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SCOPE OF PRACTICE OF CLINICAL MEDICAL PHYSICS
 
STATEMENT OF BASIC RESPONSIBILITY
 The essential responsibility of the Qualified Medical Physicist's clinical practice is to assure the safe and effective delivery of radiation to achieve a diagnostic or therapeutic result as prescribed in patient care. The medical physicist performs or supervises the technical aspects of procedures necessary to achieve this objective. The responsibilities of the medical physicist include: protection of the patient and others from potentially harmful or excessive radiation; establishment of adequate protocols to ensure accurate patient dosimetry; the measurement and characterization of radiation; the determination of delivered dose; advancement of procedures necessary to ensure image quality; development and direction of quality assurance programs; and assistance to other health care professionals in optimizing the balance between the beneficial and deleterious effects of radiation; and compliance with applicable federal and state regulations.
 
 
DEFINITIONS
 
 
3.1 Medical Physics is that branch of physics that is associated with the practice of medicine. The term Medical Physics, as it is used here, includes diagnostic medical physics, therapeutic medical physics, nuclear medical physics, and medical health physics. 
3.2 Radiation includes both ionizing and non-ionizing radiation such as electromagnetic radiation, particulate radiation, and ultrasound. These modalities, used for diagnostic or therapeutic purposes when prescribed by a properly qualified practitioner, are herein described as radiological procedures. 
3.3 The Practice of Medical Physics means the use of principles and accepted protocols of physics to assure the correct quality, quantity, and placement of radiation during the performance of a radiological procedure. 
3.4 Practitioner means a doctor of medicine, osteopathy, podiatry, dentistry, or chiropractic who is licensed to practice their medical specialty and who either prescribes or utilizes radiological procedures for other persons. 
3.5 Quality Assurance consists of activities designed to assure adequate quality, precision and accuracy in the uses of radiation and reproducibility of the procedures and systems used. 
3.6  Qualified Medical Physicist (QMP) is an individual who is competent to practice independently in one or more of the subfields of medical physics, and meets the criteria set forth in the Definition of a Qualified Medical Physicist  (AAPM Professional Policy 1 ). In addition, a QMP must hold a professional medical physics license where required and should uphold the AAPM Code of Ethics (AAPM Professional Policy 24 ).
SPECIFICS OF PRACTICE
 This document summarizes the tasks for which medical physicists are uniquely qualified. Additionally, medical physicists participate in many procedures in the clinic not listed here, depending on the specifics of clinic operation. A scope of practice consistent with the aforementioned practice guidelines for the different sub-specialties of medical physics is outlined below. The medical physicist is an essential member of the patient care team that includes Physicians, Nurses, Radiologic Technologists, Dosimetrists, Radiation Therapists, Engineers and QA personnel. In every case, the medical physicist subscribes to the AAPM Code of Ethics (AAPM Professional Policy 24).
 
 
 
4.1 Supervision
A medical physicist who does not meet the criteria to be considered a QMP should work under the supervision of a QMP, with the level of supervision appropriate to the task as described in AAPM Professional Policy 18: "Statement on the description of involvement of Medical Physicists in clinical procedures ".
4.2 Collaboration 
Collboration is essential in the performance of Medical Physics duties, and such collaboration includes, but not limited to:
     
        4.3 The scope of practice of the QMP may include, but is not limited to:
4.3.1 GeneralConsultation with Practitioners and Allied Health Personnel for treatment planning dose delivery.Consultation with Practitioners to assure accurate radiation dose to a specific patient.Consultation iwth Practitioners and Allied Health Personnel to address the balance between radiation dose and image quality for patient care.Consultation and instruction regarding radiation safety to patients, staff, and for general public radiation safety.Consultation and collaboration with research and development scientists and equipment manufacturers to guide the development and improvement of products and procedures designed to ensure quality patient care and radiation safety. 
        4.3.2 For Diagnostic Medical PhysicsServes as the institution's Radiation Safety Officer,Serves as a member of the institution's Radiation Safety Committee, Serves on other institution committees including but not limited to Risk Management, Quality Assurance, and Professional staff. 
        4.3.3 For Nuclear Medical PhysicsDevelop specifications for imaging equipment and diagnostic radiation detectorsDevelop procedures for the initial and continuing evaluation of imaging equipment and diagnostic radiation detectorsProvide evidence of compliance of imaging equipment with regulatory and accreditation agency rules and recommendationsMeasure and characterize of medical radiation from imaging equipment prior to clinical utilizationPerform acceptance testing, evaluation and commissioning of imaging equipment and/or their associated computer systems, algorithms, data, and outputDevelop and/or evaluate of policies and procedures related to the appropriate clinical use of radiation for imaging purposesReview diagnostic imaging dosimetry information noted in patient recordsDevelop and manage of a comprehensive Quality Management Program that monitors, evaluates, and optimizes imaging processesConsult in the development and/or evaluation of a comprehensive clinical radiation safety program in diagnostic imagingConsult on patient or personnel radiation dose and associated risksProvide diagnostic imaging physics training for medical practitioners and other health-care providersProvide consultation to assure an optimized balance between image quality and patient doseProvide institutional consultation on program development in diagnostic imagingPlan and specify of thickness, material, and placement of shielding needed to protect patients, workers, the general public and the environment from radiation produced incident to diagnosis or treatment of humansAssess and evaluate of installed shielding designed to protect patients, workers, the general public and the environment from radiation produced incident to diagnosis or treatment of humansParticipate in informatics development and directionApply other medical applications of physics as appropriate to safely carry out diagnostic radiologic proceduresDevelop and apply Medical Health Physics procedures associated with the practice of Diagnostic Radiology
 
