Tuesday, April 26, 2005
Women are waiting weeks for a mammogram
"Women had to wait between 1 and 4 weeks for diagnostic mammography, designed to investigate a possible problem. For regular screening mammograms, women waited up to 8 weeks for an appointment.
Study author Dr. Carl D'Orsi of Emory University in Atlanta, Georgia said that he believed that over time, women might have an even harder time getting an appointment for a mammogram. And if women have to wait even longer for a mammogram, they may not get one at all, he said."
Hmm . . . perhaps this is because reading mammograms is a low-reward, high-risk field:
"Women had to wait between 1 and 4 weeks for diagnostic mammography, designed to investigate a possible problem. For regular screening mammograms, women waited up to 8 weeks for an appointment.
Study author Dr. Carl D'Orsi of Emory University in Atlanta, Georgia said that he believed that over time, women might have an even harder time getting an appointment for a mammogram. And if women have to wait even longer for a mammogram, they may not get one at all, he said."
Hmm . . . perhaps this is because reading mammograms is a low-reward, high-risk field:
A mammogram is an inherently limited study with relatively low sensitivity and specificity. Unfortunately, the public does not understand these limitations because the exam has been oversold as a diagnostic modality (We are told this is for the public’s “own good”). As a result, people have a difficult time understanding why breast abnormalities are “missed” or “misinterpreted” during routine mammography. Personal injury lawyers ruthlessly take advantage of this dilemma by scavenging mammograms involved in breast cancer cases. They prey on this ignorance by holding radiologists to impossible standards bolstered with retrospective analyses of mammograms done by venal physicians in their stable of experts. As a result, mammography is the single highest liability risk for radiologists (and the second highest risk in all of medicine). For a $15 reading fee, radiologists can face multi-million dollar lawsuits.
Posted by Kevin |
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Comments:
With that sort of risk/reward calculus it is a wonder any radiologists are doing mammograms at all.
If it is in fact the highest risk procedure (for the physician, not for the patient, as with many interventional procedures,) then it ought to cost more. That is only fair. Maybe they need to be subject to double readings, or perhaps to a tumor board-type panel, with a charge that better reflects the costs for that service.
If it is in fact the highest risk procedure (for the physician, not for the patient, as with many interventional procedures,) then it ought to cost more. That is only fair. Maybe they need to be subject to double readings, or perhaps to a tumor board-type panel, with a charge that better reflects the costs for that service.
# posted by 
: 8:07 PM
: 8:07 PM
On Tues, April 26, I saw my primary care physician in the morning because I had found a lump in my breast(50 yr old w/ family history of breast and other cancer). I had a diagnostic mammogram and ultrasound at 2 that afternoon in the Denver metro area. Seems like a very small sample in the article.
I had an annual screening mammogram set up for next week and had no trouble scheduling that either from about a month out.
I had an annual screening mammogram set up for next week and had no trouble scheduling that either from about a month out.
# posted by : 11:37 AM
: 11:37 AM
The reimbursement rate for screening mammography barely covers the cost of doing the service. Most mammographers survive only by doing more: diagnostic mammographs (the additional views that are needed when an abnormality, for which the reimbursement is somewhat better) and invasive procedures (mammotome biopsies, ultrasound-guided biopsies, etc.)
Given the risk-reward ratio, anonymous is right. It is a a wonder that any radiologists will do it at all. In fact, fewer and fewer are willing. As a surgeon, I'm having trouble getting wire localization biopsies (which require the radiologist to place the wire using mammographic guidance before the patient is taken to the operating room for the biopsy itself) in a timely fashion not because I don't have time but because there are too few radiologists servicing our hospital to do the localization.
It's only going to get worse. The latest generation of radiology residents is quite rationally eschewing such a high risk, low reward specialty.
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Given the risk-reward ratio, anonymous is right. It is a a wonder that any radiologists will do it at all. In fact, fewer and fewer are willing. As a surgeon, I'm having trouble getting wire localization biopsies (which require the radiologist to place the wire using mammographic guidance before the patient is taken to the operating room for the biopsy itself) in a timely fashion not because I don't have time but because there are too few radiologists servicing our hospital to do the localization.
It's only going to get worse. The latest generation of radiology residents is quite rationally eschewing such a high risk, low reward specialty.
