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ENHANCING THE VALUE OF THE MEDICAL PHYSICIST: AAPM INITIATIVES

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ENHANCING THE VALUE OF THE MEDICAL PHYSICIST: AAPM INITIATIVES

Bruce Curran, MS, ME, FAAPM, FACMP, FACRPresident, American Association of Physicists in Medicine

Associate Professor, Virginia Commonwealth UniversityChief Therapy Medical Physicist, HH McGuire VA Medical Center

Richmond, VA

Research Funding Clinical Funding

• Salary supported by a VHA contract with VCU Travel Funding (2015-6) (with some honoraria)

• AAPM• AAPM Chapters• Sun Nuclear (2016 QADS)• ASTRO (IHE-RO Technical Committee)• AIP (Audit Committee, Assembly of Society

Officers)

DISCLOSURES

Who are we? AAPM Efforts

• Ad Hoc Committees• Presidential Initiatives• Council Initiatives

AAPM Summer School AAPM Annual Meeting Medical Physics Leadership

• Medical Physics 3.0 AAPM Governance

OUTLINE

Board of Directors50 – 12 BMAL, 21 CE, 5 off, 12 NVBoard of Directors

50 – 12 BMAL, 21 CE, 5 off, 12 NV

8542 Members(as of 1/13/2016)

8542 Members(as of 1/13/2016)

Committees by Council

Committees by Council

Executive DirectorExecutive Director EXCOMEXCOMCommittees by 

TypeCommittees by 

Type

Admin (49)Board (14) 

Education(35)Professional (28)Science (132)

AAPM Staff (27)Councils (4)

Committees (41)Subcommittees (72)Working Groups (57)Task Groups (66)

Other (18)

16.1%

62.4%

2.0%

1.5%2.0%

1.7%

0.1%

14.2%

Primary Specialty as Reported by Members

DiagnosticTherapyNuclear MedicineMagnetic ResonanceRad Safety/Health PhysicsEngineeringUltrasoundUndisclosed

Ad Hoc Committee on TG100 Implementation (completed, 2015)• Created education program (approved by Board)• Suggested modifications to TG100 to extend roll-out of

process• Moved to Administrative Council WG in 2016• Certificate Course for 2016 Annual Meeting• Mini-courses for presentation at chapter meetings, …

Ad Hoc Committee on MedPhys Match Program (continuing)• Successful Matchs held in 2015, 2016• Further work on finances and corporate structure (LLC)

AD HOC COMMITTEES

Ad Hoc Committee on Corporate Relations (completed, 2015)• Submitted report at July, 2015 Board Meeting• Recommended new staff person for Corporate Relations• Additional recommendations in report• Implementation Committee initiated in March, 2016

Ad Hoc Committee on AAPM Reports Integration (continuing)• Better structure for AAPM Reports

• Keywords, sorting• More consistent availability

Ad Hoc Committee on Medical Physics 3.0 (continuing)• Initiated in late 2015• Working with Medical Physics Leadership Academy• Working with 2016 AAPM Summer School

AD HOC COMMITTEES

Certificate Programs

2016 – TG100 Certification

Annual Meeting SAMs

PRESIDENTIAL INITIATIVES (ON-GOING)

Education Council• Non-member Virtual Library Subscriptions• MP Training Center - Rwanda

Science Council• Technology Assessment• Annual Meeting Mentorships• Junior Member Travel Grants• NCI RFI on the Future of Young Investigators

Administrative Council• SAMs for Proffered Science Sessions• Restructuring of AAPM Publishing

COUNCIL INITIATIVES

Do Medical Physicists wish to be recognized as:a.Skilled equipment technicians who are capable

of solving a variety of problems.b.Technologic assistants in the diagnosis and/or

treatment process.c.Partners with physicians (and other members of

the team) in the development of techniques for improving patient health.

d.Managers of equipment.e.Overpaid staff who do not significantly

contribute to the process of patient care.

MEDICAL PHYSICS LEADERSHIP:WHAT IS THE PROBLEM?

Too often we are seen as highly paid technicians who, while contributing to the patient care process, are not recognized for our intellectual contributions, but more for getting QA and regulatory tasks done.