 
        4.3.4 For Therapeutic Medical PhysicsDevelop nuclear imaging and radioactivity measurement equipment specificationsDevelop procedures for the initial and continuing evaluation of nuclear imaging and radioactivity measurement equipmentProvide evidence of compliance of nuclear imaging and radioactivity measurement equipment with regulatory, professional and accreditation agency rules and recommendationsMeasure and characterize of medical radiation from radiopharmaceuticals prior to clinical utilizationPerform acceptance testing, evaluation and commissioning of nuclear imaging and radioactivity measurement equipment and their associated computer systems, algorithms, data, and outputEvaluate nuclear imaging and radioactivity measurement procedures prior to clinical useDevelop and/or evaluate of policies and procedures related to the appropriate clinical use of radiation for nuclear imaging, radiopharmaceutical therapy and/or radioactivity measurement purposesReview of radiopharmaceutical dosimetry information noted in patient recordsDevelop and manage of a comprehensive Quality Management Program that monitors, evaluates, and optimizes nuclear imaging, radiopharmaceutical therapy and radioactivity measurement processesDevelop and/or evaluate a comprehensive clinical radiation safety program in nuclear medicineProvide consultation on patient or personnel radiation dose and associated risksProvide institutional consultation on program development in medical nuclear imaging and radiopharmaceutical therapyProvide medical nuclear physics training for medical practitioners and other health-care providersProvide of consultation to assure an optimized balance between image quality and patient dosePlan and specify thickness, material, and placement of shielding needed to protect patients, workers, the general public and the environment from radiation produced incident to diagnosis or treatment of humansAssess and evaluate installed shielding designed to protect patients, workers, and the general public from radiation produced incident to diagnosis or treatment of humansParticipate in informatics development and directionApply other medical applications of physics as appropriate to safely carry out nuclear medicine proceduresDevelop and apply Medical Health Physics procedures associated with the practice of Nuclear Medicine 
        4.3.5 For Medical Health PhysicsDevelop of equipment specifications for radiation therapy treatment, brachytherapy, simulation, and radiation measurementDevelop of procedures for the initial and continuing evaluation of radiation therapy treatment, brachytherapy, simulation, and radiation measurement equipmentProvide evidence of compliance of equipment for radiation therapy treatment, brachytherapy, simulation, and radiation detection, with regulatory and accreditation agency rules and recommendations
        Measure and characterize medical radiation from radiation therapy treatment, brachytherapy, and simulation equipment prior to clinical utilizationPerform acceptance testing, evaluation and commissioning of equipment used for external-beam therapy, brachytherapy, simulation, treatment-planning, and radiation detection; acceptance testing and evaluation of their associated computer systems, algorithms, data, and outputApprove radiation oncology technical procedures prior to clinical useDevelop and/or evaluate, in conjunction with the medical practitioner, policies and procedures related to the appropriate therapeutic use of radiationDevelop and/or evaluate, with the medical practitioner, the dosimetric component of patients' treatment plans
        Review of radiation oncology dosimetry information noted in patient recordsDevelop and manage a comprehensive Quality Management Program that monitors, evaluates, and optimizes radiation oncology processesDevelop and/or evaluate a comprehensive clinical radiation safety program in radiation oncologyDirect the Radiation Oncology Physics program to include the technical direction of staff responsible for treatment planning, machine maintenance and repair and other physics support staff.Provide consultation on patient or personnel radiation dose and associated risksProvide radiation oncology physics and radiation dosimetry training for medical practitioners and other health-care providersProvide consultation to assure accurate radiation dose deliveryProvide institutional consultation on program development in radiation oncologyPlan and specify thickness, material, and placement of shielding needed to protect patients, workers, the general public and the environment from radiation produced incident to diagnosis or treatment of humansAssess and evaluate installed shielding designed to protect patients, workers, and the general public from radiation produced incident to diagnosis or treatment of humansUse imaging procedures as they pertain to the simulation, treatment planning and treatment delivery in therapeutic radiologic procedures.Involve in informatics development and directionApply other medical applications of physics as appropriate to safely carry out therapeutic radiologic proceduresDevelop and apply Medical Health Physics procedures associated with the practice of Therapeutic Radiology 
        Plan and specify thickness, material, and placement of shielding needed to protect patients, workers, the general public and the environment from radiation produced incident to diagnosis or treatment of humansAssess and evaluate installed shielding designed to protect patients, workers, and the general public from radiation produced incident to diagnosis or treatment of humansDevelop radiation protection equipment specificationsDevelop procedures for the initial and continuing evaluation of radiation protection equipment and proceduresMonitor compliance with radiation protection, policies and procedures, regulations, accreditation organization(s) standards, and national recommendationsPerform acceptance testing and commissioning of radiation protection equipment and devices and commissioning of facilitiesPerform acceptance testing and evaluation of radiation protection computer systems, their algorithms, data, and outputEvaluate radiation safety procedures prior to useDevelopment, manage and/or evaluate a radiation safety programProvide radiation-protection training for medical practitioners, and other health-care providersDetermine presence, evaluate and assess any radiological hazard resulting from the use of ionizing radiation or radioactivity for compliance with appropriate regulatory and accreditation agenciesFulfill the duties and responsibilities of a medical Radiation Safety Office/Protection Supervisor. |