[kaldridgewv2211]

EC2 NMIS for radiopharm management
 
MIM has a theranostics component now.

[eunjoli]

Do you know if there are good resources on the process to get a license for a practice?

[mircea.cg_544]

Nuclear regulatory commission.
Good luck

[ruszja]

Depends whether you are in a ‘NRC state’ or a ‘agreement state’. In the latter you get your license from the state, not the feds. You need to have a ‘preceptor statement’ where someone tells the NRC that you received the required training. Usually that would be from the director of nucs at your residency. I know I am only on our license for I123 and Tc99m and I prefer it that way.

[aldoctc]

Quote from DrVoxel

Can anyone point me in the right direction in how I may be able to expand the service line of an oncology practice to include nuclear medicine therapy?

The practice does not have a nuclear medicine license and I am assuming I would have to apply for one and be the sole person supervising. How does one go about this? Is this the same as getting a RAM license?

After obtaining a nuclear license, what are the next steps in order to order the pharmaceuticals and administer the therapy?

Are there guides or consulting agencies which can help with this?

 
So from the original post, you’re an oncologist or employed by an oncology practice and want to add nuclear medicine therapies (e.g. Lutathera, Pluvicto, Xofigo, etc.) to an existing oncology practice? 
 
If so, this will be quite a project.  At a minimum, there will need to be an authorized user (AU; usually MD/DO with credentials and documented training in nuclear medicine therapy), a nuclear medicine technologist (to actually administer the radiopharmaceutical), and a radiation safety officer (RSO; mainly to handle the myriad regulatory issues/steps).  I suppose it’s possible for one person to be both NM tech and RSO, but I’ve personally never heard of it.  Most of the work will be on the admin/tech/logistics/site layout side of things, for which an experienced RSO (usually a medical physicist) is a huge help.  If the oncology practice is based at a large hospital, the easiest thing would probably be to use the radiation infrastructure and personnel already in place (i.e. if the system has a radiation oncology department).  The cardiology department probably has nuclear medicine capability (for diagnostic doses of Tc-99m sestamibi at least), and may be able to give some guidance as well.  Finally, you may be able to get some guidance from the radiopharmaceutical manufacturer as to what other practices in similar situations have been able to do.  
 
As for the AU side of things….  If the AU is a radiologist, there’s usually some attestation of training from the residency program they came from.  If proposed AU is from another specialty, they’ll probably need to have some ‘proctored’ cases under their belt from another AU and additional training documented.  Again, an experienced RSO would probably be able to give you guidance on this.  
 
Tangentially related to this…  Several years ago, I got a phone call from a local independent neurologist who wanted to put a SPECT scanner in his office (think Dr. Amen wannabe).  He needed to get an authorized user (AU) for his proposed setup and called to see if I’d ‘help.’  Said that we could discuss compensation and that “…it’s probably not much more than a signature on some paperwork” as far as actual work I’d do.  Of course, he was going to ‘read’ the actual scans.  After his pitch, I told him that it didn’t sound like he had any idea how much administrative work would be involved and that I didn’t appreciate being told that a significant part of my training and professional life had been characterized by him as “a signature on some paperwork.”  

[Unknown Member]

Nice post.
 
And accurate.
 
Looking in from the outside, it appears fairly straightforward.  But go behind the curtain…
 
To the OP:  If you didn’t get the AU credentials during training, prepare to appreciate all that goes into such a practice.