee felt that a review of the actions taken with regard to the recommendations of the 1995 Ad Hoc Strategic Planning Committee and current status of associated programs would be of particular value as the AAPM moved forward into the new mil lennium. Outlined below is a brief history of this AHC with a summary of AAPM Board deci sions and subsequent action taken for each of the recommendations.
A. Introduction The Ad Hoc Strategic Planning Committee was formed in 1995 by AAPM President Guy Simmons. The AHC was chaired by Past President Rick Morin. Seven recommendations were introduced at the December 1995 AAPM Board meeting. The recommendations were voted on individually by the Board at the 1996 Annual Meeting (July 25, 1996, Philadelphia, PA).
B. AHC strategic planning recommendations, Board decisions, subsequent action: 1. Recommendation 1: The AAPM needs to formulate and adopt a Mission Statement. Action Item: That the President appoint a special
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committee to develop a Mission Statement for the AAPM. Board decision: Passed. Subsequent action: An Ad Hoc Committee to formulate an AAPM mission statement was constituted by President Stephen Thomas in 1997. The AHC, chaired by Guy Simmons, presented its recommendations at the 1997 Annual Meeting (Milwaukee, WI). At the 1997 RSNA meeting, the Mission Statement was approved by the Board. The Mission Statement is currently published in the AAPM directory. 2. Recommendation 2: The structure and function of the AAPM Board requires examination with possible revision. Action Item: (As revised by the Board) That the President appoint a special committee to re-evaluate the size, composition, and role of the AAPM Board of Directors. Board Decision: Passed. Subsequent action: An Ad Hoc Committee on the composition of the AAPM Board of Directors was constituted by President Bhudatt Paliwal in December 1996. The AHC committee, chaired by Wi l l i a m Hendee, presented its report to President Stephen Thomas in the Spring of 1997. Various forums were organized to review, discuss, and evaluate
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this report. In essence, there was a lack of consensus and apparent reluctance to reorganization of the AAPM Board of Directors at this time. In final disposition, a letter stating this conclusion advocating no further action and a thank you to the AHC for their conscientious work was sent by President Lawrence Rothenberg. This report will serve as the basis document should a reevaluation of the Board configuration be suggested/desirable in the future. 3. Recommendation 3: The access of members, particularly young members, must be improved. Action Item: (As revised by the Board) That the President appoint an ad hoc committee before the RSNA Board Meeting which will identify and implement programs and processes to encourage and ensure more participation in AAPM Governance by members within their first ten years of membership. Board Decision: Passed. Subsequent Action: The AHC was not officially constituted, however a Symposium for New Members was developed by the Professional Council under the direction of Geoffrey Ibbott as an annual event to precede the AAPM Business Meeting. This successful program was initiated in 1997 and is expected to continue. Additional measures have been instituted to introduce/acquaint members with the AAPM leadership such as inclusion of a photopage of EXCOM and the Board of Directors in the Annual Meeting registration packet (initiated 1998). 4. Recommendation 4: The role of AAPM Chapters requires
examination and change. Action Item: (As revised by the Board) That the Regional O rganization Committee undertake efforts to increase member participation in local AAPM Chapters and to increase the activity of less active Chapters. Board decision: Passed. Subsequent action: This recommendation assigned to the Regional Organization Committee for evaluation. An initial questionnaire was sent to the Presidents of Chapters in 1998 requesting information on membership demographics and chapter meeting activity, including involvement in the area of governmental affairs. However, further initiatives are in order to fulfill the recommended actions. 5. Recommendation 5: The AAPM needs to increase governmental involvement. Action Item: That EXCOM leadership identify practical effective mechanisms for representing membership interest in the formation and promulgation of government policies and regulations Board decision: Passed. Subsequent action: Under the Presidency of Stephen Thomas, the Legislation and Regulation Committee was provided with increased resources and encouraged to be active on behalf of the membership’s interests. The Legislation and Regulation Committee formed a subcommittee to provide further implementation of this change. This action item should be considered ongoing. 6. Recommendation 6: The AAPM must be involved in the development of Electronic Medical Imaging. Action Item: (As revised by
