Health Care Workforce

Two studies explore radiologists' perceptions of malpractice risk and enjoyment of interpreting mammograms

Finding radiologists willing to interpret mammograms is becoming increasingly difficult. One reason is that delay in the diagnosis of breast cancer is the second most common cause for physician malpractice lawsuits. Two recent studies took a critical look at how radiologists feel about interpreting screening mammograms and their perceived risk for malpractice. Both studies were funded in part by the Agency for Healthcare Research and Quality (HS10591).

Dick, J. F. III, Gallagher, T. H., Brenner, R. J., and others (2009, February). "Predictors of radiologists' perceived risk of malpractice lawsuits in breast imaging." AJR: American Journal of Roentgenology 192(2), pp. 327-333.

Researchers mailed a survey in 2002 and then again in 2006 to radiologists in three States—Washington, Colorado, and New Hampshire—who routinely interpreted mammograms as part of their workload. Information was compiled on practice characteristics, the radiologists' experience with malpractice, and their perceived risks of facing a lawsuit in the future. The study found that the perception of being sued was significantly higher than the actual number of reported malpractice cases involving breast imaging. The average perceived risk for a lawsuit was nearly four times higher during 2001 to 2005 than the rate of malpractice claims reported in the 2006 followup survey (41 vs. 10 percent). This risk perception remained high over a 5-year period despite actual lawsuits remaining stable over the past decade. Interestingly, those radiologists who spent more time on breast imaging or interpreting a high volume of mammograms did not have a significantly higher perceived risk of a lawsuit. Those who felt more at risk for lawsuits were more likely to have had a malpractice claim in the past or knew of other radiologists who had been sued (81 percent knew of such cases in 2002). There was also a higher perceived risk among radiologists working at facilities that did not use double reading of mammograms (use of two radiologists to read each one).

Geller B. M., Bowles E. J. A., Sohng H. Y., and others (2009, February). "Radiologists' performance and their enjoyment of interpreting screening mammograms." AJR: American Journal of Roentgenology 192(2), pp. 361-369.

In this study, 131 radiologists from the same three States completed surveys about their characteristics, clinical practices, and attitudes related to screening mammograms. The researchers also used performance data to determine the odds of an abnormal mammogram interpretation. A little over half of the radiologists surveyed said they enjoyed interpreting screening mammograms. Those most likely to enjoy the task were older, female, and working part-time. All of the radiologists affiliated with academic medical centers enjoyed this type of work compared with only half of those without such primary affiliations. Radiologists on annual salaries or who spent 20 percent or more time working in breast imaging or interpreted more than 2,000 mammograms annually were also more likely to enjoy this work. Radiologists who did not enjoy the work reported it as being tedious. They also had high levels of uncertainty when interpreting mammograms. However, the researchers found no significant differences in abnormal mammogram interpretation and cancer detection rates among radiologists who enjoyed and did not enjoy interpreting screening mammograms.

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