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Balancing in-house and outsourced medical physics services

April 03, 2020
Business Affairs
Thomas J. Petrone
From the April 2020 issue of HealthCare Business News magazine

By Thomas J. Petrone

Hospital and health system administrators are unlikely to be experts in medical physics.
This lack of specialized knowledge is completely rational — their skills and experiences lie elsewhere — but it nonetheless creates uncertainty: are they spending too much to meet their institution’s medical physics needs? And if those needs aren’t being met, how much more should they be spending, and on what?

Recognizing this gap in knowledge (and in keeping with ever-increasing cost consciousness in healthcare), the American Association of Physicists in Medicine (AAPM) has conducted a series of surveys intended to clarify the needs and costs of various medical physics services. Drawing on the expertise of academic physicists and outsourced consultants alike, one 2017 study supplies consensus time estimates and effort considerations for essential functions like equipment testing, as well as value-added services like acting as the hospital’s radiation safety officer (RSO). The report also touches on the intangible and harder-to-quantify contributions that a medical physicist can make to a health system’s diagnostic medical radiation safety, effectiveness, and operations overall. Hospitals and health systems can use this report (and similar resources on the therapeutic side) to identify an appropriate scope of work and an appropriate range of costs for that scope.

As the report indicates, however, intangibles and unknowns will always remain, especially in such a swiftly evolving field. On the diagnostic side especially, where many physics activities might be done after hours when rooms are not needed, hospitals must navigate past acting “pound foolish” while also avoiding being too “pennywise.” Between the two is where an institution will derive the proper value from its medical physics investment.

Assessing unique needs
The right mix of in-house medical physicist positions and outsourced consulting services will be different for each institution — and many will not need a mix at all. For those trying to strike the right balance between the two, some fundamental questions apply:

What type of medical radiation equipment do you use?
How many machines do you have?
What are the applicable regulations for the equipment’s calibration and monitoring?
Is there a teaching or training component of the medical physicist’s job, or other administrative work you need him or her to do?
What resources are available for this purpose?

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