As the radiation oncology community gathers in Boston for ASTRO, our September User of the Month is a wonderful reminder of why new technology matters: not simply because it is new, but because it gives busy clinical teams more time for the work that truly needs their expertise.
Richard Wall is Lead Certified Medical Dosimetrist at North Mississippi Medical Center (NMMC) Radiation Oncology in Tupelo, MS. His career has taken him from the ER and fluoroscopic simulation in the “ancient times,” as he calls them, through CT simulation and on-the-job dosimetry training to becoming a CMD in 2007. More than 35 years later, he still values the opportunity to help patients through some of the hardest moments of their lives while continuing to learn new techniques and technologies.
NMMC is one of the largest rural healthcare systems in the United States, treating approximately 100 radiation oncology patients each day across two clinics. The department operates three Varian TrueBeam systems and fully utilizes ARIA and Eclipse. As treatment planning has become more complex, with a growing number of SRS and SBRT cases, the dosimetry team has expanded from two to three members. With 30–40 scans each week and many previously treated patients, efficient workflows help the team reduce repetitive tasks while keeping clinical judgment firmly at the center.
Before Radformation, the department relied on what Richard describes as a “hodgepodge” of double-checking and document-generation tools. Treatment documents required a combination of Eclipse-generated reports and creative screenshots, while field-in-field planning could be cumbersome and inconsistent. Today, the dosimetrists extensively use AutoContour, EZFluence, ClearCheck, and ClearCalc, while the physics team manages RadMachine.
AutoContour supports contouring, planning structure generation, image registration, and deformable dose summation for re-treatment cases. EZFluence is used for almost every 3D plan, making tangent breast planning faster and more consistent. As Richard explains, "EZFluence has made tangent breast planning extremely quick and easy."
ClearCalc has also been “such a great relief” for photon second checks, particularly for small-field brain SRS and lung plans. Richard adds, "I have yet to get a disagreement on a plan calculation from ClearCalc. And the best part - it is all seamlessly integrated through scripting within the Eclipse API."
Asked which solution he would find hardest to give up, Richard has no hesitation: "ClearCheck, without a doubt. That single script has saved SO much time in document generation, which had been the most monotonous, time-consuming part of treatment planning." He describes ClearCheck as a "quantum shift" in the department’s workflow, bringing greater speed and consistency to plan checks while helping identify mistakes or oversights before they could affect treatment.
For a busy department, every minute saved on documentation and routine checks is time dosimetrists can return to complex planning, physician collaboration, and supporting treatment delivery.
For Richard, the repetitive task he is happiest to hand over is an easy choice: "Documentation generation, without a doubt. No one enjoys that process." He also believes autocontouring has improved to the point where it is genuinely worthwhile and continues to get better.
The value goes beyond saving time. "Document generation keeps coming up, but it saves SO much time," he says. "And yes, it has caught many mistakes and oversights before they became issues with treatment." Although Richard is an enthusiastic advocate for automation, he believes it delivers the greatest value when supported by sound processes, clear communication, and team commitment. "Automation is only as good as the process it is built around." It is a wonderfully dosimetrist answer: embrace the efficiency automation brings while keeping clinical expertise and professional judgment at the heart of the process.
Outside work, Richard enjoys traveling, the occasional round of golf, spending time with his family, and 3D printing, which he finds relaxing. He has even printed and finished an entire Stormtrooper and Darth Vader from Star Wars. "Yes, I am a nerd," he admits. "A lot of us dosimetrists are, you know." Richard also holds an FAA license as a small unmanned aircraft system remote pilot and enjoys drone photography and video work for real estate as a side gig.
And if retirement really did arrive tomorrow? Richard would first work out how to afford health insurance, buy a lake house, and fund the vacations. Then, in his words, "I’d figure out that retirement really wasn’t tomorrow, and I’d get up and go to work."
Richard describes Radformation’s impact in three words: "consistency, simplicity, and trustworthy." Technology has not replaced the expertise of the NMMC team. It has helped protect their time so they can use that expertise where it matters most.