This month’s Narrative Matters in Health Affairs (Why I Don’t Get Mammograms) is among the best I’ve read. Author Veneta Mason is a late 50s nurse practitioner whose sister died from breast cancer. Yet she’s consciously decided not to get mammograms anymore because she doesn’t believe early detection makes successful treatment more likely or extends life. To summarize her arguments:
- Cancer is horrible but metastatic breast cancer is just as treatable and deadly whether or not a patient undergoes routine screening. Even though she accepts her risk may be significantly higher due to her sister’s illness, it doesn’t matter if screening doesn’t make her treatment better or life longer
- It’s important to have a primary care physician who accepts her reasoning about screening
I’m not a clinician and make no judgment about the specific medical perspective she provides. However, I worry about the strong embrace of excessive screening and diagnostic testing because of the negative consequences it brings, such as unnecessary –and in some cases damaging– treatments and fear.
David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma, biotech, and medical devices. Formerly with BCG and LEK. He blogs regularly at Health Business Blog, where this post first appeared.