A Deadly Waiting Game: Early Detection is Key

Just when it seems like we’re advancing in the treatment of breast cancer, one of the most dreaded diseases any woman could ever face, we seem to be losing ground.

And it’s not the disease that’s beating us.

Rather it’s an underlying attitude that’s insidiously spreading beneath the surface of what superficially appears to be a dedicated and committed nationwide effort to eradicate cancer. The culprit lurking at the root of our nation’s healthcare industry is now showing its ugly head.

A recent report by ABC News (august 23, 2001) disclosed, “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.”

Frankly I find this news shocking and sickening!

For years we’ve known that early detection is the key to improved cancer treatment. Medical scientists uniformly support the contention that cancer survival rates are typically dependent upon prompt diagnosis.

Yet despite extensive research studies supporting the obvious value of routine self-examinations and mammography, our nation’s healthcare system is turning its back on critical findings that have been proven to save lives.

Politicking about so-called patients’ rights appears to take precedence these days over nurturing the delicate foundation of trust between people and our healthcare system. The premise of valuing each and every human life is being eroded by an attitude that can only be described as infectious and malignant.

The rationale for this despicable turn of events is none other than economics. Medicare and many private third party payers reimburse radiologists at rates yielding losses of up to $30 per patient per procedure. As a result, mammography centers are closing as physicians cannot assume the losses or the potential liability.

Our legislators in their attempt to be perceived as sending a knight to a damsel in distress have introduced a bill in Congress that is aimed at increasing Medicare reimbursement for the procedure. Obviously it’s not a priority – not to the President or our elected officials. And never forget political priorities – there was no delay in the disparaging congressional hearings concerning the Clinton scandal. Beating a dead horse appears more important than nurturing a human life.

Our nation’s healthcare executives who determine and authorize payment for medical procedures must also be held accountable. These are the entrusted individuals who ultimately make financial decisions that can in many cases determine whether or not people survive. Two years ago a particular woman diagnosed with breast cancer might have lived. Today a similar person with a delayed diagnosis may be facing unnecessary suffering or even death.

Yes, survival is at stake along with emotional turmoil that’s no less than disheartening.

Imagine awakening one morning and taking a refreshing shower before leaving for work. While bathing, you recall your doctor’s suggestion which has been reverberated again and again by the American Cancer Society to perform a self-breast exam. Actually it was a combination of knowledge and fear that prompted your action.

Suddenly you detect an irregularity in your breast which wasn’t noticed previously. Your pulse immediately quickens, your color drains and you feel faint as your heart sinks into a place where only the worst thoughts are harbored. Now in a cold sweat, you frantically call your physician’s office. An appointment is scheduled toward the end of the week. Those three days seem like an eternity as you cannot escape the seriousness of your finding. The waiting game is blinding and devastating. Future prospects come to grinding halt even when the “C” word is contemplated. All you want is your life back.

By the time you make it into the doctor’s office, your life has already changed. The discussion following your physical exam is by no means consoling. Mammography and a potential biopsy are discussed. At least you’ve made it through the first stage of the gauntlet. Now for the mammogram!

While unrelieved, proceeding to the front desk for scheduling is at least a positive step – a means to an end. Doing something is better than existing day to day in limbo.

Then the unthinkable hits!

You’re informed that despite calling four centers, your doctor’s office is unable to arrange an appointment for any time in the near future. In fact, your mammogram can’t be scheduled for five months. What you’re hearing doesn’t seem to make sense. Thinking clearly isn’t a given in these situations. The clerk repeats herself and hands you an appointment for next year. The real nightmare now begins.

While you might believe this account has been presented purely for dramatization, I urge you to attempt to understand the plight of a person anticipating one of the most feared and life-changing diagnoses possible. This reality is mind-bending and incomprehensible on any humanistic level.

Perhaps it’s time to rethink our priorities as a nation. When will our elected officials understand the devastation of their action and inaction? When will healthcare insurers place people first? When will we as a nation mandate that Medicare, Medicaid and every private healthcare insurer truly serve “we” the people?

Ultimately I’m angered by this deplorable news. Yet I’m more disappointed by the fact that educated administrators and legislators in positions of power and trust are ignoring the undeniable impact of stress on the immune system. It’s time they realized that even mice stressed during chemotherapy predictably experience markedly diminished odds of survival.

I do not believe there is one elected official or health insurance company executive alive who would personally tolerate the prospect of waiting for a mammogram – Mind Over Matter!

©2001 Barry Bittman,
MD all rights reserved

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Written by Barry Bittman MD

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