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Federal Guidelines for Doctors Needed to Improve Mammography

In reaction to a New York Times three-part series that describes inadequate federal standards for doctors who read mammograms, Senator Barbara Mikulski (D-MD) plans to revamp legislation to ensure more stringent guidelines. Mikulski, who authored a law 10 years ago that focused on improving the mammograms themselves, has gained bipartisan support to study the situation over the next year and draft improved legislation. “Our original legislation was like Mammogram 1, and I’m very proud of our accomplishments,” Mikulski told the Times. “Now it’s time to go on to evaluating again how we can assure greater efficacy.” The federal government began setting minimum standards for clinics and their specialists more than a decade ago, after scandal rocked the mammography industry. However, with reluctance from the Food and Drug Administration (FDA) to regulate doctors’ performances, the federal government continues to limit its role to monitoring X-ray machines and reviewing basic paperwork. This all comes during a time when declining doctor compensation and high malpractice costs have made it so that generalists, with limited training and experience, make up the majority of the 20,000 doctors nationwide reading breast X-rays. While an accuracy rate of 85 percent is considered excellent for doctors reading mammograms, the Times found that some clinics are missing close to 40 percent of all cancers. A study published last month in the journal Radiology found that well-trained specialists discovered 76 percent more cancers than general radiologists who met only the minimum government standards, the Times reported. In today’s installment of the three-part series that first appeared in June, the Times profiles low-income patients who received free mammograms at a Bronx clinic that were inaccurately read. Although the two doctors at the clinic were well within federal standards, one missed 25 tumors in one group of patients. Eventually, New York state ended up making 25,000 phone calls to have patients retested. They were only able to track down half of the patients at the clinic. “Mammography is a poignant example of what’s wrong with our health care system,” Michael Rothman, a senior program officer at the Robert Wood Johnson Foundation, told the Times. “Shouldn’t American women have the right to know which clinics catch nine out of 10 cancers and which only catch five out of 10?”

Sources:

New York Times 10/24/02; Feminist Daily News 7/1/02