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.
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.
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.
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.