AAPM Newsletter November/December 2012 Vol. 37 No. 6

Newsletter

AME RIC AN AS S O C I ATI O N O F P H Y S I C I S TS I N M E D I CI N E We advance the science, education and professional practice of medical physics

AAPM Column VOLUME President’s 37 NO. 6

NOVEMBER/DECEMBER 2012

AAPM President’s Column Gary A. Ezzell, Mayo Clinic Scottsdale

wo recent events have given me reason to think about the related T issues of governance and trust: the dues vote and the public controversy about the lawsuit against AAPM. First, I am very glad that the dues vote passed. It was needed, and the association will be healthier for it. Many thanks to the 51% who voted for it. To the 49% who voted against, thank you for voting – and your skepticism is noted. The difference between the sentiment of the Board and the membership is striking to me. The Board voted overwhelmingly three times to ask for a dues increase in 2008 and 2009 (before any mounting lawsuit costs) and again in 2011. The membership only passed it by a small margin on the third try. Governance by representative democracy clearly has a different dynamic than governance by plebiscite, especially when it comes to money.

With respect to the lawsuit against AAPM and the costs incurred, a concern that was raised on the BBS and listservs over and over again was “why was the membership not informed?”

It is a fair question. Responding that the Board has been informed is both true and assuredly unsatisfactory to many. If everyone trusted the Board implicitly then it would not have been so difficult to get a dues increase approved. There actually is a better answer, one that has to do with the particular nature of this lawsuit.

In 2009, K&S, an Accredited Dosimetry Calibration Laboratory, filed an anti-trust lawsuit against AAPM alleging that we, along with the other ADCLs, conspired against it after it was purchased by PTW in order Included in this issue: to revoke its accreditation and put it out of business. I will not discuss the history or merits of the arguments while the p. 3 lawsuit is pending. However, I will point out this one key Chair of the Board President-Elect p. 5 fact. If we had kept the full membership informed about how we were defending ourselves and the mounting costs, Executive Director p. 6 we would have unavoidably cast K&S in a bad light. How Editor p. 9 could it be otherwise? The other side could then use that Professional Council p. 10 as “evidence” of our alleged continued efforts to conspire Education Council p. 11 against them and cost them business. I am only writing CAMPEP News p. 13 this now because I feel it absolutely necessary. I will try to mitigate any damage by confirming that K&S remains Health Policy/Econ Issues p. 14 accredited, and there has never been any concern about ABR Trustees Report p. 17 the accuracy of their calibrations.

Coolidge Award Introduction p. 19 The underlying issue is whether an ADCL should be Coolidge Award Acceptance p. 21 owned by a manufacturer of the equipment it calibrates. Leg. & Reg. Affairs p. 24 AAPM’s long-standing policy has been that this is not an Radiation Oncology acceptable situation. This has been the consistent policy Accreditation Workshop p. 26 since before 1999, when it was applied to prevent another p. 27 manufacturer’s lab from becoming an ADCL. Ironically, Obituary K&S led that opposition at the time. We did not change the

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November/December 2012

continued - AAPM President’s Column

policy in 2009; on the contrary, it has been reviewed and affirmed multiple times over the years. We were in the process of working through the appeal procedure when the suit was filed. This is the dilemma we have faced: if we tried to argue this case by newsletter article, we would improve members’ understanding but undermine AAPM’s legal position.

So that is why the Board has kept this topic low profile – to protect the AAPM. We are the defendants in this anti-trust suit alleging that AAPM is involved in a conspiracy. We have been protecting AAPM’s interests in the way we felt best. That meant not calling attention to the matter while being accurate in the accounting and honestly answering any question asked. We are dealing with a lawsuit, not science, and the considerations are different.

AAPM’s culture is and should be one of openness. As an officer, I don’t like being constrained to be circumspect, but will deal with it until the matter is settled and more can be said. You can trust me on that.

2012

Scientific, Educational and Professional Presentations

Unlimited access to the virtual library is included as a benefit of AAPM membership at no extra charge.

Join the hundreds of other AAPM members who are using the AAPM Virtual Library and Online Continuing Education Program for their continuing education, research, and information needs.

View selected presentations as originally presented by leading medical physicists, researchers, and experts in the field today by accessing the AAPM Virtual Library. Experience audio, and PowerPoint presentations.

Now available in the AAPM Virtual Library: 2012 AAPM Spring Clinical Meeting, 2012 CRCPD, 2012 AAPM Summer School, 2012 54th AAPM Annual Meeting, 2012 History Interviews In addition to the online presentations, CD ROMs are also available. View details in the AAPM Virtual Library.

November 8 Marks First Annual International Day of Radiology AAPM will take part in the first annual International Day of Radiology (IDoR) - Thursday, Nov. 8, 2012. The mission of this very special day is to build greater awareness of the value of radiology research, diagnosis and treatment in patient care and the vital role of radiologists in health care delivery.

IDoR will inform the public and lawmakers that radiology saves lives, resources and time and is essential to modern health care. AAPM joins more than 66 medical societies in 38 countries around the world in taking part in the Nov. 8 IDoR celebration. We invite you and your practice to do the same.

Please take advantage of an online “communications toolkit” for radiology groups to use to help spread the word about IDoR. The toolkit includes a customizable news release, op-ed and print advertisement for use on websites as well as other resources.

You may access the toolkit at acr.org/IDOR. For more information, visit www.IDOR2012.com or www.radiologyinfo.org.

International Day of Radiology is sponsored by the American College of Radiology, the European Society of Radiology and the Radiological Society of North America.

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AAPM Chair of the Board’s Column J. Anthony Seibert, UC Davis Medical Center

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or the last three years I have had the distinct honor and privilege of serving on the Executive Committee of the AAPM, working closely with very dedicated EXCOM officers, Council Chairs, and headquarters staff. I am very grateful for the opportunities that allowed me to interact with the Board of Directors and leaders of the AAPM, as well as the volunteers of the association who contribute so much to make a difference to our profession and to our collective success. I wish to thank all who have participated in AAPM activities, attended the annual and other AAPM-sponsored meetings, partaken in task group efforts, and those who have represented the AAPM at local chapter, state, national, and international venues.

I reflect back on a few of the persistent challenges that have confronted the AAPM over the past three years. The media reporting of radiation overdoses and mistreatment of patients undergoing radiation therapy required a proactive response from the AAPM, and we were represented by Mike Herman as he testified in front of Congress in 2010. From these events, several AAPM-sponsored summits on optimization / justification of CT and safety in radiation therapy have occurred and the upcoming summer school in 2013 on patient safety in radiation therapy is being planned.

One of the outcomes is an ongoing collaborative effort with ASTRO on a national event reporting system and the creation of a database to track significant events and near misses. The 2014 mandate for medical physics residencies for those desiring a clinical medical physics career has been in the spotlight for the past several years, and significant progress has been made as 2012 comes to a close. While the numbers of residencies are growing and approaching the number of slots that are forecast to meet the near-term workforce needs, there is still more to achieve, particularly for increasing Imaging Physics and Nuclear Medicine residency positions. However, I am very optimistic, particularly given the activities of the Education Council in this endeavor, and the recent efforts by President-Elect John Hazle to actively engage the chairs of radiology departments at the recent Society of Chairmen of Academic Radiology Departments (SCARD) meeting. The membership dues increase recently approved by a majority of voting members, will ensure that AAPM can fully undertake and fund important projects and priorities defined by the Strategic Planning committee, as well as the initiatives of Education, Science, Administrative, and Professional councils, who are chaired by George Starkschall, Dan Low, Melissa Martin, and Per Halvorsen. This will undoubtedly enhance membership benefits for all and raise the level and importance of our profession. President Gary Ezzell provided leadership in promoting the needs and Treasurer Janelle Molloy dedicated significant time for justification of the increase and making the budgetary process more efficient and transparent. I am confident that these additional funds will be used wisely to enhance the value of the AAPM for all members and for the profession.

