Feasibility and Benefits of a Simplified Physics Direct Patient Care Protocol.

Abstract

To investigate the benefits and challenges of implementing a medical physics consult program in a small clinic. A simplified physics direct patient care (SPDPC) protocol was developed based on previously described programs. The program was streamlined to 1 consult with a physicist during a 30-minute time block. Nonemergent patients were offered the program on the day of external beam simulation and, if they indicated interest in 1 of 3 consults (virtual, day of sim, first day of treatment) via an initial survey, they took the short form of the Spielberger State-Trait Anxiety Inventory (STAI-6). At consult, the physicist provided a brief overview of treatment planning and quality assurance, answered questions, and provided a tour of the treatment room (virtual or in-person). Patients repeated the STAI-6, answered 2 emotional check-in and 3 technical satisfaction questions after the consult, and then repeated the STAI-6, 3 technical satisfaction, and 1 overall satisfaction question at the end of treatment (EOT). The SPDPC clinical trial ran for 2 years. Two hundred patients were offered participation and 45% (n = 90) enrolled. Of them, 67% chose a consult in person on their first day of treatment. Seventy-eight patients completed the consult and 65 completed the EOT survey. The anxiety score was (mean ± standard deviation) 32.1 ± 12.8 at baseline, 27.5 ± 12.0 after the medical physics consult, and 26.7 ± 9.0 at the EOT. The change in mean anxiety score from enrollment to after the medical physics consult was statistically significant (P = .0004), and the change from consult to EOT was not significant. The mean technical satisfaction score was evaluated on a 4-point Likert scale. After the medical physics consult, the mean technical satisfaction score was 3.82 ± 0.51 and at EOT 3.92 ± 0.19. There was no statistically significant difference between these 2 time points. Establishing a new clinical role for medical physicists in a small clinic can be challenging because of staffing resources and time restrictions. A SPDPC protocol allows smaller clinics to provide medical physics consults despite these challenges, while maintaining a similar positive impact to larger programs on the patient and their care experience.