Mammography May Improve by Addressing the Doctor Factor

In a two-part series last week, The New York Times reported that despite increased federal standards for mammography, an X-ray system used to detect breast cancer, doctors are failing to give accurate examinations to most women. “Far from ensuring high-quality mammography for all, many experts acknowledge, the system has promoted mediocre care for all but an elite, or just plain lucky, few,” The Times stated.

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.

In part two of the series, The Times profiles a mammography program in Denver headed by Dr. Kim A. Adcock, chief radiologist for Kaiser Permanente Colorado. In a transformation that started seven years ago, Adcock bravely made a decision to track his doctors’ performance. Requiring his doctors to follow patient status over time, read thousands of mammograms per year, participate in expanded training and take competency tests at least three times a year, Adcock’s program today boasts 80 percent cancer detection in women taking regular exams. Studies conducted at clinics in North Carolina and New Hampshire show detection levels between 60 and 70 percent.

Adcock’s concept is catching on. “Kim Adcock is at the cutting edge of everything in radiology,” Dr. William E. Drobnes of Kaiser’s Maryland affiliate told the Times. “And I’m shamelessly trying to steal this.” Approximately 192,000 cases of breast cancer are diagnosed every year in the US. For more information, see The Feminist Majority’s Breast Cancer Info Center.


NY Times 6/27/02, 6/28/02

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