STANDARDS OF TRAINING FOR PHYSICIANS
FOR THE USE OF LASERS IN MEDICINE AND SURGERY
The American Society for Laser Medicine and Surgery recommends an applicant for hospital or other institutional privileges be familiar with the pertinent literature and have completed a basic training program devoted to laser physics, tissue interaction, safety, surgical techniques, and pre- and post-operative care. It is recommended that the initial program include clinical applications of various wavelengths in the particular specialty and hands-on practical sessions with lasers and their appropriate surgical or therapeutic delivery systems. A minimum of 8-10 hours is suggested by the ANSI standards with at least 40% of the time allocated to practical sessions. However, more time may be required to complete the basic course contents. Usually basic training is concentrated on one or more wavelengths. Subsequent programs covering different wavelengths or substantially different applications or devices may require more hours of training of which 50% of the time is dedicated to hands-on sessions. A small faculty-student ratio in the range of 1 to 3-5 is optimal. See the ASLMS Course Content Guidelines.
It is recommended that an applicant for privileges spend time after the basic training course in a clinical setting with an experienced operator (such programs are often called "preceptorship" training programs or "observation") when appropriate and practical. Several brief visits or a more prolonged period suffices, provided that a variety of cases is observed. It is valuable for the novice to perform the laser procedures with supervision by the expert; however, for a variety of reasons, such as hospital privileges, status of patients, and insurance coverage of physicians, this is not always possible.
In lieu of extramural course work and observation, an application should be considered for privileges after completing a residency program which has included significant laser training and practice. Individuals in training are urged to obtain laser experience as part of their residency wherever possible, especially if they believe they will ultimately apply for privileges. The program for training would be similar as outlined in paragraph 1.
Hospital privileges are and must remain the responsibility of the hospital or other institutional governing board. Physicians requiring privileges to use lasers should first meet all institutional standards with respect to Board certification, specialty training, ethical character, good standing and judgment and have interventional privileges in the specialty before requesting laser privileges. For example, a cardiologist should have coronary artery angioplasty privileges before requesting privileges for use of lasers in angioplasty procedures and, likewise, gynecologists requesting privileges for use of lasers in laparoscopic delivery for surgery should already have privileges and experience in operative laparoscopy.
It is recommended that office based facilities establish protocols and procedures for the purpose of credentialing within their practices. The protocols and procedures should be in compliance with the laws of each state and the Society’s guidelines. To maintain the delivery of the highest level of care, it is recommended that methods for continued quality assurance be in effect as per the guidelines outlined by the individual practice: