AAPM Newsletter July/August 2000 Vol. 25 No. 4

Newsletter AMERICAN ASSOCIATION

OF

PHYSICISTS

IN

VOLUME 25 NO.4

MEDICINE JULY/AUGUST 2000

AAPM President’s Column Exciting Times

By Kenneth Hogstrom Houston, TX The past few months have been very exciting for me. I have had the opportunity to represent the AAPM at a variety of meetings, to chair our second Executive Committee (EXCOM) meeting of the year, and to lead our annual long range planning retreat. Also, I continue to witness the effective operation of our many committees. As we embark on our annual meeting, I want to challenge committee chairs to carry out our strategic plans, committee members to be active, and non-committee members to pick a few committee meetings to attend during the annual meeting. We have accomplished much, but there are many opportunities and challenges before us!

Chicago 2000 World Congress The World Congress on Medical Physics and Biomedical Engineering, and the 2000 AAPM Summer School are now upon us. I look forward to an exciting meeting and seeing many of our members at our 42nd annual meeting that is part of the World Congress.

This an opportunity for med-

ical physicists to come together to gather scientific knowledge, to receive continuing education to apply in clinical practice, to review the latest in commercial technology, to report and strategize our committee efforts, to honor special members, and to visit old friends and meet new ones. As a result of our headquarters staff and many of our members, we can expect another outstanding annual meeting. I hope to see many of you there.

has signed our new 10-year lease that will provide the needed additional space in the American Center for Physics Building (for more details see Melissa Martin’s article in the May/June Newsletter). Second, Professional Council chair, Michael Gillin, and Alicia Torres of the American Institute of Physics (AIP) are near finalizing the position description and beginning recruitment of the AAPM Government Affairs Liaison. We expect this person to become a valuable asset in the associations interaction with govern-

INSIDE TABLE OF CONTENTS President’s Column……...p.1 Chairman of the Board…p.4 NCRP Meeting……………p.5 AAPM Strategic Planning…p.7

Headquarters

Hendee - ABR-VP…………p.9

One of the benefits of belonging to our association is the outstanding support that we receive from our headquarters office. Recently, many things have occurred that support the value and the future value of headquarters. First, executive director, Sal Trofi,

Stauffer Remembrance…p.10

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Trustee Report to ABR…p.11 Executive Director Col…p.13 SWAAPM Chapter Conf.…p.14 Announcments………p.15 Letters to Editor………p.16 Call for Awards………p.20

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ment legislation and regulation. Lastly, Headquarters continues to look for opportunities to add or improve services for our members, and I encourage those in leadership positions to use this resource to its fullest.

Hospital Outpatient Prospective System (HOPPS) Special thanks to Mike Gillin, chair of Professional Council and the Economics Committee, for having worked diligently to keep our membership informed of the status of Health Care Financing Agency’s (HCFA) implementation of HOPPS and reacting to its impact on medical physics.

Mike has written two letters, one under my signature, to HCFA, which express our concern over the inappropriateness of Ambulatory Patient Classifications (APCs) for medical physics charges, provide data to validate our concern, and give an offer to assist in future resolution. For more details, please refer to the AAPM web page.

Council of Scientific Society Presidents President-elect Charles Coffey and I attended the Council of Scientific Society Presidents from May 6-9, 2000 in Washington, D.C. The CSSP is an organization of presidents, presidents-elect, and recent past presidents from about 60 societies representing over 1.4 million scientists and science educators. It serves as a strong national voice in fostering wise science policy in support of science and science education, as the premier

national science leadership development center, and as a forum for open, substantive exchanges on emerging scientific issues. Topics such as government and public affairs, public understanding, science ethics, research, etc. were covered in workshops, and topics such as on-line scientific journal publishing, understanding science creativity, and research performance were mini-symposia. The most significant topics of discussion were concern over Congress adopting a favorable budget for science and science education and developing programs to attract more people into science.

These topics were best communicated by Neal Lane, Director of the Office for Science and Technology Policy, whose after-dinner lecture emphasized that technology fuels economic growth, that the United States should establish a research and development budget goal of 3% of the gross domestic product, and that there is a strong need to bring more Americans into science. Another useful bit of information was lear ning about Capitol Advantage, a company that could assist our Government Affairs Liaison in AAPM interactions with U.S. and state legislators.

Strategic Planning As mentioned in my previous column, President-elect Charles Coffey and I modified the format of the Spring long range planning (LRP) retreat to focus on strategic planning. Our purpose was to involve a broad cross section of the AAPM leadership in establishing a working strate-

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gic plan. To that end 24 members representing EXCOM, councils, committees, and subcommittees met April 29-30, 2000, at AAPM headquarters in College Park, MD. Prior to the meeting each AAPM council, committee, and subcommittee was asked to provide its current strategic plan and issues for discussion. These issues were targeted for group discussion in sessions devoted to science, education and training, professional practice, and administration at the retreat.

The resulting recommendations and strategic plan will be distributed to AAPM leadership and Board members for use in planning next year’s activities. Overall, the attendees felt the retreat was productive, and we plan to follow a similar format again next year. A summary of issues discussed and the resulting recommendations can be found later in the Newsletter.

Proposal for North American Federation of Organizations in Medical Physics (NAFOMP) On May 1, 2000, I represented the AAPM at an International Organization of Medical Physics (IOMP) Workshop on Formation of NAFOMP. Organized by Gary Fullerton, Secretary General of the IOMP, the purpose of the meeting was to discuss the formation of a North American chapter of the IOMP that would initially be composed of Canada, Mexico, and the United States.

Later, Central American nations might join. The program consisted of an introduction by Gary Fullerton, a 5-minute presentation by rep-

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resented societies giving an overview of their societies and their interest in for ming NAFOMP. Larry Filipov represented the Canadian Organization of Medical Physicists (COMP) and the Canadian College of Physicists in Medicine (CCPM), who reported as being supportive of forming the federation. Mexico was represented by Maricela Verdejo (Radiation Protection Society), Maria Ester Brandan (Academic Medical Physics), Miguel A. Perez Pastenes (Mexico Medical Physics), and Maria Carmen Franco (Northern Mexico Medical Physics). The Mexican societies are working towards formation of a unified Mexican Federation of Medical Physicists, and they were in general favor of forming NAFOMP. My presentation included an overview of the AAPM, which emphasized our position of being an international leader in medical physics and an overview of current international activities provided by our International Affairs Committee (IAC). I am in general support of the formation of NAFOMP provided it can benefit the development of medical physics in Mexico and Central America. I have asked Gary Fullerton to respond to some informational questions, which I intend to give to our Latin America Subcommittee chaired by Francisco Aguirre. I am hoping to receive those responses so that the subcommittee can make a recommendation to our IAC to bring to this summer’s Board of Directors Meeting for action.

