Blog | Thursday, April 5, 2012

The 'annual' mammogram: an enlightening letter


Peruse this letter which a woman of my acquaintance (okay, my wife) recently received. Note the importuning "annual mammogram" and the official-sounding "According to the American Cancer Society ... " (Let's not mention the U.S. Preventive Services Task Force, which recommends every two years, and only for women over 50), juxtaposed with the wishy-washy "Please contact your physician to see if it is appropriate."

Which is it? Does the recipient need an annual, or does she need to talk to her physician? Perhaps it would be better to do one or the other: either recommend in the letter straight out, or let her talk the matter over with her doctor?

Here we have (a) fragmentation of care and advice (different opinions from across the spectrum); (b) confusing, multiple recommendations (ACS vs. USPSTF, et al.); and the assumption that "annual" is a default, no matter how artificial and un-evidence-based such an interval is.

Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews. He is also a poet, journalist and translator in Yiddish and English. This post originally appeared at his blog.