To the editor:
Dr. Barbieri’s January 2004 editorial, “Low reimbursement + excessive liability = long waits for mammography” reminded me that approximately 700 mammography centers have closed in the past 2 years. We all know that the Pap smear carries a false-negative rate of 20% to 30%, but it seems that fewer people sue the pathologist for delayed diagnosis of cervical cancer. Compare mammography, with a false-negative rate of 10% and a greater number of lawsuits. One reason may be that, in our society, the breast carries more weight—cosmetically and sexually—than the cervix or uterus.
Dr. Barbieri mentioned that computerized detection systems might allow for a stronger defense at trial. This sounds reasonable, but I doubt it will prevent lawsuits against companies producing those systems. The only immediate solution is increasing Medicare reimbursement for screening mammography. Radiologists need not receive double punishment: getting sued and being poorly paid.
BO CHARLES LI, MD, PHD
DR. BARBIERI RESPONDS:
I agree with Dr. Li’s important insights. I hope all physicians, including obstetricians and gynecologists, will be adequately reimbursed for their professional efforts.