The clinic I volunteer with provides (almost) free primary care services on a first-come, first-serve basis. As recommended by the National Cancer Institute, women over a certain age are recommended for yearly mammograms. Luckily, there is another clinic in New Orleans that offers free mammograms. However, the process of getting a mammogram at this clinic is time consuming and frustrating.
Let me walk you through what I did and observed. First, I went through the files of all the women who were referred for a mammogram but did not have a report (to see if they actually did have a report). After finding few missed reports (the vast majority did not have a report), I went to the mammography clinic to determine if the women referred got a mammogram but the report was never sent. Again, although there was a higher number of reports, the majority were still missing a report.
Side note - while looking for reports, I waited with women who were getting a mammogram. Remember, these are the women who took time out of their day to get a mammogram. This is what is encouraged. Yet, some of the women waited over 3 hours - and they had an appointment! Those who did not have an appointment waited even longer.
Continuing on with a recounting of my work... Finding the majority of women referred for a mammogram did not get one, I did a phone survey to determine the "barriers to care," the fancy way of asking why they didn't go get a mammogram. What did I find?
THEY DIDN'T KNOW ABOUT THE APPOINTMENT!!!
Most women said they would have gone if they had known about it and feel it's very important to get a mammogram yearly. Many even gave me lovely anecdotes to impress upon me how important it was to be healthy and do what the doctor says.
The whole process was very frustrating. The women who try to take care of their health end up waiting absurd amounts of time with little information about how much longer it will take until their time comes. The women who don't know about the appointments have few resources to remedy the problem. And this is only my research on mammograms. Imagine all the other broken systems...
New Orleans Health Care Another Katrina Casualty: Loss of Hospitals And Professionals Slows Rebuilding
www.washingtonpost.com/wp-dyn/content/article/2005/11/24/AR2005112400730.html
After the Storm — Health Care Infrastructure in Post-Katrina New Orleans
http://content.nejm.org/cgi/content/full/354/15/1549
Breast Cancer Risk Assessment Tool
http://www.cancer.gov/bcrisktool/Default.aspx
Most Older Women Don't Get Mammograms: Study Shows Rate of Regular Screening Is Lower Than Previously Believed
http://www.webmd.com/news/20060620/most-older-women-dont-get-mammograms
Why Women Don't Get Mammograms (And Why They Should)
http://www.hoptechno.com/book55.htm
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