Women Waiting Longer for Mammograms

Aug. 23 -- During a routine physical exam last April, Joan Whitlock's doctor felt a lump in her breast. But when her doctor tried to schedule a diagnostic mammogram, the first available appointment was in July — a three-month wait.

"The first thing I wanted to do is cry, I think, because when you have a lump, you think cancer," she recalls. "It is very, very unnerving to have to imagine what is going on in your body. And you know it is not going to be a good thing."

Whitlock is not alone. All across the country, women are being forced to wait up to five months for a mammogram. And it is getting worse, as more and more mammography centers close their doors — a potentially fatal trend.

"Fewer breast cancers will be diagnosed early," says Dr. D. David Dershaw of Sloan-Kettering Memorial Hospital in New York. "Women who might not have died of the disease, in fact, will now die of the disease."

Why are so many radiologists getting out of mammography? Because it doesn't pay. Medicare reimburses at a rate of $69 per mammogram, and it has proposed cutting funds even more. Private insurers pay even less. Physicians are losing as much as $30 a patient.

"If you lose money on every mammogram you do, how can you keep a facility open?" asks Dr. Judy Destouet, a radiologist at Franklin Square Hospital in Baltimore.

She says the low reimbursement is just part of the problem. "With every mammogram I read, I face the possibility of being sued," she says.

Wait Getting Longer and Longer

Although mammograms are imprecise and miss 10 percent of breast cancers, patients often blame the doctors, who are already caught in the middle.

"These people are petrified about the potential diagnosis of breast cancer," says Destouet. "And now you are telling them that you found something wrong and make [them] wait."

And wait and wait.

"From the time of discovery of a lump to a mammogram to an appointment with a surgeon to a scheduled surgery to actually getting it done is getting longer and longer," says Dr. Judith Luce of San Francisco General Hospital. "And that is bad."