Mammogram Quality


Per a recent WSJ article,  there is new “research concluding that screening mammograms save relatively few lives from breast cancer while discovering many cancers that wouldn’t have caused problems if left alone.”  So, maybe the USPTF was not so wrong?  The bottom line is, just like in prostate cancer, no one can tell which cancers that are found are the aggressive ones. As of now, any finding on the mammogram forces us to be aggressive in treatment which could cause more harm than good.  Remember that old “First, Do No Harm” mantra we are supposed to live by?

But here is my favorite part of the article:

A growing number of doctors are rated—and compensated—on the percentage of their patients who are up to date on screenings.

Once again, the bogus quality indicator fad raises its ugly head.   These stupid P4P measurements are not proven and are always behind the scientific times.  So will a doctor order the test to make her numbers look good or will she tell the patient to wait on the mammogram?  I have a good idea what she will do and it involves money.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Mammogram Quality

  1. Kurt
    April 9, 2014 at 2:34 pm

    Ummmmm, One needs to tread lightly here. Until the ITB’s (Ivory Tower Bastards) can tell us
    “which” breast cancers are “no trouble”. Failure to diagnose carries a pretty hefty penalty.
    The ACS is still pushing the “self” exams.

    I’m reminded of a case that was discussed at a medical review course where a man in his 40’s got a PSA that was a “little” high but not acted upon by the physician. Three years later, it’s sky high and he has bone mets.

    Or the 19 year old female with metastatic cervical cancer who ultimately dies of the disease.

  2. Kurt
    April 9, 2014 at 11:09 am

    Should ding the patients who refuse a modicum of health maintenance and stop crapping on the docs.
    Am I the only one who has problems with diabetics not bringing their sugar diaries in so their treatment can
    be fine tuned? I do deal with a lower educated population and in spite of personalized, “typewritten by me” reminders handed to patients, the results are still abysmal.

  3. skssat
    April 7, 2014 at 9:37 am

    I recommend screening because I survived breast cancer, and I want my patients to know whether they have it and what their options are. Quality measures and studies recommending less frequent mammograms touted by insurance companies have nothing to do with it.

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