Improving Health Through Medical Physics

MEDPHYS 3.0 REPORT : What is it all about?

Ehsan Samei, PhD | Durham, NC

AAPM Newsletter — Volume 43 No. 4 — July | August 2018

What is MedPhys 3.0?

Over the past two years or so you have probably seen or heard something about this thing called Medical Physics 3.0 (MP3.0) and wondered what it is. Up until now, our field, medical physics, has done much to advance medicine. We can be proud of our collective accomplishments. Haven't we achieved enough already? The MP3.0 initiative reflects a conviction that medical physics still has a lot more to offer. Think about the foundational presence of physics in all aspects of nature, including the human body, and in all the technologies used in medicine. In light of this, nearly every medical inquiry or intervention could be informed by the work of physicists. Why then aren't physicists more broadly present in medicine? Wasn't that the origin of the moniker "medical physics" — physics, in medicine — the idea that energized many of us to want to become medical physicists? If physics is so foundational and relevant to the human body and medical technology, isn't it conceivable that every medical school would have a "Medical Physics Department" alongside other core basic biomedical science departments, and biomedical physics would be included in medical school curricula? Is there any reason why medical physics should not be involved outside of its current bedrock practices in radiation medicine?

Medical Physics 3.0 is an initiative to push physics into new territories of scholarship and practice in medicine. MP3.0 in some ways is a return to the aspiration implied in the name of our field, that physics be practiced more holistically across all of medicine. It is primarily based on the conviction that medicine and human health are really better off with this professional contribution than without. Further, in the domains where physics is already well-established (namely radiation oncology and radiology), there is still much room to orient our focus towards the patient, while retaining our expertise in the technologies and processes. Our current professional practices put much emphasis on technological evaluation, commissioning, and conformance, but technology is a tool intended to serve a single purpose: improving human health. We have done physics well, and we are doing physics well, but that doesn't mean we can't work to make our medical physics "more medical," as Carl Ravin, MD, the former long-time chair of Radiology at Duke once put it.

But do we need to do any of this? Is all of this really necessary? Absolutely! Why? First, because we call ourselves medical physicists — we are here to serve human health. As medical physicists, we have much to contribute in advancing human well-being. For example, we can enter other areas of medicine such as photonics, dentistry, orthopedics, surgery, cardiology, nanomedicine, and neuromedicine, to name just a few, and can apply our expertise to bring about cutting edge advances in medicine. Second, because of the seismic changes that are sweeping across all healthcare. All allied health professionals are revisiting how their value can be recognized in the new value-based care environment that is increasingly informed by cost, artificial intelligence, and care outcome. We are no exception. We need to figure out, truthfully, meaningfully, and explicitly, what our value is to the medical enterprise, and how to communicate that value effectively. If we cannot determine our value for ourselves, we cannot expect others to do so. As our committee member Dan Pavord smartly puts it, "if you are not at the table, you are on the menu!" This reality requires us first to be competent in what we are meant to do for medicine. Next, we must determine how we can make that sustainable from a workflow, technical resource, and financial standpoint. This is sustainable excellence, one of the key objectives of MP3.0. And finally we must determine and provide smart ways to make our value known to peers and superiors throughout healthcare.

You also may be wondering, why "3.0"? Why not "2.0"? Simple. For three years (2013-2015), Medical Physics 2.0 was advocated as an initiative in imaging physics alone. When the AAPM decided to take on the initiative and give it a broader mandate beyond imaging, an upgrade was deemed necessary. So there you have it: Medical Physics 3.0.

What has been accomplished thus far?

MP3.0 started as an AAPM ad hoc committee, commissioned by the president outside the AAPM committee structure, from 2016 through 2017. In 2018, the group expanded and became a committee under the Professional Council with a mandate to work across the AAPM councils and committees to advance the cause and vision of MP3.0.

So far, the initiative has led to a web presence (Google "Medical Physics 3.0") offering content including Good Practices, Areas of Growth Opportunities, Inspiring Stories, and two commissioned videos oriented towards medical physicists and prospective students. It has spearheaded six articles in various administrators' magazines and medical physics periodicals, 19 presentations at national and international conferences, and three face-to-face and social media events. A refereed article is also under final consideration. Two additional videos are nearly complete, one oriented towards patients and one towards administrators.

What's ahead?

The ongoing activities of the committee are being orchestrated through sub-committees, each of which is focused on fostering one of the seven "smart" aspirations of MP3.0. The term smart here is used to invoke the character of intentionality, intelligence, effectiveness, and leanness in targeting the objectives of MP3.0. The seven aspirations are towards:

  1. Smart practitioners – medical physicists who are as competent as possible to fully contribute their unique expertise as scientists and healthcare professionals to medicine,
  2. Smart expansion – extending the boundaries of medical physics scholarship and practice beyond radiation medicine,
  3. Smart tools – technological resources that enable the practice of MP3.0 efficiently and consistently,
  4. Smart practice – working models and practice norms that encourage and facilitate the practice of MP3.0,
  5. Smart regulations – professional expectations and regulations that require and encourage MP3.0 practice,
  6. Smart communication – strategies to inform MP3.0 through input from medical physicists and to encourage its adoption, and
  7. Smart advocacy – effective promotion of the profession to healthcare providers, administrators, and patients.

Concurrent with these advances, the Committee is spearheading the definition of Key Performance Indicators relevant to the medical physics profession (i.e., measures to define and quantitatively measure progress toward organizational goals), and seeks synergistic cooperation within the activities of AAPM councils and committees.

MP3.0 presence at upcoming conferences

At this year's Annual Meeting, we again will have a "MP3.0 Booth" (Level 3, across from the Exhibit Hall & Member Resources, Sunday, July 29 – Monday, July 30), where you are invited to join us for discussion and feedback. A workshop on "The Vision and Components of Medical Physics 3.0 Practice" (Thursday, August 2, 7:30 am - 9:30 am, Room 209) offers an opportunity for you to engage in "smart communication" as we discuss your concrete ideas to implement MP3.0 in practice. There is also a session planned at RSNA 2018 in Chicago ("Medical Physics 3.0: Re-envisioning Medical Physics in the Era of Value-based and Precision Healthcare," Course RC125, November 25, 2:00pm - 3:30 pm).

In a nutshell, while as medical physicists we have contributed tremendously to medicine, MP3.0 asserts that resting on our laurels is not enough. Through a myriad of activities, MP3.0 seeks to assure that in the future medical physicists will continue to provide and expand their valuable contributions to patient care and not be sidelined as an expensive luxury or, worse, as a mere technical exercise. We invite feedback, criticism, and collaboration from all physicists working in medicine as we continue to devise strategies to ensure the long-term vitality and responsiveness of the profession. Please join us!

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Comments (1)

Dr. McCollough

07-05-2018 21:51 PM

Thanks for all the effort of the Med Phys 3.0 team on these important issues.