While there are many who question the timing of the dues increase in reference to the ongoing lawsuit (refer to the president’s newsletter article), I would like to unequivocally state that all efforts on pursuing the dues increase were made in concert with the Board of Directors who were informed of the ongoing litigation and associated costs over the past three years.

There are so many to thank for their service to the AAPM; in particular, I would like to additionally recognize Secretary Beth Schueler, incoming Treasurer Matt Podgorsak, and incoming President-Elect John Bayouth for the many hours that they will serve in EXCOM on our collective behalf. I congratulate the Board of Directors for their willingness to provide stewardship, direction, oversight, and fiduciary responsibilities for the AAPM. I am deeply indebted to the Headquarters staff, expertly directed by Angela Keyser, for their assistance, support and friendship – helping me get organized and making my time spent within EXCOM meaningful and (more often than not) very fun. Finally, kudos and sincere thanks are in order to all members who make contributions to the association for the betterment of our profession—your volunteerism is the essence of the AAPM’s success. I look forward to remaining active and supporting this truly great organization over the coming years.

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2013 AAPM Annual Meeting August 4 - 8, 2013 Indianapolis Convention Center • Indianapolis, IN Dates to Remember: • December 2012

• January 16 • February 28

• March 27 • By April 18 • By May 10 • June 12

2013 Annual Meeting website activated. View the site for the most up-to-date meeting and abstract submission information. http://www.aapm.org/meetings/2013AM/ Web site activated to receive electronic abstract submissions.

(5 PM Eastern Deadline) for receipt of 300 word abstracts and supporting data. This deadline recognizes other conference schedules. There will be NO EXTENSION OF THIS DEADLINE. Authors must submit their abstracts by this time to be considered for review.

Meeting Housing and Registration available on-line.

Authors notified of presentation disposition.

Annual Meeting Scientific Program available on-line.

Deadline to receive Discounted Registration Fees.

2013 AAPM Summer School Save the date! More information coming soon . . .

Quality and Safety in Radiotherapy: Learning the New Approaches in TG 100 and Beyond June 16-20, 2013 • Colorado College, CO

New approaches to patient safety and quality in radiotherapy increasingly are becoming major commitments for practicing medical physicists. The pending report of Task Group 100 will change the methods physicists use to establish their quality management programs. The 2013 AAPM Summer School will help medical physicists learn about and understand the new approaches to safety and quality.

Much of this school will use real-life, in-class exercises to enhance and facilitate understanding the concepts. Panel discussions will bring out the multiple facets of many of the topics. By the end of the school, attendees should have a good understanding of the new approaches to safety and quality and know how to use them to determine the quality assurance for their facility.

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AAPM President-Elect's Column John D. Hazle, UT MD Anderson Cancer Center

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n this article I want to comment on three things: transformative changes, collaboration with other organizations and volunteerism. I’m making the rounds, visiting several chapters over the last few weeks and in the coming months. One of the main topics I’m focusing on is the need for the AAPM to take a leadership role in understanding and assessing the impact of changes in healthcare delivery, research funding and education that may be transformative with respect to their impact on medical physics. I don’t think I have to spend much time making the case that healthcare is in the throws of much change. The pressure to reduce cost while extending cover with higher quality has many people looking for completely different models of reimbursement and organization. We need to carefully examine these as they evolve and determine how they will impact medical physics. Only then can we proceed in ways that are good for our profession and the patients we serve.

Ditto on the research and education fronts. The research budgets of the federal government, charitable organizations and industry partners are mainly flat to declining. The public is demanding more progress, and like healthcare, they are expecting it to happen on a tight budget. The same is true for education where the expectations are for more access at less expense to the taxpayers. We need to stay ahead of these waves too! This includes embracing and promoting new paradigms, like a professional doctoral degree in medical physics (DMP), as ways to better align the costs of healthcare education with the ultimate desired educational products (well trained clinical medical physicists in the case of the DMP).

In terms of collaborations, the AAPM has some great partnerships with other organizations, including the RSNA. We also have a strong relationship with the ACR. Gary, Angela and I met a few months ago with ASTRO leadership and we are revisiting how we work closer with ASTRO on a number of fronts. Recently, Tony Seibert and I were invited to participate in a meeting with the Society of Chairs of Academic Radiology Departments (SCARD). We were both blown away by the enthusiasm, engagement and support that we received at this meeting from the leaders in academic radiology. We were there to solicit SCARD's help in identifying radiology chairs who would work with their imaging physics colleagues to establish new residency programs. We left with several chairs committing to go back and talk to there physicists about this. Further, we were invited by the incoming President of SCARD to come back next year and present on a topic of mutual interest. I already have the date penciled into my calendar!!! We plan to reach out to the radiation oncology chairs as well to see how we can work with them on topics of mutual interest.

Finally, a bit on volunteerism. I’ve written a couple of times about the enormous effort contributed to the AAPM by a large number of volunteers. As a starting point, I have been reminding our members that the AAPM is a board-governed organization. This board of elected volunteers are the people that you have selected to represent you and provide leadership to the organization. They, like many others, spend considerable time reviewing materials before meetings and giving up their time at board meetings to help guide the AAPM into the future. As for the scope of volunteerism, Michael Woodward is helping me to collect some hard data on the number of volunteer hours committed by our members. Considering only the time spent in committee meetings, task groups, working groups, etc. at the AAPM annual meeting, the RSNA meeting and on conference calls logged by AAPM, we are well over 10,000 person-hours. That's about 5 person-YEARS of work and counting!!! So, if you haven’t volunteered, but want to, my recommendation is to consider a topic of interest, contact the chair of the committee/TG/WG that you want to volunteer for and let them know you are ready for duty! If that doesn't work, drop me a line and I’ll help you get engaged with a topic of your choice.

See you in Chicago!!!

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AAPM Executive Director’s Column Angela R. Keyser, College Park, MD AAPM events during RSNA 2012 he most up-to-date schedule for AAPM meetings during the RSNA meeting is available online at: http://www.aapm.org/meetings/ rsna2012/default.asp.

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Make plans to join your colleagues on Tuesday, November 27 from 6:00 PM – 8:00 PM at the Chicago Hilton for the annual AAPM Reception. Special thanks to Landauer, RTI Electronics and Siemens for their financial contributions to offset the costs for this event.

Visit AAPM at Booth 200 Lakeside Center - Hall D for information on association programs and membership, demonstration of the AAPM Virtual Library, the current list of AAPM publications, and to pick up complimentary copies Medical Physics.

AIP’s Support of the Physics Community AAPM is one of 10 member societies of the American Institute of Physics (AIP). I came upon an interesting article in the June issue of Physics Today that does a great job outlining the many ways in which the AIP serves the broader physics community. You receive Physics Today because AAPM is a member of AIP. You may be most familiar with AIP’s publishing activities. But, the activities of AIP extend to extensive statistical research, preserving history, supporting student activities, and outreach to Congress and the agencies as well as the public. I encourage you to read the article, Physics resources for varied communities.

2013 Meeting Dates The 3rd CT Dose Summit: Strategies for CT Scan Parameter Optimization will be held March 15 – 16, just prior to the 2013 Spring Clinical Meeting. The Spring Clinical Meeting is scheduled for March 16 – 19 at the Pointe Hilton Tapatio Cliffs Resort in Phoenix, Arizona.

The 2013 Summer School, Quality and Safety in Radiotherapy: Learning the New Approaches in TG 100 and Beyond, will be held June 16 – 20 at Colorado College in Colorado Springs, Colorado.

The 55th AAPM Annual Meeting will be held August 4 – 8 in Indianapolis, Indiana.

Details will be online very shortly so stay tuned to email announcements!

Your Online Member Profile This is a reminder to keep your AAPM Membership Profile information up to date by going to http://www.aapm.org/memb/profile/ and making any changes necessary.

Please, upload your picture if you have not already done so.

Remember to review the “Conflict of Interest” area of the Member Profile to self-report conflicts per the AAPM Conflict of Interest Policy.

2013 Dues Renewal 2013 dues renewal notices were recently distributed. You may pay your dues online or easily print out an invoice and mail in your payment. Nineteen AAPM Chapters have elected to have HQ collect chapter dues. Make sure to check to see if your chapter is participating. If it is, we hope that you will appreciate the convenience of paying your national and chapter dues at one time!

