Tuesday, May 23, 2006

Women's Health Needs Help!


I'm in my early 20s and I can name three girls off the top of my head that have had breast lumps removed. All, have thankfully been benign, but lumps are simply not dealt with lightly anymore, even in 20 year old women.

You'd think with all the pink ribbon bonanza and breast cancer awareness, research etc that we could rest easy, right? No need to worry about the cause. I mean, you can find pink ribbon jewelry, candles, pins, picture frames etc. And all those high profile commercials on TV advocating mammograms and early detection. Breast cancer is not a back-burner issue by any means.

We are told that one in 8 American women will be stricken with invasive breast cancer in her lifetime. So consequently, we take any lump seriously, we donate to the cause and wear our pink ribbons proudly.

I thought we were doing all we could, until I read June's issue of "Marie Claire" magazine.

An investigative piece revealed the puzzling fact that it's easier to schedule yourself for breast augmentation surgery than schedule your mammogram!

The reporter attempts to schedule an appointment with a plastic surgeon in New York City. She calls two separate offices and finds that she can see a doctor as soon as tomorrow and can have a new set of breasts anywhere from 4 weeks to 3 months from now.

However, when she places a call to "a leading New York City Hospital" she's told she has to wait SIX MONTHS for a mammogram. A call is placed to another hospital, where she leaves her information on an answering machine but never receives a call back. A third facility says the wait will be two months. When the reporter tells them, "But I found a lump," the woman says there's nothing she can do; it will still be a two month wait.

According to this article "early detection facilities for breast cancer have been closing rather than opening!"

The American College of Radiology says that facilities that perform mammograms have dropped 9% from 2000 to 2004.

This is likely due to the money factor because mammograms lose money not MAKE money for a hospital.

From Marie Claire:

"In 2005, 63% of radiology facilities lost money on the procedure while just 29% broke even on it. Insurance companies reimbursement rates do not fully cover the cost of performing the procedure- partly because of the high insurance premiums radiologists themselves have to pay for performing mammograms. According to the Physician Insurers Association of America, misdiagnosed cases of breast cancer are the leading cause of diagnostic malpractice claims (Mammograms miss 10 to 15% of cancers)."

How to look out for yourself:
When you're getting your current mammogram, don't leave the doctor's office without scheduling your next one!

The cold hard truth is that in our society, cosmetic surgery to enhance our breasts is more readily avaliable than a relatively simple procedure to prevent cancer and save a life.

****
Pick up this issue of Marie Claire (it features Julia Stiles on the cover). Other great investigative pieces show that:
-- It can take only 30 minutes to get a gun and yet 4 weeks to issue a restraining order!
and
-- You can get heroin in 35 minutes while is takes 72 hours to fill Emergency contraception!

5 comments:

Tyler M Tupa said...

Where exactly are you getting heroin? If you bought EC on the street, I bet you could get it quick too.

In fact, that's probably what we're coming to.

Tobes said...

You're right... It is a comparison of buying heroin on the street vs. filling a prescription, but think about it.... This points out that a woman can get heroin no big deal, in 35 minutes. I mean, she bought if off a man on a busy streetcorner in broad daylight.

While at the same time, a woman has to go to 3 different pharmacies and is treated like a criminal for even asking for something LEGAL. It shows the insane hypocrisy of it all.

Women shouldn't have a harder time filling a legal prescription than buying an illegal drug from a street dealer. It's insane!

zZz said...

I must live in healthcare nirvana.

My wife is an x-ray tech and does about 35 mammograms a day and at least once a week she has someone come in at five o'clock and want a screening. They don't turn away patients. This is not to mention the many walk-ins during the day that have to be squeezed in to the regular schedule. My wife has worked in places where they take two hour lunches and leaving an hour early is "ok" if you have something to do. I guess these can be great places to work but they pay less and the patients are the ones that suffer. I don't know but I suspect that is the attitude at the place that wanted to schedule that lady 2 months out when she felt a lump.

Where my wife works, if you feel a lump you can walk in and you will be squeezed in at the first available opportunity, it may be a couple of hours but they get you in, then the x-ray tech walks back to the radiologist and has him read the image and if it shows something that is suspicious the radiologist talks to the lady and they usually do a biopsy on the spot. They don't waste any time at all. If it is malignant they do surgery the day after the determination if at all possible.

I guess either New York City has an awful healthcare system or the reporter had some extremely bad luck.

As for profitability of mammograms let me run some numbers by you. My wife is scheduled to do exams every 10 minutes for 8 hours, counting no-shows and days that just aren't filled she averages 35 exams per day over time. Each exam costs $125.00 the reading of the exam is separate and that is how the radiologist is paid. So you have a couple of receptionists a nurse that splits her time with the ultrasound group next door and 2 other x-ray techs.

35x$125= $4375.00 billed per day on average. 250 work days a year means she is doing exams that bring in just over 1 million dollars per year. They have 2 other techs that are doing the same there. They also do other procedures such as biopsies and different kinds of exams that take longer but they cost much more.

My wife came in worried one day because the department head came by and had a meeting with the whole crew and talked about the "numbers" being down, so I sat down and ran the numbers. She doesn't worry anymore and after talking to the supervisors about those numbers the issue doesn't come up anymore. Diagnostic imaging is a very lucrative business, if a hospital can't make money with numbers like that they have management or bookeeping issues.

Tobes said...

Well it's very nice that your wife is having a different experience. But your wife is an x-ray tech, not a hospital administrator or an insurance company...

While her hospital seems to be doing well, the overal percentages...

"In 2005, 63% of radiology facilities lost money on the procedure while just 29% broke even on it. Insurance companies reimbursement rates do not fully cover the cost of performing the procedure- partly because of the high insurance premiums radiologists themselves have to pay for performing mammograms. According to the Physician Insurers Association of America, misdiagnosed cases of breast cancer are the leading cause of diagnostic malpractice claims"

...show a different story. I was at my own hospital just today and am informed that mammogram screening is a touch business.

ESPECIALLY SINCE THESE TESTS ARE AT RISK OF LOSING COVERAGE FROM INSURANCE! See previous post "Insurance woes" in fact in the state of Utah, mammograms are not even covered currently.

So unfortunately, the majority of situations are not as rosy as you assume. The example of one x-ray tech can not mean that this is not a big deal. It simply means, your wife is apparently seeing the small percentage where things happen to be working out.

zZz said...

Heh, I was not saying that some places are not losing money, or that the article was incorrect, what I am saying is that my wife and I have seen both sides of the picture. A facility that does mammograms can make money if managed correctly. If you are doing mammograms as a side business just to keep all of the business "in house" then you have to take the good with the bad.

Just think about the numbers for a second. An x-ray tech doing mammograms can generate in excess of $1,000,000.00 of billables per year. Each. That is a staggering sum. If you can't make money with those numbers you can't make money.

I went back and dug out the bill for my wifes last screening, the bill was for $154.25, my insurance covered $124.00 and I picked up the rest. That puts the $1,000,000.00 quoted above as a low side estimate.

When I hear a someone complain about how tough business is I always take it with a grain of salt. And always run the numbers!