RESUMEN
A freestanding Gamma Knife radiosurgery center has been open for just over 1 year in La Jolla, Calif., USA, located in the grounds of a medium-sized community hospital. The center employs a full-time medical physicist and neurosurgical nurse together with clerical personnel. The neurosurgeons and radiation oncologists are drawn from the entire community and bill their fees separately. Written protocols for each indication to be treated govern patient eligibility and suggested treatment algorithms. Additionally, each patient to be treated is presented in conference, and a treatment strategy (i.e., radiosurgery, craniotomy, conventional radiation therapy) is decided. Twenty new physicians and physicists have begun training to use the Gamma Knife in the first year. Certification must be achieved before a clinician can be physician of record.