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the Board) That the Science Council consider the formation of a new Committee on Electronic Imaging. This committee would allow the AAPM to ensure image quality, image integrity, and could alleviate some of the regulatory complexity associated with PACS and IMACS implementations. Board decision: Passed. Subsequent action: Although not an exact implementation of the recommendation, and Electronic Media Coordinating Committee was constituted in December 1996 with the charge of overseeing the AAPM introduction into electronic processes and worldwide web facilities on behalf of the membership. Thus this committee has been actively involved in electronic communication processes rather than, per se, the focus of the recommendation - namely, electronic imaging. Future directives must be initiated, more specifically the area of PACS/IMACS technology and quality control. 7. Recommendation 7: The AAPM must increase its involvement in professional medical physics matters. Action Ite m: That the AAPM, through its Professional Council, further develop professional activities to support the pro f e s s i o n a l needs of all of its members and work cooperatively with other sister organizations to this effect. Board decision: Disapproved Subsequent action: None. â–
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Executive Director’s Column By Sal Trofi College Park, MD Medical Physics Journal M ed ical Ph ysi cs w e n t online the first week in February. To gain access to the online journal, members must start at the Medical Physics Website www.medphys.org and agree to the “Online Subscriber Agre ement.” The next day, AIP will send the member instructions for acquiring a unique username and password for accessing the journal online. The printed version of the Journal will continue to be delivered to all members except student members. At the end of the 1999-year, all members will receive a CD-ROM containing all manuscripts for 1997 through 1999, and abstracts and title listings from the inception of the Journal. In mid January, AAPM took delivery of a new Manuscript Tracking System (MTS) for Medical Physics. The new system was built by a local software house with a great deal of database design input by Colin Orton, Penny Slattery, and Michael Woodward. The new system automates the submission tracking process and constantly keeps Penny abreast of abstracts that have not progressed by preset deadlines, offering her single click E-mail reminders to the Editor, AE’s and Referees. The new MTS is dynamically linked to the AAPM Membership Database “IMPak,” meaning that all changes made to IMPak will automatically ren-
der in MTS. The new system is fully customizable, written in Visual Basic for Micro s o f t Access and can be expanded to allow online submission of manuscripts via the WWW in the future.
World Congress Meeting
Membership Directory
Over 42,000 Pre l i m i n a r y Announcements have been circulated to medical physicists and engineers worldwide for the Chicago 2000 World Congress on Medical Physics and Biomedical Engineering which will be held in Chicago in July of 2000. The announcement w as in sert ed i n M e d i c a l Physics World, IFMBE News and EMB Magazine . The Organizing Committee agreed that they would not mail out a hard copy version of the Preliminary Program, Call for Papers or the registration brochure. All this information will be available via the Internet and an announcement of these plans will again be placed in Medical Physics World, IFMBE News and EMB Magazine this summer. The Scientific Program Committee, chaired by Russ Riten o u r, is in the process of inviting Track Chairs for the Chicago 2000 program. The key deadline dates are: November 1, 1999 - Abstract submission and registration information available on the web; January 14, 2000 - Deadline for submission of abstracts; and May 15, 2000 - Deadline for Discounted Registration Fees.
The 1999 AAPM Membership Directory was mailed out to the membership on January 14th, six days sooner than expected. There was a “glitch” with the zip codes for those members living in the New England states and did not provide headquarters with a Zip + 4 code. When we ran the program that created the tape to send to the printer, the leading “zero” for any Zip Code without a zip + 4 number was dropped. We have informed the database vendor of the problem and asked that it be fixed. I recommend that you use the membership dire c t o r y posted on the AAPM web site whenever possible. Demographic changes come in daily from members. It does not take long before the printed version becomes unre l i a b l e because of address changes. On the other hand, the web version is updated twice daily, at Noon and 5 p.m.