Headquarters News In October we welcomed Janet Harris to the AAPM HQ team as our new Accounting Assistant.

Janet has extensive accounting experience, as a GL accountant, Junior Accountant and 30 years with the FRB Federal Credit Union. I am certain that she will be a great asset.

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continued - AAPM Executive Director’s Column I firmly believe that part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of high performing association management professionals. The following AAPM team members have celebrated an AAPM anniversary in the last half of 2012. I want to publicly thank them and acknowledge their efforts.

Lisa Rose Sullivan Penny Slattery Michael Woodward Farhana Khan Noel Crisman-Fillhart Yan-Hong Xing Tammy Conquest Corbi Foster Jackie Ogburn

19 years of service 16 years of service 16 years of service 14 years of service 7 years of service 6 years of service 5 years of service 5 years of service 5 years of service

The AAPM Headquarters office will be closed Thursday, November 22 – Friday, November 23, Monday, December 24 – Tuesday, December 25 and Monday, December 31 – Tuesday, January 1.

I wish you and your loved ones a happy and healthy holiday season.

AAPM Online Learning Center Need medical physics continuing education credits?

ABR-certified and need Maintenance of Certification (MOC) credits?

Sign up for access to the AAPM Online Learning Center

Members have the opportunity to earn CAMPEP-approved Medical Physics Continuing Education Credit (MPCEC) for successfully passing quizzes associated with informational sources such as journal articles, AAPM Virtual Library presentations, task group reports, and other publications.

Many AAPM members now require Maintenance of Certification (MOC) as defined by the American Board of Radiology (ABR). One component of MOC is the completion of Self-Assessment Modules (SAM). SAMs offerings can be found in the online learning center. 2010, 2011 and 2012 SAMs content is now available.

To maintain certification, ABR requires candidates to take an average of 2 SAMs per year, with no limit on the maximum number per year. The online SAMs carry CAMPEP MPCEC/Category 1 CME credit as well as SAM credit The Online Continuing Education Program runs on a calendar year. The annual fee is $65.

Choose this option on your AAPM dues invoice or pay online at:

http://www.aapm.org/education/ce/info.asp.

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Editor's Column

Mahadevappa Mahesh, Baltimore, MD

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elcome to the final issue of the 2012 AAPM Newsletter. As usual, I seem to repeat the same statement that ‘the year has gone so fast,’ in fact this is true again this year. Before I realized, it was already time for me to work on the last column for this year. It has been three years since we began to publish the Newsletter in an electronic format only, there by transforming the Newsletter into a revenue source for AAPM. I hope to take the Newsletter into the next format, that is, mobile platform provided the AAPM Board approves my budget request. I would like to thank all of the Corporate Affiliates who continue to support the Newsletter and hopefully if we move to mobile platform it will provide even greater capability to reach out to the readers.

This issue contains many interesting articles including the President’s column discussing the membership due increase and on-going lawsuit against AAPM, President-elect’s column discussing AAPM's effort to advance medical physics residency programs, Education Council Chair’s report on the medical physics education related issues and the acceptance speech from this year’s Coolidge award winner (Dr. Stephen R. Thomas – page 21). Congratulations once again Steve.

As the last issue of this year, I’d like to thank Ms. Nancy Vazquez, for all of her work on the Newsletter and Ms. Farhana Khan for facilitating in posting the Newsletter on the AAPM website through this year. I would like to express my sincere thanks to the Newsletter Editorial Board for their support and timely advice and to Angela Keyser, Michael Woodward and the all of the headquarters’ staff. Last but not least, a big "thanks" goes to my wife and kids for their patience with my involvement in the Newsletter. As this issue arrives at your desk, we are entering the holiday season and I wish you and your family a very happy holiday season. As always, I look forward to receiving any comments/suggestion related to the Newsletter.

Save the Date!

More information coming soon

Endorsed by:

2013 Radiation Oncology Program Accreditation Meeting Texas Health Presbyterian Hospital, Dallas February 8-9, 2013 9 9

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Professional Council Report Per Halvorsen, Newton, MA

“Safety is no accident” publication is updated s many of you know, ASTRO convened a collaborative project to develop a guidance document describing the crucial elements of a strong safety culture in radiation oncology. AAPM participated in the development of this publication along with 10 other societies. When the publication was distributed, we recognized that some important qualifiers were missing from the staffing recommendations, and we worked with ACR and ASTRO leadership to restore these qualifiers. The updated version of the publication is available on the ASTRO website. If you practice in radiation oncology, I encourage you to read the publication and discuss it with your clinical team.

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Specialty meeting on radiation oncology accreditation planned for February 8-9, 2013 Interest in radiation oncology practice accreditation has increased significantly in recent years.

At the same time, we have seen significant changes in the accreditation programs, with ACRO updating their program while ASTRO has terminated their participation in the ACR program and have announced their intention Radiation Oncology Physics Services to develop their own program.

With this in mind, the Professional Services Committee is preparing for a hands-on workshop on how to prepare for radiation oncology accreditation, with representatives “They continually exhibit from all accreditation programs clinical quality, responsiveness, participating alongside seasoned and the ability to integrate surveyors who will provide “mock with our team and culture of surveys” and practical tips. Look for service excellence. Our phydetailed information in a few weeks!

Medical Physics Practice Guidelines on track – Open Comment periods to commence soon The first two Medical Physics Practice Guidelines, on CT Protocol Management and Review and InRoom X-Ray Image Guidance, are currently undergoing internal review and will soon be ready for their 30day Open Comment periods. These documents are intended to define the minimum level of medical physics support which the AAPM considers prudent for supporting a given clinical service. Look for announcements from Headquarters when these documents are ready for your input – every AAPM member will have the opportunity to read the draft documents and offer suggestions for possible edits prior to finalizing the guidelines.

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J. Magruder, President

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Education Council Report George Starkschall, Houston, TX

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ne of the busiest committees in Education Council is the Committee on the Education and Training of Medical Physicists (ETC). This month I asked John Bayouth, Chair of the ETC, to describe for you the working of the Committee. John will be resigning his position as Committee Chair at the end of the calendar year, to take on the position of President-Elect of the AAPM. I would like to take this opportunity to thank John for his three years of service, both as Chair of the ETC, and as Vice-Chair of Education Council.

Education and Training of Medical Physicists John Bayouth For the past couple of years I’ve had the pleasure to chair The Committee on the Education and Training of Medical Physicists (ETC). ETC is an active committee within Education Council that addresses matters related to the academic and clinical training of medical physicists. This committee is one of six committees positioned within Education Council, chaired by George Starkschall. The other five committees within Education Council focus on continuing professional development, international education activities, public relations, and the education of physicians and other allied health professionals. I’m grateful to George for providing me the opportunity to use this issue’s Education Council space to inform you as to the activities occurring within ETC. At its core, ETC sets out to formulate and implement activities to collect information about medical physics education programs and issue recommendations on how to improve these programs.

Examples of activities include: 1. The collection and distribution of information regarding the number, characteristics, and current trainees in graduate and residency training programs in medical physics. Today there are 65 CAMPEP-accredited Medical Physics Residency programs; 59 in therapy and 6 in imaging, training over 100 residents. There are also 38 CAMPEP-accredited graduate programs, educating nearly 915 students who are currently enrolled. A special thanks goes out to Ed Jackson who serves as the Chair of CAMPEP GEPRC and the SDAMPP Outcome & Statstics Committee; his annual surveys contain much more detail on these topics, and can be found on the SDAMPP website at http://www.sdampp.org/resources.asp 2. The preparation and distribution of training guidelines for academic and clinical residency for medical physicists and the establishment of appropriate standards for such training. Two working groups perform this task on a continuing basis: Joann Prisciandaro chairs the Working Group on Periodic Review of Medical Physics Residency Training, while Richard Maughan chairs the Working Group on Medical Physics Graduate Education Program Curriculum. Both of these groups have been addressing critical issues regarding the breadth and depth of our Medical Physics educational programs. For example, definitions for levels of required supervision during clinical training, the necessity of additional skills (safety education, ethics, professionalism, FMEA), and the role of research in graduate and residency education.