Medical Physics Resident Training Medical Physics Residency Programs continue to evolve.

Congratulations to the Radiation Oncology Physics Residency Program at the Fairview University Medical Center/ University of Minnesota Medical School, which recently became the second CAMPEPaccredited medical physics residency program. This program was formed and accredited under the leadership of program director, Faiz Khan, who has made significant contributions to efforts to establish medical physics residency programs. The CAMPEP Residency Education Program Review Committee, chaired by Dick Lane, reports that there are several other programs under review! In the April 28, 2000 EXCOM meeting, there were two residency issues discussed. First, to further encourage application for accreditation, EXCOM recommends to the Development Committee that medical physics residency programs, which were awarded AAPM fellowships and have not yet achieved CAMPEP accreditation, receive the lowest priority in deter mination of fellowship award recipients.

Second, EXCOM recommends to Membership Committee that a Rules change be initiated that will create a special membership category for medical physics residents that will give them benefits identical to Junior members, but costs the same as student members.

Ad-hoc Committees Appointed Two ad-hoc committees

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have been appointed recently.

The first, "AAPM Annual Meeting Organization," has the goal of developing a proposal, which improves the efficiency and effectiveness of the annual AAPM meeting through changes in organizational structures, assignment of responsibility, and changes in the By-laws and Rules. This committee, chaired by Melissa Martin, will have members from the Continuing Education, Program, Annual Meeting Coordination, and Rules Committees and from the Technical Exhibit Subcommittee. The second, "AAPM Participation in RSNA Annual Meeting," has the goal of determining which issues are significant for improving the visibility, attendance, and participation of AAPM members in the annual RSNA meeting and to recommend a strategy to AAPM leadership for immediate and future resolution of such issues. This committee, co-chaired by Steve Thomas and Bob Gould, will have members from EXCOM, Program Committee, and liaisons to the RSNA Scientific Exhibits, Refresher Course, Program, and Technical Exhibits Committees.

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Report of the Chairman of the Board of Directors

by Geoffrey Ibbott Lexington, KY Development of AAPM Standards The AAPM publishes a number of well-researched and useful documents; including original investigations, literature reviews, technical advice, and scientific and professional recommendations. Most of our Task Group reports present advice or recommendations of the AAPM, such as the often-cited report of TG-40 of the Radiation Therapy Committee. This report recommends procedures and frequencies for quality assurance in radiation therapy.

There have been several instances recently of regulatory agencies wishing to incorporate all or part of AAPM task group reports into their regulations. This is generally considered undesirable because, as stated earlier, TG reports are intended as advisory. There are other instances in which the AAPM might approve regulatory agencies adopting certain of our recommendations as regulation, but because of legal restrictions, this cannot be done.

The solution is for the AAPM to develop standards. In the US, national standards can be published by organizations accredited to do so by the American National Standards Institute (ANSI). Such organizations are called "Accredited Standards Developers." Standards developed by accredited developers are published as

American National Standards, and then carry considerable weight in the technical arena.

They also can then be adopted by regulatory agencies simply by reference. Through reciprocal agreements, ANSI participates in development of standards by the International Electrotechnical Commission (IEC) and by the International Organization for Standardization (ISO). AAPM participates already in these standards organizations, and contributes to the development of standards applicable to medical physics.

Standards should be concise statements of methods or procedures for measuring or determining something. Examples of suitable AAPM/ANSI standards might be our methods of calculating dose from a brachytherapy source (the "TG-43 report") or of measuring the output of a linear accelerator (the "TG-51 report".) Similar opportunities for standardization exist in imaging, for example, methods of deter mining and expressing image quality. The AAPM should not develop professional standards (for example, staffing requirements, or billing procedures) as these are addressed adequately by other organizations.

To become an accredited ANSI standards developer, the AAPM must complete a fairly comprehensive application process. Some time ago, after observing the success of the Health Physics Society in this regard, I proposed that AAPM

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follow a similar route, and received the encouragement of the AAPM EXCOM to start the process. We are now moving well along, and have formed a subcommittee chaired by John M. Boone, Ph.D., of University of California, Davis, to develop a list of topics that could potentially be addressed by AAPM standards. AAPM members who are interested in the process and who have suggestions for standards are invited to comment directly to Dr. Boone or to me at ibbott@pop.uky.edu.

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NCRP Annual Meeting 2000

by Edward Webster AAPM Liaison Boston, MA Ionizing Radiation Science and Protection in the 21st Century The thirty-sixth Annual Meeting was held in Crystal City, MD on April 5-6. There were 360 registered attendees of whom 48 (13%) were AAPM members. There is a strong affiliation between the AAPM and the NCRP. The current president C. B. Meinhold and the president-emeritus W. K. Sinclair are both AAPM members, the latter being a pastpresident of the AAPM. Forty-six organizations sent representatives to the meeting.

At the closed annual meeting of the Council members, there was an animated discussion of a comprehensive report on a strategic plan for the Council’s role in the 21st century prepared by a special NCRP Committee.

The program was introduced

by Warren Sinclair whose philosophical subject was "self-restraint: the wisest aim of free men." This theme was illuminated by the following quotation from Alexander Solzhenitsyn: "If we do not learn to firmly limit our desires and demands, to subordinate our interests to moral criteria, humankind will simply be torn apart as the worst aspects of human nature bare their teeth." The second speaker was Gilbert Omenn, M.D., CEO of the University of

Michigan Health System, who discussed "American values for this millenium." He presented an excellent review of radiation hazard perception in the context of the expert vs. the public view, ranging from observable to non-observable consequences. Risks were classified as controllable (not catastrophic, not fatal) or uncontrollable (global catastrophe, fatal). This led to a discussion of Federal Hazard Control Policy: 1. To balance risks and benefits. 2. To set maximum exposure levels and risks. He noted that hazard control involved risk assessment, decisions, actions, final evaluation and above all, collaboration of the stakeholder.

A problem was the additivity of different environmental contaminants, particularly when radiation is involved because of the lower tolerance (i.e., greater fear). Another problem was the divergence between worker and general public limits by a factor of 50.

The final advice was to apply generally the ALARA principle.

Hans Blix from Sweden and the International Atomic Energy Agency discussed "What Views and What Uses of Radiation Sources in the 21st Century?" This topic primarily involved nuclear weapons and nuclear power. He was optimistic about the future, particularly the further employment of nuclear power. He emphasized the further growth of nuclear power which provides about 17% of electric power internationally and reduces the

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problem of the "greenhouse" gases (CO2) from fossil fuels.

