AAPM Newsletter January/February 2014 Vol. 39 No. 1

Page 1

AAPM

N E W S L E T T E R The American Association of Physicists in Medicine We advance the science, education and professional practice of medical physics

JANUARY/FEBRUARY 2014 Volume 39 No. 1

AAPM Executive Committee

AAPM succeeds in 62% payment increase for

medical physics consult

and more...


AAPM

NEWSLETTER

AAPM NEWSLETTER is published by the American Association of Physicists in Medicine on a bi-monthly schedule. AAPM is located at One Physics Ellipse College Park, MD 20740-3846

EDITORIAL BOARD EDITOR Mahadevappa Mahesh, MS, PhD Johns Hopkins University

E-mail: mmahesh@jhmi.edu Phone: 410-955-5115 John M. Boone, PhD Robert Jeraj, PhD George C. Kagadis, PhD E. Ishmael Parsai, PhD Charles R. Wilson, PhD 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 PUBLISHING SCHEDULE The AAPM Newsletter is produced bimonthly. Next issue: March/April Submission Deadline: February 12, 2014 Posted Online: Week of March 3, 2014

CONTENTS JANUARY/FEBRUARY 2014 Volume 39 No. 1

Articles in this Issue

Events / Announcements

AAPM President’s Column

Career Services

Chairman of the Board’s Column

2014 AAPM Summer School

AAPM President-Elect’s Column

56th Annual Meeting & Exhibition

AAPM Executive Director’s Column

Radiation Oncology Program Accreditation Meeting

Editor’s Column

AAPM Spring Clinical Meeting

Treasurer’s Column

Grant and Fellowship Offerings

Legislative & Regulatory Affairs Report

News from ORVC & Penn-Ohio Chapters

Education Council Report

ABR

Professional Council Column

Quantitative Imaging Track

ACR Accreditation FAQs

Staff Announcements

Health Policy & Economic Issues

Int Day of Medical Physics

CAMPEP News Website Editor’s Report

www.AAPM.org

Contact us with your feedback

Editor’s Note Follow us on Facebook, Twitter and LinkedIn.

I welcome all readers to send me any suggestions or comments on any of the articles or new features to assist me in making the tablet edition a more effective and engaging publication and to enhance the overall readership experience. Thank you.


AAPM President’s Column

John Bayouth, Madison, WI

Residency Programs

I

must begin my first Newsletter article as our association’s President thanking John Hazle for his outstanding leadership as President during the last year and I look forward to our continued collaborative efforts. Having him at the helm has been extremely positive for AAPM, which I’m sure will continue during his year as Chairman of the Board. John has left some big shoes for me to fill, but suspect I don’t own enough socks to pull that off, so I’ll keep those in the closet for our President-&lect John Boone whose foot size might be close. I just hope I’m in the camera’s field of view in our new EXCOM photo when standing in between these two guys. I’ve been waiting for 2014 for a very long time, and I’m so excited for its arrival. This year means a lot to me personally as I now have a unique opportunity to contribute to AAPM, but I’ve long looked forward to 2014 as the target date for the emergence of Medical Physics Residency programs as the exclusive pathway into Clinical Medical Physics. I believe this is important because of its impact on patient care. As an association we have historically and continue to “Promote the highest quality medical physics services for patients,” which is the first goal of the AAPM as listed in our Mission Statement and Strategic Plan. I believe TRAINING is a critical component to achieving competency, and in the clinical setting patients (rightfully) expect to receive the highest quality of care. Although a necessary component, board certification does not inherently yield high quality care, but a rigorous well-defined and documented training can. This is the motivation for requiring graduation from a CAMPEP accredited residency program as eligibility criteria for board certification; we need to provide rigorous clinical training just like all others certified by the American Board of Medical Specialties, whose motto is “Higher standards. Better care.”® Many argued in 2004 we could never create enough residency programs to meet the workforce requirements. Frankly, it seemed nearly impossible as only 9 programs were accredited and the growth at that point was very modest (7 programs in the 5 proceeding years). History has shown the impossible to be possible through the hard work of many; since 2004 the number of CAMPEP-accredited residency programs has grown exponentially with a doubling time of 2.67 years. Today we have 76 programs that are approved with 14 more in the CAMPEP review process. That’s 90 residency programs, and when assuming 1.5 residents/year/program we can imagine ~135 residents graduating per year. Fortuitously, the number of new programs applying to CAMPEP is declining, which may find us landing near a number of residency AAPM Newsletter | Volume 39 No. 1 | January/February 2014


graduates annually closely matching job market demands for clinical medical physicists. Great progress is now being made in Clinical Residencies in Imaging Physics by establishing a scholarship program with RSNA. A clear pathway for Clinical Residencies in Nuclear Medical Physics is now established through the hard work of the Working Group on Periodic Review of Medical Physics Residency Training, CAMPEP, and an AAPM-SNMMI Joint Task Force; this has lead to a scholarship program for Nuclear Medical Physics Residencies as well. Clinical Medical Physics Residencies still face the challenge of establishing a long-term strategy for sustained funding; I believe we need to consider working with the Centers for Medicare & Medicaid Services (CMS) to establish funding for Medical Physics Residents identical to Medical Residents. There are many issues surrounding this challenge, but the sustainability of residency programs cannot be contingent upon the generosity of Radiology and Radiation Oncology Chairs. Finally, I want to speak to the notion that Clinical Medical Physics Residency reduces science in our field. I strongly agree that Medical Physicists, yes-even Clinical Medical Physicists, need to have been trained to understand and utilize scientific methods. Clinical Medical Physicists must be able to fundamentally understand how technologies work and implement those technologies in a way that enables our physician colleagues to practice medicine at a much higher level than without our participation. When new technologies come into our clinic, the Clinical Medical Physicists needs to use scientific methods to determine the required system specifications, design appropriate acceptance tests, establish safe and effective methods of implementation, and create a quality assurance program that maintains a highest quality of care. Emerging technologies and procedures are in the clinic for years before an AAPM Task Group report will provide a consensus document. So, is Clinical Medical Physics Residency and scientific training mutually exclusive? I believe it does not have to be, nor should it be the case. Rather, I argue that if someone is going to work in a clinical environment, they should be trained to do so, and Residency is that training pathway. But AAPM leadership needs to continue to support pathways for the brightest scientists to enter our field, both through academia and the clinic. We need to support Residency training programs that include time for research, as long as that work compliments and does not detract from the 24 months of clinical training required in a residency program. The road for those individuals who want to be both researchers and clinical medical physicists has grown longer, but I believe the end result is better for everyone involved, most importantly the patients we serve.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Chairman of the Board’s Column

John D. Hazle, Houston, TX

Recognitions

I

’d like to open this first Newsletter article as Chairman of the Board by recognizing a couple of people for outstanding service. First is outgoing Chairman Gary Ezzell. I didn’t know Gary very well when I entered the Executive chain. During the past couple of years I have come to appreciate Gary’s methodical and calm approach to solving problems and addressing issues. He was at the helm of the organization during arguably one of our most turbulent times, dealing with a lawsuit that could have crippled the organization. Gary guided us through those troubled waters to the most positive conclusion possible. The number of hours that Gary, and E9$0., spent on this issue are well into the thousands, but Gary was always able to keep the group focused on the task at hand – reaching a solution that was the best for AAPM and its members. Congratulations Gary and good luck in the future!

Medical Physics Editorial Board

I would also like to recognize the contributions of a “retiring” volunteer – Bill Hendee. Bill is ending his current leadership roles of President of CAMPEP, Editor of the journal Medical Physics and Chair of the Technology Assessment Committee. For most people, that would have been the apex of their career, but not Bill, that was his feathering of activities into retirement! Bill’s contributions to medical physics are immense, but he also had a huge impact AAPM Newsletter | Volume 39 No. 1 | January/February 2014


on the profession of radiology in general and in medicine – feats not often accomplished by medical physicists. Just to highlight a few of Bill’s unique career highlights, he was Chairman of the Radiology Department at the University of Colorado, Vice President for Science and Technology at the American Medical Association, Senior Associate Dean for Research, Dean of the Graduate School of Biomedical Sciences, and interim Dean of the medical school at the Medical College of Wisconsin, and President of the American Board of Radiology. He has won virtually every award from our own Coolidge Award to the RSNA Gold Medal in recognition of his contributions. These accomplishments are the peaks of Bill’s contributions, along with those were innumerable task groups, committee and working group leadership roles. He is, in fact, a model for leadership in our profession. His life story, from growing up in a small town in Mississippi, to playing football in college, to becoming one of the luminary figures in his chosen profession is a fascinating and inspiring story. Bill had a huge impact on my career by setting an example for strong leadership and that we should also be looking at how medical physics can impact medicine outside medical physics. In honor of Bill’s lifelong contributions to the AAPM, we hosted a reception in his honor at the Metropolitan Club in Chicago during RSNA. Bill was able to invite many of his medical physics and radiology colleagues to this event and virtually everyone came to pay their respects to a man who made outstanding contributions to our profession. Please join me in wishing Bill good luck as IF takes more time off to spend with his family. The theme of the RSNA meeting this year was The Power of Partnership. What an appropriate title for a meeting that highlights the science of radiology across therapy and diagnostic disciplines. In my opening address of the meeting, I highlighted our extremely successful partnership with the RSNA in establishing new, accredited imaging physics residencies. I pointed out that it was not just the money that RSNA committed, which we very much appreciated, but the weight of the entire RSNA organization in supporting this project. We emphasized the commitment of the radiology chairs from the selected programs in committing to make these sustainable programs after the fellowship funding runs out. I had the chance to speak with all three radiology chairs from the selected programs and they each appreciate the need for these programs and have pledged their support in making them successful. We look forward to selecting five more programs over the next year or two for fellowship funding. Finally, while we had a modest presentation board at this RSNA meeting, we plan to really highlight these programs at the 2014 AAPM and RSNA meetings to further promote the program among medical physicists and radiologists alike. With my term as President is over, I have handed over the &9$0. reigns to the very capable John “Badger” Bayouth. Badger has been a very active President-&lect and I look forward to him getting into an even higher gear this year. Good luck to him in his year as President! I also want to wish incoming President-&lect John “Mustang” Boone the best in this year as President-&lect. I want to once again recognize the outstanding Headquarters staff in College Park. Angela Keyser and Lisa Rose Sullivan reached their 20 year anniversary with the organization this AAPM Newsletter | Volume 39 No. 1 | January/February 2014


year. Their professionalism not only fuels the engine of the HQ staff and supports our volunteers in an outstanding manner, but presents a very positive projection of the AAPM to our sister societies and everyone else who comes in contact with the AAPM. Congratulations Angela and Lisa on exceptional service histories to AAPM! Michael Woodward is also closing in on that 20 year mark, enjoying his th year anniversary with the organization this year. To Lisa “G” Schober, I can’t thank you enough for the professional support during my year as President. I couldn’t have gotten half of what was done without you! Thanks to Corbi Foster for taking care of my housing arrangements at the hotels during the meetings and being so professional in dealing with a high-maintenance traveler! And thanks to the rest of the outstanding AAPM HQ staff for a job well done!!!

