Proton center staffing: A multicenter survey in the United States

Abstract Purpose: A survey was conducted to evaluate staffing among operational proton therapy centers in the United States. Methods: Seventeen operational proton therapy centers in the United States with multiple treatment rooms were contacted. Two separate questionnaires were generated for centers offering proton therapy only (Group A questionnaire) and centers providing both proton therapy and photon therapy (Group B questionnaire). The survey included questions on the relative full-time equivalent (FTE) for therapists, dosimetrists, physicists, and radiation oncologists, number of patients undergoing procedures, and number of treatment machines and imaging equipment. Results: Fourteen centers completed the questionnaire (response rate 82.3%). Among them, seven centers provided proton therapy only. The average daily patient per staffing ratios for therapists, dosimetrists, physicists, and radiation oncologists were 4.2, 8.8, 11.9, and 20.6, respectively, for Group A and 4.5, 12.4, 12.0, and 12.8, respectively, for Group B. When relative FTE for physicists was increased from 0.25 to 0.35 per proton treatment machine as a proposed modification to the ASTRO worksheet, predicted FTE for physicists compared well with survey data. Conclusions: There was a noticeable difference in the patient per staffing ratio between the two groups for dosimetrists and radiation oncologists. In contrast, a negligible difference was found for therapists and physicists. The 0.35 physicist FTE factor per treatment machine proposed in the revised ASTRO staffing model improves the accuracy of staffing calculation. Our study provides an important data basis for further discussion to determine mandatory minimum staffing levels in proton therapy.