He envisaged an expansion of nuclear power use, for example in desalination of sea water, space heating and ship propulsion. The expansion would overcome opposition based on accident risk (e.g. the NOPE groups: "No place on earth.") Advantages are the high efficiency of nuclear fuels, their small mass, relatively small storage waste repositories and negligible impact on climate and environment. He felt that nuclear waste should be returned to the ground from which it originated.

The second and major part of the program was a series of papers on the Scientific Basis for Radiation Protection in the 21st Century. R. J. Michael Fry from ORNL discussed the deterministic effects of radiation (as distinct from stochastic effects). Central to these effects is cell killing after a threshold dose (which depends on fractionation) is reached. The primary mechanism is DNA damage and failure to repair it. The sensitivity of cells depends on cell type and their genetic differences.

He noted that there is much to learn regarding the effect of protracted low dose irradiation on tissues such as the bone marrow and the testis. He also urged that radiation effects should be classified into cancer, genetic effects, and noncancer effects following this classification for the Japanese A-bomb survivors.

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A paper entitled "Resolving the Molecular Mechanisms of Radiation Tumorgenesis: Past Problems and Future Prospects" was presented by Roger Cox from the U.K. National Radiological Protection Board. This paper lists a number of radiation observations involved in occupational exposure and the corresponding biological judgments related to risk. Examples are: 1.

Low dose/dose-rate. Biological Judgments: DNA response, cellular targets. 2. Distribution of risk in population. Biological Judgments: age, lifestyle. An important biological factor related to risk is the repair of double-strand breaks by illegitimate recombination.

The relationships between tumor risk and dose, dose-rate, radiation quality and genetic factors are being explored.

Potential target genes in a range of radiation-associated human tumors have been analyzed. Projecting to the future, this author placed genetic susceptibility to cancer and its relationship to dose as a major area for basic radiation protection study. The continuation of the linear no-threshold dose response debate is expected.

The next paper by Elisabeth Cardis of the International Agency for Research on Cancer (France) discussed the enhancement of radiation risk estimates from presently ongoing epidemiological studies in several countries, particularly accidentally exposed persons in the Soviet Union, e.g. the Chernobyl accident. An example is the high thyroid cancer risk found in very young children after that acci-

dent. She noted that a new large epidemiological study of 600,000 workers in 17 countries has recently started.

Robert Hoover of the National Cancer Institute discussed the future of cancer control.

He used the control of infectious disease in the last century through microscopes and antibiotics as a model for cancer control through radiation, chemotherapy and surgery, and particularly the increasing contributions of molecular biology, which has revealed "molecular signatures." In his opinion, this development was not a new panacea.

K. Sankaranarayanan (Netherlands) well-known for his studies of human genetic risks, discussed the estimation of hereditary radiation risk in the descendants of a radiationexposed population expressed as the doubling dose, which is the dose producing as many mutations as occur naturally.

This has been derived for human populations by reference to the experimental mouse risk. His conclusion was that human risk per gray is about 0.4% of the normal risk of genetic mutations in the children of parents without radiation.

John Till reviewed the public involvement in science and decision-making using as an example the clean-up methods and criteria for the Rocky Flats contaminated site near Denver, CO. A community panel was educated on how to arrive at contaminated (with plutonium) soil action levels requiring clean-up.

James Thomas, a paralegal for a law firm, discussed the public distrust of organizations

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that set and enforce radiation protection standards. He stated for example, that the assessment of hazard from nuclear weapon tests fallout by the NRC and EPA was a "deceit," i.e., lie. The speaker said that the public want "a seat at the table" and "an apology f r o m th e P r e s i d e n t" regarding fallout harm and to participate meaningfully in the decision-making process.

John Ahearne, a recent NRC chairman, discussed the discontent of younger scientists with governmental decisions, e.g., on high energy radiation facilities. He pleaded for an effective dialogue between scientists, policy makers and the public, and improved quality of science teaching in schools.

The 24th Lauriston Taylor Lecture on Radiation Protection and Measurements was presented by S. James Adelstein, M.D., Ph.D., from the Harvard Medical School. The title of his lecture was "Administered Radioactivity: Unde Venimus Quoque Imus." It was primarily a historical review of nuclear medicine both diagnostic and therapeutic. The early work of R. D. Evans at MIT using I-130 for thyroid uptake was cited. The development of the scintillation counter and its 1951 incorporation by Cassen et al into a linear scanner were significant developments. The review cited the NCRP Report 70 (1982) on the choice and use of radionuclides in nuclear medicine as a major document. It was prepared by NCRP Committee 32 on which Adelstein served. Targeted radionuclide therapy when there is knowledge of organ

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and cellular distributions and its cost effectiveness were also discussed.

The program on risk management was continued the following day with 5 papers.

The first by John Page was "Harmonizing Controls for Chemicals and Radionuclides" in which again the inclusion of the public in decision-making was stressed. Paul Locke from Johns Hopkins University also discussed Risk Management of chemical and radiation contamination at several sites, noting that the chemical cancer risk usually is dominant. The participation of citizen groups in management was again stressed.

Roger Clarke (UK) speaking as a member of the ICRP dis-

cussed the risks of low-level ionizing radiation. He noted that at low doses epidemiologic evidence will be weak and therefore understanding of the cellular mechanisms of carcinogenesis was of major importance. Today, the greater concern is for individual risk rather than group risk.

In legal challenges, the courts will not accept a threshold with no risk at low doses. The range of risk vs. dose quoted

by Clarke in mSv/year was 30 (high), 3 (moderate), 0.3 (tolerable) and 0.03 (low). The principle is to control the dose to the most exposed.

The final paper was given by H. K. Florig from CarnegieMellon University on Policy Mechanisms for Radiation Pro-

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tection. NCRP Report 116 contains the current NCRP guidelines. There has been a societal decline in deference to experts. The "Common Sense" layman’s calculus holds that individual risk should be below the acceptability threshold, and there should be benefits to those exposed and to society. In summary, the ALARA principle advocated by NCRP should be practiced.

After a summary of the NCRP status and policy in the 21st century by C. B. Meinhold, President, the meeting adjourned.

Two AAPM Members Named to NCRP The National Council on Radiation Protection and Measurements (NCRP) has named the following two AAPM members to its organization: Benjamin Archer - Baylor College of Medicine – Houston, Texas John Dicello - John Hopkins University – Baltimore, Maryland

AAPM Strategic Planning Meeting

by Kenneth Hogstrom Charles Coffey, II Each Spring, the AAPM Executive Committee (EXCOM) hosts a long range planning (LRP) meeting at AAPM Headquarters in College Park, MD, and this year’s meeting was April 29-30, 2000.

