Radiologists' Performance and Their Enjoyment of Interpreting Screening Mammograms

Abstract

Objective-One might speculate that radiologists who enjoy mammography may exhibit better performance than radiologists who do not.Materials and Methods-One hundred thirty-one radiologists at three Breast Cancer Surveillance Consortium (BCSC) registries completed a survey about their characteristics, clinical practices, and attitudes related to screening mammography. Survey results were linked with BCSC performance data for 662,084 screening and 33,977 diagnostic mammograms. Using logistic regression, we modeled the odds of an abnormal interpretation, cancer detection, sensitivity, and specificity among radiologists who reported they enjoy interpreting screening mammograms compared with those who do not.Results-Overall, 44.3% of radiologists reported not enjoying interpreting screening mammograms. Radiologists who reported enjoying interpreting screening mammograms were more likely to be women, spend at least 20% of their time in breast imaging, have a primary academic affiliation, read more than 2,000 mammograms per year, and be salaried. Enjoyment was not associated with screening mammography performance. Among diagnostic mammograms, there was a significant increase in sensitivity among radiologists who reported enjoyment (85.2%) compared with those who did not (78.2%). In models adjusting for radiologist characteristics, similar trends were found; however, no statistically significant associations remained.Conclusion-Almost one half of radiologists actively interpreting mammograms do not enjoy that part of their job. Once we adjusted for radiologist and patient characteristics, we found that reported enjoyment was not related to performance in our study, although suggestive trends were noted. Keywordsbreast cancer screening; breast imaging specialists; mammographers; practice of radiology; radiologists; screening mammography Address correspondence to B. M. Geller (berta.geller@uvm.edu). NIH Public AccessAuthor Manuscript AJR Am J Roentgenol. Author manuscript; available in PMC 2010 February 18. Published in final edited form as:AJR Am J Roentgenol. 2009 February ; 192(2): 361-369. doi:10.2214/AJR.08.1647. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThe declining numbers of radiologists willing to provide mammography services [1][2][3] and the increasing evidence suggesting wide variability in their performance [4,5] raised the question of whether mammography performance is associated with radiologists' enjoyment of interpreting screening mammograms. Given the negative incentives for joining the breast imaging field [6], one might speculate that radiologists who enjoy mammography are more likely to remain in the field and may exhibit better performance than radiologists who do not. However, we know of no studies that have tested this idea.Radiologists in general are satisfied with their professional choice of specialty, with 93% reporting that they enjoy their career [7]. In the single published study on career satisfaction related to mammography, Lewis et al. [8] reported t...

Demographic and practice characteristics of pathologists who enjoy breast tissue interpretation

“…Workforce shortages are a concern in the field of radiology, where nearly half of radiologists report that they do not enjoy interpreting screening mammograms. 22 Our study, however, suggests that a workforce shortage in breast pathology interpretation may not be problematic. One promising development is the rapid advancement in whole slide imaging digital technology 23 for primary diagnosis.…”

Frequency and Determinants of a Short-Interval Follow-up Recommendation after an Abnormal Screening Mammogram

“…In support of this hypothesis, Carney et al [22] observed that radiologists with a higher discomfort with uncertainty have a higher false-positive rate during the diagnostic mammogram interpretation. However, other American studies have investigated the variability in the performance between radiologists in relation to the level of uncertainty during the reading of screening mammograms [23], their perception of medical malpractice [24], and their enjoyment of interpretation of screening mammogram [25], but no statistically significant effects were observed. Moreover, Ong et al [26] conducted a study in 1992-1993 on the utilisation of the early rescreen or recall in the United Kingdom.…”

Characteristics and diagnostic performance of pathologists who enjoy interpreting melanocytic lesions

“…It is likely that indicators of caseload volume and training or experience have an impact on job satisfaction and diagnostic accuracy owing to the resulting increase in skill and confidence. Radiologists who reported higher confidence or less uncertainty in their mammographic assessments had higher positive predictive values for detecting cancer and lower recall rates, especially among low-volume readers [22][23][24]. The clinical experience level and training of dermatologists or dermatopathologists has also been shown to have an impact on diagnostic accuracy of malignant melanomas [4,25].…”