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


AAPM President-Elect’s Column

John M. Boone, Sacramento, CA

AAPM mobilizes human potential

T

his is my first column as President-Elect of the AAPM, and I look forward to the next three years of my tenure on the Executive Committee with a commitment to service, a profound respect for the AAPM and its members, and a pledge to promote the field of medical physics. Medical physics is not just one thing; medical physicists have a wide array of interests. This is true for any individual medical physicist, and it is especially true when considering the breadth of interests across all medical physicists. Medical physics is radiation Training Academy oncology, diagnostic radiology, and nuclear medicine. But it is also ultrasound imaging, MEDICAL SAFETY TRAINING photodynamic therapy, magnetic resonance Available Courses imaging, proton therapy, image quality Medical Radiation assessment, IMRT, and much more. Medical Safety Officer Course physics is clinical service, education, research, CAMPEP Accredited. certification, private practice, government Fluoroscopy Training and service, and academic pursuit. The American Refresher Course Association of Physicists in Medicine addresses Custom Courses most of these issues, in one way or another. Designed to meet your needs. Sometimes you may have to look - dig down Available Formats into the committee tree or focus on individual Classroom task groups, but the breadth and scope of (Las Vegas NV, Gaithersburg MD activities in our organization is nothing short or Oak Ridge TN) of amazing; and if we are not doing it this On-site (your choice) year, perhaps we did it five years ago and On-line Courses recorded that effort in an AAPM report. Or, Webinar Courses perhaps we will do it next year. The AAPM 1-800-871-7930 is a vital organization that seeks to both serve Complete online catalog at and represent our members in a wide array of www.moellerinc.com/academy activities. The four councils; Science, Education, Offering Medical Physics and Radiation Safety Consulting Services Professional, and Administrative Councils are the pillars within the society in which most of the work of the AAPM is done. I look forward to working with each of the councils, and the many volunteers who make up the life blood of the AAPM. At the joint AAPM/RSNA Annual Meeting in Chicago in early December, former Secretary of State Dr. Condoleezza Rice presented an inspiring lecture entitled, “mobilizing human potential”. It dawns on me that this, in fact, is precisely the role of the AAPM; an organization that provides the infrastructure to mobilize human potential - specifically, that of the medical physicists who comprise the membership. I am grateful to be a part of that infrastructure. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


AAPM Executive Director’s Column

Angela R. Keyser, College Park, MD

Important dates and announcements AAPM Meeting Updates Radiation Oncology Program Accreditation Meeting March 14 – just prior to the AAPM Annual Spring Clinical Meeting Denver Marriott Tech Center, Denver, Colorado Registration Now Open &BSMZ SFHJTUSBUJPO GFF EFBEMJOF JT‫'ڀ‬FCSVBSZ The Radiation Oncology Program Accreditation Meeting is a one day, focused, interactive workshop aimed at providing information on how to prepare for radiation oncology accreditation, with material and content specific to existing accrediting bodies. Material will be presented by experienced surveyors on requirements, preparation, application, and maintenance. The target audience is Physicists, but Physicians, Administrators, Dosimetrists, and Therapists involved in the accreditation process will also benefit. AAPM is pleased to welcome program participation from the following accreditation bodies: ACRO, ASTRO’s Accreditation Program for Excellence (APEx) AAPM Annual Spring Clinical Meeting March 15 - 18 - just after the Radiation Oncology Program Accreditation Meeting Denver Marriott Tech Center, Denver, Colorado Registration Now Open! Early registration fee deadline is February 7! The Spring Clinical Meeting focuses on clinical topics of current interest and offers additional opportunities to meet continuing education requirements. This Meeting is designed to provide easy access for clinical physicists in a compact format for up-to-date clinical education. Denver, Colorado has been selected as the location and provides participants with flexible travel schedules from locations throughout the US. The program permits participants to meet continuing educational requirements for their clinical specialties, including SAMS on a wide variety of topics, and accommodates attendees who may be limited to participating only on the weekend, or only during weekdays. The full meeting program runs from Saturday March 15 through Tuesday March 18 and encompasses a series of topics of current clinical interest. AAPM 2014 Summer School SRS/SBRT/SABR: Safely and Accurately Delivering High-Precision, Hypofractionated Treatment June 22 – 26, 2014, University of Vermont, Burlington, Vermont Registration will open on March 12 During this Summer School, participants will gain a comprehensive knowledge base of state-ofAAPM Newsletter | Volume 39 No. 1 | January/February 2014


the-art SRS/SBRT practice from clinical experts in the field. There will be a round-table session for equipment-specific, focused discussion in addition to the lectures. By the end of the school, participants will have the tools to implement and maintain a high-quality, safe SRS/SBRT practice in their clinic. 10 Self Assessment Modules (SAMs) will be included in this program (no extra fee).

/FX 3FQPSU Essentials and Guidelines for Clinical Medical Physics Residency Training Programs: Report from UIF Work Group on Periodic Review of Medical Physics Residency Training. Report #249 – a revision of AAPM Report # 90.

Funding Opportunities AAPM is pleased to announce the following 2014 Funding Opportunities: • Two $25,000 Research Seed Funding Grants will be awarded to provide funds to develop exciting investigator-initiated concepts, which will hopefully lead to successful longer term project funding from the NIH or equivalent funding sources. It is expected that funding will begin on July 1 of the year in which the award is made, and that subsequent research results will be submitted for presentation at future AAPM meetings. Deadline: March 10, 2014. • AAPM Graduate Fellowship is awarded for the first two years of graduate study leading to a doctoral degree in Medical Physics. Deadline: April 17, 2014. • Summer Undergraduate Fellowship Program is designed to provide opportunities for undergraduate university students to gain experience in medical physics by performing research in a medical physics laboratory or assisting with clinical service at a clinical facility. In this program, the AAPM serves as a clearinghouse to match exceptional students with exceptional medical physicists, many who are faculty at leading research centers. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be an AAPM summer fellow. Each summer fellow receives a $4000 stipend. Deadline: February 3, 2014 • Diversity Recruitment through Education and Mentoring Program “DREAM” (formerly “MUSE”) is a 10 week summer program designed to increase the number of underrepresented groups in medical physics by creating new opportunities, outreach and mentoring geared towards diversity recruitment of undergraduate students in the field of medical physics. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be a DREAM fellow. Each DREAM fellow receives a $4,000 stipend from the AAPM. Deadline: February 7, 2014. Additional program details and access to the Online Applications can be found here. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


2014 Dues Payments 2014 renewal notices have been sent several times since October, with payments due by March 1. If you have an email address on file, the invoice was sent electronically in an effort to make it more convenient for you to pay your dues and to reduce administrative costs. There is a mechanism provided to print a copy of the invoice if you wish to mail your payment. Please go to the AAPM Homepage, log in and click on “Pay Your 2014 Dues Online.� Remember, you can pay Chapter dues with your AAPM dues for any Chapter of which you are already a member! The AAPM Rules are very specific regarding the cancellation of membership if dues are not paid by the deadline and the fees required for reinstatement. As the administrative staff of the AAPM, we must consistently enforce the rules of the organization. It would be very difficult to make exceptions for some members and enforce such fees on others. If you need any assistance or have any questions about the dues process, please contact Janet Harris at 301-209-3396.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Editor’s Column

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From the Editor’s desk

I

wish all of you a very Happy New Year. This is the 2nd year of the Newsletter being published in multiple formats and we are still exploring ways to utilize the various capabilities of multi-media formats. Being the first issue of the New Year, the Newsletter has articles from our new leaders and also the association’s budget overview. In this issue, I would like to draw your attention to the ‘Health Policy and Economic Issues’ article highlighting the efforts of AAPM in obtaining increased payment for medical physics consult. It gives me great pleasure to serve as the Editor for the Newsletter, which gives me a 30,000 foot view of what is happening in the medical physics profession and in particular, the AAPM. I will continue my efforts to fine-tune the Newsletter and would like to encourage you all to send me any comments and/or suggestions for improvement. Once again, I welcome all of you to the first edition of 2014 and wish all of you a very happy and productive year.

AAPM Career Services

Make sure you’re putting your best self forward to potential employers with an excellent resume! AAPM’s Placement Services Subcommittee recently posted resume advice and templates to the Career Services site; visit www.aapm.org/careers/jobseekers/resources/resume/ to review this helpful information. And as always, apply for the latest medical physics job openings at the Career Services site (www.aapm.org/careers)!