In recent years this meeting has consisted of the Education, Professional, and Science Council chairs and vice chairs reporting current plans of their

respective councils to EXCOM. This year’s LRP meeting was different in that the purpose of the meeting was to discuss initiatives and issues of importance to the AAPM and to reach consensus recommendations that could be incorporated into further development of the strategic plans of the appropriate committees. The meeting was very successful, and we intend on continuing to develop this Strategic Planning Meeting in future years.

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A variety of predetermined and new issues were discussed in one of six sessions: (2 Administrative, 2 Professional, 1 Education and Training, and 1 Science). To ensure sufficient expertise and a broad representation of member opinion, 24 members of the AAPM representing EXCOM, councils, committees, and subcommittees (including Administrative committees) attended.

Prior to the meeting, each council, committee, and sub-

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committee was asked to provide its current strategic plan for distribution to attendees.

These strategic plans and recommendations from the Strategic Planning Meeting will be reported to council, committee, and subcommittee chairs and the Board of Directors to assist in their setting and prioritizing their activities for the next year.

The Education and Training session produced the following recommendations: (1) The AAPM should increase the rate of attracting physics graduates into medical physics by initiating programs such as placing medical physics articles in the SPS newsletter and offering medical physics summer fellowships to upper level undergraduate physics students. (2) Strengthen visibility of medical physicists with hospital administrators by educating them through the AHRA, SROA, and AHA annual meetings. (3) Increase medical physicist’s visibility with patients by forming liaisons with patient advocacy groups.

(4) Study the possibility for offering M.S. fellowships similar to presently offered Ph.D. fellowships. (5) Continue to find ways to make the Summer Schools more competitive through improving their promotion and developing a standardized method for providing administrative support. (6) Develop methods for educating non-radiology physicians in radiation safety through speaking at their annual meetings. (7) Encourage the use of development funds or annual operational funds to assist in the growth of medical physics residency programs through

supporting residencies and through assisting in accreditation fees.

The Science session produced the following recommendations: (1) Ensure proper inter-committee communications by establishing an electronic document routing system that triggers on key words. (2) Develop authorization and methods for incorporating technical recommendations into IEC and ISO standards. (3) Increase opportunity for medical physics research by educating members on writing successful grant applications and by promoting increased availability of funds for medical physics research. (4) Increase participation of SPIE, IEEE, etc. in AAPM annual meeting. (5) Develop a repository of AAPM statements made to regulatory agencies for future reference.

The Professional sessions produced the following recommendations: (1) Continue to develop the AAPM Government Affairs Liaison position.

(2) Continue to analyze and to advocate change to the HCFA HOPPS, which would be fair to medical physics and patient care. (3) Evaluate the potential for achieving direct HCFA reimbursement for medical physicists. (4) Increase ability to interact with regulatory agencies by educating AAPM members, by establishing a body of published information to address regulatory issues, and by establishing liaison committees within the local chapters. (5) Continue to coordinate professional activities with the ACMP through having staff cooperation, hav-

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ing overlapping memberships at the committee level, and issuing technical standards in concert with ACMP and ACR standards. (6) Develop an accurate model of the supply and demand for medical physicists, and coordinate this activity with ASTRO and ACR. (7) Develop a web-based Newsletter, preserving the printed copy if desirable. (8) Validate the salary data in the Professional Survey, and poll the membership to see opinion for making the Professional Survey public domain. (9) Promote regulation of medical physicists through licensure and regulatory rules. (10) Further develop guidelines for hospital credentialing of medical physicists, and push to get credentialing required in JCAHO guidelines. (11) Begin work in defining the role of medical physicists in supporting non-radiological physicians.

The Administrative sessions produced the following recommendations: (1) A mechanism for electronic polling of the Board will be developed that will allow adequate time, background information, and a mechanism for on-line discussion. (2) Paralleling this is the need to develop a policy to clarify when EXCOM needs to go to the Board, e.g. fiscal decisions greater that 0.5% of the budget and policy-setting decisions.

(3) There is need to establish an ad hoc committee to refine our policies for publications and distribution of public information, which will be annotated, provide critical and efficient reviews, are applied consistently, and make entities

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accountable. (4) Now that the AAPM has achieved its goal for a 1-year’s budget in reserve, councils will be encouraged to expand existing and develop new programs that will enhance the value of the AAPM to medical physics. (5) The Rules Committee is charged with updating by-laws and rules, as well as recommending policies, to accommodate subcommittees and changes needed for current operations. (6) Methods for the President-elect’s appointment of new committee members need to be established that will allow chairs more input, ensure that members are qualified and able to actively par-

ticipate, and cultivate our newer members. (7) EXCOM needs to draft a Policy statement for allowing its headquarters resources to be used by other organizations so long as the action is revenue neutral and that it is to the benefit of medical physics. (8) Consider moving the publication operations for the Newsletter to headquarters, as well as its electronic publication. (9) Consider expanding the size and diversity of the Nominating Committee, e.g. by adding the 4 senior elected At-large Board members to the President and his 2 ex-President appointees. (10) Maintain our international leadership in

medical physics by encouraging the International affairs Committee to bring proposals to the Board, to better use available AAPM resources, e.g. aapm.org, to have a liaison to Education Council, and to explore government funding for international activities.

Bill Hendee Named Vice President of ABR

by Guy Simmons Bhudatt Paliwal At its Annual Meeting in Louisville in May, 2000 the American Board of Radiology (ABR) Board of Trustees elected William Hendee to the office of Vice President of the Board. After two years as Vice President, he will be eligible to serve a two-year term as President of the ABR. Dr. Hendee is one of three medical physicists on the Board, having been nominated by the AAPM, a sponsor of the ABR.

Dr. Hendee’s election to this prestigious office is a significant milestone in the evolution of medical physics and its professional partnership with radiology and radiation oncology.

It is also a clear testimony to Dr. Hendee's administrative and professional skills. It brings prestige not to him alone, but to the profession of medical physics. We congratulate Dr. Hendee for his achievement. He deserves the support of the entire medical physics community in this important position.

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Del Stauffer - Remembrance of a Friend of the AAPM

by Stephen Thomas Richard Morin Jon Trueblood Joel Gray Robert Gould The radiology profession was saddened at the unexpected death of Delmar Stauffer, Executive Director of the RSNA who passed away on March 1, 2000 as a result of a heart attack. The AAPM, through its close and cherished relationship with the RSNA, feels this loss acutely, as Del was truly a friend of our Association. Over the past eleven years during which time he served as Executive Director, many of us came to know Del personally through our activities on various RSNA committees and participation in the organizational aspects of the RSNA Annual Meeting. We benefited from his direct input as well as from the talented, dedicated staff assembled under Del’s leadership who provided willing assistance on various projects of importance to the medical physics community. If we had an issue for discussion, we knew that Del’s office door would be open.

