Leading past COVID-19: An analysis of remote work now and beyond.

In response to the coronavirus disease 2019 (COVID-19) pandemic, many cancer centers and clinics deployed remote work options for their employees. Due to the rapid response needed during this crisis, little to no feedback was obtained from dosimetrists. This study aimed to assess the productivity level and job satisfaction of medical dosimetrists in response to changes in working conditions due to the COVID-19 pandemic. With the assistance from the medical dosimetrists certification board (MDCB), critical data was gathered via an original instrument conducted and distributed by The University of Texas MD Anderson Cancer Center-School of Health Professions to all current practicing certified medical dosimetrists registered with the MDCB. Data were collected using Qualtrics and analyzed with IBM's SPSS. Most (326, 77.7%) participants indicated they transitioned to a version of remote work due to COVID-19. Almost half of the participants (208, 49.5%) reported increased job satisfaction due to the option to work remotely. The participants reported being extremely satisfied with the individual (247, 58.8%) and department (201, 47.9%) productivity levels even after implementing remote work options. Most participants (225, 53.6%), independent of age and years of experience, would prefer to stay in a hybrid role even after COVID-19 abates. These findings suggest that most dosimetrists prefer to perform their job remotely or asynchronously. A one size fits all job model design may make it difficult for organizations to attract, retain, and grow top dosimetrists. Industry leaders and employers may benefit by embracing this change as dosimetrists may value work-set-up flexibility over other employer-based benefits. Further research is needed to assess the unintended consequences of remote work environments in this profession.

Young Adult Populations Face Yet Another Barrier to Care With Insurers: Limited Access to Proton Therapy.

PURPOSE: Young patients, including pediatric, adolescent, and young adult (YA) patients, are most likely to benefit from the reduced integral dose of proton beam radiation therapy (PBT) resulting in fewer late toxicities and secondary malignancies. This study sought to examine insurance approval and appeal outcomes for PBT among YA patients compared with pediatric patients at a large-volume proton therapy center. METHODS AND MATERIALS: We performed a cross-sectional cohort study of 284 consecutive patients aged 0 to 39 years for whom PBT was recommended in 2018 through 2019. Pediatric patients were defined as aged 0 to 18 years and YA patients 19 to 39 years. Rates of approval, denials, and decision timelines were calculated. Tumor type and location were also evaluated as factors that may influence insurance decisions. RESULTS: A total of 207 patients (73%) were approved for PBT at initial request. YA patients (n = 68/143, 48%) were significantly less likely to receive initial approval compared with pediatric patients (n = 139/141; 99%) (P < .001). Even after 47% (n = 35 of 75) of the PBT denials for YA patients were overturned, YAs had a significantly lower final PBT approval (72% vs pediatric 99%; P < .001). The median wait time was also significantly longer for YA patients (median, 8 days; interquartile range [IQR] 3-17 vs median, 2 days; IQR, 0-6; P < .001). In those patients requiring an appeal, the median wait time was 16 days (IQR, 9-25). CONCLUSION: Given the decades of survivorship of YA patients, PBT is an important tool to reduce late toxicities and secondary malignancies. Compared with pediatric patients, YA patients are significantly less likely to receive insurance approval for PBT. Insurance denials and subsequent appeal requests result in significant delays for YA patients. Insurers need to re-examine their policies to include expedited decisions and appeals and removal of arbitrary age cutoffs so that YA patients can gain easier access to PBT. Furthermore, consensus guidelines encouraging greater PBT access for YA may be warranted from both medical societies and/or AYA experts.

Confidence and proficiency levels of medical dosimetry graduates.

The purpose of this study was to examine the confidence and proficiency levels of medical dosimetry graduates as they transition from student to professional during their first employment as medical dosimetrists. In addition, this study explored the support provided by employers to assist those medical dosimetry graduates during this transitional period. With assistance from the Medical Dosimetrist Certification Board (MDCB), individuals who graduated from a Joint Review Committee on Education in Radiologic Technology accredited medical dosimetry program between 2011 and 2018 and earned MDCB certification between 2012 and 2018 were invited to complete an original survey detailing their experiences during their first employment as medical dosimetrists. Data were collected using Qualtrics and analyzed with IBM's SPSS. Most (93, 56.7%) participants indicated a moderate confidence level in their abilities to function as medical dosimetrists and suggested it took approximately 6 months (56, 34.1%) to feel confident in their role as medical dosimetrists in the professional clinical setting. Regarding treatment planning techniques, participants indicated low proficiency levels in proton beam and brachytherapy plans and high proficiency levels in 3-dimensional conformal radiation therapy, intensity modulated radiation therapy, and electron beam plans. These findings suggest that educators should consider strengthening curricula and offering additional clinical rotations specific to those areas that lacked proficiency. Most (128, 78.0%) did not complete a dosimetry-specific new employee training program, but believed such support would have been somewhat helpful (44, 34.4%) during their transition from student to professional. Hiring managers and dosimetry supervisors may find it beneficial to implement support measures to assist medical dosimetry graduates as they transition from student to professional.