I have great doctors, great insurance coverage, and go to one of the most highly regarded hospitals in the country. I am pretty privileged when it comes to medical care and since I've had periods of time in my adult life when I've been uninsured, broke, and under the care of a doctor I didn't trust, I do not take that for granted. Still, I came pretty close to waiting almost a year to be able to get a mammogram I really need to have right away.
That's right, a year.
My doctor gave me a list of three recommended mammogram screening centers. One is a private office where my insurance is not accepted and where I am invited to pay full price out of pocket (and would probably be paying out of my pockets for the next few years).
With that option scratched from the list, I called the second recommendation on the list. It is considered the breast health center in my city. An automated message blared through the phone telling me, "Due to a nationwide shortage of radiologists, we have an unusually long wait time for scheduling mammograms."
I prepared myself. My doctor warned me it might take a few months for me to get an appointment. What I wasn't ready for was the first available date the scheduler read off to me. She would be happy to put me down for the last week of January of 2010.
I declined the appointment time offered a year out, hung up, and dialed the third place on my list. I'd never heard of it, don't think it is affiliated with my hospital, and was more concerned about their wait time than their reputation, location, or any of those other logistical issues.
I easily got an appointment in a time slot less than 24 hours from when I called. I feel like I lucked out. And isn't that crazy? Isn't it odd that I should feel so fortunate to have a routine - and critical - exam within a year from the day my doctor tells me I should have it, and probably pretty soon?
This is not just an issue in my city. This is also an issue in San Francisco, where this piece that just ran in last Sunday's Chronicle says the shortage of radiologists is having a dire impact on the screening and treatment of women in need in California. A state-of-the-art breast center built with the intention of serving low-income women can now only serve half the patients it did when it opened five years ago. Back then, a woman could schedule a mammogram within a few weeks. Today, a lack of professionals legally qualified to read the scans has put the center and it's patients in crisis. It now takes 300 days for women to schedule a precautionary mammogram. What's even worse is that it takes 128 days for women who've felt a lump in their breast to be screened.
Those women, the ones who've felt a lump, are bumped up in priority for appointments. However, an aggressive tumor could grow enough to sharply impact the woman's chances of survival, according to Susan Brown, the director of health education for Susan G. Koman for the Cure. Isn't that terrifying?
Other facilities in California, just as I experienced in my city, can see women within a few days. However, it seems critical to understand how the shortage of radiologists has led to these ridiculous and threatening scheduling lags.
One reason, the article reports, is that radiologists are not compensated as well as other doctors, and that there is an increasing risk of being sued by patients who say breast cancer was not detected by the person who read their mammogram.
Whatever the causes, the trickle down effect for women - particularly for women who have few resources, little or no insurance coverage, not as many places to get a mammogram where they live, or any of the many obstacles to getting medical attention - is so frightening. This could be life or death for a woman. And that woman could be one of us.
I am going to go to my appointment today, breathe deeply, and pray that my breasts are healthy. And then I am going to have a moment of gratitude that someone in the office where I stand in a dingy green, open gown is there to read my results. When I do, I will hope that each of you can get a mammogram when you need one, too.
What's going on with getting a mammogram where you live? Have you had to wait a long time to schedule your scan?
Read more:
- Want to know when to get a mammogram? I found this quick-read article to be very helpful.
- Also, this Q & A on breast cancer risks is straightforward and still reassuring.
- Finally, these three personal stories are worth a read.