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1999 Summer School The 1999 Summer School, entitled Practical Digital Imaging and PACS, will be held June 27 - July 1 at Sonoma State University in Rohnert Park, California. There is still time to register before and receive the discounted registration fees, avail-
AAPM NEWSLETTER
able through April 30. P rogram Directors To n y Seibert, Larry Filipow and Kathy And riole h ave put together an excellent program intended for medical physicists, administrators and radiologists who are going to be key personnel in their institution’s inevitable evolvement into a largely filmless facility. Participants will gain a thorough, fundamental knowledge of these areas, including specifications, performance expectations, quality assurance testing, w o r k s - i n - p ro g ress, future s . The goal of this summer school is to enable participants to become knowledgeable members of their facilities who will be involved and will contribute to the implementation of digital, filmless radiology. Register on line and find ad dition al infor mation at http://www.aapm.org
AAPM Annual Meeting Nashville Local Arrangements Chair Ron Price and the Nashville Committee Members are hard at work pulling together the plans for the 1999 AAPM Annual Meeting and Technical Exhibition. The meeting, scheduled for July 25 - 29, will be held at the Opryland Hotel and Convention Center. If you have not had the opportunity of visiting Opryland, there’s no place quite like it. You will find indoor river, restaurants, shopping and more than nine acres of unique indoor gardens with thousands of tropical plants, along with meeting and exhibit space - all under a glass roof. The Night Out this year will include a buffet dinner, and a
show at the legendary Grand Ole Opry, followed by a dessert extravaganza. Plans for the scientific and education program are progressing, under the direction of Scientific Program Dire c t o r Maryellen Giger, Co-Director Eric Klein and Education Program Director Jerry Allison. Exhibit space sales indicate that Nashville will be another re c o rd-setting meeting for AAPM. Look for the Preliminary Program and Registration materials in your May monthly mailing, which should reach you the first week of May.
Publications AAPM’s inventory of books and reports was transferred from Springer-Verlag to Medical Physics Publishing (MPP) during the second week of February. MPP will begin ord e r fulfillment the first week of March. They are creating a brochure that will include all AAPM Publications. This brochure will be mailed to all AAPM members this spring. AAPM members will continue to receive a member discount on all AAPM books. MPP will always make available any AAPM title previously published. Orders for books and reports should be directed to: Medical Physics Publishing 4513 Vernon Blvd Madison, WI 53705-4964 Phone: 800-442-5778 or 608-262-4021 Fax: 608-265-2121 E-mail: mpp@medicalphysics.org ■
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MARCH/APRIL 1999
Medical Physicists Involvement in PACS/Electronic Imaging by Donald Frey Charleston, SC Medical Univ. of SC and Richard Morin Jacksonville, FL Mayo Clinic The authors of this letter are both medical physicists in medical centers that host large numbers of PACS site visits. Both of us are concerned by the observation that o n l y about 20% of the site visit teams include a medical physicist. This absence of medical physicists in the PACS area is worrisome. PACS is fast becoming the core technology around which all radiology departments will be org anized. Since PACS functions as both an acquisition and display device, medical physic i st s s ho u ld be a c ti v e l y involved in specification, purchase, acceptance testing and quality control. If medical physicists are not able to assert themselves in the PACS arena, they will be excluded from a major area that could benefit from the expertise. We believe that Medical Physicists are uniquely qualified by training and experie nce in th e pro c ess o f acquisition, display, interpretation, and distribution of medi cal ima ges , t o le ad t he conversion from conventional to electronic practice. We recommend that med-
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MARCH/APRIL 1999
ical physicists take an active r o l e i n as s e r t i ng th e i r importance in the electronic radiology department. Physicists should make the i nve st men ts of tim e and money necessary to be able to function in the PACS arena. It is much easier for a physicist to acquire the necessary knowledge of PACS systems than it is for others to obtain the vital knowledge of technology, image quality and radiology that the physicist a l ready knows. Physicists should make their knowledge and availability known to radiologists and administrators and they should actively seek to participate in purchases, acceptance testing and quality control of PACS. ■
Letters to the Editor
