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Mammography Continues to Be Threatened

How our best defense against breast cancer is being driven to extinction.

Punta Gorda, FL — In 2006, the American Cancer Society reports more than 212,000 new breast cancer cases in women will be diagnosed, and 40,970 will die of the disease. Early detection of breast cancer can make the difference between life and death.

However, women also need to be aware that malpractice litigation is driving mammography toward extinction. The number of women needing regular mammograms outpaces the capacity of the dwindling ranks of radiologists able and willing to read a mammogram. Radiologists across the country, faced with the prospect of litigation and the high cost of malpractice insurance, are now refusing to read mammograms. Radiology residents are passing over specializing in breast imaging, and over 700 mammography centers across the United States have closed their doors in the last few years.

President George W. Bush recently stated in his State of the Union address that we need liability reform. But, until then, good physicians are still being sued. While there is reform legislation under debate in states nationwide, pressure from the litigation industry continues to thwart efforts to set limits on damages and put other controls in place. For the small amount radiologists are reimbursed for mammography compared to the fear of being sued and the possible million dollar payouts, they are justifiably deciding it is not worth it.

Mammography is still the only reliable tool available to diagnose breast cancer in its earliest and most treatable stages, though it can have up to a 30 percent miss rate. In The Death of Mammography (Caveat Press 2006), co-authors Rene' Jackson, R.N., B.S.N., M.S., and Alberto Righi, M.D., present a sharp critique of the failures of the medical liability system in the United States, as it pertains to "failure to diagnose breast cancer on mammography" litigation.

The Physician Insurers Association of America (PIAA) reports that since 1985 over $304 million has been paid on behalf of physicians nationwide on claims related to cancer of the female breast. The Center for Legal Policy (CLP) at the Manhattan Institute says that currently, out of the total U.S. tort costs of over $200 billion more than 2 percent of the gross domestic product (GDP), trial lawyers gross $40 billion a year in revenues, or 50 percent more than Microsoft or Intel and twice that of Coca-Cola. It also says that the lawsuit industry is increasingly sophisticated in targeting its customer base through the Internet and traditional media outlets, and its government relations and public relations arms are the most powerful of business lobbies.

Anti-tort reform organizations such as The Center for Justice and Democracy (CJD) counter that the insurance industry is responsible for the skyrocketing insurance rates driving radiologists out of business. However, The Capital Research Center, an education and research organization, reported recently that CJD published a 50-state study claiming that jury verdicts do not influence the insurance rates paid by physicians, and that lawsuits don't drive insurance rates. A General Accounting Office (GAO) Report released in June 2003 refutes this claim.

Rene' Jackson, R.N., B.S.N., M.S., is a special procedures nurse at Charlotte Regional Medical Center in Punta Gorda, Florida, and the author of more than forty healthcare articles.

Alberto Righi, M.D. is the medical director of a radiology group in Florida. He obtained his M.D. at the University of South Florida; his radiology specialty at Tulane; and his neuroradiology specialty at the U. of Miami.

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