Now With New Resume Advice and Templates

AAPM Newsletter | Volume 39 No. 1| January/February 2014


SAVE THE DATE!

http://www.aapm.org/meetings/2014SS/

2014 AAPM SUMMER SCHOOL SRS/SBRT/SABR: Safely and Accurately Delivering High-precision, Hypofractionated Treatments

University of Vermont • Burlington, VT • June 22 - 26, 2014 Editor’s Note I welcome all readers to send me any suggestions or comments on any of the articles or new features to assist me in making the tablet edition a more effective and engaging publication and to enhance the overall readership experience. Thank you.

AAPM Newsletter | Volume 39 No. 1| January/February 2014


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AAPM Treasurer’s Report

Matthew B. Podgorsak, Buffalo, NY

The current financial picture and the 2014 budget

I

continue to thank the Membership of the AAPM for the trust placed in me as one of the stewards of our association’s financial resources. As always, I look forward to receiving suggestions, questions, comments, and advice any time via e-mail at: Matthew.Podgorsak@RoswellPark.org. Significant collaborative effort was once again put forth by members of AAPM’s Budget Subcommittee and its parent committee, known as ‘FINCOM’, in establishing our 2014 budget such that it meets AAPM’s fiscal guidelines and directives while simultaneously supporting our organization’s Strategic Plan and bringing value to AAPM’s members. Sincere thanks to all members of FINCOM (too many to list here) for their service. I would like to extend special thanks to Cecilia Hunter, who continued as an unofficial ‘consultant’ past her retirement last May and contributed to the 2014 budget process. And finally, I would like to thank Chris Oronsaye, AAPM’s Controller, and Angela Keyser, our Executive Director, for their insight, judgment, and advice as we worked together over the past year. The following data present the current financial picture, as well as the 2014 budget as approved by the Board of Directors on December 4, 2013.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


2014 FINCOM Approved Budget Revenue FINCOM APPROVED 2014 Membership Dues

Expenses Direct

Dues (Net of Journal) Renewal Notices Applications and Reinstatements Subtotal

2,137,210 7,000 15,500 $2,159,710

Net

Overhead

Total

$2,500

56,789 0 0 $56,789

56,789 2,500 0 $59,289

2,080,421 4,500 15,500 $2,100,421

Subtotal

0 0 0 $0

0 0 0 $0

84,002 1,796 435,952 $521,750

84,002 1,796 435,952 $521,750

(84,002) (1,796) (435,952) ($521,750)

Subtotal

0 0 0 $0

25,550 125,350 46,727 $197,627

49,927 101,117 0 $151,044

75,477 226,467 46,727 $348,671

(75,477) (226,467) (46,727) ($348,671)

50,000 234,500 294,500 20,000

384,033 485,450 599,779 584,730 384,033 2,155 $2,440,180

282,165 87,388 70,093 45,429 91,675 1,418 $578,168

666,198 572,838 669,872 630,159 475,708 3,573 $3,018,348

(616,198) (338,338) (375,372) (610,159) (475,708) (3,573) ($2,419,348)

1,449,882 149,519 135,042 102,000

431,990 29,987 67,212 66,423 62,589 $658,201

1,881,872 179,506 202,254 168,423 62,589 $2,494,644

888,677 53,761 (30,489) (158,423) 150,000 $903,526

114,596 12,170 0 $126,766

1,653,854 138,194 0 $1,792,048

1,237,777 (108,194) 0 $1,129,583

19,250 1,148,414 $1,167,664

258,690 1,148,414 $1,407,104

(258,690) (1,147,914) ($1,406,604)

0 1,617 0 0 57,121 4,491 0 0 0 $63,229

0 1,617 50 25,000 57,371 4,491 8,000 79,500 500 $176,529

1,750 16,833 200 125,500 29,244 3,759 (7,775) (79,500) (100) $89,911

$3,323,611

$9,818,383

Statistical Model

($472,932) ($422,058)

to target

(50,874)

2,500

Membership Services Member Inquiries/Services Membership Directory AAPM Web Site

Organizational Board of Directors Executive Committee Executive Committee - Contingency

Councils and Committees Administrative Council Education Council Professional Council Science Council Committees Reporting to the Board Liaisons with other Organizations Subtotal

$599,000

Subtotal

2,770,549 233,267 171,765 10,000 212,589 $3,398,170

$1,836,443

2,891,631 30,000

1,539,258 126,024

Subtotal

$2,921,631

$1,665,282

Subtotal

500 $500

Education & Professional Development Annual Meeting Summer School Spring Clinical Meeting RSNA Specialty Meetings

Publications Medical Physics Journal JACMP Other Publications

Administrative Services Administration/Prof Services/AIP General Operations

239,440 $239,440

Other Income & Expense Computers in Physics, Royalties AAPM Mailing Lists Membership Certificates Investment Earnings & Fees CAMPEP Services to other organizations (COMP, SDAMPP, etc.) Contributions and Donations Dues and other payments/AIP Miscellaneous

1,750 18,450 250 150,500 86,615 8,250 225

50 25,000 250

Subtotal

400 $266,440

8,000 79,500 500 $113,300

TOTAL FROM OPERATIONS

$9,345,451

$6,494,772

AAPM Education & Research Fund

Grand Total

451,175

454,850

851

455,701

(4,526)

$9,796,626

$6,949,622

$3,324,462

$10,274,084

($477,458)

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Financial Position and Estimates for 2013 Conservative estimates for 2013 indicate that we will complete the year with a relatively balanced budget for operations and a positive gain on reserves. The 2013 budget as approved by the Board of Directors last year was developed using a statistical model to project revenue and expenses based on historical spending trends. Income from the Annual Meeting along with advertising and subscription income from the Medical Physics Journal were higher than anticipated due in large part to the contribution to these budgetary items of the recent onetime tax refund of $342,000 based on the new methodology used in calculating the Unrelated Business Income Tax (UBIT), for 2009, 2010, 2011 and 2012. As you will see in the accompanying reports, revenue and expenses for 2013 are estimated at $9.41 million and $9.39 million, respectively, compared to approved budgeted revenue of $9.0 million and expenses of $9.64 million. At present, AAPM’s investment portfolio has gained substantially in 2013 and, assuming the market continues to advance, our reserves at the end of the year will exceed $11 million.

2014 Budget Thanks go once again to the Council and Committee Chairs, who, along with their staff liaisons, worked extremely diligently in developing their budgets to meet the criteria for presenting the Board with a balanced budget within the confines of the statistical model. Attention was focused on meeting the goals of AAPM’s Strategic Plan. AAPM’s Budget Subcommittee, FINCOM, and, ultimately, the Board of Directors, gave their approval of the 2014 budget, summarized below. For 2014, revenue projections are budgeted to total $9.3 million with expenses budgeted at $9.8 million, producing a deficit of $472,932. This is approximately $51,000 above the suggested deficit defined by the statistical model. Based on theoretical aspects associated with using this model, it is anticipated that we will once again break even at the end of 2014, barring any unforeseen non-budgeted expenses that may arise. In closing, I look forward to sharing further details of AAPM’s financial situation in future Newsletter articles. In the meantime, please feel free to contact me anytime with questions or concerns regarding AAPM’s financial situation at Matthew.Podgorsak@RoswellPark.org

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


AAPM Newsletter | Volume 39 No. 1 | January/February 2014


New this year… • • • • •

John R. Cameron Young Investigator Symposium will take place on Monday, July 21. President’s Symposium and Innovation in Medical Physics – will take place on Tuesday, July 22. Special 2-Day Program on Quantitative Imaging Monday - Tuesday, July 21-22). The Science Council Session – The Physics of Cancer (see below). In addition to Symposia and regular Sessions, new Keynote Sessions on topics of special interest.

Society. Imaging for Proton

Therapy. • •

Dedicated time in the meeting program for Visit the Vendors.

• Legendary live music • A burgeoning restaurant scene • Unique culture … and a list of other things that you just have to experience for yourself to truly understand why Forbes named Austin ‘One of America’s Coolest Cities’.

(see below).


been allocated as one of the parallel session options

been developed for the meeting, so please consider submitting relevant abstracts in these new categories.

exciting topics highlighting the collaborative efforts between imaging and therapy medical physics. This in medical physics and engineering; highlight of

Imaging Conference; MR-guided radiation therapy, the promise and potential pitfalls of deformable image registration; dual-energy CT imaging in diagnostic and radiation therapy, and a new forum in proton therapy.

topics in therapy with a focus on medical physics research and innovation. Symposia will include the medical physicists; uncertainties in radiation therapy; the relative biological effectiveness of proton beams relative to photon beams; nanoparticles to improve treatment outcome; status of intensity modulated

demo with interactive audience participation (a la Texas Holdem Poker) of adaptive radiotherapy implementation by commercial vendors.

far-term directions of medical physics research and for low radiation doses, virtual validation tools for x-ray breast imaging systems, as well as advanced imaging methods for breast cancer. Additional topics include advances in models of image quality, nanotechnology & molecular imaging, and multi modal imaging for therapy response. These sessions will explore the state of the art and also show some of pushed towards.

diagnostic and therapy settings, these new sessions should be very interesting and exciting.

The Physics of Cancer The Science Council Session includes proffered abstracts on a topic at the cutting-edge of medical physics research, presented in a special, high-visibility

“The Physics of Cancer,” emphasizing fundamental systems for measurement of cancer pathogenesis, progression, and response. Abstract submissions from investigators outside conventional domains of clinical medical physics are encouraged, especially research addressing cancer complexity – for example, the heterogeneity of patient response to cancer therapy, or the prediction of complex metastatic patterns. • Mathematical models of cancer – e.g., multi-scale models, Bayesian models, and game theory models response. radio-genomics as measurements providing input models. • Clinical data – e.g., multi-center clinical trials, retrospective studies, etc. to test the predictions of such models. Criteria for abstract evaluation include the novelty of the research, the emphasis on fundamental physical sciences outside conventional domains of medical cancer diagnosis or therapy.


designed to address the broad educational needs of our membership and will include topics in SRS, SBRT,

The Practical Medical Physics Track offers presentations of use and interest to the practicing implementation of newly-published AAPM Task

proton therapies as well as radiobiology. The emphasis of the program will be on safe and effective use of new technologies addressing current issues in clinical practice. The program will feature at least seven SAM sessions distributed throughout the entire meeting program. Several new sessions have been

in imaging and radiation oncology; imaging review for therapy physicists; lean tools and methods; new methods of teaching physics to physicists and physicians; balancing dose and quality in imaging; effective presentation skills; and a hands-on, interactive workshop on writing questions.

