1 INTRODUCTION

Vendor‐provided commercialized equipment and software are well accepted in the medical physics profession, since they are designed to free up physicists’ time, improve workflow efficiency, and provide higher accuracy and precision. There have been clear lines dividing three parties, at least in the field of radiation oncology: patients, health care providers, and medical device suppliers. Medical physicists (and dosimetrists) are part of the health care providers group. One of their main duties, as defined by IAEA (International Atomic Energy Agency), is “mainly related to the safety and performance of related equipment and computer systems”.¹ Therefore, any financial relationship between medical physicists and medical device vendors should be clearly disclosed to avoid conflicts of interest (COI). However, in recent years, vendors of radiotherapy equipment and software are increasingly engaged in directly providing radiotherapy physics services to the clinic. This includes not only vendor‐sponsored equipment commissioning but also vendor‐employed dosimetrists conducting treatment planning (i.e., “software as a service” or “oncology as a service”) for radiation oncologists through its business subsidiaries.² The vertical integration of technical services, traditionally provided separately by vendors and clinical medical physicists or dosimetrists, may lead to unavoidable conflicts of interest and thus this parallel/opposed debate on the following opinion statement: Vendor‐provided clinical physics services are a disservice to patients and the medical physics profession.

Parallel to this opinion is Dongxu Wang^{1 1} Views and opinions expressed here are this author’s alone, and do not represent those of Memorial Sloan Kettering Cancer Center. Dongxu Wang discloses the following Conflict of Interest: the author is a beneficiary of an intellectual property licensed to Ion Beam Applications, S.A.
. Dongxu Wang received his PhD in Medical Physics from University of Wisconsin‐Madison in 2011. After graduate school, he joined the University of Iowa Hospitals and Clinics as an Assistant Professor in Medical Physics. At the University of Iowa, he studied part‐time and received his Master’s degree in Business Administration (MBA) in 2019. He is now Associate Attending Physicist at Memorial Sloan Kettering Cancer Center. Dr. Wang’s earlier expertise and focus were in proton therapy and proton imaging. Recently he became an active member of the Medical Physics Leadership Academy (MPLA), with a particular interest in using the case study method to advance the leadership and professionalism education for medical physicists.

Opposed to this opinion is Per Halvorsen. Mr. Halvorsen is the Chief Physicist for the Lahey division in Radiation Oncology at Beth Israel Lahey Health in suburban Boston. He received his MS degree in Radiological Medical Physics from the University of Kentucky in 1990 and was certified by the American Board of Radiology in 1995. He has been a member of the American Association of Physicists in Medicine (AAPM) for nearly 30 yr and has been an active volunteer in professional societies, chairing the AAPM Professional Council and serving on the Board of Directors. He has authored numerous peer‐reviewed manuscripts, recently as the chair of the Medical Physics Practice Guideline for Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT) and as a member of the ASTRO–ASCO–AUA Evidence‐Based Guideline for Hypo‐fractionated Prostate treatment. He is a volunteer surveyor for the American College of Radiology (ACR) and served many years on its accreditation program oversight committee. He is Deputy Editor‐in‐Chief of the JACMP, and a Fellow of the ACR and AAPM.

中文翻译：

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供应商提供的临床物理服务不利于患者和医学物理学专业

1引言

由供应商提供的商业化设备和软件在医学物理学界广为接受，因为它们旨在释放物理学家的时间，提高工作流程效率，并提供更高的准确性和精度。至少在放射肿瘤学领域，有明确的界线将三方划分为：患者，医疗保健提供者和医疗设备供应商。医学物理学家（和剂量学家）是医疗保健提供者小组的一部分。根据原子能机构（国际原子能机构）的定义，其主要职责之一是“主要涉及相关设备和计算机系统的安全性和性能”。^1个因此，应明确披露医疗物理学家与医疗设备供应商之间的任何财务关系，以避免利益冲突（COI）。但是，近年来，放射治疗设备和软件的供应商越来越多地直接向诊所提供放射治疗物理服务。这不仅包括供应商赞助的设备调试，还包括通过其业务子公司为放射肿瘤学家进行治疗计划（即“软件即服务”或“肿瘤学即服务”）的供应商雇用的剂量师。^2个传统上由供应商和临床医学物理学家或剂量师单独提供的技术服务的垂直整合可能会导致不可避免的利益冲突，因此，对以下意见的这种平行/对立辩论：供应商提供的临床物理服务对患者不利和医学物理学专业。

与这种观点平行的是王东旭^{1 1} 这里表达的观点和观点仅是作者的个人观点，并不代表斯隆·凯特琳纪念癌症中心的观点和观点。王冬旭披露了以下利益冲突：作者是获得Ion Beam Applications，SA许可的知识产权的受益人
。Wang Dongxu Wang于2011年在威斯康星大学麦迪逊分校获得医学物理学博士学位。毕业后，他加入爱荷华大学医院和诊所，担任医学物理学助理教授。他在爱荷华大学学习非全日制课程，并于2019年获得工商管理硕士学位（MBA）。他现在是Memorial Sloan Kettering Cancer Center的准主治医师。Wang博士较早的专业知识和重点在于质子治疗和质子成像。最近，他成为医学物理领导力学院（MPLA）的活跃成员，对使用案例研究方法推进医学物理学家的领导力和专业教育特别感兴趣。

反对这种观点的是Per Halvorsen。Halvorsen先生是波士顿郊区Beth Israel Lahey Health放射肿瘤学Lahey部门的首席物理师。他于1990年从肯塔基大学获得放射医学物理学硕士学位，并于1995年获得美国放射学委员会认证。他已成为美国医学物理学家协会（AAPM）的成员近30年，并且一直是专业协会的活跃志愿者，主持AAPM专业委员会并担任董事会成员。他撰写了许多同行评审的手稿，最近担任立体定向放射外科医学物理实践指南（SRS）和立体定向人体放射治疗（SBRT）的主席，以及ASTRO–ASCO–AUA循证医学基于证据的指南的成员分期前列腺治疗。他是美国放射学院（ACR）的自愿测量员，并在其认可计划监督委员会中担任了多年。他是JACMP的副主编，ACR和AAPM的院士。