3. The collection of information regarding funding opportunities for academic and clinical residency training. John Antolak chairs the subcommittee on Medical Physics Residency Training and Promotion, who is actively working on these efforts. Plans are currently underway for an AAPM-sponsored workshop to promote further development of residency programs based on proven financial models. Other activities from the Work Group on Coordination of Medical Physics Residency Programs, which John chairs, include the establishment and oversight of the AAPM Common Application Program. This program makes it easier for individuals to apply for residency programs, reduces administrative burden for existing programs, and allows AAPM to capture data regarding the number of individuals who apply. Although only in its second year, this has been very successful; check it out at http://www.aapm.org/CAP/

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continued - Education Council Report 4. Encourage recruitment of a diverse and talented student body into medical physics training programs. Two different subcommittees under ETC are actively working to achieve these goals. One is the subcommittee on Summer Undergraduate Fellowship Programs, chaired by Jennifer Smilowitz. This group has supported over 148 students and fellows, providing funding at nearly half a million dollars. When investigating the outcome of these efforts, Jennifer’s group found the vast majority (nearly 80%) were still in Medical Physics following participation in the program. A full description of their investigation has been accepted for publication in the JACMP. The second subcommittee is focused on Minority Recruitment. This group, chaired by Stephen Avery, seeks to increase the number of women and minorities in medical physics, creating new activities geared towards the recruitment of women and minority faculty, establish collaborations of women and minority physicists, and offer opportunities to minority students in pursuing the field of medical physics.

5. Development of Medical Physicists as educators. The subcommittee on Medical Physicists as Educators, chaired by Jay Burmeister, is working to provide cognitive science resources for educators to improve teaching methodology. This exciting effort should better enable educators to evaluate and assess their teaching methods, and is being led by Stephen Avery. The focus is on providing resources on ‘how to teach’ rather than ‘what to teach’. As such, the materials they are working to identify will be specifically aimed at cognitive science and teaching tools rather than information on course content.

We have several subcommittees, task groups, and working groups within ETC that contribute towards these goals; space considerations restrict me from describing more of the committee’s efforts. Although ETC itself monitors and integrates many of these activities, which much of the “real” work being accomplished within the reporting groups. I want to personally thank all AAPM members who have volunteered their time to improve the Education and Training of Medical Physicists, and encourage those who have a passion for this area to roll up your sleeves and join the effort. Finally, I want to thank John Gibbons who is the incoming chair of ETC, who I’m sure will do an outstanding job.

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CAMPEP News

William R. Hendee, CAMPEP President & Chair

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n my last quarterly report in the AAPM Newsletter, I described actions taken by the CAMPEP Board of Directors related to eligibility requirements for the alternate pathway into a medical physics residency.

At that time the entry requirements for the alternate pathway were that an individual must possess a PhD in physics or a closely-related discipline, and complete the six courses described in AAPM Report 197S. Only courses offered by a CAMPEP-certified graduate or residency program could satisfy the course requirements. These decisions were interim decisions subject to refinement by CAMPEP upon further deliberation.

CAMPEP has deliberated further on the alternate pathway requirements and arrived at some additional specifications for the alternate pathway that are described in the Questions and Answers below.

Question: Answer:

What is meant by a “closely-related” discipline?

A closely-related discipline is one that includes the same or equivalent undergraduate courses that are typically taken by an undergraduate physics minor.

Question: For an individual wishing to enter the alternate pathway and who has taken courses identical or similar to those in AAPM Report 197S, can the 197S course requirements be waived by the residency program director?

Answer: Up to two courses may be waived by the program director, but justification for waiving the courses must be explained in the residency program director’s annual report. The remaining four courses must be taken in a graduate or residency program certified by CAMPEP to offer the courses.

Question: Can a residency program be certified to offer one or more of the 197S courses, or must the program offer all six of the AAPM Report 197S courses?

Answer: A residency program may be certified by CAMPEP to offer one or more of the 197S courses, including all six courses, provided that it is in or affiliated with an academic institution and meets the criteria for a certificate program established

by CAMPEP. Question: Will individuals with less than a terminal degree (that is, students with a master’s degree) be eligible for the alternate pathway?

Answer: Eligibility for the alternate pathway is restricted to persons with a terminal degree.

CAMPEP is seeking its own accreditation from the Commission on Higher Education Accreditation.

This is a multi-step and complex process that we hope to have consummated by January, 2014.

The CAMPEP Board of Directors will be discussing this process at its 4-hour meeting in Chicago on Sunday November 25th, along with several items on its agenda.

The American Association of Physicists in Medicine cordially invites you to attend the AAPM Tuesday Evening Reception at RSNA during the 2012 AAPM / RSNA Meeting Tuesday, November 27, 2012 • 6:00 pm - 8:00 pm Waldorf Room, Chicago Hilton • Chicago, Illinois light hors d’oeuvres

AAPM gratefully acknowledges the following co-sponsors for their contributions to this reception:

RTI Electronics, Inc.

Siemens, Inc.

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AAPM Newsletter

November/December 2012

Health Policy/Economic Issues Wendy Smith Fuss, M.P.H. AAPM Health Policy Consultant

AAPM Submits Comments on 2013 Medicare Rules

A

APM recently submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the 2013 Medicare proposed rules that apply to hospital outpatient departments, freestanding cancer centers and physician payment.

Medicare Physician Fee Schedule AAPM provided comments supporting CPT 77336 Continuing Medical Physics Consultation as a potentially misvalued service under the Medicare Physician Fee Schedule (MPFS). This procedure code was last reviewed for the 2003 MPFS and AAPM supports review and revaluation of the Continuing Medical Physics Consultation code. AAPM advised CMS that, "CPT code 77336 is misvalued because changes in the technique for rendering continuing medical physics consultations have resulted in changes to the knowledge required, time, and effort expended, and complexity of technology associated with the tasks performed by the medical physicist and other staff. We assert that the direct practice expense inputs no longer accurately reflect the resources used to deliver this service and may be undervalued. The Continuing Medical Physics Consultation code now takes more time due to increased complexity of treatments and patient setups, increased use of image guided radiation therapy (IGRT) and associated workload for review of images, and the increased emphasis on safety, which has changed the level of oversight of patients under treatment. Given the complexity of current radiation therapy, the majority of work under 77336 is now being provided by medical physicists." If CMS agrees that CPT 77336 is potentially misvalued, AAPM will submit new direct practice expense inputs and data to support the revaluation during the 60-day comment period after the 2013 MPFS final rule is published.

Under the 2013 proposed rule, capital-intensive specialties, including radiation oncology, are projected to decrease due to proposed changes in how the interest rate used in the practice expense calculation is estimated. Also, under the potentially misvalued codes initiative, CMS proposes to adjust the payment rates for two common radiation oncology treatment delivery methods, intensity-modulated radiation treatment (IMRT), and stereotactic body radiation therapy (SBRT) to reflect more accurate time projections based upon publicly available data. The combined effect of the Physician Practice Information Survey transition and the latter two proposals would be a reduction in payments to radiation therapy centers and radiation oncology. Radiation Oncology and Radiation Therapy Centers have the largest negative impacts to both 2012 and 2013 total payments compared to all 57 specialties.

AAPM advised CMS of significant concerns regarding the proposed reductions to radiation oncology and freestanding radiation therapy centers in the 2013 MPFS. AAPM wrote that, "Cuts of this magnitude will harm cancer care, especially in rural areas, and will negatively impact Medicare beneficiary access to life-saving treatments. We fear that many freestanding cancer centers may close or reduce expenses, including clinical labor, which could impact the safety and quality of radiation therapy and compromise patient outcomes." AAPM recommended that CMS stabilize radiation oncology relative value units (RVUs) and payments in order to ensure Medicare beneficiary access to life saving cancer treatments provided in freestanding and community-based cancer centers.

CMS will address public comments in the 2013 MPFS final rule, which will be published on our about November 1st. To read the complete AAPM comment letter to CMS, go to: http://www.aapm.org/government_affairs/CMS/default.asp Medicare Hospital Outpatient Prospective Payment System AAPM also provided written comments to CMS regarding the 2013 Hospital Outpatient Prospective Payment System (HOPPS). CMS proposes to use the geometric mean costs of services within an ambulatory payment classification (APC) to determine the relative payment weights of services, rather than the median costs that CMS has used since the inception of the HOPPS. AAPM wrote that, "CMS has historically relied on median costs. We agree with the CMS statement that

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AAPM Newsletter

November/December 2012

continued - Health Policy/Economic Issues medians are generally more stable than means because they are less sensitive to extreme observations. We believe that medians are a more reasonable choice, because they ignore outlier data." AAPM did not support the geometric mean-based relative payment weight proposal and recommended that CMS delay this proposal for at least one year.

CMS also proposes to reassign simple proton therapy code 77522 to APC 667 Level II Proton Beam Therapy and reassign complex proton therapy code 77525 to APC 664 Level I Proton Beam Therapy, which creates significant payment reductions to both APC payments in 2013. CMS reported there were only 3 hospital outpatient facilities that billed Medicare for proton beam therapy services in 2011. AAPM advised CMS that one of the 3 facilities began reporting CPT 77525 beginning in 2010 and may not have been correctly reporting their costs based on the extremely low cost-to-charge ratio compared to the other facilities reporting these codes. AAPM recommended that CMS maintain the current 2012 APC assignments for proton beam therapy codes 77520, 77522, 77523, and 77525 for 2013 as the data for the proposed reassignments appear to be flawed. If necessary, CMS could make an exception to the Two Times Rule for APCs 664 and 667 in 2013.

AAPM supported the following CMS proposals: • Unpackaging intraoperative radiation therapy (IORT) codes 77424 and 77425 and pay them separately beginning in 2013.

• Pay hospitals for the additional cost of using Tc-99m from a non-highly enriched uranium source effective January 1st.

CMS will address public comments in the 2013 HOPPS final rule, which will be published on our about November 1st. To read the complete AAPM comment letter to CMS, go to: http://www.aapm.org/government_affairs/CMS/default.asp

Visit us at RSNA booth 831

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AAPM Newsletter

November/December 2012

best abr exam preparation ever

Go!

I’m feeling prepared

Coming soon in January 2013: Diagnostic Oral and Therapy Part 2

The most comprehensive forum on optimizing CT parameters for physicists, technologists and imaging physicians.

Yes! We are back with the 3rd CT Dose Summit with enhanced content and new partners. Enhanced content will span from the more elementary components of good scan protocols to the most advanced and recent technologic developments, which will be invaluable for both in-training and practicing CT physicists and technologists for managing CT radiation dose. Additional content on specific diagnostic requirements, pictorial relation of scan parameters to image quality, and the art of building indicationdriven scan protocols makes the 3rd Dose Summit a must-attend for imaging physicians in CT. The focus of the 3rd CT Dose summit will remain on demonstration of how scan acquisition and image reconstruction parameters should be selected and managed to improve image quality and reduce radiation dose. Faculty members will explain the essential criteria for specific diagnostic tasks. The goal of the summit is to provide practical information for users that will help them operate their CT scanners wisely, improving the quality and usefulness of CT images while reducing the radiation dose to patients.

We are delighted to partner with the Webster Center for Advanced Research and Education in Radiation of the Massachusetts General Hospital Imaging for the 3rd CT Dose Summit.

Save the Date! More information coming soon

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AAPM Newsletter

November/December 2012

ABR Trustees Report

Jerry Allsion, Geoffrey Ibbott, Richard Morin

O

ver the past few years, the ABR has received many comments about the Maintenance of Certification (MOC) Program that began in 2002. Many diplomates have had concerns about how the program functioned. The major ones were: • It was hard to keep track of where one stood in the process.

• The Personal Database (PDB) was difficult to use.

• It was possible to get hopelessly behind and lose one’s certificate no matter what one did to try to catch up.

• The practice quality improvement (PQI) requirement was difficult to understand.

• One received a new certificate every ten years.

To address these concerns, the ABR has undertaken a number of major initiatives. The two most important are: • Replacing the 10-year MOC cycle with one of “continuous certification” (being implemented in 2012) • Replacing the PDB with an improved, interactive system that will be called “myABR” (coming in 2013) This newsletter article will address the major features of continuous certification. Details of the practice quality improvement (PQI) requirement will be covered in a subsequent article, as will the new myABR. Background Along with several other Member Boards of the American Board of Medical Specialties (ABMS), the ABR is implementing a new integrated process that links the ongoing validity of certificates to meeting the requirements of Maintenance of Certification (MOC). Under the new process, known as “continuous certification,” ABR certificates will no longer have “valid-through” dates. Instead, on each new and renewed certificate in diagnostic radiology, radiation oncology, or medical physics, the effective date will be noted and accompanied by the statement that “ongoing validity of this certificate is contingent upon meeting the requirements of Maintenance of Certification.”

This policy change, being implemented in 2012, encourages diplomates to engage in more continuous professional development and meet their MOC requirements on time. The total number of MOC requirements will not change, but progress will be evaluated on a yearly basis, and the type of CE/CME activities required and accepted as self-assessment will be broadened. For each diplomate who is a current enrollee in MOC, continuous certification will replace the 10-year MOC cycle.

Advantages of Continuous Certification Diplomates with two or more time-limited certificates will have their certificates synchronized into one MOC cycle.

• The annual look-back at MOC participation (in March of each year) examines a rolling threecalendar-year window, providing diplomates with flexibility for how they distribute the credits needed over the three years. The first “full” annual look-back, which includes Parts 1, 2 and 4, will be in March 2016.

• The number of CE/CME and self-assessment credits that diplomates may obtain and attest to the ABR per year is unlimited. So, if a diplomate has a year—or even two—in which it is difficult to meet requirements, he or she may obtain and report as many credits as needed in the third year to meet the three-year requirements.

• With the new system, it will be difficult for any individual to fall behind. The ABR will send automatic reminders to help diplomates avoid delay and the stress of trying to meet all their requirements in a very short period of time.

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continued - ABR Trustees Report • During the transition to continuous certification, diplomates who have already taken and passed the MOC exam will be given a one-time “break” because the date of their exam passage will be attributed to the last day of their 10-year MOC cycle.

• Time-limited certificates that have already been issued with an end date will still be honored, even if a diplomate does not meet continuous certification look-back requirements. The status of such diplomates will be reported as “certified, not meeting the requirements of MOC” (see information below on public reporting).

Public reporting of diplomate status to begin next spring If for no other professional or personal reasons, keeping current with MOC requirements is important because beginning in spring 2013, ABMS will report on its public website, www. certificationmatters.org, whether or not each ABR diplomate is meeting MOC requirements for each certificate held.

The • • •

three public reporting categories to be included on the ABMS website are: Meeting the requirements of Maintenance of Certification Not meeting the requirements of Maintenance of Certification Not required to participate in Maintenance of Certification (In June 2012, ABMS added this category for lifetime-certified diplomates.)

The ABMS website will refer users to the ABR website (www.theabr.org), where further information will be found. The ABR’s website is being enhanced to include its own online verification database of ABR diplomates, which will also be available in spring 2013.

Public reporting of certification and MOC status on the ABMS and ABR websites represents a natural development in the evolving transparency and accountability that are part of ABMS’ Enhanced Public Trust Initiative. It is also in keeping with the ABR’s mission to assure the public that its diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill, understanding, and performance essential to the safe and competent practice of diagnostic radiology, radiation oncology, and medical physics. Continuous certification will ensure that public reporting is as clear and accurate as possible.

Some minor changes in the requirements for medical physicists were made to ensure that the process is clear and to align the medical physics requirements more with those of the other two ABR disciplines of diagnostic radiology and radiation oncology.

MOC Part 1 – Professional Standing - The Part 1 requirements for physicists with a state license (in Texas, Hawaii, Florida, and New York) are unchanged. For those with a requirement for attestation, this may be done at any time but must take place once every five years. We are working on ways to simplify the process.

MOC Part 2 – Lifelong Learning and Self-Assessment - The total number of lifelong learning continuing education requirements has not changed, but beginning in March 2016, there will be a three-year look-back to ensure that requirements are being met. The percentage of CME that must be self-assessment will increase slightly, but the definition of self-assessment activities will be expanded. Self Directed Educational Projects (SDEPs) remain a viable, optional method for CE. The self-assessment changes will be highlighted in a future article.

MOC Part 3 – Cognitive Expertise – One exam is required every 10 years for each certificate you hold; however, it can be taken at any time during the 10-year period.

MOC Part 4 – Practice Quality Improvement – Because physicists can be a resource for PQI, the learning year has been retained. Documentation is now in the form of an SDEP. The number of projects has been aligned with the other disciplines, and one is required every three years. A separate newsletter article will describe this process.

These changes and future revamping of the ABR website and PDB (myABR) should address many of the concerns that diplomates have voiced about the certification process. At this point, MOC requirements listed on the ABR website do not reflect this new policy. Further details regarding continuous certification will be available soon, and diplomates will be notified on the website and by email. Meanwhile, if you have any questions or concerns, please contact the MOC Services Division at abrmocp@theabr.org, or visit us online at www.theabr.org.

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AAPM Newsletter

November/December 2012

AAPM Coolidge Award 2012

INTRODUCTION OF STEPHEN THOMAS by G. Donald Frey

O

ne should not judge an organization by the size of its membership, the wealth of its investments or the length of its history. Rather one should judge an organization by the roll of the winners of its highest award. By that standard the AAPM stands second to none. Tonight we are here to add the name of Stephen Russell Thomas to that distinguished company.

The list begins with the name of William David Coolidge, who was born before the invention of the automobile and lived until 1975. Coolidge was the outstanding scientist-inventor of his era on a par with Edison but also a distinguished scientist.

His development of ductile tungsten and the modern x-ray tube moved medical imaging from a curiosity to an integral component of medical care.

Coolidge’s name is followed on that roll by the best and the brightest medical physicists in the history of the profession.

Tonight we add an additional distinguished name to that list.

Dr. Stephen R. Thomas was born in Massachusetts. He received his BA degree, in 1963, from Williams College, an institution famous for developing great scientists and great educators.

Following his time at Williams he undertook service in the Peace Corps. He answered the call to serve the developing world by teaching science in Accra, Ghana. Those of us who know Steve well appreciate how much his service was a reflection of his character and how much it transformed him.

Upon his return to the US, he moved to the mid-west, a region he has never left, for his Ph.D. which he received from Purdue in 1973. After brief service as an assistant professor of physics at Kentucky Wesleyan College, in 1974, he made the transition William David Coolidge into medical physics by undertaking a post doctoral fellowship at Radioisotope Laboratory at the Cincinnati General Hospital.

Here he worked with two individuals, James G. Kereiakes, Ph.D. and Eugene L. Saenger, MD, who greatly influenced his academic development. In 1975 he joined the faculty of the University of Cincinnati, where he has spent the remainder of his academic career. Steve rose quickly through the ranks becoming a full professor in 1989 and Director of the Division of Medical Physics in 1991.

Winners of the Coolidge Award must distinguish themselves, not just in one area, but in education, research and professional service.

A charming custom in the German academic system is the practice of calling your Ph.D. advisor your “doctor-father.” Steve has been a prolific parent. During his years at the University of Cincinnati, he has served as the advisor, dissertation committee member and/or mentor for 5 doctoral and 22 masters’ degree students. His academic children are spread far and wide and have made outstanding contributions in their own right.

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continued -AAPM Coolidge Award 2012 In research Dr. Thomas has made exceptional contributions both in nuclear medicine and in magnetic resonance imaging. His contributions to the dosimetry of radionuclides and his excellent scientific management ability as chair of the Medical Internal Radiation Dose, or MIRD, committee has earned him the affectionate title of “Dr MIRD” for many of us. In the early days of magnetic resonance imaging, whole body units were very expensive and hard to acquire. Steve solved this problem by building his own, an activity that harkens back to the scientist-inventor that this award is named after. Steve went on to a productive role in MRI research and leadership in the Society of Magnetic Resonance Imaging. Altogether Dr. Thomas has authored more than 100 publications.

The third characteristic of Coolidge Award winners is their leadership in the development of medical physics as a profession. Here again Steve is far above ordinary. Leadership in the AAPM is a sine qua non. He served on countless committees and task groups. He was our president in 1997.

He has also had major leadership roles in the Radiological Society of North America and the American Board of Radiology. He has served as Third Vice-President of the RSNA and has served as a member of the RSNA Research & Education Foundation’s Board of Trustees. His leadership on the American Board of Radiology as a trustee and its first Associate Executive Director for Medical Physics has truly transformed the way medical physicists are trained and certified.

Finally we come to a characteristic that is never listed but which underlies and unifies the rest.

That is character. From his earliest days in the Peace Corps to the pinnacle of our profession, Steve has exhibited a sense compassion, integrity, hard work and service to others that make him unique among his peers.

It is with great pleasure that I present Dr. Gary Ezzell, President of the AAPM, to present the William Coolidge Award to Dr. Stephen Russell Thomas.

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AAPM Newsletter

November/December 2012

2012 William D. Coolidge Award Acceptance Speech Stephen R. Thomas

T

hank you Don for providing that gracious introduction. I am indebted to both Rick Morin and you for initiating my nomination for this prestigious award.

I am most appreciative of this high honor of being the recipient of the AAPM 2012 William D. Coolidge Award. It is quite humbling to have my name added to that distinguished list of awardees starting with Coolidge himself. Many of the more recent recipients are in the hall this evening including Rick who stood at this podium a year ago.

A truism, recognized by all on professional tracks, is that one’s career gains momentum through the collective “boosts” provided by mentors and colleagues along the way. Many thank-you’s are always in order. However, my apologies in advance for not having time to give credit to all those individuals to whom that credit is due.

Each of us could recount defining phases or events that shaped our career paths. I will be relating several over the next few minutes. Certainly one of mine was the Peace Corps experience (as Don has mentioned) teaching secondary school science in Accra, Ghana, West Africa (1964-66).

Quite understandably, my world outlook at this time of the Vietnam War was broadened in a straight forward, positive sense through contact with the Ghanaian society and culture as well as the diverse expatriate community of which I became part (Russian, East German, Swedish, British, Canadian … ). I believe that the lessons learned in those 2 years in how to interact with others of different backgrounds carried through and served me well in my medical physics career.

My entry into medical physics represented a transition from the solid state physics embodied in my doctoral thesis to the practice of science in medicine. This metamorphosis took place at the University of Cincinnati Medical Center in 1974 - the institution at which I have spent my entire academic career. And the reason for that longevity was the encouragement, support, and freedom to spread my wings which I experienced within that environment.

Jim Kereiakes, Ph.D. and Eugene Saenger, MD, the latter then Director of the Radioisotope Laboratory, were key individuals who served as professional mentors as well as personal friends through those early years and later. I am very much indebted to them both. Jim had been the advisor and mentor to a “stable” of medical physics graduate students and post doctoral fellows. Many of you will recognize a number of them in this photo taken at the 1988 RSNA the year Jim got his Gold Medal.

RSNA 1988 on the occasion of the Gold Medal for Jim Kereiakes. Left to right- Steve Thomas, Howard Elson, Jim Deye, Cliff Born, Guy Simmons, Jim Kereiakes, Joe Windham.

With respect to Gene Saenger, what struck me from day one was the value and trust that he put in the ability of the medical physicist to bring quantitative expertise into clinical research. I was impressed with the appreciation that he and other radiologists at the University of Cincinnati Medical Center held for the role played by medical physicists.

Another nuclear medicine physician with whom I worked closely as a professional colleague, friend, and coauthor on a number of papers, was Harry R. Maxon, MD. Early on, he got me started thinking about ways to quantitate activity in bone scans of Paget’s disease patients.