“Basics of Proton Therapy and Proton SRS”, “Radiation

Partners in Solutions offer a new way for physicists

subjects such as Small Field Dosimetry, Imaging

physics-level applications training classes in a special-purpose lecture room built on the exhibit

Continuing the tradition begun last year, there will be a live point-counter point debate; this year the merits

capabilities. These are not sales pitches but practical information for the clinical physicist from the people who know the system in depth.

the Medical Physics editor of the Point-Counterpoint series. This year the debate format will also include relevant lectures to provide an instructive yet enlightening opportunity for audience participation.

total of seventeen educational sessions including six SAM sessions. The program will again be focused on meeting the continuing education requirements of our membership at various stages of professional development. This year course content will be balanced to cover innovations in various areas of diagnostic imaging, ACR accreditation updates across different imaging modalities, best practice in pediatric imaging, radiation dose reduction strategy, and radiation risk associated with medical imaging. Continuing the tradition begun last year on the “art” of diagnostic imaging artifacts, this year the session will be on diagnostic ultrasound imaging artifacts. Symposium, there will be a session on “genomics and radiomics for medical physicists.”

The Professional Track continues to grow in depth and breadth to keep our members abreast of the latest professionally-related developments. Topics this year cover clinical, research, management and sessions on interviewing skills and ABR preparation. to providers and patients, giving real-world situations and how you might handle them. Since communication is central to what medical physicists do, several other sessions are also being planned around various topics of communication, from writing journal articles to working with physicians. Plans are being made for at least one session to provide ACR RLI credit, and a SAMS session. The Professional Track will also have a proffered paper


nnovation Dates to Remember January 15: Web site activated to receive electronic abstract submissions. March 3 at 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.

March 12: Meeting Housing and Registration available online. By April 17: By May 12: June 4: Deadline to receive Discounted Registration Fees.

For More Information, Please Visit: www.aapm.org/meetings/2014AM/

innovation


Legislative and Regulatory Affairs Report

Lynne Fairobent & Debbie Gilley, College Park, MD

Status of Computed Tomography (C5) dose recording requirements in state legislation and /or regulations

T

his report provides information on the current status of legislation or regulations requiring facilities to record computed tomography (CT) patient dose. Each state was surveyed to determine if they currently have legislation or regulations; are developing legislation or regulations; or if they are discussing the need for legislation or regulations.

In the United States the use of X-ray in the healing arts, the state radiation control programs regulate including CT. The Conference of Radiation Control Program Directors (CRCPD)1 publishes suggested state regulations to aid in the development of consistent regulations, but each state has the authority to adopt as much or as little of the suggested state regulations as they choose. Because of this, there are variations in the regulations. In addition, the CRCPD routinely revises their suggested state regulation and these regulations are in the process of being reviewed and revised.2 There are two other documents that raise awareness of CT dose that may be of interest. The first is a position statement published by the CRCPD3 and the second is United States Food and Drug Administration (FDA) information on the investigation into the high exposures received from CT Brain Perfusion Scans4. In response to significant reports of increased exposures in CT, the California 2010 legislation session passed legislation requiring the recording of dose for patient who receives a diagnostic CT examination.

Background The California Senate Bill 12375 was signed into law in August 2010 and required patient receiving CT scans to have the dose from the procedure included in the medical record. The law and corresponding rules (California Health and Safety Code, Sections 115111, 115112 and 115163) 6 provides guidance on how this information is collected and recorded. The method for recording of the patient dose can be accomplished by using several methods, including index volume (CTDIvol) and dose length product (DLP) or by using a dose unit as recommended by the American Association of Physicists in Medicine (AAPM)6. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


There are some situations where the recording of the patient dose is not required. These include CT used for therapeutic radiation treatment planning or delivery or for calculating attenuation coefficients for nuclear medicine studies. Otherwise all imaging CT require patient dose to be recorded. For patients required to have multiple CTs, the recording of the dose can be accomplished using several methods including index volume (CTDIvol) and dose length product (DLP) and the dose unit as recommended by the American Association of Physicists in Medicine (AAPM). The CTDIvol and DLP may be summed and the results reported or the highest CTDIvol and the DLP may be reported as well as the number of sequences performed to which the maximum values apply. This reporting requirement must be in the interpretive report of the patient record and can be provided by either a radiologists or a licensed physician. Effective July 1 2013, CT exams providers shall be accredited by an accrediting organization that is approved by the Centers for Medical and Medicaid Services (CMS) or accrediting organization approved by the Medical Board of California or the State Department of Public Health. The law and corresponding regulations also describe situations that would require the facility to report to the department events where the dose exceeded defined constraints; or the exam was performed without the approval of a physician or the exam was of another area of the body than approved by the physician or radiologist; or a therapeutic dose to the patient or embryo or fetus or to the wrong patient or wrong treatment site. More specific information is available in the Information Notice provided by the at the California Department of Public Health.6

Results of the survey It is not unusual for states to draw upon other state’s experiences with legislation and rules. There have been a number of issues that have began in one state and migrated to others, most recently the passing of numerous no texting while driving laws. According to the Governors Highway Safety Association all but nine states ban text messaging for all drivers.7 Some states have the capability to develop regulations that can meet the same or similar needs to legislations, and this is particularly true in the radiation regulations where the legislators have given regulatory agencies broad authority to promulgate rules. The survey conducted by AAPM, from October 22 to November 20, 2013 had a response rate of 68 percent (34 of 50 states responded). The results identified four states with CT dose reporting requirements and six states currently developing regulations. Four other states were in the exploratory phase of rule development. Twenty-three of the responding states indicated that the topic of recording a patient CT dose in the diagnostic interpretation report had been discussed in their state. Some to the reasons that regulations were not being developed included difficulty in determining patient dose and the use of equipment that did not provide a digital readout of equipment measurements. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


In fact, the CRCPD suggested state regulations are used by states to initiate rule development. The Suggested State Regulations for X-ray in the Healing Arts (Part F)8 is currently being revised. Once these rules are adopted by the CRCPD, there may be more interest in requiring CT patient dose reporting. Of the states with a reporting requirement only California passed legislation, the other three states promulgated rules requiring the reporting of the patient dose. During the 2013 Connecticut legislative session, a Bill was introduced similar to the California law, but did not passed. It is unknown if the 2013 Bill will be reintroduced in 2014. For those states that promulgated rules, one state required more than six revisions to receive consensus on the language and regulatory requirements. Another state is using an advisory committee to develop the regulations. Other states expressed concern over the methodology used for reporting patient dose and the use of CT equipment that did not provide digital output information. Several states are awaiting the revised CRCPD Part F to determine if regulations will be developed. The response table is provided with reference to the existing CT patient dose reporting regulations. The table also captured some of the additional comments, while longer comments are provided in the footnotes.

Impact on the practice of medical physicists One of the most significant impact on medical physicists will be the type of information that is reported in a patient record and if the information can be measured and accurately reflected as patient dose. The trend is to use CTDIvol and DLP to determine the output and make assumption of the dose received by the patient. Other techniques could require other measurements or calculations or simply may not result in a valid method. Equipment capabilities for capturing and displaying the information will assist efforts to easily provide the information. Manufacturers are assisting by developing equipment that provides this information. Though only four states have legislation/regulations in place, three of these states did not require legislation. The development of rules without legislation has a significant importance. The notification process for rule development is usually not as robust as required to pass legislation. There is little or no media coverage to raise citizen awareness. For those interested in regulatory activities within a particular state, contact with the state regulatory authority should be pursued. As states look to address the issue, more states are likely to promulgate rules requiring the recording of CT patient dose if the CRCPD revised suggested state regulations include this requirement. AAPM has several members who are advisors to this committee. Reimbursement may also influencing CT dose reporting. Currently CT facilities must be accredited by one of three accrediting bodies as a condition of reimbursement. The Joint Commission (JC) has provided guidance on how to evaluate California imaging facilities compliance with the CT law13. Further action by the CMS or the accrediting bodies might require patient dose reportAAPM Newsletter | Volume 39 No. 1 | January/February 2014


ing requirements as a condition of accreditation. Other medical insurance schemes could also address this issue in evaluating contracts or reimbursement. As with other legislation and regulations, significant media, medical errors or accidents may expedite the passing of legislation or the promulgation of regulations, just as California responded to the events that occurred in 2009 and 2010. State Response to Survey on Computed Tomography Patient Dose Reporting Requirements Survey Conducted 10/22/2013 until 11/20/2013

This table continues on the next page. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


1

http://www.crcpd.org/about/about.aspx

2

Personal conversation with John Winston, Chair of Suggested State Regulations, Part F, October 24, 2013.

3

Conference of Radiation Control Program Directors, Position Statement Relating to Computed Tomography Protocol Reviews, October 2009, http://www.crcpd.org/Positions_Resolutions/Healing_Arts/HA27.pdf. (Accessed October 24, 2009).

4

US Food and Drug Administration, Safety Investigation of CT Brain Perfusion Scans: Update 11/9/2010, http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm185898.htm. (Accessed October 24, 2013).

CA Senate Bill 1237 http://www.leginfo.ca.gov/pub/09-10/bill/sen/sb_1201-1250/sb_1237_ bill_20100929_chaptered.html. 5

CA Information Notice: http://www.qaservices.net/resources/ct_7-17-12_information_notice_regarding_ ca._health-safety_code.pdf 6

7

Cell phone driving laws http://www.ghsa.org/html/stateinfo/laws/cellphone_laws.html (Accessed November 13, 2013)

8

Conference of Radiation Control Program Directors, Suggested State Regulations Part F, DIAGNOSTIC X-RAYS AND IMAGING SYSTEMS IN THE HEALING ARTS, May 2009, http://www.crcpd.org/SSRCRs/F-Part%202009.pdf (accessed October 24, 2013).