Dummy Seed Caught Among I-125 Prostate Implant Seeds by Xiaolin Shi Oklahoma City, OK. On October 22, 1998 while a radiation therapist and I were getting ready for a prostate implant case, a dummy seed was caught while verifying the autoradiograph of the loaded needles with the needle loading plan. The dummy appeared as a spacer in a loaded regular needle and made it look like a specially loaded needle. After checking all four seeds in the needle one by one by a GM survey meter, the dummy was isolated and saved for further investigation. A seed from an extra needle was used to replace the dummy and the needle was reloaded. This incident should be brought to the attention of the brachytherapy physics community. It should be a wake-up call for those physicists who do not perform seed activity verification nor make autoradiograph to check the loaded needles. In this case, an autoradiograph is very helpful. With the needle loading tool I used, it only takes five minutes to make an autoradiograph and to verify it with the needle loading p lan . I think i t is t ime well spent. ■
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Medical Health Physics by Stewart Bushong Houston, Texas Just a note of information to add to Matthews’ letter to the editor in the July-August, 1998 AAPM Newsletter and his reference to the earlier letters of Tolbert and Tonry. The Texas Board of Licensure for Professional Medical Physicists (TBLPMP) re c o gnizes Medical Health Physics as a medical physics specialty. The re q u i r ements for licensure as a Medical Health Physicist include certification by the ABHP or the ABMP or the successful completion of a licensure exam administ e red by the state. In the S t a t e o f Te x a s , M e d i c a l Health Physicists who perform in a professional manner providing consultative services on radiation matters such as patient and personnel expo sure, radiation design criteria, perf o rm a n c e monitoring of imaging equipment, and operational radiation protectio n pro g r a m s must be licensed by the TBLPMP. Like it or not we live in a society that is ever more credential-conscious, and the specialty of Medical Health Physics is here to stay. For instance, the concern e x p ressed by Tolbert and
AAPM NEWSLETTER
Matthews that board certified medical physicists would provide services for which they are not qualified is addressed by the professional ethi cs statements and requirements of the ABHP, the ABMP, and the TBLPMP. ■
AAPM President Has Right Direction by Douglas Jones Lynwood, WA I count myself fortunate to belong to a society under the guidance of Geoff Ibbott whose broad experience in both the scientific and professional aspects of our job is surely unequaled by any other member. In his first column in the newsletter he clearly classifies the issues and specifies a pragmatic approach to their resolution. I think it an excellent notion that standards of practice, other than task group reports and those embodied in suggested State regulations, promulgated by the CRCPD, be adopted. These are available now through the ACR and it seems unnecessary to duplicate this effort. The problem of trying to satisfy double stand a rd s ar e pr o bab ly w ell known to your readers. ■
MARCH/APRIL 1999
Chicago 2000 Local Organizers Present Remarkable Lakeshore Plan by Gary Fullerton Chicago 2000 Publicity Chairman San Antonio, TX P reparations for the next World Congress on Medical Physics and Biomedical Engineering continue on schedule with increasing excitement as additional details are shared at each meeting of the Organizing Committee. At the November 1998 meeting of the O rganizing Committee in Chicago, Dr. Robert Arzbacher, Chairman of Local Arrangements for Chicago 2000, pres ent ed p lans to us e th e outstanding Chicago lakeshore setting. The Local Arrangers plan uses the lakeshore to suppl ement the Congress to enhance the quality of the scientific program and augment the long-term impact of the meeting. Local committee members have done their job previously for smaller meetings but this opportunity is unique. The size of the meeting and the focus on the next millenium allow Chicago to pull out all the stops and use th e fu ll ext en t of lo c al resources to support innovative programmatic concepts. Dr. Arzbacher confirmed that all contracts are in place for Chicago 2000 at Navy Pier (see HYP ER LI N K http://www.wc2000.org/ http://www.wc2000.or g/ for view of meeting site) from July 23-28, 2000. It will be a good
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place to bring children and spouses, with attractions such as the Ferris wheel, beaches, botanical garden, children’s museum, IMAX Theater, museums, cultural activities, lakefront cruises, carriage rides, restaurants, nightlife, entertainment, promenade, and parks all right at Navy Pier. Jeannie Hendee, Chairperson of the Compan io ns Commi ttee, promises to provide Companion Program details at the 1999 meeting. The Local Arrangements Committee complained that transportation planning is difficult. “We need to get numbers together re g a rding busing between the hotels and Navy Pier but it’s hard to figure. The weather will be pleasant and the distance is short enough that many people will walk to t ake a d van tag e of th e lakeshore. The public beach is nearby and the chance to swim in Lake Michigan (one of the world’s largest fresh water lakes) will be irresistible to some attendees. The scientific program is also so broad that some people will not do the 8to-5 thing. They will pick and choose, sightsee, bug-out, sl ee p -in, and othe rw is e require transportation at odd times of the day. We need not necess ar ily accommo dat e them with the same transportation availability we have at the beginning and end of each day but we must still consider their needs. Committee members last talked to the local universities