Yet Del was more than a passive supporter of the AAPM. During our search for an executive director, he provided much thoughtful and appreciated counsel that was of significant benefit to the search committee.

The RSNA’s growth statistics during Del’s tenure as Executive Director are impressive.

The Society’s membership

increased by 30% to over 30,000 members, assets jumped from $ 6 .8 million to over $50 million, and the staf f grew from 40 to over 125 employees.

The annual RSNA assembly in Chicago is now the largest medical meeting in the world hosting more than 60,000 attendees in each of the past several years. The new headquarters building that opened in Oak Brook, Illinois in October 1998 was constructed under Del’s careful supervision. As medical physicists often practicing in academic environments, we recognize the significance of the RSNA’s mission as focused on research and education in radiology and the allied sciences. Del played an instrumental part in coordinating the expansion of the RSNA Education Center, in restructuring the Research & Education Foundation, as well as in the opening of the Office of Research Development. All of these accomplishments will serve as an enduring legacy of Del’s dedication and management skills.

Del, born in Saybrook, Illinois in 1939, completed a

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bachelor’s degree in Health Education and Biology and received a Master’s Degree in Health Education both from the University of Illinois. His professional career quickly focused on the area of medical association management. Del was Executive Director of the Chicago Dental Society for three years and with the American Dental Association for 15 years, eight as the Assistant Executive Director. He was appointed Executive Director of the RSNA in 1989.

As the RSNA’s Executive Director, the many faceted qualities of Del’s professionalism were evident. When the situation called for tough negotiations, he carried forward his responsibilities on behalf of the Society with authority. In this regard, with his seat on the Chicago Convention and Tourism Board of Directors, he was instrumental in convincing the City of Chicago to formulate new policies conducive to the RSNA maintaining its annual meeting in the Windy City. Yet Del was remarkably sensitive with great attention to detail.

As one example, following the

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days-end reception for an Electronic Communication Committee meeting that happened to fall on Valentine’s day, he presented all spouses with roses to mark the occasion and thank them for sharing their day and family with the RSNA. Del Stauffer promoted and helped define the vision of radiology as symbolized by the RSNA and shared by the AAPM. Through his capacity as

Executive Director, he touched the lives of many individuals and organizations. The depth of the emotions raised were in evidence during the moving ceremony held before an overflowing congregation at the Lake Forest, Illinois, Church of Saint Mary attended by one of us (SRT) as the representative of the AAPM. Our deepest sympathies extend in many directions: to the leadership of the RSNA, to the staff of the

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RSNA, to professional colleagues and associates within Radiology. But most profoundly they extend to Del’s immediate family - his wife Mary, sons Andrew and Mathew, daughter-in-law Audrey, and his seven brothers and one sister. The AAPM will always remember Del as a supporting professional colleague and a friend.

Report of AAPM Trustees to ABR

by William Hendee Bhudatt Paliwal Guy Simmons Year 2000 Annual Report This report constitutes the annual report of the American Association of Physicists in Medicine (AAPM) liaisons to the American Board of Radiology (ABR). In the capacity of liaisons, we three individuals serve as trustees nominated by the AAPM and elected by the ABR. This report of activities covers the period July 1999 – June 2000.

Physics Certification Examination The physics trustees direct all aspects of the examination process for ABR-certification in the specialties of radiological physics (therapeutic radiological physics, diagnostic radiological physics, and medical nuclear physics), including the preparation and delivery of the written and oral examinations.

Aspects of this direction include the solicitation of questions for the written and oral examinations from the membership of the AAPM, establishment of committees of physicists to compose each part of the written examination in physics, and identification of potential examiners for the oral examination in the specialties of radiological physics.

Questions and inquiries about participation in various aspects of the ABR certification examination for physics can be sent at any time to any of the physics trustees. An information booth describing the ABR certification process in physics, and opportunities for involvement of medical physicists in the process, was provided at the 1999 annual meeting of the AAPM, and will be available at the World Congress 2000 this coming July.

Participation in Activities of the American Board of Radiology The three trustees participate

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actively in all activities of the ABR, including meetings of the Board of Trustees and the fall and winter extended meetings of the Board. Over the period addressed in this report, G. Simmons has served as Assistant Executive Director of the ABR, and W. Hendee has served as ABR Secretary-Treasurer. The trustees individually are on numerous committees and task forces of the ABR, and also attend nonABR meetings on behalf of the ABR.

Radiology/Radiation Oncology Examinations in Physics The physics trustees continue to oversee the preparation of the written examination in physics for residents in radiology and radiation oncology.

This oversight includes appointment of members of the examination committees in physics for both specialties, in collaboration with appropriate radiologists and radiation oncologists.

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JULY/AUGUST 2000

Certification Examination Restructuring Committee Under the direction of the physics trustees, a restructuring committee of physicists has been working to enhance the relevance and accountability of all aspects of the ABR certification examination for radiological physicists. Among accomplishments of this committee are the following: 1 Revisions in the eligibility criteria for admission to the certification exam, including making the clinical and Part I of the physics exam available to candidates in training 2 Revisions in the essentials document that describes expected areas of competence to be demonstrated by candidates 3 Migration of the oral examinations in physics to computer workstations, with the following schedule: i. One of the five examiners on each oral examination panel will use a workstation in 2000 ii. Three of the five examiners on each oral examination panel will use a workstation in 2001 iii. All five examiners on each oral examination panel will use workstations in 2002. iv. Improvements in the predictive value of questions used in written and oral examinations for physicists, achieved with the guidance of an ABR statistician and psychometrician. v. Implementation of testing methodologies such as the Angoff and Hofstee procedures to identify questions that test the candidate’s mastery of

knowledge considered essential in radiological physics. vi. Implementation of a standardized scoring procedure for the oral examination that evaluates the candidate’s: i. Understanding/Con text of Questions ii. Analytic/Deductive Skills iii. Explanation/Clarity Abilities iv. Clinical Context Knowledge

Physics Maintenance of Certification Under the direction of the physics trustees, a "Physics Recertification Committee" has been working to establish criteria for renewal of physics certification for individuals granted 10-year time-limited certification beginning in 2002.

This committee has developed a program for Maintenance of Certification for ABR-certified physicists that is aligned with the objectives of the American Board of Medical Specialties (ABMS) for all ABMS-approved certification boards. This program uses self-assessment, peer-assessment and periodic examination as a composite mechanism for maintenance of certification. The program is being developed for implementation in 2002.

Terms of Appointment of Physics Trustees B. Paliwal was nominated by the AAPM and elected as a trustee, with a 4-year term beginning in July, 1999. G. Simmons’ term of office as a trustee will end in July, 2001.