9

The rules in Arizona include the following 2013 changes, but it may take a year or more for the changes to be added to the code as the Sec of States office is currently behind. However, they are legally binding and enforced by the Agency as of the date published in the Register. Co is monitoring other states. The concern is the “dose” value recorded on the patient record is not a true dose to the patient but some comparison number to what the phantom’s measured dose was. The number may be “meaningless” on a patient record and may not address the real problem of the facility

10

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


is paying attention to their CT protocols. The root of the problem is training. One solution might be to see requirements for protocol review by the physicist/RSO written in the facility’s procedures. CT operators should be ARRT certified in CT and a recognized body such as ACR should accredit the facility. Measuring and recording patient dose on a medical record is a good idea, but it should be recorded with its standard deviation. 11 Six revisions before the regulations were promulgated. 12 The topic is being hotly debated by our CT rulemaking advisory committee. The main point of contention is that most modern CT units automatically calculate a CTDIvol or DLP for each scan that is electronically recorded on each scan record. These records generally get sent to PACS where the dose becomes difficult for the patient to request without legal action. The main question being debated is whether it is necessary for medical staff to transcribe the dose in writing for each scan into a logbook and/or hardcopy patient file record. The main concern of the stakeholders seems to be liability incurred by the facility and practitioners when doses are recorded by hand in the patient files. Another concern voiced by health professionals is that patients will possibly avoid another necessary CT scan or decide not to allow their children to have further necessary scans based on their inability to put the dose information into proper perspective. Our agency (Washington State Department of Health) is strongly committed to patient advocacy, so our agency is leaning toward CT recording and dose reporting rules being incorporated in our WAC. 13 http://www.jointcommission.org/assets/1/6/Changes_response_CA_CT_scans.pdf

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


MACHINE MLC IMAGING

QA

RITCognition™ (patent pending) New in V6.2: The RIT Cerberus system has been expanded to include a FILE HUNTER feature in addition to the powerful file watcher capability. File hunter allows you to search swiftly through directory structures for files meeting your criteria and then automatically processes them through analysis and reporting. Combine the newly streamlined Cerberus interface with the Artificial Intelligence capabilities of RIT Cognition true automated analysis!

Model Training System Updated Models

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Clients upload new anonymized image recognition data.

Clients download updated models.

Elekta Hancock Test New in V6.2: This unique test that measures both leaf position and jaw setback on Elekta machines has more refinements to make it even more accurate and robust. We have added independent control over jaw and leaf thresholding to give you even more control over the analysis along with a number of algorithm choices to match your precise situation.

3D Stereotactic Alignment Test New in V6.2: We added the ability to choose amongst a number of alternate coordinate systems in this routine so that the results are relevant to your system’s configuration.

RIT EPID New in V6.2: We have added HD MLC versions of tests so that you can enjoy the same speed and accuracy analyzing your HD picket fence patterns as you do with your Millennium MLCs. We have also automated the recognition of the pixel value polarity so no more requirement to scale images from your True Beam machines.

RIT Version 6.2 Is Here - Download Now Download RIT software upgrades, documentation and even demo images. Call 719-590-1077, option 2 or email sales@radimage.com.

radimage.com © Radiological Imaging Technology, Inc., December, 2013


Education Council Report

George Starkschall, Houston, TX

The AAPM Virtual Library

O

ne of the more exciting news items to come out of the RSNA meeting, at least from an educational point of view, is the new edition of the Virtual Library. I had the opportunity to preview the Virtual Library when I visited AAPM Headquarters in October for a Council Chairs meeting and was immediately impressed by its ease of use and versatility. Consequently, I asked $IVDL #MPDI, Chair of the Online Learning Services Subcommittee of the Continuing Professional Development Committee, whose Subcommittee oversees the Virtual Library, to introduce you to the features of the new version of our Virtual Library.

The AAPM Virtual Library Seasons greetings from the Online Learning Services Subcommittee. This month I’d like to introduce you to some major changes to the AAPM Virtual Library (VL). First, a bit of background. Since its inception, the VL has been hosted on a commercial website (Blue Sky Broadcast). They take the video and audio captured at our meetings, format it and serve it from their systems. As AAPM captures content from more meetings (e.g. Spring Clinical meeting), the cost of formatting and hosting the VL increases. While the service provided by Blue Sky Broadcast was a reasonable solution when the VL first started, technology changes so rapidly it seemed that there might be better solutions now. To that end, .JDIBFM 8PPEXBSE and his team at AAPM headquarters proposed taking direct control of the Virtual Library. His proposal saves money (even when including the additional effort from headquarters), increases the flexibility of our hosting and hopefully improves the overall experience of the Virtual Library. This proposal has been accepted and is currently being implemented. Michael has one additional FTE in his budget (out of the savings from dropping our Blue Sky Broadcast) support. They have tested and plan to host our VL content on Vimeo.com. This will allow them to embed video presentations directly into web pages at aapm.org. This way we can view presentations without being re-directed to another web site. We will be leveraging the bandwidth provided by Vimeo while retaining complete control over the webpages, as well as providing a seamless single sign-on. Older material from the VL (2008-2012) can also be seen by going directly to vimeo.com/ AAPM. That material is freely available to the general public as has always been our policy. On AAPM Newsletter | Volume 39 No. 1 | January/February 2014


the Vimeo.com/AAPM website, go to Collections/Channels link to see the meetings that are available now. Material from prior to 2008 will require additional work to convert the format, but that will happen. Blue Sky Broadcast has been cooperating with our new plans by returning all of our original content to us in a format Michael’s team can work with. Current presentations (2013) are available now via the Blue Sky Broadcast page at the AAPM VL page (only to AAPM members) and will soon be served from our new provider. In addition, we plan to have direct links to VL content in other AAPM web pages (e.g. each member’s online directory listing will also have links to VL presentations they have made). Our new VL allows us additional flexibility. Sharing links will be easier. Media can be downloaded for offline viewing. VL content can be embedded in our own web pages. We have looked at embedding presentations into the same web page as the relevant continuing education quiz for those who do online continuing education. The team at AAPM has put together various demos of the new formats in a “sandbox” which has been reviewed and is in the final stages of approval. Soon the VL will have seamless integration with the AAPM website. Stay tuned for a whole new look and feel to the online learning center. Based on the planning and testing that has gone into the new VL, I don’t expect any significant problems. (Obamacare joke goes here). We always welcome feedback, however, so send your complaints to me and complements to Michael and the staff at AAPM. As a reminder, the VL is free to all AAPM members. Online CE credits are available at an additional cost ($75 in 2014 for full members, less for many other categories of membership) which can be paid with your annual dues. That fee allows members to take as many quizzes as they like during the year. It is a great value and I recommend members check that box when renewing their membership and combine it in a single payment. Charles Bloch, Ph.D. Chair, AAPM Online Learning Services Subcommittee

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


AAPM Spring Clinical Meeting

March 15-18, 2014 Denver, Colorado Denver Marriott Tech Center

Registration & Housing Now Open! http://www.aapm.org/meetings/2014SCM/ New This Year!

Join Us For ROPA!

The Radiation Therapy track program highlights the clinical application of several AAPM Science Council Task Group Reports, Advanced Treatment Planning and Safety topics.

AAPM Members will save $100 by registering for both the Spring Clinical and the Radiation Oncology Program Accreditation Meetings! (Register before February 7 and receive $50 off each meeting .)

Important Dates to Remember January 7: Deadline for receipt of YIS and poster abstract submissions January 24: Scientific Program available February 7: Deadline to receive discounted registration fees February 19: Last day to make hotel reservations at the group rate

Application will be made to the Commission on Accreditation of Medical Physics Education Programs, Inc. (CAMPEP) for approval of the program in order to provide medical physics continuing education credits (MPCEC) to qualified medical physicists attending this Meeting. AAPM will offer up to 19 ABR approved SAMs Sessions. AAPM will also apply to the Medical Dosimetrist Certification Board (MDCB) for MDCB credits and the Radiology Leadership Institute (RLI) for RLI continuing education credit hours.


Professional Council Column

Per Halvorsen, Newton, MA

Professional Council news and announcements Radiation Oncology Practice Accreditation workshop The leaders of the Professional Services Committee and the new Therapy Accreditation Subcommittee are working together to prepare for a one-day focused workshop on therapy accreditation, to be held on March 14th just prior to the AAPM Spring Clinical Meeting in Denver. This will build on the well-received workshop held this past February in Dallas. All three accreditation programs (ACR, ACRO, and ASTRO) have been invited to participate, and the organizers are working to confirm experienced surveyors to participate and to facilitate the breakout sessions. Click here for more details, and check back frequently as the program is being finalized. The early registration deadline is February 7th.

Medicare reimbursement and your Professional Economics Committee’s efforts As you’ll see in a separate article in this Newsletter, the Centers for Medicare and Medicaid Services (CMS) recently issued the Final Rules for the 2014 reimbursement schedules for hospitals and freestanding clinics. Overall, the results are a significant improvement from the originally proposed 2014 reimbursement schedules. While many factors influenced the Final Rules, the reimbursement for the “core” medical physics code in therapy, 77336 Continuing Medical Physics Consultation, had been a focus of the AAPM’s Professional Economics Committee for several years, and with the help of our consultant Wendy Smith Fuss and with ASTRO’s support, the AAPM was able to address CMS directly regarding the underlying cost factors for 77336 and how that has evolved with the technological advancements in radiation oncology in the last decade. Jim Goodwin and Jerry White presented the AAPM’s position and supporting data to CMS, and we believe this was a key factor in the decision to significantly increase the reimbursement for 77336 under the Medicare Physician Fee Schedule for 2014. To have such a tangible impact on reimbursement policy requires years of focus and a strong understanding of how the complex healthcare reimbursement system works – and most of the members of the Professional Economics Committee have been actively engaged in this area for many years. We are fortunate to have such dedicated volunteers in our Association.