AAPM NEWSLETTER
MARCH/APRIL 1999
about student housing six months ago. We got some information about price, distance from Navy Pier, number of rooms and availability of a i r-conditioning. However, none are able to commit until closer to the meeting time. The Committee remains confident that cost conscious student attendees will have a good se l ec ti on of in expe n si ve accommodations with good meeting access, but these will not be confirmed until shortly before the meeting. The last major item to organize is the “Night Out” which is already locked-in for the new Chicago Museum campus just a short distance to the south down the lakeshore from Navy Pier. Joanne O’Connor from the Museum Campus Administration attended the meeting and reported on plans for the party arrangements using the F ield Mus eum, Shedd Aquarium and Adler Planetarium. These world class cultural institutions recently cooperated to create a park like environment connecting all three museums to provide a wonderful lakefront space for group events. Because of the newness of the three-museum troika it is not yet possible to p rovide confirmed prices; however, the Night Out will be a strong part of Chicago 2000 programming. ■
Announcements Society of Computer Applications in Radiology: “PACS: Performance Improvement in Radiology”
May 6-9 Houston, TX If you haven’t yet felt the explosion of computer technology in your Radiology department, you will soon. At last year’s annual meeting in San Antonio, the AAPM Presidential address recognized the significance of this revolution in radiology and the medical physicist’s central role. Whom else can the radiology department turn to that has the technical skills to understand complex technology and the training to comprehend the impact on clinical operations? The Society of Computer Applications in Radiology (SCAR) annual meeting on the topic “PACS: Perf o rm a n c e I m p rovement in Radiology” will be held in Houston, Texas May 6-9, 1999. This m e e t in g c ov e r s t h e f u l l breadth and scope of PACS adoption, recognizing that performance improvement is an enterprise-wide issue. Past meetings have focused on “ PACS into Pra cti ce ” and “Filmless Radiology— Reengineering The Practice Of Radiology For The 21st Century.” The meeting includes 11 scientific sessions, 10 tutorials, and a PACS minicourse that serves as an excellent introduction and overview of PACS for medical physicists who are just starting to become involved in this area. The objective of the PACS
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minicourse is to describe PACS and its relationship to the hospital health care system without commercial bias. At the conclusion of the course, the attendees should be able to enumerate reasons for implementing PACS, describe the components of PACS, discuss significant issues concerning PACS, and identify pitfalls that can be avoided while implementing PACS. For more information on the SCAR99 meeting, visit the SCAR web site at http://www.scar.rad.washington.edu or contact the SCAR office at 703-757-0054 or by email at SCAR@scarnet.org. ■
AAPM NEWSLETTER
MARCH/APRIL 1999
Announcements
Aetna U.S. Healthcare Requires ACR Accreditation for MRI Providers Aetna U.S. Healthcare has become the first national managed care organization to announce it will require participating magnetic re s o n a n c e imaging (MRI) providers to be accredited under the American College of Radiology (ACR) accreditation program, effective Jan. 1, 2000. Under the ACR program, MRI facilities receive three-year accreditation based on qualification of personnel, equipment perf o rmance, effectiveness of quality control measures, and quality of clinical images. Aetna U.S. Healthcare is the nation’s leading health and related benefits organization, wit h t ot al h ealth enrollment of nearly 16 million members nationwide. ■
ABMP News
Deceased AAPM Members
by Eric Klein St. Louis, MO American Board of Medical Physics Written Examinations, Parts I and II July 24th & 25th, 1999 Nashville, TN. The American Board of Medi ca l Ph ysi ci st s ( ABM P ) has m ad e th e fo ll ow i ng policy change: A physicist who has been certified by the ABMP, American B oa rd o f R a dio log y (ABR),or the CCPM (Canadian College of Physics in Medicine) may apply to sit for Parts II and III of the ABMP exam, regardless of the specialty in which the physicist is currently certified, and which specialty the physicist would like to be now certified in. ■
Head qu art e rs ha s b ee n informed that the following members passed away in 1998.
Dale F. Beckstrand Long Beach, CA Martin Braun Castro Valley, CA B. Leonard Holman Boston, MA Harold E. Johns Amherstview, ON CANADA George R. Meckstroth New Orleans, LA Raymond S. Quick Rochester, NY Per O. Spanne Grenoble Cedex, FRANCE Joe P. Windham Detroit, MI
Bob Gould, Program Committee Chair (1992-1998), was presented “The Bob” award at the recent RSNA by committee members for his “brilliant guidance” as chair. Many thanks to Bob for a job well done.
