[ RadSafe ] Re: traveling after nucmed procedures

Carol Marcus csmarcus at ucla.edu
Sun Jul 24 10:12:02 CDT 2005

Dear George and Radsafers:

NRC has been told for years to increase the qualifications for physicians 
wishing to practice nuclear medicine.  However, NRC has to fund its 
deleterious "medical" program with User Fees, and these fees are already 
outrageously high and Congress does not want to see an increase.  If NRC 
quit selling licenses to poorly qualified physicians, it would lose a large 
amount of money, and have to lay off workers.  While I think that this 
would be terrific, NRC will never do this without Congressional action such 
as a law or refusal to approve NRC's "medical" program budget.  That's not 
going to happen without enormous pressure.  One is basically going up 
against the American College of Radiology and the American College of 
Cardiology, and that's tough.  By the way, one of the main reasons given by 
cardiologists for developing nuclear cardiology is that the diagnostic 
radiologists did such an unacceptably poor job of it, which was true.

NRC, in its recent revision of Part 35, decreased physician requirements to 
practice nuclear medicine, having been successfully lobbied by non-nuclear 
medicine physicians.  I personally believe that the radiation hazards of 
nuclear medicine procedures are virtually non-existent, but that the real 
danger lies in exposing unwitting patients to care by poorly qualified 
physicians who cannot offer the full spectrum of nuclear medicine procedure 
choice, cannot determine the appropriate way to perform the needed 
procedures, and cannot competently interpret the results, depending upon 
technologists for procedure choice and image interpretation, a function 
technologists are incapable of performing competently.  NRC therefore, in 
my mind, is a greater danger to public health and safety than the nuclear 
medicine materials it purports to regulate.

Nuclear medicine is the only medical specialty in which the standard of 
medical practice is malpractice, given the poor quality of many of the 
physicians that practice it.  We can thank the NRC for this.

And now, given that many technologists are basically asked to practice 
nuclear medicine by the unqualified physicians they work for, the techs 
have decided to develop a "supertech", analogous to a nurse 
practitioner.  Will NRC license these supertechs to practice nuclear 
medicine?  If NRC stands to make more money in User Fees, it probably 
will.  NRC has repeatedly shown itself to have no ability to intelligently 
regulate any kind of medicine or any kind of pharmacy, and I do not believe 
it should be permitted to do so.  This is not just my opinion---this was 
also the opinion of the National Academy of Sciences-Institute of Medicine 
in its 1996 study, "Radiation In Medicine: A Need For Regulatory Reform".

Ciao, Carol

Carol S. Marcus, Ph.D., M.D.
<csmarcus at ucla.edu>

At 09:21 PM 7/23/2005, George J. Vargo wrote:

>Carol and List,
>Thank you for speaking out on this.  I have found the  level of ignorance 
>among those authorized to administer diagnostic radionuclides to be 
>utterly appalling in many cases.  Patient information is nonexistent in 
>many cases, and some patients are given outright disinformation, which if 
>submitted to a regulator could be considered to be a material false 
>statement.  I have first hand experience that I can cite off-line.  Either 
>the medical community needs to raise the bar for minimum knowledge, 
>skills, and ability, or NRC needs to do it.  This cuts across both 
>physicians and technologists.
>George J. Vargo, Ph.D., CHP
>Senior Scientist
>MJW Corporation
>610-925-5545 (fax)
>vargo at physicist.net

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