Why the government cannot fix health care
Many radiologists, and other analyzers of x-rays, lack the ability to discern the shadows and swirls in a mammogram that indicate cancer. But no one knows who can do it and who cannot. No one checks. No one is counting. Even the doctors themselves do not know how they are doing. Patients are shooting dice when getting mammograms hoping to luck into doctors capable of doing the job. In a country where batting averages and pitching speeds are known to the fourth decimal place, there is no data on which doctors accurately detect cancer and which can't.
If baseball were run that way, your physician could be pinch hitting for Ken Griffey, Jr.
Patients need to know success rates of caregivers
Studies in North Carolina and New Hampshire found that some clinics miss 40% of tumors. In New York a radiologist in the Bronx was found to have missed 25 tumors while finding only 7 in two years. No one knows how the rest of the clinics in America are doing. No one keeps track.
The federal government was alarmed and wanted to weed out doctors whose track records at discovering cancer were worse than bad luck. Doctors and their allies derailed it. Instead, to appease the government, they allowed the government to monitor the mammography equipment used by inept radiologists. Health care professionals want it to be assumed that all operators are equal and good. Inept doctors reviewing x-rays earn livings for decades without anyone looking to see which doctors can detect cancer and which can't. (A long article about it is in The New York Times, June 27, 2002). It is not in the interest of people in medicine to collect accurate data on competency. So they don't. And they don't allow others to do it either.
Sunshine is not in the interest of caregivers
Success rates are the most important thing for patients to know. Otherwise they are rolling dice hoping to happen upon a good radiologist. And then after that, rolling dice hoping to get the right treatment. Should they get MammoSite, for instance? It is one of the treatments available for breast cancer. Is it the best option? Click the link to it.
Sometimes it is better not to get tested at all according to the book above right "Should I be tested for cancer."
More Bad News
Dr. E. James Potchen at Michigan State University in East Lansing studied the accuracy with which certified radiologists studied x-rays. One of the most interesting things he found was that even those who were the worst at it were highly confident in the accuracy of their work. This is endemic in medicine. It's one of the reasons that asking for health care professionals to make problems in medicine more transparent is ignorant. They don't see the problems. Especially when they are the problem.