Abt IV As most of you know, the AAPM has commissioned an independent survey of the clinical radiation oncology physics work values on several occasions over the years. This is critically important information when we advocate for appropriate reimbursement for clinical physics AAPM Newsletter | Volume 39 No. 1 | January/February 2014


services (see Medicare comments above), and can be very helpful in estimating appropriate medical physics staffing levels to support a given scope and volume of clinical services. We have contracted with Abt Associates to conduct these surveys in the past, as they are highly respected by CMS and other stakeholders. The first such survey was jointly commissioned by the ACMP and AAPM in 1995, with follow-up studies conducted in 2003 and 2008. Now, five years later, it is important that we update this information again, to provide current and relevant information that reflects the technological advancements of recent years as well as the (presumed) efficiency gains of modern QA hardware and software. After significant discussion among the Council Chairs, E9$0. and the Budget Subcommittee, we agreed to commission a fourth study (Abt IV) and the Board of Directors approved the budget request for this study at its meeting in Chicago in early December. We have already signed the contract with Abt and the Workforce Assessment Committee, led by Michael Mills and Yan Yu, are working with AAPM staff and with Abt to initiate the study as soon as possible. We hope that the results of the study will be available by mid-year in 2014.

Volunteers The end of the year marks a change in volunteer assignments within the AAPM. I’d like to recognize a few individuals who complete terms at the end of 2013, and others who assume new responsibilities in January. David Hintenlang completes his term as Vice Chair of the Professional Council, and Bruce Curran assumes that responsibility in January. Many thanks to Dave for his support and advice these past 3 years, and we look forward to Bruce’s leadership in the years ahead. Jessica Clements completes her term as Chair of the Professional Services Committee, where she has provided invaluable leadership to the Committee’s broad scope of responsibilities. She begins a new term as an Imaging Vice Chair of the Clinical Practice Committee and as an At-Large Member of the Council, so we are fortunate to benefit from her leadership for several more years. Russ Tarver becomes Chair of Professional Services and receives the baton from Joann Prisciandaro to chair the Practice Guidelines Subcommittee, which is charged with the important initiative of developing a core set of Medical Physics Practice Guidelines. Finally, we are forming new subcommittees under Clinical Practice, focused on Therapy Accreditation (chaired by Steven deBoer), Imaging Accreditation (Tyler Fisher), and Practice Environment (Dustin Gress). My sincere thanks to everyone who contributes their time and expertise to the many initiatives within the AAPM.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


PIPSPRO!SOFTWARE

1351-20, 11/13 PIPSproâ„¢ Software


ACR Accreditation FAQs

Priscilla F. Butler, Reston, VA

ACR accreditation: Frequently asked questions for medical physicists

D

oes your facility need help on applying for accreditation? In each issue of this Newsletter, I’ll present frequently asked questions (FAQs) of particular importance for medical physicists. You may also check out the ACR’s accreditation web site portal for more FAQs, accreditation applications and QC forms. The following items address questions we have received regarding the ACR Computed Tomography Quality Control Manual. Please feel free to contact us at ctaccred@acr.org if you have questions about CT accreditation. Q.

When do facilities currently accredited by the ACR in CT have to comply with the test criteria in the 2012 ACR CT Quality Control Manual?

A.

Effective one year from the publication of the 2012 ACR CT Quality Control Manual (12/01/2012), all ACR CT accredited facilities and those applying for accreditation must maintain a documented quality control (QC) program and must comply with the minimum frequencies of testing outlined in the manual. All facilities applying for accreditation or renewal must demonstrate compliance with ACR QC requirements by including a copy of the facility’s most recent Annual CT System Performance Evaluation with their accreditation testing materials. Effective December 2013 this evaluation must include, but not be limited to, the following:

• • • • • • • • • •

Review of Clinical Protocols Scout Prescription and Alignment Light Accuracy Image Thickness Table Travel Accuracy Radiation Beam Width Low-Contrast Performance Spatial Resolution CT Number Accuracy Artifact Evaluation CT Number Uniformity AAPM Newsletter | Volume 39 No. 1 | January/February 2014


• Dosimetry • Gray Level Performance of CT Acquisition Display Monitors • Other tests as required by state or local regulations The continuous QC program must include, but not be limited to, the following: • • • • • •

Water CT Number & Standard Deviation - Daily Artifact Evaluation - Daily Wet Laser Printer Quality Control - Weekly (if applicable) Visual Checklist - Monthly Dry Laser Printer Quality Control - Monthly (if applicable) Display Monitor Quality Control - Monthly

Q.

Isn’t QC only checked by the ACR as part of the application completed once every 3 years?

A.

No. The Medicare Improvements for Patients and Providers Act (MIPPA) calls for all providers of CT, MRI, breast MRI, nuclear medicine, and PET exams that bill under Part B of the Medicare Physician Fee Schedule to be accredited by Jan. 1, 2012, in order to receive payment for the technical component of these services. (Currently, the CMS/ MIPPA mandates apply to outpatient facilities only, NOT to hospitals.) Per MIPPA, the ACR must perform unannounced site surveys to validate compliance with accreditation criteria. This includes adherence to QC requirements. For more information, go to the bottom of the following link.

About the author: Priscilla F. Butler, M.S. is the Senior Director and Medical Physicist, for ACR Quality and Safety.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Health Policy/Economic Issues

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

AAPM succeeds in 62% payment increase for weekly medical physics consult

T

he Centers for Medicare and Medicaid Services (CMS) recently released the 2014 Medicare Physician Fee Schedule (MPFS) final rule. The MPFS specifies payment rates to physicians and other providers, including freestanding cancer centers. It does not apply to hospital-based facilities. Changes in facility payments for hospital outpatient departments are described in a TFDPOE BSUJDMF CFMPX In the 2014 final rule, CMS establishes interim work relative value units (RVUs) and direct practice expense inputs for 14 radiation oncology codes that were considered potentially misvalued. CMS agreed with the AAPM recommendation to revalue the continuing medical physics consultation code (CPT 77336) and has increased reimbursement by 62% effective January 1, 2014. AAPM advised CMS in 2012 that CPT code 77336 was 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 qualified medical physicist and other staff. In the final rule, CMS accepted all of the recommendations submitted by AAPM without revision, which included increased qualified medical physicist time and updated medical equipment. The 2014 relative value unit (RVU) is XJUI BO FTUJNBUFE QBZNFOU PG XIJDI JT B TJHOJGJDBOU JODSFBTF GSPN UIF .FEJDBSF SFJNCVSTFNFOU PG 2014 payment for simple (CPT 77280) and intermediate (CPT 77285) simulation procedures increase by 42.5 percent and 25.5 percent, respectively. Payment for the single session LINACbased stereotactic radiosurgery (CPT 77372) increases by 26.5 percent in 2014. Other radiation oncology procedure codes did not fare as well when they were revalued by the AMA Relative Value Scale Update Committee (RUC). The high dose rate (HDR) brachytherapy codes (CPT 77785, 77786, 77787) have decreases that range from 10 percent to 23.2 percent. The external superficial hyperthermia code (CPT 77600) has a decrease of 12.4 percent. $.4 GJOBMJ[FE UIF QSPQPTBM UP SFWJTF UIF DBMDVMBUJPO PG UIF .FEJDBSF &DPOPNJD *OEFY .&* "QQMJDBUJPO PG UIF .&* BMPOH XJUI UIF TVTUBJOBCMF HSPXUI SBUF 4(3 EFUFSNJOFT UIF

AAPM Newsletter | Volume 3 No. | +BOVBSZ/'FCSVBSZ


conversion factor that is used to calculate payments made each year under the MPFS. The changes are in response to 2012 recommendations by a Technical Advisory Panel. The changes involve revising the MEI categories, cost shares and price proxies. This policy holds the work RVUs constant, decreases the practice expense and malpractice RVUs and applies a budget neutrality adjustment to the conversion factor. The effects of these changes are summarized in the table at the end of this article. Of note, CMS did not finalize the proposal to address nearly 200 codes that they believe have misvalued resource inputs. These are codes for which the total MPFS payment, when furnished in an office or freestanding cancer center, would exceed the total Medicare payment when the same service is furnished in a hospital outpatient department or an ambulatory surgical center. AAPM strongly opposed this proposal, which would have decreased payment to 15 radiation oncology codes. The most significant impact of the RVU changes for radiation oncology is related to the Medicare Economic Index (MEI) revisions, which decrease practice expense and malpractice RVUs (see table CFMPX).

Specialty

Radiation Oncology Radiation Therapy Centers Radiology Total

Medicare Allowed Charges (millions)

Impact Impact Work & Practice Malpractice Expense RVU RVU Changes Changes

Impact of Medicare Economic Index Revisions

Combined Impact (does not include the 20.1% reduction to 2014 CF)

$1,788

0%

3%

-2%

1%

$63

0%

5%

-6%

-1%

$4,655 $87,552

0% 0%

-2% 0%

0% 0%

-2% 0%

Lastly, based on the currently flawed sustainable growth rate (SGR) calculation, CMS estimates a 20.1 percent reduction to the 2013 conversion factor of $34.02. If Congress does not pass legislation the 2014 conversion factor would reduce all payments by an additional 20.1 percent to the impacts shown above. Based on the history of congressional intervention to avoid large decreases in reimbursement due to the SGR formula, it is extremely unlikely that this additional payment reduction will occur.

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To read a complete summary of the proposed rule and to review impact tables go to website.

