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Physician Workload in Mammography

Rebecca Smith-Bindman1,2, Diana L. Miglioretti3,4, Robert Rosenberg5, Robert J. Reid3, Stephen H. Taplin6, Berta M. Geller7, Karla Kerlikowske2,8 the National Institutes of Health Breast Cancer Surveillance Consortium

1 Department of Radiology, University of California, San Francisco, China Basin Landing, 185 Berry St., Ste. 350, Lobby 7, Campus Box 0946, San Francisco, CA 94107.
2 Departments of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
3 Group Health Center for Health Studies, Seattle, WA.
4 Department of Biostatistics, University of Washington, Seattle, WA.
5 Department of Radiology, University of New Mexico, Albuquerque, NM.
6 Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.
7 Departments of Family Medicine and Radiology, Vermont Cancer Center, University of Vermont, Burlington, VT.
8 General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, San Francisco, CA.


Figure 1
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  		Fig. 1 —Graph shows distribution of annual volume of mammographic interpretations by radiologists participating in Breast Cancer Surveillance Consortium (BCSC).

 

Figure 2
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  		Fig. 2 —Cumulative percentage of radiologists who interpret within each volume category and cumulative percentage of screening and diagnostic mammograms interpreted by volume category. Dotted lines are at annual mammographic volumes of < 1,000 and < 3,000. Overall, 31% of radiologists interpreted < 1,000 mammograms annually (point a), and these radiologists interpreted 10% of all screening mammograms (point b); 10% of radiologists interpreted ≥ 3,000 mammograms annually (difference between 100%, point c, and 90%, point d), and they interpreted 32% of all mammograms (31% of all screening mammograms [difference between 100%, point c, and 69%, point e]) and 39% of all diagnostic mammograms [difference between 100%, point c, and 61%, point f].

 

Figure 3
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  		Fig. 3 —Cumulative percentage of radiologists who interpret within each volume category and cumulative percentage of mammograms interpreted by volume category, stratified by urban and rural locations. Ninety percent of rural radiologists (point a) versus 70% of urban radiologists (point b) read < 2,000 mammograms annually. In urban locations, cutoff of 2,000 mammograms would result in 42% of mammograms (point c) needing to be redistributed to high-volume radiologists if low-volume radiologists stopped interpreting mammograms. In rural locations, this cutoff would mean that majority of mammograms (63%, point d) would have to be redistributed to high-volume radiologists.

 

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