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The Manpower Crisis in Medical Physics
These quotes were taken from publications and presentations authored by Ivan A.
Brezovich, Ph.D., Dept. of Rad. Onc., Univ. of Alabama at Birmingham,
Birmingham, AL 35233, Phone: (205) 934-1758, Fax: (205) 934-2546, e-mail:
ibrezovich@uabmc.edu, with permission.
- There is a shortage of highly skilled medical physicists
- “Above all, hospital administrators must recognize the new reality, that
the “a dime a dozen” oversupply of physicists has come to an end.”
- “Ever since radiation has been introduced into medicine, medical
physicists have been readily available to bring this lifesaving modality to
the patient. Only a decade ago, an ad in the AAPM Placement Bulletin brought
typically 20 responses, many from highly qualified, Board certified medical
physicists.” Some ads still generate 20 responses, the differences is in the
quality and or experience level of the candidates. To win in this war for
talent, you must utilize methods not thought of a decade ago. You must be
able to take your unique message directly to those in the passive job market
who are happy, not looking but are at least receptive to hearing about a
potential career enhancement. To do this requires not only the knowledge of
every facility and every professional in those facilities but the expertise
and manpower to make the necessary volume of personnel contacts with the
ability to convey the best message to attract the most talented and
qualified. Furthermore you must be able to match the uniqueness of the
facility to the professional’s wants, needs and desires.
- “The word “shortage” implies to most people that there is an
insufficient number of resources available, and one has no choice but to
accept – maybe lower quality – substitutes. You should therefore emphasize
that medical physicists are available…”
- “You may mention, that the supply of physicists will probably not
improve in the foreseeable future. This will put the ball into the
hospital’s court: if they hire an ersatz-physicist who causes
misadministrations, the hospital administrator will have to share the blame
for a costly rash of law suits.”
- Highly skilled professionals can impact the facilities’ ability to deliver
the newest and highest level of treatment, without significantly increasing
hiring needs.
- “While a simultaneous glut and shortage of medical physicists may be a
paradox of academic interest, its effect on patients is real. Radiation
oncologists are often limited in the sophistication of treatments they can
prescribe due to unavailable medical physics expertise. The situation is
especially regrettable since reimbursement from Medicare and private
carriers is generally sufficient to provide the very best patient care.”
- “Despite a commonly held belief that medical physics services are
bimodal, i.e., that all medical physics services are equal in quality unless
an outright mistake has been made, the outcome of radiotherapy depends in a
graduated way on the skill of the medical physicist. The reason for that is
the narrow therapeutic window in radiotherapy. A dose deficit of only 10%
can more than double the probability of tumor recurrence, whereas a similar
excess dose can lead to quality of life degrading side effects. The
necessary precision can be achieved only by a most competent physicist who
can devote sufficient time and resources to his work. The cumulative error
of machine calibration, inaccuracies in TMR measurements, output factors,
wedge factors, data entry into the treatment planning system, etc., can
exceed 10%, even if all individual steps are performed within acceptable
tolerances. It should therefore not be surprising that cancer death
increases when medical physics services rendered to patients are reduced
(New England Journal of Medicine 1992, Vol. 327, p.1499).“
- Because there is about 360 Medical Physicist Positions vacant, many
organizations are hiring unqualified or under qualified professionals instead
of changing the way they attract, recruit and retain the best and brightest.
- “Unqualified medical physicists. No exam can guarantee competency, and
Board certification is no exception. Nevertheless, absence of proper
credentials indicates a low level of experience and/or lack of dedication to
the profession. Given the chance, most patients would prefer being cared for
by a Board certified medical physicist rather than by one who lacks
certification.”
- “Consultants are typically hired to do specific tasks. However, unless
there is a long-term relation with a given consulting group, errors in the
process may go undetected. For example, a treatment planning system may be
recalled by the manufacturer, yet the information may not be transmitted to
the consultant, or the contract not include maintenance of the computer
system. Consequently, some treatment plans may have errors in them that the
recall was supposed to correct. During acceptance testing and commissioning,
a consultant may take the minimum amount of data specified in the contract,
rather than the amount of data required for optimum performance of the
treatment planning system.”
- “Beware of the lowest bidder. Due to the critical nature of healthcare,
Medicare and other carriers base their payments on a set fee schedule rather
than on an auction to the lowest bidder customary in other industries.
Selecting a medical physicist based on how low a salary he/she is willing to
accept violates this safety precaution and leads to the dreaded bidding wars
prevalent in HMO penetrated areas.”
- When positions stay vacant for long periods of time, patient care as well
as staff retention and moral suffers.
- “Excessive workload. Conscientious medical physicists resign when an
excessive workload downgrades the quality of care they can give to their
patients. In doing so, the burden on the remaining physicists goes up and
that can lead to additional resignations, and further drop in patient care.”
- 130 medical physicists leave the industry each year.
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