It was a familiar sound. The crunch of metal against metal as one car plowed into another. There were no screeching tires trying desperately to stop its two ton cargo. No, simply a crunch that wasn’t supposed to be heard, ever. Somebody had just been rear-ended and the cause was most likely due to someone checking a text, misjudging the distance ahead—someone not paying attention, distracted.
I was stopped at a red-light, behind a long line of cars all waiting their turn to move forward, some waiting patiently others not insisting on inching forward at every opportunity hoping for a jump on the changing light. The ‘crunch’ was so loud it vibrated through my car and for the briefest of moments I thought I had been hit.
A look in the rear view mirror confirmed the victim wasn’t me or my vehicle.
I watched as a look of disbelief swept over the driver’s face as she looked in her rearview. A ‘what just happened?’ expression followed by the “Oh Crud” look of annoyance. She must have just realized the aggravation and hassle that lay ahead. It would start with the hour of insurance exchange as the two stopped cars blocked the now three block long line of waiting cars—filled with equally annoyed and anxious to get home drivers. Then certain to follow a few days to a week of car repairs, having to get a rental car or hitching rides, all a huge inconvenience.
I watched her snap on the hazard lights, the blink- blink announcing the dead stop to all. She climbed out of her car, leaving her door a bit ajar. A man, cell phone in hand, emerged from behind her car and their discussion began.
No one was hurt, thank goodness. That’s the most important thing I thought as I drove away.
One car separated me from being her. The thought bothered me. One car, 15 to 20 feet of metal or plastic or whatever they use these days to make our vehicles. One car, one distracted driver. A near miss for me, an inconvenience for her.
For whatever reason, my thoughts jumped to one year, one distracted woman, one forgotten phone call, one missed annual mammogram.
But for her, that one year meant being diagnosed at stage 2 instead of stage 0.
Women tell me all the time, “I didn’t realize it had been a whole year.” They add “I had so many things going on in my life, people I had to take care of, work that was unbelievable. I never miss my mammogram but that year got away from me.” Those are the same women who will forever question what would have happened if they hadn’t missed that year, hadn’t been so busy, so distracted.
Unfortunately we are on the edge of a time when skipping a year won’t be due to our own distractions but due to mandates by the United States Preventative Services Task Force. The same Task Force that finalized national recommendations that state women between 40 and 49 don’t need an annual mammogram. Those recommendations indicate that there is no need to start mammography screening until a woman is age fifty and then they recommend having a mammogram only every other year.
The most dangerous element of these recommendations is even if that woman’s doctor believed mammograms are critical, she or he will question writing an order for it or even encouraging the woman to have one. It’s simple. These recommendations will be sure to penalize that decision if they do order it or recommend it—their reimbursements reduced, their HEDIS scores lowered.
At The Rose and every other reputable mammography center that I know, a doctor’s referral is required. Not only is it best practice, it’s required by our licensing.
A dilemma—caught between the bull’s horns, for both the doctor and the woman.
And the irony of it all is that unlike the drivers, that woman’s life will be compromised, not inconvenienced.
Not having an annual mammogram or missing a year will have nothing to do with her being distracted. It will be mandated.
This is a near miss that could cost her life.