Tuesday, May 12, 2015

What is a medical physicist? Origins, word clouds, and perceptions

(This post was published on physicsfocus.org to celebrate International Day of Medical Physics, November 17 2014, http://physicsfocus.org/medical-physicist-origins-word-clouds-perceptions)

If you were to ask a stranger the question “What is a medical physicist?” in the early 1900s, you would be greeted with a blank or confused expression. Today (based on anecdotal evidence) that reaction has not evolved. But ask them who Marie Curie is…

7 November marks the International Day of Medical Physics. The day celebrates the birthday of a pioneer in the field, Marie Curie (1867–1934), recipient of the 1903 Nobel prize in Physics, shared with Pierre Curie and Henri Becquerel, and another in Chemistry in 1910 for discovering Radium and Polonium, and isolating and studying Radium.

Her career stimulated profound changes in diagnostic and therapeutic medicine. During World War 1, she help pioneered the concept of portable x-ray imaging—devices known as “Petite Curies”—throughout Europe. The impact of Radium in the treatment of cancer (via brachytherapy) cannot be overstated. She was a scientific pioneer in the truest sense.

In many ways, Marie Curie provides the perfect starting point in defining the core facets of a medical physicist. It all started with intelligence, innovation, critical thinking, and an undeniable passion for excellence.
Once it was realized that radiation could be used for so many helpful purposes, clinical medical physicists helped bridge the gap between clinical needs and available technology. By the mid-century, clinical support, technology adoption, and patient safety became important facets of a medical physicist. Today, with the advent of advanced technology and complex computerized imaging and treatment delivery systems, along with educational programs to foster emerging generations into the field, most Medical Physicists would find teaching, risk reduction, and quality control to be important aspects in their role.

Today, just as in the days of Marie Curie, the core facets of a medical physicist remain innovation, critical thinking, and a passion for excellence, but are now accompanied by a focus on patient care. So in many ways, while the technology has dramatically changed, the essence of what a medical physicist is has not.

A medical physicist may have a variety of roles. In the clinical setting, they are a part of the team of medical specialists that help ensure patients are diagnosed or treated safely. In the academic setting, they are scientists and engineers who are involved in the application of physics in medicine. Many academic medical physicists are heavily involved in the advancement and training of students within a variety of health care disciplines, ranging from technicians and technologists, to physicians, to healthcare administrators.

You will find great examples and definitions of a medical physicist on the Internet (see this excellent piece on the physicsfocus). For interest, shown below are word clouds displaying the top 25 words generated from web pages of each of a variety of medical physics organizations from around the world. As the word clouds evidence, the definition of a medical physicist’s role does not seem to vary between medical physics institutions, and this suggests some degree of global consistency.

WordCloud1
Word cloud from the American Association of Medical Physicist’s webpage on “What do Medical Physicsists do?” (https://www.aapm.org/medical_physicist/default.asp)

WordCloud2



Word cloud from the Australian College of Physical Scientists & Engineers in Medicine’s webpage on “What does a Medical Physicsist do?” (http://www.acpsem.org.au/index.php/home/careers-information/careers-in-medical-physics)

WordCloud3 
Word cloud from the Canadian Organization of Medical Physicists webpage on “What is Medical Physics?” (http://www.medphys.ca/content.php?doc=9)

WordCloud4 
Word cloud from the European Federation of Organisations for Medical Physicists (http://www.efomp.org/index.php/component/content/article/83-staticcontent/105-malaga-declaration)

Ask any medical physicist what they do and they will gladly fill your ears because they know the subject matter intimately. But what about those they work with? Medical physicists are commonplace in multidisciplinary environments, such as hospitals, research and educational hubs. There is constant mingling with people in different vocations and specialties. What about their perceptions on what a medical physicist is?

As an experiment, I took the opportunity to walk around my clinical environment, which consists of therapists, secretaries, nurses, doctors, electronics and mechanical technologists (basically anyone I could find) with a simple mission: to ask “What is a medical physicist?” and see where the responses took me. The responses were revealing:
“They support clinical programs, and keep the place going.”
“They take care of the equipment, plan patients.”
“I really had no clue on what medical physicists do until I started working with them, and now I appreciate how much they actually do.”
“It’s mysterious stuff, like the Twilight Zone.”
“They’ll check things and look at stuff.”

“Take care of hotlabs, do stuff with phantoms, invent crazy contraptions, and boss people around.”
“They’re these hermits that only come out at the end of the day and steal our chocolates at night.” 
“They’re smart folks who tend to answer all questions by including the word ‘Scatter Dose’.”
“They’re the guys that make sure that neither the doctors nor the people operating health care equipment hurt people.”
Apart from the teasing and good humour, what is striking is that many of the responses capture the essence of what a medical physicists does on a daily basis, albeit in a non-specific way. Some of the nouns and verbs used to help describe what medical physicists do were not obvious in the word clouds—“patients”, “innovation”, and “smart”, for example. There is also a sense that some education (or perhaps re-education) for our colleagues on what medical physicists do would be helpful. I would be hard-pressed to believe that these responses are unique to our centre. This reveals some differences in how medical physicists define themselves, and how allied professionals perceive them.

The reality is that, in the clinical setting, the medical physicist is a small but important cog in the giant machine that helps deliver safe healthcare. That machine relies heavily on trust and partnerships between different vocations and fields of study, with a focus on patient care.

Fostering and developing those partnerships and relationships should be a priority for medical physicists. Celebrating International Day of Medical Physics, and sharing that celebration with colleagues seems a fitting way to help facilitate and enhance those relationships, while paying respect to a pioneer in the field who help make it all happen in the first place.