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New Newsletter e-mail address: rdixon@rad.wfubmc.edu
AAPM NEWSLETTER
MARCH/APRIL 1999
Announcements ACR QC Manual The ACR Barium Enema Quality Control Manual has been designed to help facilities establish and maintain a quality control program. Included in the manual are four sections, one for radiologists, one for radiologic technologists, one for medical physicists, and one for the principles of a barium enema. Each section includes step-
by-step instructions on equipment testing, performance criteria and patient positioning. The manual also seeks to define the areas of responsibility for each of the professionals involved. This manual was modeled along the same lines at the ACR mammography QC manual, and contains suggested phantom tests for the technologist as well as the medical physicist. The medical physicist is responsible for establishing baseline data for the
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technologist's QC tests as well as obtaining other fluoroscopic and spot film image quality data. Suggested performance limits are included. For more information contact: BE QC Manual American College of Radiology 1691 Preston White Drive Reston, VA 20191 â–
1999 AAPM SUMMER SCHOOL
Practical Digital Imaging and PACS
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Sonoma State University Rohnert Park, California USA June 27 - July 1, 1999
This summer school is intended for medical physicists, administrators and radiologists who are going to be key personnel in their institution's inevitable evolvement into a largely filmless facility. Fully digital, filmless imaging is now very possible, with computing capability, network technology, soft-copy display quality, storage capacity, and overall cost at levels that make this endeavor very plausible. Practical aspects of the physics and technology behind the four main areas of digital imaging are presented: (1) Production of Images: CT, MRI, CR/DR, Ultrasound, Nuclear Medicine (2) Network / Communications: PACS and DICOM (3) Display / Analysis / Reporting: Workstations (4) Archival issues Participants will gain a thorough, fundamental knowledge of these areas, including specifications, performance expectations, quality assurance testing, works-in-progress, and futures. The goal of this summer school is to enable participants to become knowledgeable members of their facilities who will be involved and will contribute to the implementation of digital, filmless radiology. Program Directors: J. Anthony Seibert, Ph.D. jaseibert@ucdmc.ucdavis.edu
Larry J. Filipow, D.Phil. filipow@raddi.uah.ualberta.ca
Katherine P. Andriole, Ph.D. kathy.andriole@radmac1.ucsf.edu
Faculty: Katherine P. Andriole, Ph.D.
UC San Francisco
Richard L. Kennedy, M.S.
UC Davis
David Avrin, M.D.
UC San Francisco
Richard L. Morin, Ph.D.
Mayo Clinic Jacksonville
John Boone, Ph.D.
UC Davis
J. Anthony Seibert, Ph.D.
UC Davis
Ian A. Cunningham, Ph.D.
Robarts Research Institute
Ken Spicer, M.D., Ph.D.
Medical Univ. of South Carolina
Keith Dreyer, D.O., Ph.D.
Massachusetts General Hospital
Brent K. Stewart, Ph.D.
University of Washington
Larry J. Filipow, Ph.D.
Univ. of Alberta Hospital
Douglas Tucker, Ph.D.
Storage Technology Corp.
G. Donald Frey, Ph.D.
Medical Univ. of South Carolina
David Weber, Ph.D.
UC Davis
Robert G. Gould, Sc.D.
UC San Francisco
Charles E. Willis, Ph.D.
Texas Children's Hospital
Nicholas J Hangiandreou, Ph.D.
Mayo Clinic
Martin Yaffe, Ph.D.
Sunnybrook Health Science Ctr.
John D. Hazle, Ph.D.
UT M.D. Anderson Cancer Ctr
James A. Zagzebski, Ph.D.
Univ. of Wisconsin
Janice Honeyman, Ph.D.
Univ. of Florida
Local Arrangements Chair: Stephen Thompson sthompson@prowess.com
For additional information, contact: Nancy Vazquez AAPM Programs Manager One Physics Ellipse College Park, MD 20740-3846
nvazquez@aapm.org Tel: (301) 209-3390 Fax: (301) 209-0862
Register on-line at http://www.aapm.org
AAPM NEWSLETTER
MARCH/APRIL 1999
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 e-mail: rdixon@rad.wfubmc.edu 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.
NEXT ISSUE May/June, 1999
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MAIL DATE
April 15,1998
May 15, 1999
Editorial Board Benjamin Archer Bruce Curran Marsha Dixon Don Frey John Kent Richard Morin
AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE One Physics Ellipse College Park, Maryland 20740-3846 (301) 209-3350 Phone (301) 209-0862 Fax e-mail: aapm@aapm.org http://www.aapm.org
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