The Mammography Quality Standards Act: Misread Mammograms, Malpractice, and The Politics of Regulation

Abstract

Recent studies and reports suggest that the MQSA has not been successful at improving physician interpretation of mammograms. This paper argues that in order to assess the impact of the MQSA accurately, one must look beyond its symbolic and cultural importance, both as an important women’s health achievement and as a tool in the struggle to encourage more women to be screened for breast cancer. Once this is done, it becomes apparent that many of the current problems with mammography reflect deeply rooted historical problems with the delivery of health care and the regulation of medicine. To that end, this paper looks at the response of health care systems in general to the introduction of standards and looks at representative malpractice cases to illustrate where the MQSA succeeds and where it runs into difficulties because of greater problems with the health care system. It acknowledges that the technological limitations of mammography techniques may be contributing to the physician interpretation problem. However, in the end, it suggests that perhaps the answer to current difficulties with mammography is not to create more mammography-specific rules, but to re-examine these other, more fundamental problems that plague health care.