Nominations for a replacement for G. Simmons have been

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solicited from the AAPM, with a request that the nominees be certified in radiological physics (umbrella certification), or in medical nuclear physics and either diagnostic or therapeutic radiological physics.

Resolution of the Two Physics Board Issue The physics trustees, and the American Board of Radiology, continue to hope for resolution of the two-board controversy over certification in medical (radiological) physics. The ABR physics trustees have expressed an interest in reopening discussions with representatives of the American Board of Medical Physics (ABMP) concerning this hope.

AAPM NEWSLETTER

JULY/AUGUST 2000

Executive Director’s Column

By Sal Trofi College Park, MD Headquarters Office Space Update Construction of the new headquarters office space is scheduled to begin on September 11, 2000, and work will be completed by the end of December. The staff will temporarily relocate to space in the same building. The American Institute of Physics (AIP) and the American Association of Physics Teachers (AAPT) have graciously offered us free space within their offices. The move to the temporary space will take place during the week following Labor Day. The staff will be dispersed in areas on two floors of the building, but every effort will be made to provide high quality member services during the moving and construction periods.

We have contracted for architectural services, which will include complete project management. Existing furniture will be used to the extent possible as well as furniture components left over from the original outfitting of the offices in the entire building six years ago.

The timeline for planning and implementation of the move and construction was arrived at with consideration of the staff’s full involvement with the World Congress Meeting in the Chicago this July.

Society of Physics Students (SPS)

AAPM participates in an AIP program to expose physics students to the benefits of the ten AIP member societies. SPS has about 6,000 members with chapters in over 600 colleges and universities. SPS members are both undergraduate and graduate students. As a benefit of membership in SPS, students can choose a free membership in one of the ten AIP member societies. The member society determines the class of membership and the services that will be provided.

AAPM classifies SPS members as "Affiliate Members" and provides them with brochures about medical physics, the AAPM Newsletter, and reduced rates for AAPM meetings and summer school. This program has been in existence for over one year. To date 109 students have selected membership in AAPM. Regular student membership is available free of dues for the first year to students enrolled full time in a graduate training program in medical physics.

Regular student members receive all the benefits of membership with the exception of the Medical Physics Journal and the right to vote.

The wavier of first year dues for students was introduced in 2000.

Placement Statistics The number of job offerings listed in the AAPM Placement Bulletin continues to exceed job offerings for similar periods of previous years. This

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year the first six months of job offerings exceed last year’s offerings for the same period by 17%, and by 137% from the least offerings in 1996.

Job offerings are posted to the AAPM website soon after its position description is received by Bob Rice, the AAPM Director of Placement Services. Visit the AAPM website at www.aapm.org and click on "AAPM Bluebook."

After entering your username and password, you will be offered the option of receiving a copy via email or in PDF format. A printed copy of the Placement Bulletin is mailed to members on the 15th of each month.

Staff News We are in the search stage in the process of hiring a government affairs specialist. This new staff person will assist AAPM with their interaction with Congress, federal agencies and other policymaking groups. This person will also be expected to maintain relation with non-government agencies and other associations with which AAPM has an interest.

AAPM NEWSLETTER

JULY/AUGUST 2000

Southwest Chapter AAPM Conference: Quality Assurance for the Third Millennium

by George Starkschall President, SWAAPM Houston, TX From April 30 to May 2 of this year, the Southwest Chapter AAPM sponsored a conference on the topic of Quality Assurance for the Third Millennium at the Marriott Casa Magna Hotel in Puerto Vallarta, Mexico. The program had three goals: to present examples of quality assurance for some of the newer technologies that lead into the Third Millennium; to build bridges with medical physicists in Mexico; and to achieve the first two goals in a beautiful setting. All three goals were successfully achieved.

The program began with a plenary session consisting of three talks. Michael Mills from the University of Louisville presented a talk entitled "Manpower and Training Requirements for Support of QA." He was followed by Richard Stark, of Richard Stark and Associates, speaking on the topic of "Human Factors Affecting a Comprehensive QA Program."

The third talk in the plenary session was delivered by Maricela Verdejo, the Director of Radiological Risks of the Mexican Secretariat of Heath, who spoke on "The Mexican Initiative in Diagnostic Imaging QA." Her efforts in mandating a quality assurance program for diagnostic imaging equipment in Mexico have resulted in a significant

enhancement of the role of medical physicists in Mexico.

Following the plenary session, the program divided into two simultaneous sessions, one for radiation oncology physics, the other for diagnostic imaging physics. Topics in the radiation oncology physics program included: "TG-43 Implementation," "QA in Permanent Prostate Brachytherapy," "QA of Intravascular Brachytherapy," "Commissioning and QA of Treatment Planning Systems," "QA of Intensity-Modulated Radiation Therapy," "QA of Stereotactic Radiosurgery," "QA of Dynamic Wedges," "A QA Process for Static” and “Dynamic Multileaf Collimation," "QA of Electronic Portal Imaging Devices," "Clinical Implementation of the TG51 Protocol," "QA using

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Modern Dosimeters," and "QA Expectations for the Next Millennium." Topics in the diagnostic imaging physics program included: "MR Acceptance Testing," "Implementing an MRI Quality Control Program," “QA for Fast MRI Techniques," "Controlling Dose in Angiographic Procedures," Acceptance Testing and QA of a Direct Digital Chest X-Ray System," "Calibration and Quality Control of Hard- and Soft-Copy Digital Display Devices," "Acceptance Testing of a Multislice Helical CT Scanner," "Radiation on Diagnostic Radiology – High Dose Exams, Reference Values, and Hospital Privileges for Radiation Users," The Role of QA in ACR Accreditation," "Quality Control of Computed Radiography Systems," "The Justification for

AAPM NEWSLETTER

a PACS," and "PACS Quality Assurance and Quality Control Programs."

During the lunch hour, radiation oncology physics participants heard presentations by several of the commercial vendors, while diagnostic imaging participants had the opportunity to hear two talks on digital mammography. Continuing education credits were available to participants through CAMPEP. Program faculty was approximately equally divided between members of the Southwest Chapter, AAPM, and experts from around the country.

The second goal of the conference was to build bridges between medical physicists in the U.S. and medical physicists in Mexico. This goal was aided significantly by the AAPM, which provided the Southwest Chapter with a grant to fund the registrations for the Mexican participants. Approximately 100 participants attended the conference, equally divided between physicists from the U.S. and Mexico. For the Mexican medical physicists, the conference was truly eye-opening, giving many of them their first opportunity to explore the topic of quality assurance with same degree of intensity as the topic is treated in the U.S. Coming so soon after the mandating of quality assurance of diagnostic imaging equipment as described in Dr. Verdejo’s presentation, the opportunity to learn about quality assurance from the point of view of north of the border proved to be an exciting educational experience for Mexican medical physicists.

