A matter of time
New equipment may be forthcoming to cut delays, but the harder task may be finding radiologists to run it
Dr. Mack Bandler's work starts after a woman finishes her mammogram.
The Medford radiologist pores over women's breast X-rays, searching for signals of disease. Working in a darkened room, he scans the films with a magnifier, looking for tiny irregularities that could be the first sign of breast cancer.
He and other radiologists compare a woman's most recent mammogram with previous images to see whether changes have occurred in breast tissue.
What we like to see is symmetry, he said.
Jackson County women have been waiting longer and longer for their annual screening mammo-grams since the Medford Medical Clinic dropped the service last January. Women who called the three remaining mammography centers in November to arrange their annual screening mammogram typically had to wait at least four months for an appointment.
Bandler and others in the field say it will take time to reduce the long wait ' time to add equipment; time to recruit technicians to operate the machinery; and time to bring in more radiologists to read the films.
It's a much deeper problem than reminding women (to make their appointments) six months ahead instead of six weeks, he said.
The long wait applies only to women who need a screening mammogram. Clinics reserve time for women who have symptoms that need immediate attention.
Bandler and his colleagues at the Medford Radiological Group plan to add another mammography machine to their Women's Imaging Center to help meet the growing demand. He said bringing in new equipment is easy compared to hiring people to run the machinery and recruiting new radiologists to read the films.
All of those factors combine to limit the number of mammograms we can do, he said.
Radiology technologists ' the people who operate mammography machines and other medical-imaging equipment ' are in short supply, and they'll remain scarce for the foreseeable future. Projections suggest a need for an additional 75,000 radiology technicians during the next 10 years to supplement the 225,000 working today.
The shortage is phenomenal, said Jenny Kellstrom, who chairs the radiology department at Oregon Institute of Technology in Klamath Falls. There just aren't enough people in schools to fill the needs.
Kellstrom said many people who acquire the formal training to qualify for a job in mammography choose other medical imaging specialties that are more interesting.
It takes a certain kind of person to want to image breasts all day, she said.
There are lots of people who just don't want to do mammography. If you had a chance to run an MRI or a CT scanner, or do a few chest X-rays and mammograms, there's little doubt where most people would go.
Some people who have the training are disqualified by their gender, Kellstrom noted. For obvious reasons, men are totally eliminated from this position.
All those factors combine to create fierce competition for the pool of available mammography technologists, said Dr. John Barton, a radiologist at Ashland Community Hospital. When you look at the professional journals, there are ads begging for people to come.
Barton said the Ashland hospital has hired an additional part-time mammography technologist to help reduce the long wait for appointments.
Radiologists want more eyes to read the growing volume of mammograms, but luring new blood to Southern Oregon has been challenging.
For the past five years, we've been trying to recruit radiologists who are specifically interested in mammography, Bandler said. There are fewer of them out there, and they seem to be less interested in coming to a small community.
Bandler and his colleagues read mammograms from their practice and from Providence Medford Medical Center. Providence added a second mammography machine in December 2000, but has no plans to add more in the near future. Spokeswoman Deborah Elliott said adding new equipment wouldn't be useful if there aren't enough radiologists to read the films.
Bandler and his colleagues hope to bring at least one additional radiologist to Southern Oregon next year, and they've been wooing at least one more. If they can bring in new doctors to share the work and add more equipment, they'd like to bring the wait time for a screening mammogram down to one month at their clinic.
They know all too well how women feel about the current arrangements.
We all have wives, he said, and mothers, and sisters, and friends.Recommendations for mammograms frequency by age group
The American Cancer Society recommends women over 40 should have a mammogram every year. In addition:
Women 40 and older should have a physical examination of the breast every year, performed by a health care professional such as a physician, physician assistant, nurse or nurse practitioner. This examination should take place near and preferably before the annual mammogram.
Women ages 20 to 39 should have a physical examination of the breast every three years, performed by a health-care professional.
Women 20 years of age and older should perform breast self-examinations every month.
Mammograms can be scheduled at:
Ashland Community Hospital, 482-2441.
Providence Medford Medical Center, 732-5082.
Women's Imaging Center, Medford Radiological Group, 773-6251.