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Re: Mammograms From: art fougner, md (evsono@pipeline.com) Fri Jun 11 07:44:36 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Braun, R. Daniel: "Leff Forceps" Previous message: art fougner, md: "Re: Mammograms" In reply to: art fougner, md: "Re: Mammograms" Next in thread: ainsron: "Re: Mammograms" Mammograms in the news - Mammograms Harder to Get, Report Finds By THE ASSOCIATED PRESS ASHINGTON, June 10 (AP) - A shortage of providers is threatening women's access to mammograms, a federal health advisory panel said in a report released Thursday. The number of mammography sites has dropped more than 8 percent since 2000, to a total of 8,600 around the country. In parts of Florida, three-month waits for an appointment are common, the report found. In New York City, the average wait for a first-time mammogram is more than 40 days, compared with two weeks in the late 1990's. The scans, while imperfect, remain the best method for detecting breast cancer when it is most treatable, the panel, the Institute of Medicine, said. The group recommended improving access through steps like allowing specially trained nondoctors to help radiologists do the work. "Mammography saves lives and we need to figure out a way to get it to more patients, more uniformly," said Dr. Etta Pisano, chief of breast imaging at the University of North Carolina, an author of the report. But the American College of Radiology immediately criticized the idea of letting nondoctors, even those given extra training, play any role in reading mammograms. "We should not lower the bar so that women have a perception of increased access, only to find that the access is to inferior care," Dr. James Borgstede of the radiology group said. Fewer radiologists are specializing in breast imaging because of long hours, low reimbursement, heavy regulation and fear of lawsuits. Only about 60 percent of the women old enough for routine mammograms get them, and every year, 1.2 million more women turn 40, the age when some groups suggest they should begin getting the tests. Lack of insurance, lack of a system for notifying women to have a checkup and fear about breast cancer detection all play a role in the problem, the institute's report says. At the same time, it found, women have a 1 in 10 chance of a suspicious spot on the mammogram turning out to be noncancerous, so-called false-positive readings that have nearly doubled since the 1980's. That may be due partly to radiologists' practicing "defensive medicine" in hopes of avoiding lawsuits, but it leads to costly, unnecessary repeat testing. art http://www.nytimes.com/2004/06/11/health/womenshealth/11mammogram.html?amp;ei=5062&en=45522b038a6b2eaf&partner=GOOGLE&ex=1087531200&pagewanted=print&position As an aside, you should thank god your patients can still get mammograms on a timely basis. Six centers that I know of in Queens have closed. High Risk and Low Reimbursement, as we well know, is NOT a business plan. At Fri, 11 Jun 2004, art fougner, md wrote: > >Have you communicated your reservations with them? If so, what was their >response? > >art > >At Thu, 10 Jun 2004, Dr. Ainsworth wrote: >> >>One of our local mammogram clinics has recently indicated that they want >>me to order diagnostic mammograms on all patients who have a history of >>breast cancer, not screening mammograms. My feeling is that screening >>mammograms are indicated as a first step on all patients without signs >>or symptoms that warrant extra views. They point to a Medicare >>publication that states that a radiological mammogram is a covered >>diagnostic test in patients who have a history of breast cancer. This >>Medicare bulletin is from 1978, and to me, their use of this argument is >>simply revenue enhancing, not based on EBM. I have no problem ordering >>diagnostic mammograms when indicated, but I resist the idea of extra >>views in asymptomatic women who have had breast cancer several years ago >>and are clinically free of disease or suspicious areas. Is anyone else >>getting or sees a good reason for getting diagnostic mammograms in this >>subset of patients? > >-- >art fougner, md >ich bin ein New Yorker > -- art fougner, md ich bin ein New Yorker Next message: Braun, R. Daniel: "Leff Forceps" Previous message: art fougner, md: "Re: Mammograms" In reply to: art fougner, md: "Re: Mammograms" Next in thread: ainsron: "Re: Mammograms"

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