I have been a patient at Manatee Gynecology since 2018. Last year, they discharged me from their practice because I did not have a follow up breast ultrasound on time. I do not have a significant breast history (no history of cancer, no family history), and I get studies done every 3 years. I've had cystic breasts for 35+ years and I always require both a mammogram and ultrasound together. My cysts come and go, and fibrocystic breasts disease is a benign condition. I am a compliant patient but I was going through a horrific divorce and looking for employment at the same time, and my breast follow-up took a back seat. I did call administration twice to fight the decision and never heard back from them. Today, I went to Manatee Gynecology for a pelvic problem and they REFUSED CARE. I was on the table undressed with a drape over my lap when they refused care. The woman told me it's because I didn't have my tests on time. Here are my thoughts: 1) I have been an Internal Medicine Physician Assistant since 1997, and I know that mammograms and ultrasounds have been over-utilized. Recent data shows outcomes don't improve with annual mammograms, and may in fact cause harm. The recommendations surrounding mammograms are highly controversial (globally), and are being revisited. Also, to state the obvious, it's MY body, and I should be able to make my own choice regarding testing, and how much ionizing radiation exposure I receive. See studies below! I also understand the financial incentive to push testing; medicine is a business. 2) I would've expected more leniency given that I was an overwhelmed female going through a divorce. The leadership at Manatee Gynecology is objectively NOT supportive. 3) In this setting, they should NOT have refused care. My problem was not related to the breast, and I offered (in the room) to schedule whatever tests were 'overdue'.
I walked out of the office today without receiving care, horrified and embarrassed....
Ann Intern Med. 2023 Sept;176(9):1172-1180 [doi: 10.7326/M23-0133. Epub 2023 Aug 8].
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