The second component, the intellectual pursuits, can be harder to define, and it largely depends on what else is going on in each of the many departments in one’s institution that utilize some form of radiation. That would include understanding what the teaching requirements will be for the medical physics team. It may be very simple: things like cursory radiation safety sessions to nurses; or it could be a comprehensive curriculum of radiation physics for a place that has diagnostic radiology residents.

Other things that would be under the category of intellectual pursuits might be the investigations that medical physicists have to do when, as an example, a computed tomography dose is higher than the national average. In that instance, a certain amount of investigation has to occur as to why that might happen. And as you know, benchmarking of CT doses is a Joint Commission requirement, so this is a fairly new area for physicists to have to be expending their time. CT dose optimization is another intellectual pursuit that’s a little harder to quantify because it depends on how often there is deviation from the standard. The Joint Commission is adding similar comprehensive standards for fluoroscopy which will duplicate the CT effort.


Protocol establishment is yet another topic that falls under intellectual pursuits. This could come into play when investigating unusual staff exposures to radiation at a very busy practice that does a lot of interventional radiology, cardiac catheterization procedures or cardiac ablations. Or if there is a lot of radiopharmaceutical and brachytherapy or PET scanning, you might see a situation where employees on a monthly basis are showing personnel exposures higher than certain trigger levels. Now, the time expenditure on the physicist’s part will be in performing investigations and coming up with corrective actions of remediation if necessary. So, again, it’s semi-quantifiable and the amount of the effort and expenditure allotted to these endeavors could be significant.

Staffing structure
Once all the needs are determined, the structure of the staff can be considered. Some hospitals find it makes sense to keep everything in-house. Others turn to consultants. Still others take a hybrid approach where there are in-house employees and supplemental support of them, either after hours or online such as in remote dosimetry or remote tasks of that nature.

There are benefits and drawbacks to each. In-house employees have the potential to grow with the facility’s needs and they’re part of the local community, so there’s the goodwill benefit. Turning to consultants, facilities have the advantage of only paying for results. Consultants aren’t being paid for vacations and time off, and the time employees might spend chatting about their weekends. Essentially, it’s possible to avoid some of the inefficiencies that can come with full-time staff. And obviously with the hybrid approach, it’s a mix of pros and cons from the in-house or consultant options.

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