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continued -AAPM Coolidge Award Acceptance Speech That led into development of quantitation techniques involving conjugate view imaging in-vivo.

This work opened the door to my membership on the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. As Don has mentioned, I spent many years on the MIRD Committee. I greatly benefited from my association with members of the Committee who were pioneers in the field of radioisotope dosimetry. I should list them all but, in light of the time allowed, I will limit my remarks and mention only one. I was fortunate to have had the opportunity to work directly with Bob Loevinger, a Coolidge Award recipient in 1995, who was a principal architect of the MIRD Schema that revolutionized and standardized the calculational methods used in internal dosimetry. The MIRD Committee’s work and impact is still going strong under its current leadership and membership.

My introduction into MR in medicine started in the late 1970’s. Under no pretense regarding my own knowledge in the area, I reached out to experts at the Department of Chemistry for collaboration. We began converting a small bore (2.25 inch), 1.45T research magnet donated by Proctor & Gamble into an imaging unit (rat pups maximum). On a trip to Philips, Netherlands in 1982, ostensively to evaluate CT units, we also were given a tour of the Philips low field (0.15T) MRI unit then under development. Upon return, I challenged the Radiology Department with either buying a commercial system or providing initial funding for developing our own low field whole body imaging unit. I was University of Cincinnati Medical Center, Spring 1995. aware of a 0.15T magnet available then in L to R: Jerome Wiot, Steve Thomas, Jim Kereiakes, a sub-basement at Technicare. The decision Eugene Saenger. was made for the latter course and, under the support of Jim Kereiakes, Eugene Saenger along with Jerome Wiot, MD, then Radiology Department Chair, the magnet was funded and installed in the medical sciences building.

In short, although the system was intended for large animal, non-human research, the first patient receiving a clinical MRI procedure within the city of Cincinnati was scanned on the medical physics unit in 1985. However, most of our research on the system involved F-19 MRI using perfluorocarbon compounds for pO2 imaging in animal models. On the other hand, we did have the occasional unique client such as a baby gorilla from the Cincinnati Zoo that visited us for a neuro scan. Let me take this occasion to acknowledge those colleagues who were most responsible as part of our group working to develop the 0.15T system: RC Samaratunga, Larry Bussy, and Ron Pratt - A very dedicated team.

I want to mention also Jerry Ackerman, Ph.D., then Assistant Professor in the Department of Chemistry at the University of Cincinnati, who provided expertise in MR technology as we were starting the initial projects.

Certainly, a most rewarding facet of my career in medical physics has been my association with and involvement in a number of professional organizations. The reward comes not only with the satisfaction of completing a given critical task successfully but also in relationships that are forged with dedicated colleagues and professional staff. In brief, foremost among these has been the AAPM from my days as founding chair of the Task Group University of Cincinnati Medical Physics MRI on MR, through years on the Program Committee, Group, Spring 1985 following imaging of first and time on EXCOM. The RSNA has been another clinical patient. L to R: RC Samaratunga (Sam), organization with which I have been highly involved.

Larry Busse, Ron Pratt, Steve Thomas.

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continued -AAPM Coolidge Award Acceptance Speech Among other roles, I appreciated the opportunity of contributing to the RSNA Research & Education Foundation mission as a member of the Board of Trustees. There is tremendous gratification in seeing the doors open for young investigators in radiology by providing initial seed grants that serve to launch their careers in research. With regard to the ABR, I participated as a member of item writing committees for the various exams well before my term as an ABR Trustee and my tenure as Associate Executive Director for Medical Physics.

The theme here that I would emphasize is commitment. In particular, I would urge all of the younger medical physicists in the audience who are starting out or are early in their careers to look around and identify committees and projects ongoing within our professional societies to which they can contribute. The efforts of volunteers are crucial to ensure the well being of our organizations. But it is truly a symbiotic relationship. You will gain immensely as a member of the medical physicist community through contribution and commitment. Clearly that has been my experience.

In closing, I gratefully acknowledge the supreme moving force behind my career.

Ingrid has been at my side since the graduate school days. She’s quick to remind me that it was she who financed our first vehicle back then (a ’68 Chevy sports van). Ingrid is a true ambassador who’s ability to make friends and fit into our professional circles is legendary. So often I have heard at society meetings: “Steve, it’s nice to see you but we’re really here to visit with Ingrid.” I take this opportunity to thank her for the vital support she has provided and the love we continue to share. Our daughter Kirstin was not able to join us on this occasion, but I thank her as well for being understanding through the years with regard to the various time demands of my career.

Once again, I am truly grateful to the AAPM for bestowing on me this tremendous honor as the recipient of the 2012 William D. Coolidge Award.

Steve and Ingrid Thomas

SAVE THE DATE! AAPM Spring Clinical Meeting March 16 – 19, 2013 Pointe Hilton Tapatio Cliffs Resort Phoenix, Arizona Registration and Housing open on December 6th http://www.aapm.org/meetings/2013SCM/ 23 23

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AAPM Newsletter

November/December 2012

Legislative and Regulatory Affairs Lynne Fairobent, College Park, MD

NEMA announces publication of "NEMA XR 26 Access Controls for Computed Tomography: Identification, Interlocks, and Logs" http://www.nema.org/News/Pages/NEMA-PublishesNEMA-XR-26-Access-Controls-for-Computed-TomographyIdentification,-Interlocks,-and-Logs.aspx

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he standard's inclusion of information related to saved changes in protocols complements AAPM's ongoing project to develop a CT Protocol Review practice guideline (currently under review). This standard is part of ongoing efforts by CT manufacturers to provide improved facility quality assurance tools. Another example is the NEMA CT Dose Check standard(http://www.nema.org/Standards/Pages/Computed-Tomography-DoseCheck.aspx) and related "AAPM Recommendations Regarding Notification and Alert Values for CT Scanners: Guidelines for Use of NEMA XR 25 CT Dose-Check Standard" (available at: http:// www.aapm.org/pubs/CTProtocols/). Facilities are encouraged to ask about the availability of and implement such equipment quality assurance tools and related AAPM professional guidelines.

Reminder: One-Year Waiver for Certain “Class A” Sealed Sources for Disposal at the Energy Solutions Clive, UT Facility The Source Collection and Threat Reduction Program (SCATR) administered by the Conference of Radiation Control Program Directors (CRCPD) is providing sealed source licensees in states which do not have access to a low level radioactive waste disposal facility an opportunity to dispose of certain unwanted radioactive sealed sources. The collection, which is supported by the Department of Energy’s Global Threat Reduction Initiative (GTRI), the State of Utah Division of Radiation Control, and Energy Solutions of Utah, will include a range of sealed sources that meet the definition for Class A waste and will last for a period of one year from the date the first waste is received at the Clive, UT facility. CRCPD is offering financial assistance equal to half the cost of disposal to generators who participate in the effort.

Only sealed sources which meet the criteria specified below will be considered for the program: • Each source by itself must meet the definition of Class A waste as defined in 10 CFR § 61.55: o The quotient of the current activity of the radionuclide in the source divided by the volume of the source cannot exceed the Class A limit as specified in 10 CFR § 61.55 tables; o This includes any radionuclide not specifically listed in the 10 CFR § 61.55 tables with a half-life < 5 years; o Commonly used radionuclides that could qualify for the collection include: Isotope

Class A Limit

Isotope

700 mCi/cm

125

Cs

1 mCi/cm3

109

Gd

700 mCi/cm3

133

Fe

700 mCi/cm3

68

Co

3

700 mCi/cm

152

700 mCi/cm3

147

Co

60

137 153 55 57

Po

210

•

3

Class A Limit

Isotope

I

700 mCi/cm

192

Cd

700 mCi/cm3

65

Ba

Unlimited

204

3

Ge

Class A Limit

Ir

700 mCi/cm3

Zn

700 mCi/cm3

Tl

700 mCi/cm3

Na

700 mCi/cm3

Mn

700 mCi/cm3

Au

700 mCi/cm3

700 mCi/cm3

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Eu

Unlimited

54

Pm

700 mCi/cm3

195

The sealed source must be registered with the Off Site Source Recovery Project (OSRP) before it can be accepted for disposal. Go to http://osrp.lanl.gov/PickUpSources.aspx for information about how to register your source(s). If your sources are already registered, you may wish to update your registration.