As reimbursement changes to a capitated model where an institution receives a fixed reimbursement, it will be necessary for Medical Physicists to justify their importance to the process (as opposed to using MPAs or other less-expensive personnel) to accomplish the task.

WHAT IS THE PROBLEM?

Presentation Matters!

Marketing• We must ensure that our capabilities and

contributions are recognized and used by:• Our peer physicians (Radiologists, Radiation Oncologists,

…)• Senior Management (VPs, Deans, Owners, Managers, …)• The “C-Suite”

We need to “come out of the closet”• Must be present at:

• Tumor Boards• Chart Rounds• New Patient Rounds• Morbidity and Mortality Rounds

HOW DO WE CHANGE PERCEPTIONS?

Getting involved / known by Senior Leadership• CEO, CMO, CFO, COO, …

Recognition for your skills and education• Technology Decisions

• Equipment Characteristics• What is Clinically Necessary

• IT Support• TMS, TPS systems are Medical Devices for which the

Medical Physicist is the responsible individual per ACR, NRC, …

• Technical Leadership• Training for RTTs, Nursing, Dosimetrists, …

THE C-SUITE

Recognition of your clinical skills• Tumor Board• New Patient Rounds• Chart Rounds

Don’t just check charts!• Imaging• Contouring• Planning• Delivery

THE C-SUITE

You need to document the value that you bring to the clinic

Document• Charges that result from Physics Services• Errors caught / Good Catches done• Training

• RTT / CMD / MD Training hours• Regulatory Activities

• Radiation Safety Training

METRICS

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MEDICAL PHYSICS 3.0

With thanks to Ehsan Samei, …

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AAPM GOVERNANCE:CAN WE DO BETTER?

Is the AAPM Board of Directors an Effective Board?• Formulate key policies and strategic goals• Authorize major transactions or other actions• Oversee matters critical to the health of the organization• Evaluate and help manage risk• Steward the resources of the organization for the long run• Mentor volunteers and staff by providing resources, advice,

and introductions to help facilitate operations. Should be focused on Strategic rather than Operational

issues. Board Members should be elected based on skills

needed by AAPM

AAPM GOVERNANCE

Do AAPM Members understand the responsibilities of a Board Member?• Duty of Care

• Exercise reasonable care when he or she makes a decision as a steward of the organization.

• Duty of Obedience• Must be faithful to the organization's mission. They are not

permitted to act in a way that is inconsistent with the central goals of the organization.

• Duty of Loyalty• Never use information obtained as a member for personal

gain, but must act in the best interests of the organization.

AAPM GOVERNANCE

Reference:  Bruce R. Hopkins, Legal Responsibilities of Nonprofit Boards (BoardSource 2003).  Taken from:  http://www.bridgespan.org/Publications‐and‐Tools/Nonprofit‐Boards/Nonprofit‐Boards‐101/Legal‐Responsibilities‐Nonprofit‐Boards.aspx#.Vp56Ijbnvqw

Do AAPM Chapter-elected Board Members “represent” a chapter?• NO: once elected, their loyalty and fiduciary responsibility

is to AAPM, not to the chapter.• They are FROM the chapter, not FOR the chapter.

AAPM GOVERNANCE

AAPM GOVERNANCE

The organization characteristic that seems to most influence both the individual board member’s perception of board performance and his or her satisfaction with board service is the number of board members. In general, particularly in boards with more than 20 individual members, board members tend to rate both their perception of board performance and their satisfaction with service significantly lower than those serving on boards with 20 or fewer.

Board Retreat (March 8-9, 2016)• Vision / Mission

• Our Vision and Mission are not where we want to be / go.

• Who do we want to be?• Governance Structure

• Changes in the structure of AAPM could help to focus on Strategic issues.

• Developing an operational structure would allow the Board to focus on strategic issues.

• Communication• Need to communicate more effectively with the

Membership and Chapters on the issues of Governance and how to improve.

GOVERNANCE ASSESSMENTSTRATEGIC PLANNING / AD HOC MEETING

from xkcd.com

THANK YOU

Thanks

Blue LagoonSt. Vincent and the Grenadines