To further relationships between Mexican medical

physicists and those of other North American nations, the IOMP hosted a workshop to discuss the formation of a North American Federation of Medical Physics (NAFOMP), including the AAPM, the COMP, and the medical physics organizations in Mexico. The purpose of NAFOMP would be to promote international cooperation by promoting programs of regional interest to the three countries involved.

The final goal of the conference was to achieve the first two goals in as enjoyable a manner as possible. Certainly the venue of Puerto Vallarta contributed greatly towards achieving this goal. Organized activities allowed conferees to go snorkeling in the Pacific Ocean or hiking in the Sierra Madre or enjoying a cruise on a simulated pirate ship. Nonorganized activities included shopping in the Old Town, dining at some of the many enjoyable restaurants or simply increasing melanoma risks at the swimming pool or on the beach.

Several of the participants in the IOMP Workshop on the Formation of NAFOMP. L to R: Gary Fullerton, Secretary-General of IOMP; Maria-Ester Brandan, President of the Academic Medical Physics Society; Maricela Verdejo, President of the Mexican Radiation Protection Society; Maria del Carmen Franco, President of the Northern Mexico Medical Physics Society; George Starkschall, President of the Southwest Chapter, AAPM; Miguel A. Perez Pastenes, President of the Mexico Medical Physics Society.

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ANNOUNCEMENTS February 10-14, 2001 WIMPS Frisco, CO The Winter Institute of Medical Physics will be held February 10-14, 2001 at Frisco, CO. This is an informal educational/scientific/professional meeting with four hours of sessions per day and generous time available for skiing, sledding, etc. All attendees participate in the program, which also includes nationally recognized invited speakers.

See the website www.utmem.edu/wimp/ for detailed information.�

AAPM NEWSLETTER

JULY/AUGUST 2000

Letters to the Editor Radiation Oncology Reimbursement under the Hospital Outpatient Prospective Payment System (HOPPS)

by Chester Ramsey Knoxville, TN On August 1, 2000, the Health Care Financing Administration's (HCFA) Hospital Outpatient Prospective Payment System (HOPPS) is scheduled to go into effect for Medicare Part A outpatient reimbursement. For most institutions, this effectively ends the formula-driven fee schedules that have been used for Medicare outpatient technical reimbursement since the 1980s. Physician reimbursements, third-party payment rates, standalone centers not associated with a hospital, and certain select hospitals are not included or are exempt from HOPPS. HOPPS is based on newly created ambulatory payment classification (APC) groups for outpatient services. The APCs consist of groups of similar services that are assigned a single Medicare payment weight. These groups should be arranged so that the resources used within each group are clinically comparable.

In the original 1998 HOPPS proposal, all treatment planning, simulations, and beam modifiers were lumped into Level I and Level II Therapeutic Radiation Treatment Preparation groups. Level I Treatment Preparation, which included all basic dose calculations, isodose plans, brachytherapy plans, special port plans, and beam modifiers, was assigned a Medicare payment of $58.27. Level II Treatment Preparation, which included all simulations and 3D treatment planning,

was assigned a Medicare payment of $179.37.

The predicted result of the 1998 HOPPS proposal, as estimated by HCFA, was a 30 percent decrease in total Medicare technical reimbursements for radiation oncology departments. Fortunately, the proposal provided for a 60-day comment period, which was extended four times. When the comment period ended on July 30, 1999, approximately 10,500 responses were received. Comments from individuals and professional organizations, such as the AAPM, ACR, ACMP, and ASTRO, resulted in a more realistic grouping of services and payment weights for radiation oncology services.

In the revised 2000 HOPPS proposal, all technical radiation therapy services were divided into 11 APCs: Level I - III Radiation Therapy, Treatment Device Construction, Level I - III Therapeutic Radiation Treatment Preparation, Radiation Physics Services, Radioelement Applications, Brachytherapy, and Hyperthermic Therapies. Tables I to IV show a sample comparison between technical reimbursements for Medicare HOPPS and the 2000 fee schedule system for various treatment sites.

Based on the proposed HOPPS payment weights, Medicare payments have increased for beam modifiers (+9%) and daily treatments (+18%) when compared to the 2000 fee schedule system. Fortunately for radiotherapy departments, these services often represent the majority of payments

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associated with a course of radiation therapy.

However, reimbursements for medical physics services have been significantly decreased under the proposed system. Special Medical Physics Consults and Continuing Weekly Physics were assigned a Medicare payment rate of $64.00, a 45% decrease compared to the 2000 fee schedule system. Furthermore, the payment rate for 3D Simulations was decreased by 38% to $677.85.

Overall, the average technical reimbursements for radiotherapy departments as a whole appear to have increased by approximately 8%, which is welcome news given the grim outlook of the original 1998 HOPPS proposal.

For more information on the 2000 HOPPS proposal, the Final Rule and Payment Weights can be down loaded by visiting the Health Care Financing Admin istration WebSite at www.hcfa.gov/regs/hopps/ default.htm

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Disclaimer: The comments and financial analyses expressed in this article are based on the author's interpretation of current billing practices and the "HOPPS-APCs" Final Rule.

Table I. Sample six-field conformal prostate case with one reduction.

Number CPT Old Medicare APC New Medicare Description Done Code Payment Code Payment 3D Simulation 1 77295 $1,089 310 $678 Post-3D Simulation 1 77290 $254 305 $197 MLC Fields 12 77334 $1,512 303 $1,644 Immobilization 1 77334 $126 303 $137 Basic Dosimetry 6 77300 $312 304 $432 Complex Treatment 35 77414 $3,185 301 $3,745 Port Films 7 77417 $161 260 $266 Continuing Physics 7 77336 $812 311 $448 Total Medicare Payment: $6,639 $7,099 Table II. Sample head & neck case with electrons added Number CPT Old Medicare Description Done Code Payment Simulation 2 77290 $508 2D Isodose Plan 1 77315 $104 Blocks 6 77334 $756 Immobilization 1 77334 $126 Basic Dosimetry 3 77300 $156 Complex Treatment 35 77413 $3,185 Port Films 7 77417 $161 Special Port Plan 1 77321 $157 Continuing Physics 7 77336 $812 Total Medicare Payment: $5,965

after first reduction.

APC New Medicare Code Payment 305 $394 305 $197 303 $822 303 $137 304 $216 301 $3,745 260 $266 305 $197 311 $448 $6,422

Table III. Sample lung case treated AP/PA with off-cord obliques.

