While the radiation oncologist maintains the final responsibility for the patient’s treatment, the radiation oncology physicists is responsible for the physical accuracy of the doses delivered.
The radiation oncologist holds the responsibility for verifying the diagnosis and specifying the doses to be delivered to the treatment targets, as well as limitations on doses to critical structures.
The physicist, however, should be aware of whether the prescription for a given patient is consistent with previous, similar patients, and also consider possible critical, dose-limiting structures. Any inconsistency noted by a physicist should be discussed with the radiation oncologist
Physicist is responsible for the generation of possible treatment plans. The plans should evolve from, but not necessarily be limited to, those discussed with the radiation oncologist. The actual calculation of the dose distributions can be performed by other trained technical personnel, under the supervision of a physicist. Because of limitations of radiation therapy treatment planning computer systems, approximations may cause calculated dose distributions to differ from the actual dose distributions. The physicist is responsible for interpreting these calculations and advising the radiation oncologist where such differences may be clinically significant.
If any aspect of a treatment plan seems inappropriate to the point of being detrimental to the well-being of the patient or to the safety of the staff, and the radiation oncologist does not agree with such an assessment, the physicist has an ethical obligation to seek outside reconciliation of the difference of opinion