A Mammogram As A Metaphor For Patient-Centered Care

Cheryl Clark, for HealthLeaders Media , May 19, 2010

Recently while at a health fair promoting Quakerbridge, Davis recalled talking with women about the benefits of same-visit results, and hearing them marvel at the possibility. "They said, 'Really? I can get the results before I walk out?' That's right, I said, and they said, 'Okay!'"

So why aren't more mammography centers more patient-centered, especially in this sensitive and emotionally-driven area? Why aren't same-visit results the standard? And with so many mammograms in this electronic age, why can't interpreters in distant locations instantly read the images via networks?

Turns out, the process of reading mammography is a bit more complicated for most centers. Carl D'Orsi, MD, co-chair of the American College of Radiology's Breast Imaging Commission, says centers find it more efficient to have separate teams of radiologists reading batches of screening mammograms versus diagnostic ones—those tests done when the woman detects something unusual. When the same radiologist is reading both types of mammograms, he says, "the accuracy goes down."

Most centers, he says, "don't have someone physically sitting there in a screening center."

That's certainly true in rural areas, which have to send images elsewhere in batches to be interpreted, Winchester says.

Susan Brown, director of health education for Susan G. Komen For The Cure says throughout the country "it's customary for women to leave their mammograms without having the results."

Brown says she understands how some women—women like me—might fret if they have to wait.

Brown says this worry may translate into many women not getting mammograms when they should. "It may mean next year they don't want to go through the hassle again. Maybe they've had good results for the last few years, and their concern was less, perhaps, than the degree of hassle they felt going through the process."

There may be good excuses why most centers can't give results right away, but with today's capacity for telemedicine and electronic images easily sent within moments of capture, perhaps more mammography results could be given more promptly. That would be a great way to provide patient-centered care.

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