Majority of Radiation Oncology Payments Increase for Hospital Outpatient Departments in 2014 The Centers for Medicare and Medicaid Services (CMS) recently released the 2014 Hospital Outpatient Prospective Payment System (HOPPS) final rule. The final rule would increase payment for hospital outpatient services by 1.7 percent in 2014. CMS’ intent is that the HOPPS become more of a prospective payment system through expanding packaging and less a fee-for-service system, which pays separately for each coded item. For 2014, CMS modified the packaging proposal by adding five new categories of supporting services for packaging. These services will not receive separate payment in 2014: 1) Drugs, biologicals, and radiopharmaceuticals used in a diagnostic test or procedure; 2) Drugs and biologicals when used as supplies in a surgical procedure; 3) Certain clinical diagnostic laboratory tests; 4) Procedures described by add-on codes; and 5) Device removal procedures. CMS did not finalize the proposal to package ancillary services effective January 1, 2014. AAPM opposed this policy in its written comment letter to CMS, which would have impacted 22 radiation oncology codes, including CPT 77336 Continuing medical physics consultation and CPT 77370 Special medical physics consultation. Ancillary services will continue to be paid separately in 2014. CMS states that the 2014 packaging policies are not exhaustive and they expect to continue to review the HOPPS and consider additional packaging policies in the future. Other key policies for 2014: • CMS will delete stereotactic radiosurgery (SRS) codes G0173, G0251, G0339 and G0340 and replace them with existing CPT codes 77372 and 77373. There will no longer be a code differentiation between robotic and non-robotic treatment modalities. • The single session cranial treatment codes (CPT 77371 and 77372) will be assigned to the same APC 67. The fractionated SRS code (CPT 77373) will be assigned to APC 66.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


• CMS did not finalize the proposal to reassign the simple proton delivery codes (CPT 77520, 77522) to the same APC as the intermediate (CPT 77523) and complex (CPT 77525) proton delivery codes. CMS will continue the current APC configuration in 2014. • CMS did not finalize the proposal to delete C9726 Placement and removal of applicator into breast for radiation therapy. Instead CMS will package this add-on code into the primary procedure codes for intraoperative radiation therapy (IORT) delivery (CPT 77424 and 77425). • CMS finalized the proposal with modification to create 29 comprehensive APCs to prospectively pay for the most costly device-dependent services, but is delaying implementation of this policy until 2015. The modified policy will recognize variation in the complexity of services that will be paid through the comprehensive APCs in 2015. This will impact breast brachytherapy catheter placement codes in 2015. The majority of the radiation oncology procedure codes have payment increases in 2014 (see UBCMF PO UIF OFYU QBHF).

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Summary of Final 2014 Radiation Oncology HOPPS Payments

A complete summary of the proposed rule and impact tables is on the AAPM website

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


CAMPEP News

Wayne Beckham, Victoria, CBOBEB

CAMPEP news and announcements

T

his is my first opportunity to communicate to you as the incoming president of CAMPEP. I just want to thank Bill Hendee (huge shoes to fill!) and the rest of the Board of Directors for showing confidence in me to lead the organization over the next two years. I’m excited about this opportunity and will do my best to ensure that CAMPEP stays on course and is true to its mission. It is timely to repeat that mission here I think: The Mission of the Commission on Accreditation of Medical Physics Educational Programs (CAMPEP) is to promote consistent quality education of medical physicists by evaluating and accrediting Graduate, Residency and Continuing Education programs that meet high standards established by CAMPEP in collaboration with its sponsoring organizations. I’m pleased to report that our new CAMPEP standards documents for graduate and residency programs have been formally adopted by the Board and they are now available on the CAMPEP website. It is important for directors (both for existing and potential accredited programs) to appreciate that these are the standards that programs will be held to for accreditation. Directors are encouraged to review the standards with their faculty and use your continuous quality improvement processes to ensure that you align with the standards. CAMPEP will also use the annual reporting process to assist programs with compliance. I have a couple of announcements regarding Board of Director composition. At our winter meeting at the RSNA in Chicago, Ed Jackson PhD was elected by the Board to the position of Vice President. This caused a vacancy in the position of Secretary/Treasurer. Joann Prisciandaro PhD was duly elected to that position. Congratulations to Ed & Joann, I very much look forward to working closely with them and of course the rest of the Board as we carry out our business. As Bill forecast in the last issue of the newsletter, Steve Thomas PhD has now joined the Board as of 1 January 2014, which is excellent news. At our winter meeting the Board did identify that multi-site programs (e.g. hub & spoke) should not be adding additional sites to their overall program without first contacting CAMPEP and any additional sites will need to be declared in the annual reporting process. New standards are also being developed for multi-site programs and as re-accreditation looms for these programs they will be expected to comply. CAMPEP will be having a Spring retreat in Houston on April 11 – 12. The retreat allows the CAMPEP Board to dedicate about a day and a half of focused discussion on regular business, AAPM Newsletter | Volume 39 No. 1 | January/February 2014


but also to be more strategic in our direction in the year ahead. As is always the case, the Board is interested in hearing from the medical physics community with ideas and feedback to CAMPEP. In particular if you have something you wish to suggest to CAMPEP, getting it to us well in advance of the April retreat will potentially allow us to consider it during the meeting. CAMPEP’s application for accreditation by the Council for Higher Education Accreditation is back on track after postponement so that the Board could finish the CAMPEP standards and curricula documents and reflect them appropriately in the Policies and Procedures. I’m hopeful we may have good news on this front by the July/August newsletter. One final point I’d like to make and this is directed towards diagnostic imaging residency programs considering CAMPEP accreditation. If you have an associated nuclear medicine program in which residents can do 2 years in one discipline and then 1 further year in the other, CAMPEP will consider both programs for accreditation simultaneously and for only an additional $1,000 fee. That sounds like a good deal!

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Website Editor Report

George C. Kagadis, Rion, Greece

Web assets in high demand

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he current Newsletter report has been written just after the RSNA Annual Meeting in Chicago, IL. The meeting has been a great success and we are now looking forward for the 2014 AAPM Annual Meeting that will take place in Austin, TX. The first Website Editorial Board face-to-face meeting took place on December 2, 2013 and a lot of interesting things have been discussed with regard to the revamping of our official site and social media appearance. A lot of changes will occur in the following months and we hope you will enjoy them. AAPM HQ staff has already uploaded 1,074 videos to Vimeo (as of December 10, 2013). The AAPM Virtual Library is also in the process of being added to Vimeo. We continue to work on the migration and when it is complete we will let the membership know. Since AAPM began uploading those videos to Vimeo, there have been 4,740 plays (as of December 10, 2013) most of which oriented from the U.S. (1,594), India (363), Turkey (195), Saudi Arabia (166), and Spain (156). We expect that when all past meetings are uploaded these presentations will be a valuable toolkit for all our colleagues. With regard to our introductory videos from AAPM’s Committees and Subcommittees that debuted during the Indianapolis meeting, we have received 10 more videos from R. Pizzutiello, W. Pavlicek, L. Rothenberg, T. Podder, C. Liu, L. Fong, J. Prisciandaro, K. Kanal , S. Goestch and E. Lief, that can be accessed from Vimeo. I urge the Chairs of other AAPM Committees and Subcommittees to prepare such an introduction and send it to us to put together

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


with the other introductions for presentation on our website, and during the next year’s Spring Clinical Meeting in Denver, CO and Annual Meeting in Austin, TX. Social media plays a critical role in our web presence and we are trying to further advance them for the benefit of our society. I am pleased to report that as of December 10, 2013 we have 36,223 images posted to AAPM’s Flickr, 1,545 likes on Facebook, 5,507 members on LinkedIn and 2,335 followers on Twitter. Last but not least, I would like to thank once again my colleagues Ms. Farhana Khan and Mr. Michael Woodward for their precious help on driving the AAPM web presence. I wish a happy new year to all of you! I hope you find the AAPM website useful, visit it often and send me your feedback or directly at george@mail.aapm.org.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE

Grant and Fellowship Offerings

GRANTS

FELLOWSHIPS

The Research Seed Funding Grant

The AAPM Fellowship For the Training of a Doctoral Candidate in the Field of Medical Physics

Two $25,000 grants will be awarded to provide funds to develop exciting investigator-initiated concepts, which will hopefully lead to successful longer term project funding from the NIH or equivalent funding sources. Funding for grant recipients will begin July 1 of the award year. Subsequent research results will be submitted for presentation at future AAPM meetings. Must be a member of the AAPM at time of application (any membership category). Pending membership status not accepted. **No Exceptions** Sponsored by the AAPM Education and Research Fund. Award duration: 7/1/2014 – 7/1/2015 Application Deadline: 3/10/2014 Recipients notified by: 6/2/2014

2014 APPLICATION DEADLINES • February 3: The AAPM Summer Undergraduate Fellowship Program • February 7: The AAPM Diversity Recruitment through Education and Mentoring Program “DREAM” • March 10: The Research Seed Funding Grant • April 17: The AAPM Fellowship For the Training of a Doctoral Candidate in the Field of Medical Physics

Awarded for the first two years of graduate study leading to a doctoral degree in Medical Physics. Sponsored by the AAPM Education and Research Fund. Award duration: 7/1/2014 – 6/30/2016 Application Deadline: 4/17/2014 Recipient Notified on: 5/23/2014

The AAPM Summer Undergraduate Fellowship Program Designed to provide opportunities for undergraduate university students to gain experience in medical physics by performing research in a medical physics laboratory or assisting with clinical service at a clinical facility. In this program, the AAPM serves as a clearinghouse to match exceptional students with exceptional medical physicists, many who are faculty at leading research centers. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be an AAPM summer fellow. Each summer fellow receives a stipend from the AAPM. The fellowship will be for a period of 10 weeks during the summer academic

period (May to September), which is mutually suitable to the mentor and fellow. Sponsored by the AAPM Education Council through the AAPM Education and Research Fund. Application Deadline: 2/3/14 Recipients Notified by: 3/3/2014

The AAPM Diversity Recruitment through Education and Mentoring Program “DREAM” A 10 week summer program designed to increase the number of underrepresented groups in medical physics by creating new opportunities, outreach and mentoring geared towards diversity recruitment of undergraduate students in the field of medical physics. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be a DREAM fellow. Each DREAM fellow receives a stipend from the AAPM. The fellowship will be for a period of 10 weeks during the summer academic period (May to September), which is mutually suitable to the mentor and fellow. Sponsored by the AAPM Education Council through the AAPM Education and Research Fund. Application Deadline: 2/7/2014 Recipients Notified by: 3/7/2014

APPLY: http://www.aapm.org/education/GrantsFellowships.asp


Chapter Activities

Chris Allgower, Bloomimgton, IN

Ohio River Valley and Penn-Ohio chapters presented a joint 2013 fall symposium

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he Ohio River Valley and Penn-Ohio chapters presented in partnership a joint 2013 fall symposium, held October 11 and 12 at the Beachwood Embassy Suites Hotel near Cleveland, Ohio. The program was an expanded one, including a Friday afternoon session with five student research talks featuring speakers from the Penn-Ohio chapter and ranked by a panel of judges. (The ORVC does the same at its spring meetings.) This was followed by two talks on safety topics and an award presentation. The first place winner of the student presentations was Jeffery Fabien, M. S., of UH Case Medical Center in Cleveland. That evening, there was a reception and dinner, followed by a lively town hall discussion about updates to physics initial certification and maintenance of certification featuring David Laszakovits from the American Board of Radiology.