Number CPT Old Medicare APC New Medicare Description Done Code Payment Code Payment Simulation 2 77290 $508 305 $394 Irregular Field Calc.

1 77315 $73 304 $72 Blocks 6 77334 $756 303 $822 Basic Dosimetry 3 77300 $156 304 $216 Complex Treatment 30 77413 $2,730 301 $3,210 Port Films 6 77417 $138 260 $228 Continuing Physics 6 77336 $696 311 $384 Total Medicare Payment: $5,057 $5,326 Table IV. Sample tangent breast case with electron scar boost Number CPT Old Medicare APC Description Done Code Payment Code Simulation 2 77290 $508 305 3D Isodose Plan 1 77315 $104 305 Blocks 3 77334 $378 303 Wedge 1 77334 $126 303 Basic Dosimetry 2 77300 $104 304 Complex Treatment 30 77413 $2,730 301 Port Films 6 77417 $138 260 Special Port Plan 1 77321 $157 305 Continuing Physics 6 77336 $696 311 17 $4,941 Total Medicare Payment:

New Medicare Payment $394 $197 $411 $137 $144 $3,210 $228 $197 $384 $5,302h

AAPM NEWSLETTER

JULY/AUGUST 2000

Medical Physics Brochure

by Peter Almond Houston, TX I am disappointed by the latest brochure to be published by the AAPM titled "The Medical Physicist Brochure - Highlighting the Role of a Vital Member of Your Treatment Team." I am aware that it is intended for distribution to patients, but the brochure does little if anything to enhance the professional aspects of medical physics in radiation oncology. If this publication represents the concepts among todays’ practicing medical physicists in radiation oncology, then those of us who are at the end of our careers have failed in imparting the essence of our profession.

The point is not that we should be good physicists, as indicated by the brochure (we understand the equipment, we keep it calibrated and running correctly, we know about

radioactivity, etc.), that is a given. The point is we should be good medical physicists. In addition to our physics training we should have had the necessary clinical training, so that while working with the radiation oncologist as a team, the optimal treatment for the patient can be determined.

This determination has little to do with how well the machines are running on whether their calibration is upto-date, but has everything to do with our knowledge of how radiation interacts in the body with our knowledge of anatomy and the disease process. Surely our training programs and especially the residency programs should not primarily aim at teaching physicists how to do the physics part of the work ( a well trained physicist can pick that up very quickly) but to teach them the overall picture of what is involved when a

patient is presented for treatment, determining the best treatment for that patient and seeing that treatment through to completion.

This kind of training takes time. It also enables the medical physicists working with the radiation oncologist to modify a treatment if things don't work out as originally planned. Sometimes such decisions must be made quickly (in the operating room for example) which is the essence of being a professional.

I know the brochure makes some allusion to training and teamwork in the last two paragraphs, but I'm afraid the average patient would miss the point.

I believe that most patients reading this brochure (and perhaps hospital administrators also) would see the medical physicist as a highly trained technician and not a professional.

ASTRO Membership Solicitation Dear AAPM Member: In the March/April AAPM Newsletter, your President, Kenneth Hogstrom, outlined several new partnership activities between AAPM and the American Society for Therapeutic Radiology and Oncology (ASTRO) and "strongly encouraged" medical physicists working in radiation oncology to become members

of ASTRO. Radiation physicists serve on the ASTRO Board of Directors and multiple ASTRO committees. Several sessions of the ASTRO Annual meeting are devoted to radiation physics and its clinical applications. ASTRO is redoubling its efforts to represent the legislative and economic interests and fulfill the educational needs of and enhance communication

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between all radiation oncology professionals. On behalf of ASTRO, I invite you to join the Society, participate in our meetings and special programs, and help chart our future course.

Radiation physicists certified by the ABR or ABMP may choose to become either Active or Associate members of ASTRO. Other radiation physicists or medical

AAPM NEWSLETTER

dosimetrists are eligible for Associate membership in ASTRO. As either an Active or Associate Member of ASTRO, you will receive: • Discounted Member only registration fee for ASTRO’s Annual Fall Meeting • Discounted Member only registration fee for ASTRO’s Annual Spring Review Course • Discounted Member only registration fee for all other ASTRO Educational Programs • Free Subscription to the bi-monthly ASTRO News • Free ASTROgram by email and other Internet Services

and you will be eligible for: • ASTRO Travel Grants and other Awards • Membership in ASTRO Committees Active Members also receive: • Free subscription to ASTRO's official journal, the International Journal of Radiation Oncology Biology Physics • Full voting rights and involvement in society decision making • The right to hold elective office in ASTRO The next ASTRO Annual meeting will be held on October 22-26 in Boston. If you plan to attend, please obtain and send in a membership

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JULY/AUGUST 2000

application now to get the discounted member rate for your advance registration.

To become an ASTRO member, you may download your membership application fr om our website, www.astro.org, or request it from Lucy Biedziak by email at lucyb@astro.org or by telephone at 1-800-9627876. We look forward to serving you.

Sincerely, Robert Lavey Chair, Membership Committee, ASTRO

AAPM NEWSLETTER

JULY/AUGUST 2000

AAPM Awards and Honors - Call for Nominationsand Call for Competitive Applications for 2000 Travel Grants Deadline - All nominations must be received by October 15, 2000. Further information is in Section 3.9 of Rules of AAPM (see AAPM 2000 Membership Directory, p.59).

Address Awards and Honors nominations to: AAPM Awards and Honors Committee One Physics Ellipse College Park, MD 20740-3846 Award winners and nominators will be notified of decisions by June 15, 2001.

Please see the August AAPM mailing for Primary Criteria and Nomination Procedures for the following awards:

William D. Collidge Award - recognizes an AAPM member for a distinguished career in medical physics.

AAPM Aw a r d for A c h i e v e ment in Medical Physics - recognizes AAPM members whose careers have been notable based on their outstanding achievements.

AAPM Fellows - recognizes distinguished contributions by AAPM members.

AAPM-IPEM Medical Physics Travel Grant - made to a U.S. AAPM member who

shows evidence of an active scientific career in medical physics. Grant promotes communications and professional partnerships between U.S. AAPM members and IPEM members from the United Kingdom.

AAPM Medical Physics Travel Grant - made to a U.S. AAPM member to travel to a foreign country of the recipient's choice. Grant assists in career development of the recipient and promotes communications in medical physics between nations.

AAPM NEWSLETTER e-mail: rdixon@rad.wfubmc.edu The AAPM newsletter is printed bi-monthly. Deadline to receive materials 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, disk or mail. Faxes are encouraged as back-up, and are accecptable alone.

NEXT ISSUE September/October, 2000

DEADLINE August 15, 2000

MAIL DATE September 15, 2000

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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