JCAHO etc.

["Michael P. Grissom" <MIKEG%SLACVM.bitnet@vmd.cso.uiuc.edu>]

1.  I noted Ted's comments regarding strange standards creeping into
JCAHO's thinking and think some history might be in order (JCAHO for
those curious is the Joint Commission on the Accreditation of Health
Organizations--I think--at any event the chief Hospital review body
in the US-->if you aren't accredited you can't get payments for
government supported care, i.e., Medicare, etc., and your facility's
medico-legal liability goes through the roof, etc.).

2.  Health Physicists have been engaged in radiation producing
machinery surveys in the Medical, Dental (and yes, Veterinary) medical
communities for many years.  As the use of radionuclides in Nuclear
Medicine, increasing RGD (Radiation Generating Devices) use in
Diagnostic and Therapeutic Radiology, and other locations
(Cardiology/Urology) began to proliferate whole new jobs came into
existence.  Some of these came from the biomedical engineering
community, some came from radiobiology programs, some came from
persons with classical physics training, some came from persons with
accelerator and solid state physics training, and some were health
physicists who in some form or other became medical physicists or
medical health physicists.

3.  The ACMP and the ACHP have in recent years (at least some of their
members), largely driven by the ACR mammography quality assurance
standards, begun to show signs of turf battling.  Some efforts have
been made to limit, for example, the ability of health physicists
(even if CHPs) to perform RGD surveys in medical environments, even
when they have been doing it for years!  The distinction, and in the
medical physics community the whole issue of state licensure, has been
somewhat divisive (although for most members of both the HPS and AAPM
it's not as burning an issue as some of the officers seem to expect!).
[By the way, as a member of both communities for several years, I look
forward to the joint meeting in Boston as a great opportunity to meet
old friends in both communities.  I think everyone will find a richer
program this year than in the past (even the power folks, trust me).]

4.  For these reasons, a whole new layer of qualifications has
appeared in all the various governing/regulating bodies.  At least it
sounds like the JCAHO may be trying to reduce that trend and move to
a higher level, but as in any program dependent on site visits by an
individual or group of individuals, a certain amount of
interpretation/subjectivity will still arise.
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The opions expressed above are those of the author alone and do not
not represent those of the Stanford University or the US Department
of Energy.
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