A year ago, as I embarked on opening a new practice, I was asked, “How can you survive doing breast imaging”? At that time I wrote “Taking a Chance” in this journal, in which I chronicled my move from academia to opening a private radiology practice for women’s imaging.
is the Founder and Director of The Ellen Shaw de Paredes
Institute for Women's Imaging, Glen Allen, VA. She is also a
member of the editorial board of this journal.
A year ago, as I embarked on opening a new practice, I was
asked, "How can you survive doing breast imaging"? At that time I
wrote "Taking a Chance" in this journal, in which I chronicled my
move from academia to opening a private radiology practice for
women's imaging. Since then, much has happened that has inspired me
to share some thoughts, particularly about mammography. Here are
the facts about breast imaging:
- Mammography is a proven method to reduce the mortality rate
from breast cancer.
- The volume of patients who undergo mammography has grown
tremendously over the last 2 decades, yet only approximately 50%
of women are being screened.
- There is a current shortage of breast imagers, and there are
many positions available.
Here is the fiction:
- Mammography services are financially unable to stand
- Malpractice risk is so great that one should not specialize
in this field.
In opening the practice, I felt that I was taking a large risk,
but based on an analysis of the business plan it seemed feasible.
So I took the plunge. The basic concept is to provide the highest
level of service that I possibly can, including offering immediate
interpretation to all patients. This requires working efficiently
and accurately, being organized, and having a terrific staff. The
vast majority of patients prefer to wait for the mammogram to be
read and to receive their results in person the same day.
The convenience to patients, the reduced anxiety in getting
immediate results, and the ability to have a full diagnostic
work-up, if necessary, on the same day have made this practice
highly sought after. The convenience to the referring physicians
has also been improved by completing the work-up and helping to
organize the management plan for the patient.
I recently saw a new patient who told me that her doctor had
referred her to me specifically. Her doctor had told her that I had
"raised the bar" for radiology practice in the area.
Interestingly, I recently spoke with one of my former fellows
who had opened a similar practice just a few months before I did.
Initially, he was very concerned about the financial risk, yet he
wanted to focus on breast imaging and to try to provide a higher
level of service than he was able to in his prior practice. He also
has achieved great success in his practice. In our conversation, he
told me that another physician had also described him as "raising
the bar" for patient care.
Practicing breast imaging is highly rewarding. Providing the
best level of service that one can is wonderful. The personal
reward is knowing that the detection of a small, early breast
cancer results in a cure. Patients are most appreciative of the
attention to their care. In addition to the clinical benefits, the
financial rewards are significant. In the outpatient setting,
mammography is not a financial loser but instead can be very
successful. Perhaps most importantly, as my former fellow agreed,
the ability to be the decision makers and to establish and
implement the philosophy of the practice allows us to perform our
best work. I encourage anyone who has even the slightest interest
in breast imaging to investigate it further. You will find great
professional fulfillment and tremendous personal satisfaction.