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continued - Legislative and Regulatory Affairs •

•

Each source must be uniquely identified by a serial number or other unique identifier and the site should have ready any documentation available pertaining to a particular source’s activity, isotope, and date of manufacture or original assay upon broker’s packaging and acceptance of material.

Other restrictions may apply.

A list of the sealed sources you have registered with OSRP will be sent to a broker included in the list below. A broker to schedule a date and time for collection of your sources will contact you. If you have additional questions regarding the collection effort, please call or email Russ Meyer at CRCPD (512-761-3822 or rmeyer@crcpd.org).

Clive Qualified Radioactive Material Brokers ALARON

Wampum, PA

Barnwell Processing Facility

Barnwell, SC

Bear Creek (Energy Solutions)

Oak Ridge, TN

Studsvik Processing Facility Erwin, LLC

Erwin, TN

TOXCO

Oak Ridge, TN

Bionomics (Clive-Qualification Pending)

Oak Ridge, TN

Information on the Source Collection and Threat Reduction (SCATR) Collection Sealed Sources for Disposal at the Waste Control Specialists Andrews, TX Facility The Source Collection and Threat Reduction Program (SCATR), administered by the Conference of Radiation Control Program Directors (CRCPD), is providing sealed source licensees in states which do not have access to a low level radioactive waste disposal facility an opportunity to dispose of certain unwanted radioactive sealed sources. On April 25, Training Academy 2012 the Waste Control Specialists’ (WCS) Compact Waste Facility (CWF) located in MEDICAL SAFETY TRAINING Andrews County, Texas was authorized to collect and dispose of sealed sources.

Available Courses The Department of Energy’s Global Threat Medical Radiation Reduction Initiative (GTRI), the Texas Safety Officer Course Commission on Environmental Quality CAMPEP Accredited.

(TCEQ), the Texas Low-Level Radioactive Waste Disposal Compact Commission (Texas Fluoroscopy Training and Compact Commission), and Waste Control Refresher Course Specialists support this effort. CRCPD may Custom Courses offer financial assistance as needed to Designed to meet your needs. generators who participate in the SCATR program. Full details on what the WCS’s Available Formats license allows for disposal of Class A, B and Classroom C sealed sources can be found at: http:// (Las Vegas NV, Gaithersburg MD crcpd.org/StateServices/WCS.pdf.

If or Oak Ridge TN) you have additional questions regarding On-site (your choice) the collection effort, please call or email On-line Courses Russ Meyer at CRCPD (512) 761-3822 or Webinar Courses rmeyer@crcpd.org).

1-800-871-7930 Complete online catalog at www.moellerinc.com/academy

Offering Medical Physics and Radiation Safety Consulting Services

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AAPM Newsletter

November/December 2012

Radiation Oncology Program Accreditation Workshop Jessica Clements, Dallas, TX - Co-Chair Russell Tarver, Ft. Worth, TX - Co-Chair Save the Date (February 8-9, 2013)!

Radiation Oncology Program Accreditation Workshop

F

or those of us in the therapy world, we’re well aware that accreditation requirements are on the horizon. The Centers for Medicare & Medicaid Services (CMS) has already implemented requirements for advanced imaging, States are considering and adopting language consistent with accreditation, and private payers are targeting practice quality documentation. There are multiple accrediting organizations currently in operation; the American College of Radiation Oncology (ACRO), and the American College of Radiology (ACR) being the two likely candidates for consideration. The American Society for Radiation Oncology (ASTRO) is currently in the process of developing their program.

The AAPM is pleased to announce the first AAPM produced meeting dedicated to therapy accreditation.

Both ACRO and ACR have officially endorsed this meeting and are providing both a physician and medical physicist speaker. This meeting is designed to be a hands-on, workshop style practicum, with emphasis on how-to rather than why. In addition to the content presented by ACR and ACRO, there will be presentations by medical physicists with significant experience in reviewing and being reviewed. Breakout sessions with direct focus on paperwork, documentation, follow-up, and avoiding

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WWW.OCTAVIUS4D.COM 26

AAPM Newsletter

November/December 2012

Obituary By: Azam Niroomand-Rad, Washington DC Wendell R. Lutz, Tucson, AZ Siamak Shahabi, Madison, WI Dr. Nasser Maleki January 25, 1953 – January 6, 2012

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r. Nasser Maleki, formerly Director of Medical Physics at the Anderson Cancer Institute, Memorial University Medical Center in Savannah, Georgia, passed away on January 6, 2012 at his residence with his family by his side, after a three year battle with glioblastoma.

Dr. Maleki was born in Tehran, Iran and after completing his BS in Physics in Iran, he went on to receive his PhD in Theoretical Atomic Physics from the University of Nebraska. In 1982, Dr. Maleki accepted a post-doctoral fellowship in medical physics at the Joint Center for Radiation Therapy at Harvard Medical School. While at the Joint Center he worked with Wendell Lutz on an early linearbased system for stereotactic radiosurgery. According to Dr. Lutz, Dr. Maleki was imaginative, hard working and always a pleasure to interact with and played a significant role in developing this radiosurgery system.

Subsequent to his work at the Joint Center, Dr. Maleki implemented linac-based radiosurgery at Mt. Sinai Medical Center in New York City and later at the Memorial University Medical Center in Savannah, GA. In addition he assisted a number of other medical centers in their efforts to initiate radiosurgery programs, always finding ways to make improvements.

Dr. Maleki worked as a Radiation Therapy Physicist and Assistant Professor of Radiotherapy at Mount Sinai Medical Center in New York and in 1989 became Director of Medical Radiation Physics at the Anderson Cancer Institute, Memorial Health University Medical Center, Savannah, GA until December 2011. He was also an Associate Professor of Medical Physics at Armstrong Atlantic State University and at Georgia Tech.

Dr. Maleki is survived by his loving wife of 25 years, Johanna Hynes-Maleki; 4 sons, Gian, Aria, Cyrus and Sia all of Savannah; 2 brothers, Mansoor Maleki of Tehran and Nasir Maleki Paydar of Norway; 2 sisters, Mahin Maleki of Tehran and Farzaneh Maleki of Savannah, Georgia.

continued - Radiation Oncology Program Accreditation Workshop mistakes will occur in addition to panel style question and answer sessions. It is highly recommended that a team approach to the accreditation process be adopted, and attendance by multiple members of the team is encouraged.

The meeting will be held in the education facilities of Texas Health Presbyterian Hospital Dallas over a long Friday and half-day Saturday. Presbyterian is well situated with an educational setting and nearby hotels, restaurants, and world-class shopping. There are two major airports making the city of Dallas quite accessible. Once here, there is easy access to the facility by the public transportation system, DART, with a train stop on campus.

If you’ve already recognized the value (and future necessity) of accreditation, and need detailed instruction on the “how to,” then this meeting is for you and your department colleagues. Further announcements including the opening of the online registration system will be coming very soon via email broadcast and future newsletter articles.

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American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740-3846

Editor

Mahadevappa Mahesh, MS, PhD Johns Hopkins University e-mail: mmahesh@jhmi.edu phone: 410-955-5115

Editorial Board Priscilla Butler, MS, Eileen Cirino, MS, Allan deGuzman, PhD, William Hendee, PhD, Chris Marshall, PhD (ex-officio) SUBMISSION INFORMATION Please send submissions (with pictures when possible) to: AAPM Headquarters Attn: Nancy Vazquez One Physics Ellipse College Park, MD 20740 e-mail: nvazquez@aapm.org phone: (301) 209-3390

PRINT SCHEDULE • The AAPM Newsletter is produced bimonthly.

• Next issue: January/February • Submission Deadline: Dec. 4, 2012 • Posted On-Line: week of Jan. 1, 2013