Last week a study commission appointed by the Bush administration, consisting primarily of medical doctors, recommended that women under 50 years of age didn’t need to get mammogram screening.  This was a major change in the existing recommendation which called for women 40 and over to get regular screening.  Many women came forward in response to this new recommendation and gave examples of how they were diagnosed with breast cancer because of receiving a mammogram at an age less than 50.  They proclaimed that the mammogram saved their life.

        How does all this relate to medical malpractice?  It is an example of the attitude that pervades the medical profession today that measures the possibility of saving a life by statistical probability and cost.  The medical profession refers to it as “defensive medicine”.  I see it over and over in cases where a physician has elected to not perform a test or procedure on a patient which could have revealed valuable information about a patient’s condition and which would have led to intervention saving the patient’s life.  The physician, and his or her lawyer, defends the failure to do the test or procedure by claiming that performing such test or procedure was not justified because statistically, it would not have been positive, and because it would cost too much. 

        We are the most advanced nation in the world in medical technology and knowledge.  If you or a loved one has a potential life threatening condition about which a test or procedure might reveal important information for life saving treatment, would you want that test performed even if the physician felt that “probably” the test would be negative but could be helpful?  Would you be satisfied with an explanation that, even though it might reveal important information, in the doctor’s opinion, the cost didn’t justify the possibility it would be helpful?  I know I would!  Isn’t every patient in our country entitled to the same consideration? 

        Rather than rationing medical treatment based upon statistics and blaming the cost of medical care on “defensive medicine” to avoid a medical malpractice lawsuit, shouldn’t the benefit of the doubt go toward the possibility of obtaining information to save the patient’s life?  What about reducing healthcare costs by eliminating every hospital in a community having duplicate expensive diagnostic machines?  What about eliminating hospitals paying for television commercials to get patients to come to their hospital when they get sick?  What about analyzing how to reduce the cost of healthcare without basing such analysis on how we keep health insurance companies making huge amounts of money?

        Many, perhaps most, women are outraged by the rationale behind this recent commission recommendation, i.e. that the potential benefit of revealing breast cancer at an early stage is outweighed by the “anxiety” of a false positive from a mammogram and the possibility of needing to have a needle biopsy.  I know my wife is.  She has been through a false positive experience and had the biopsy.  Asked if she would do the mammogram again having gone through this experience, her response was “Are you kidding, yes!”

- Neil Hillyard