Submitted by Art Fougner MD, May 8, 2008 08:54

Women in the Boro of Queens are waiting up to six months or longer for mammograms. The longer wait times have been shown to discourage actually getting the necessary screenings. Why are waits so long? Reimbursement is surely part of it, for reimbursement by payers often do not cover the costs of providing the service, especially if extra views are needed. But it's not merely the reimbursement that's the problem. Fewer young physicians are pursuing careers in Breast Imaging because Failure to Diagnose Breast Cancer is one of the top causes of action for a malpractice suit.

One large local radiology practice has been trying to recruit more radiologists to read mammograms for a year without success. Put simply, Mammography is risky business. Breast cancer has an incidence of around one in ten women. Mammography has a sensitivity of 85%. Statistically, that's a very good test. However, that means that 15% of cancers are missed — false negatives. A 15% miss rate with a high incidence cancer means a high incidence of lawsuits. With fewer and fewer Queens docs reading mammograms, some centers have closed their doors. No matter how one feels about malpractice, the situation is having a deleterious effect on the women's healthcare. Something clearly needs to be done about this dysfunctional system. Doctors cannot solve this problem. Only Albany can solve this problem — a problem which has festered for over 30 years. Who will step up to the plate? Anyone?

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