Jeffery Fabian (M. S.) receiving the award for best student presentation from Keli Wilson, Penn-Ohio President.

On both days, at least a dozen research posters were on display outside the meeting room, which attendees were encouraged to bring with them to the meeting. More than half of the posters were by students from a large group from the University of Toledo, led by their director, Prof. E. Ishmael Parsai.

The Saturday program had as its theme “Building new facilities and upgrading existing ones.� The keynote speaker was Dr. Olga Green from Washington Univ. in St. Louis, MO, where they are about to begin treating patients with a first-of-its-kind Viewray machine, which combines MRI imaging with cobalt fan beams for therapeutic treatment delivery. Topics covered in other talks included QC concerns for new generation CT, MRI, and PET, a description of a small hospital-based accelerator facility for generation of PET isotopes at Case Western Reserve University, the process of converting to using electronic medical records, a description of a new single-room proton facility under construction at UH Case Medical Center in Cleveland, two talks about SBRT from the perspectives of a medical physicist and a physician, and a final talk about quality management by M. Saiful Huq, the TG-100 committee chair. For those who are AAPM Newsletter | Volume 39 No. 1 | January/February 2014


interested, slides from the meeting presentations are available on the Penn-Ohio web site. Total attendance was 128 people, including representatives from 29 industrial exhibitors, 25 of whom had tables at the meeting. Five of the exhibitors (Varian, MIM Software, Standard Imaging, RIT, and Sun Nuclear) were elite sponsors, entitling them to give 15-minute presentations during the Saturday lunch break. All officers of both chapters were heavily involved in the meeting planning, especially the Penn-Ohio 1resident &lect, Valdir Colussi, who had primary responsibility for the content of the meeting program. The officers of both chapters thank the attendees for their support in making this a particularly lively and successful chapter meeting. A maximum of 10.15 CAMPEP CE credits were awarded to attendees.

Keynote speaker Olga Green (Ph. D.) receiving plaque from Bryon Murray, 1resident-&lect of Ohio River Valley Chapter.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


ABR News

Richard L. Morin, PhD, FAAPM Radiology, Mayo Clinic, Jacksonville, FL

A farewell note: My ABR retirement On June 30, 2013, I retired from the American Board of Radiology Board of Trustees. I was nominated for the position almost 10 years ago by the AAPM Board of Directors, and I’m forever grateful. I was selected by the ABR and became the second diagnostic medical physics trustee, following the legendary Dr. William Hendee. My good friend Bill did not quite explain the range of duties, which during my tenure grew substantially. With the addition of Maintenance of Certification (MOC) and the diagnostic radiology Exam of the Future (EOF), the three physics trustees are responsible for the medical physics content of 42 examinations every year. There were some significant changes during my tenure: the continuing maturation of MOC, the 2012 and 2014 initiatives requiring CAMPEP-accredited education and training, the change of the ABR title of our field from radiologic physics to medical physics, the diagnostic radiology Exam of the Future, the formulation of the ABR Information Technology Advisory Committee, and revision of the ABR website and the launching of myABR. I was honored to serve four years as the ABR secretary-treasurer and a member of the Executive Committee. I can assure you that ABR leadership is continually concerned with candidates and diplomates. Their concern about medical physics is genuine and very thoughtful. I’m sure the current secretary-treasurer, Dr. Geoff Ibbott, will continue to advise leadership regarding medical physics issues. My experience as an ABR trustee was truly a once-in-a-lifetime journey. Becoming the senior medical physics trustee sometimes comes with interesting challenges. I surely enjoyed speaking at meetings and explaining how MOC works. That was certainly uplifting, and I always learned so much about decisions made. The ABR selected Dr. Tony Seibert to be the third diagnostic medical physics trustee, and I have the utmost confidence that he will speak with wisdom, insight, and strong leadership. I thank my fellow medical physics trustees during my service—Drs. Bhudatt Paliwal, Steve Thomas, Don Frey, Geoff Ibbott, and Jerry Allison— for their counsel, assistance, and thoughtful discussions. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


I was always impressed by my fellow trustees and the many thoughtful debates over the many issues we faced. It was an honor to serve and work to better our profession and serve our patients. I wish the current medical physics trustees and all ABR trustees all my best. I shall miss our work but look forward to our continued friendships. The profession of medical physics is in wise and thoughtful hands. Thanks so much for the opportunity to serve.

Valerie P. Jackson, MD Professor of Radiology and Chair of the Department of Radiology and Imaging Sciences Indiana University School of Medicine, Indianapolis

American Board of Radiology names Valerie P. Jackson, MD, as executive director The American Board of Radiology (ABR) Board of Trustees has unanimously approved Valerie P. Jackson, MD, as its next executive director, effective July 1, 2014. She will succeed Gary J. Becker, MD, who will retire June 30, 2014. Dr. Jackson is the Eugene C. Klatte professor of radiology and chair of the Department of Radiology and Imaging Sciences at the Indiana University School of Medicine in Indianapolis. An expert in the field of breast imaging, she has been active in clinical work, research, and teaching regarding mammography, breast sonography, and interventional procedures of the breast. Dr. Jackson served as an ABR trustee from 2001 to 2010. During that time, she was active on numerous board committees. In addition to her considerable volunteer efforts for the ABR, Dr. Jackson has been active in a number of national organizations. She has been a member of the American College of Radiology (ACR) Breast Task Force, chaired the ACR Commission on Education, and was a member of the ACR Board of Chancellors. She was president of the ACR in 2002-2003. She was elected to the Society of Breast Imaging (SBI) in 1986, became a fellow of the SBI in 1991, and served as president of the SBI from 1991 to 1993. A member of the Radiological Society of North America (RSNA) since 1982, Dr. Jackson served as chair of the Refresher Course Committee from 2009 to 2012, chair of the Breast Imaging Subcommittee of the Scientific Program Committee from 2003 to 2006. AAPM Newsletter | Volume 39 No. 1 | January/February 2014


Dr. Jackson is the author of approximately 100 peer-reviewed articles and 20 books and book chapters with an emphasis on breast imaging and radiologic education. She has served as principal investigator on numerous funded grants, including several focused on radiologic education. She is a sought-after lecturer and educator who has made more than 300 scientific and educational presentations at meetings worldwide. The recipient of numerous honors throughout her career, Dr. Jackson is a fellow of the American College of Radiology and has received the gold medals of the Indiana Radiological Society, SBI, and ACR. The Valerie P. Jackson Education Fellowship also recognizes her work with ACR. Established in 1934, the mission of the American Board of Radiology (ABR) is to serve patients, the public, and the medical profession by certifying 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, interventional radiology, radiation oncology, and medical physics. The ABR is one of 24 Member Boards of the American Board of Medical Specialties. More information is available at www.theabr.org

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


QUANTITATIVE IMAGING: DEDICATED PROGRAM TRACK AT THE AAPM 56TH ANNUAL MEETING & EXHIBITION July 21 & 22, Austin, TX http://www.aapm.org/meetings/2014AM New for 2014: The Quantitative Imaging (QI) Track will feature 2 days of invited

images for the assessment of normal or the severity, degree of change, or status of a disease, injury, or chronic condition relative to normal.� [rsna.org/QIBA] the acquisition as well as data analysis techniques. The QI Program at AAPM 2014 features the latest research in physical and synthetic phantoms, metrology, and

Abstract submission site opens January 15, 2014 (due March 3, 2014). Please plan to attend the QI Track events on July 21-22, 2014!

AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE | WWW.AAPM.ORG


Staff Announcements

Angela Keyser, College Park, MD

AAPM HQ Team...at your service!

In this issue, I would like to profile a member of the team who is critical to the smooth operations and success of the Medical Physics journal.

Penny Slattery, AAPM Journal Manager, celebrated her 17th AAPM

anniversary in 2013. She began her AAPM career in 1996 when AAPM transitioned the administrative support of the Medical Physics journal to HQ. She provides support to the editorial process, coordinates the processing of manuscripts for the journal and serves as liaison to the publisher, the American Institute of Physics. Penny has played an instrumental part in the continuity of journal operations and the transition from Editor Bill Hendee to Editor in Chief Jeff Williamson, Imaging Editor Mitch Goodsitt and Therapy Editor Shiva Das.

AAPM Newsletter | Volume 39 No. 1 | January/February 2014


International Organization for Medical Physics

November 7, 2013 The birthday of Marie Sklodowska-Curie has been named by IOMP as the

International Day of Medical Physics

Celebrating the professionals who work to advance technology and ensure safe and effective radiation.


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