Each October, we celebrate breast cancer survivors, participate in fund-raisers for breast cancer research and awareness, and remember those lost to this brutal disease. As hospitalists, our job is to facilitate the care of our patients suffering from this disease. We admit patients with neutropenic fever after a recent bout of chemotherapy. We order palliative radiation therapy after the cancer has metastasized and causes severe pain and suffering. And, we order morphine drips when all else has failed, and our focus shifts to helping our patients pass on with the most dignity and least pain possible.
As hospitalists, our services typically come into play after the fact, not before. After the complications of chemo; after the cancer has spread; after there is nothing else we can do to prolong the lives of our patients. No doubt, what we do can make a tremendous impact on the lives of our patients, but can we do more? I believe we can.
How many seconds does it take to ask whether our female patients are up to date with their mammograms and Pap smears? Less than 10.
How many seconds would it take to dictate a brief reminder on preventive medical services, such as a screening mammogram, in our H&Ps? Less than 5.
How many women are aware that the American Cancer Society recommends breast MRI along with the yearly mammogram for certain high-risk women? Very few.
Yes, we are all very busy and sometimes it seems if anything else is added to our plates we will explode, but let’s think about the ROI for a moment. If we admit 30 women over age of 40 each month, and spend, on average, 15 seconds inquiring about and recommending routine mammography, at the end of the year we will have invested a whopping 90 minutes of our lives counseling 360 women. If out of those 360 women, 25% (90) are overdue for their mammogram, and a third heed our advice, 30 women will get a mammogram. Since the lifetime risk of breast cancer is close to 1 in 8, chances are, within a year, we could collectively play a vital role in a multitude of women getting an early diagnosis of breast cancer, and thus a high chance of a complete cure.
A few years ago, I had the gut-wrenching experience of watching someone I loved very much die an excruciating death from breast cancer in my home. She told me I could tell her story so others would be spared her fate. Essentially, she waited too long to get a mammogram.
Now I ask you to help me rewrite her story and rewrite the stories of all of our loved ones who have passed away from breast cancer. If even 100 hospitalists will commit to investing 90 minutes over the next year to recommend screening mammography to patients, and perhaps even do a breast exam on some patients when they have a little extra time, I feel confident that someone, somewhere will be spared the ravages of this vicious disease and their deaths will not be in vain.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.