Medical physics is generally speaking the application of physics concepts, theories and methods to medicine. A Medical Physics department may be based in either a hospital or a university and its work would include clinical work and research and development. In the clinical areas, medical physicists are traditionally found mostly in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiation Oncology but areas of specialty are widely varied in scope and breadth e.g., clinical physiology and neurophysiology (Finland), audiology (Netherlands).
In the case of CLINICAL MEDICAL PHYSICS SERVICES the mission statement is as follows (Ref: European Federation of Organizations for Medical Physics, EFOMP, www.efomp.eu, ‘Guidelines on the Medical Physics Expert’ which is a project funded by the European Commission. Sub-section ‘Qualification and Curriculum Development Frameworks’ (Caruana C. J. et al)):
“Medical Physics Services will contribute to maintaining and improving the quality, safety, and cost-effectiveness4 of healthcare services through patient-oriented activities requiring expert action, involvement or advice regarding the specification, selection, acceptance testing, commissioning, quality assurance including quality control, and optimised clinical use of medical devices and regarding risks from associated Physical Agents (particularly though not exclusively ionising radiation); all activities will be based on current best evidence or own scientific research when the available evidence is not sufficient. The scope includes risks to volunteers in biomedical research, workers and public (when associated with patient safety and including carers and comforters)”
The term ‘Physical Agents’ refers to not only ionising radiation but also static magnetic fields, radiofrequency radiation, ultrasound, lasers and any other Physical Agents associated with medical devices. As stated in the introduction at the moment the profession is mostly concerned with those devices used in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiation Oncology and associated physical agents (ionising radiation in X-ray based imaging, radionuclides in Nuclear Medicine, magnetic fields and RF frequencis in MRI, ultrasound in Ultrasound imaging and Doppler cardiovascular measurement).
This mission includes the following 11 key activities:
1. Comprehensive Physics Problem Solving Service: Recognition of less than optimal performance or clinical use of medical devices, identification and elimination of causes, and confirmation that proposed solutions have restored devices and use to acceptable status. All activities are to be based on current best evidence or own scientific research when the available evidence is not sufficient.
2. Physical Agents Dosimetry Measurements: Measurement of patient (including volunteers in biomedical research), occupational and public doses (including carers and comforters ) and dose related quantities; selection, calibration, maintenance of dosimetry related instruments; independent checking of dose related quantities provided by commercial dose reporting or estimating devices (including software devices); measurement of dose related quantities required as inputs to commercial dose reporting or estimating devices (including software).
3. Patient Safety / Risk Management (including volunteers in biomedical research: Evaluation of clinical protocols to ensure the ongoing protection of the patient (including volunteers in biomedical research) from the deleterious effects of Physical Agents associated with the use of medical device in accordance with the latest published evidence or own research when the available evidence is not sufficient. Includes the development of risk assessment protocols.
4. Occupational and Public Safety / Risk Management (when associated with patient safety and including carers and comforters): Evaluation of clinical protocols to ensure the ongoing protection of workers and public (when associated with patient safety and including carers and comforters) from the deleterious effects of Physical Agents associated with the use of medical devices in accordance with the latest published evidence or own research when the available evidence is not sufficient. Includes the development of risk assessment protocols.
5. Clinical Medical Device Management: Specification, selection, acceptance testing, commissioning and quality assurance including quality control of medical devices in accordance with the latest published European or International recommendations and the management and supervision of associated programmes.
6. Clinical Involvement: Carrying out, participating, and where appropriate managing and supervising the everyday, routine and non-routine clinical radiation protection and quality control procedures to ensure effective use of devices and patient, staff and public safety including patient specific optimization.
7. Development of Service Quality and Cost-Effectiveness: Participation in the introduction of new devices and techniques into clinical service and new medical physics services whilst giving due attention to economic issues. Introduction of new devices and techniques should be based on current best evidence or own scientific research when the available evidence is not sufficient.
8. Expert Consultancy: Provide expert advice to outside clients (e.g., smaller clinics with insufficient in-house medical physics expertise).
9. Education of Healthcare Professionals (including Medical Physics trainees). Contribute to quality healthcare professional education through knowledge transfer activities concerning the technical-scientific knowledge, skills and competences supporting the clinically-effective, evidence-based and economical use of medical devices and safety issues concerning associated Physical Agents. Participation in the education of Medical Physics students and organization of Medical Physics residency programmes.
10. Health Technology Assessment (HTA): Take responsibility for the technical component of a Health Technology Assessment related to medical devices and /or Physical Agents and associated activities.
11. Innovation: Develop new or modify existing devices (including software) and protocols for the solution of hitherto unresolved clinical problems.
In the case of RESEARCH BASED UNIVERSITY departments the mission is wider and to emphasize this fact we often speak of BIOMEDICAL PHYSICS (formerly Medical Biophysics): Biomedical physics is the use of physics concepts, theories and methods for the greater understanding and development of clinical practice AND EXPERIMENTAL MEDICINE. This is a wider definition than Clinical Medical Physics Services and would include physics based aspects of life science research which would have a future impact on clinical practice (e.g., various forms of microscopy, nanodevices, spectrometry, biomolecular structure, cell biology physics). Most basic science departments within faculties of medicine / health science are now being grouped under the generic term ‘biomedical sciences’. Many biomedical physics departments today are of necessity multi-disciplinary and may include not only physicists but also engineers, mathematicians and sometimes chemists and physicians. (Ref: Caruana C.J., Wasilewska-Radwanska M., Aurengo A., Dendy P.P., Karenauskaite V., Malisan M.R., Meijer J.H., Mornstein V., Rokita E., Vano E., Wucherer M. (2008). The role of the biomedical physicist in the education of the healthcare professions: an EFOMP project. Physica Medica – European J of Medical Physics, 25, 133-40).
Areas of specialty
Para-sagittal MRI of the head in a patient with benign familial macrocephaly.
Used to monitor and measure various physiological parameters. Many physiological measurement techniques arenon-invasive and can be used in conjunction with, or as an alternative to, other invasive methods.