title: Current realities of delivering mammography services in the community: do challenges with staffing and scheduling exist?
abstract: OBJECTIVE
  To evaluate the current (2001-2002) capacity of community-based mammography facilities to deliver screening and diagnostic services in the United States.
  
  
  METHODS
  Institutional review board approvals and patient consent were obtained. A mailed survey was sent to 53 eligible mammography facilities in three states (Washington, New Hampshire, and Colorado). Survey questions assessed equipment and staffing availability, as well as appointment waiting times for screening and diagnostic mammography services. Criterion-related content and construct validity were obtained first by means of a national advisory committee of academic, scientific, and clinical colleagues in mammography that reviewed literature on existing surveys and second by pilot testing a series of draft surveys among community mammography facilities not inclusive of the study facilities. The final survey results were independently double entered into a relational database with programmed data checks. The data were sent encrypted by means of file transfer protocol to a central analytical center at Group Health Cooperative. A two-sided P value with alpha = .05 was considered to show statistical significance in all analyses.
  
  
  RESULTS
  Forty-five of 53 eligible mammography facilities (85%) returned the survey. Shortages of radiologists relative to the mammographic volume were found in 44% of mammography facilities overall, with shortages of radiologists higher in not-for-profit versus for-profit facilities (60% vs 28% reported). Shortages of Mammography Quality Standards Act-qualified technologists were reported by 20% of facilities, with 46% reporting some level of difficulty in maintaining qualified technologists. Waiting times for diagnostic mammography ranged from less than 1 week to 4 weeks, with 85% performed within 1 week. Waiting times for screening mammography ranged from less than 1 week to 8 weeks, with 59% performed between 1 week and 4 weeks. Waiting times for both diagnostic and screening services were two to three times higher in high-volume compared with low-volume facilities.
  
  
  CONCLUSIONS
  Survey results show shortages of radiologists and certified mammography technologists.
authors.affiliation: Breast Imaging Center, Dept of Radiology, Emory Univ, W.C.I. Building, 1701 Uppergate Drive, Suite C1104, Atlanta, GA 30322, USA. carl_dorsi@emoryhealthcare.org
authors.forename: Carl
authors.initials: C
authors.lastname: D'Orsi
authors.forename: Shin-Ping
authors.initials: SP
authors.lastname: Tu
authors.forename: Connie
authors.initials: C
authors.lastname: Nakano
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Linn A
authors.initials: LA
authors.lastname: Abraham
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Taplin
authors.forename: R Edward
authors.initials: RE
authors.lastname: Hendrick
authors.forename: Gary R
authors.initials: GR
authors.lastname: Cutter
authors.forename: Eric
authors.initials: E
authors.lastname: Berns
authors.forename: William E
authors.initials: WE
authors.lastname: Barlow
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D003625:Data Collection; D003695:Delivery of Health Care; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011871:Radiology; D013679:Technology, Radiologic; D014481:United States; D014850:Waiting Lists; D000078329:Workforce