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    Friday, June 11, 2004

    MedMal Crisis Update: The Institute of Medicine says that mammograms are getting harder to come by:

    For women who are seeking mammograms, the closure of scanning centers suggests 'a serious decline in access,' the report said.

    In parts of Florida, three-month waits for an appointment are common, the report said. In New York City, the average wait for a first-time mammogram is more than 40 days, compared with two weeks in the late 1990s.

    According to government inspection records, the number of mammography facilities has dropped by 8.9 percent since 2000.

    'We need to do something to address that,' Pisano said.

    The decline is thought to be due to low insurance reimbursement for mammograms, rising malpractice litigation and fewer radiologists choosing breast imaging instead of other specialties, the scientific committee said.

    The shortage comes even as more women -- an additional 1.2 million each year -- become old enough to need routine mammograms. Yet no more than three dozen breast-imaging subspecialists -- the radiologists with the most mammography expertise -- enter the profession each year.

    At the same time, the number of false-positive mammogram readings -- when something suspicious turns out to be noncancerous -- has nearly doubled, the report found. That may be due partly to radiologists practicing 'defensive medicine' in hopes of avoiding lawsuits."

    Litigation is no doubt playing a big role in radiologists' reluctance to make reading mammograms their livelihood. It's a perfect set-up for a malpractice disaster. Here you have a test that's done for one purpose only - to screen for cancer. But unlike other tests, such as a pap smear or a blood test, the finished product is there forever to be scrutinized with a retrospectoscope when cancer may pop up years later. The various shadows and shades of a mammogram are often difficult to interpret. Today's benign-appearing confluence of shadows can too easily become tomorrow's infant malignancy to the eyes of a trial lawyer's expert witness. Especially when that witness has the advantage of already knowing cancer was subsequently found there. It's kind of like looking at an optical illusion and not getting it until someone else points it out. Suddenly, what wasn't obvious is glaringly so. It's the nature of the beast. And it makes easy pickings for trial lawyers.

    UPDATE: CodeBlueBlog says that "mammactivists are also playing a role.

    posted by Sydney on 6/11/2004 07:32:00 AM 0 comments


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