Comments on: http://www.kevinmd.com/blog/2005/04/women-are-waiting-weeks-for-mammogram.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Orachttp://www.kevinmd.com/blog/2005/04/women-are-waiting-weeks-for-mammogram.html#comment-52569 Orac Wed, 27 Apr 2005 23:53:00 +0000 http://clients.emmense.com/kevinmd/2005/04/18217.html#comment-52569 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.)<br/><br/>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.<br/><br/>It's only going to get worse. The latest generation of radiology residents is quite rationally eschewing such a high risk, low reward specialty. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2005/04/women-are-waiting-weeks-for-mammogram.html#comment-52568 Anonymous Wed, 27 Apr 2005 16:37:00 +0000 http://clients.emmense.com/kevinmd/2005/04/18217.html#comment-52568 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.<br/><br/>I had an annual screening mammogram set up for next week and had no trouble scheduling that either from about a month out. 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.

]]> By: Evan Allenhttp://www.kevinmd.com/blog/2005/04/women-are-waiting-weeks-for-mammogram.html#comment-52566 Evan Allen Wed, 27 Apr 2005 02:58:00 +0000 http://clients.emmense.com/kevinmd/2005/04/18217.html#comment-52566 I thought that the benefit of the US Healthcare system was its absence of such waiting times. I thought that the benefit of the US Healthcare system was its absence of such waiting times.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2005/04/women-are-waiting-weeks-for-mammogram.html#comment-52563 Anonymous Wed, 27 Apr 2005 01:07:00 +0000 http://clients.emmense.com/kevinmd/2005/04/18217.html#comment-52563 With that sort of risk/reward calculus it is a wonder any radiologists are doing mammograms at all.<br/>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. 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.

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