MODERN HEALTHCARE's July 17, 1995, issue (p. 3) carried an Associated Press article headlined "Kaiser says doctor misread 259 mammograms." I was the physician mentioned in the article, which contained information that was erroneous, misleading and damaging.
Forced to resign from the Colorado Permanente Medical Group in April 1995, I was publicly accused three months later by Kaiser of misreading 259 of 2,958 mammograms I interpreted from October 1993 to April 1995. The retrospective evaluation of the mammograms took place after I was terminated, and Kaiser refused to disclose to me the results of the evaluation.
I have found the following facts:
After further evaluation of those 259 women, 222 were immediately classified as normal, thus agreeing with my original interpretations.
The remaining 37 women were subjected to biopsy, after which 30 of those also were called normal, again agreeing with my interpretations.
Seven women in a series of 2,958 mammograms were found to have early cancer.
Those seven breast cancer cases were reviewed by the breast imaging expert at the University of Colorado Health Sciences Center in November 1995, and it was determined that I personally had three "misses." The other four cases were either interval cancers or "minimal signs present."
It is a well-known fact that screening mammography is far from a perfect detector of breast cancer. My three false-negative interpretations in 2,958 cases represented an error rate of one-tenth of 1%, which is well within the standard of care for large series of mammograms published in medical literature. Comparison with other Colorado Kaiser Permanente radiologists is not possible because my 2,958 mammograms were the only ones reviewed of more than 50,000 mammograms read by 19 Kaiser radiologists during that period.
In November 1995 I was severely punished by the Colorado Board of Medical Examiners. In its final document, the BME stated: "The panel has no evidence that any other aspect of the respondent's practice, other than the reading of mammograms, is deficient," but it refused to acknowledge favorable evidence regarding my mammogram performance I presented to them in a January 1996 appeal.
I was also subject to a hearing by the Ohio State Board of Medicine, where I hold a license. The Ohio board was presented with the same data as the Colorado board. Expert review has determined that I did not "misread" 259 mammograms. I accurately interpreted 2,955 of the 2,958 screenings.
James A. Walsh, M.D.
Hilton Head Island, S.C.