Re: population exposure

[Philip Hypes <phypes@lanl.gov>]

>In my understanding  there is a need to  improve the knowledge base on
>radiation matters in the medical  professions.

Most of the radiologists will be on the dosimetry program and will therefore
get annual training.  Anyone who gives the same annual training content to
a radiologist and the rest of the monitored staff needs to make some
changes.  When I gave rad training to radiologists, I spent more time on
risk to the patient than on their own risk;  they need the required reminders
about regulatory matters and ALARA, but talking to them about the exposures
they give patients is also a very important topic.  You can do a very good job
of this if you have ESE charts and other relevant data from your x-ray machine
surveys, Nuc Med surveys and dose estimates, etc.  With that information,
it's much less a theoretical discussion, despite the disclaimers about not
using general ESE calculations to assess precice (ha!) risk for an individual
patient.

  Also an specific training
>requirement needs to be identified  for public health physicians, who have a
>key role in allaying public anxiety, and for accident and emergency
>personnel who may need to deal with patients who have been accidentally
>irradiated or contaminated.

When the PM doc I worked for took his boards, there was a section on
radiation safety.  I don't know the details, but I imagine a PH doc who is
board certified would also have had to demonstrate some level of awareness
of rad health issues.  Anyone out there with more knowledge on this care to
comment?

As long as I'm typing, I'd like to point out that, as others have implied, an
RSO who tells a tech not to make exposures an MD has prescribed is, in
effect, practicing medicine (unless it's a matter of "none of the phototimers
work on that machine, and the kVps are all 20% low";  that's obviously not
what we're talking about here).  Doing so has legal ramifications that I, for
one, would not like to get caught up in.  On the other hand, sitting down
with the chief of radiology and going over the specific exposures in a
standard x-ray series, in a policy review sort of setting, is another matter
entirely, and if written up properly makes a good addition to the QA files.

These are merely my own opinions.
___________________________________________________________
Philip Hypes
Los Alamos National Laboratory
Safeguards Science and Technology Group (NIS 5)
(505) 667-1556  phypes@lanl.gov

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