Sunday, November 22, 2009

Of mammograms and pap smears


Are mammograms and pap smears a risk management issue? For that matter are tests for prostate and colorectal cancers a risk management issue?

They are if we value employees.

It goes beyond Joe or Jo at the workplace.

It includes their near kin; parents, children.

The subject comes up because recent news announcements have suggested that women reduce the frequency of both mammograms and pap smears.

There is scientific evidence that these diagnostic procedures most often show negative results for certain age groups, but to my mind, the operative words are "most often."

I am cognizant that there are too many false positives that lead to additional, always expensive and often uncomfortable, testing, but it seems to me that it beats the alternatives for both the woman and the insurance company or government (that has to pay for extended treatment).

Because I have a suspicious mind, I immediately suspect the insurance industry as the behind-the-scenes promoter of fewer exams. But unless the insurance companies can somehow avoid paying for extended treatments, what do they gain?

I confess to having a personal interest in the recommended cut-backs on the procedures.

I'm told that neither mammograms or pap smears are a walk in the park; women have to steel themselves to the discomfort, but they do it because - given today's technology - they know the annual squeeze and scrape is necessary for a long and happy life.

As a man. I know the discomfort of a manual prostate exam (and the relative ease of the blood test that, I am sure, is easier on me than it is on the insurance carrier). I don't LIKE being "needled," but it's less bothersome than "getting the finger."

But, let's say that G-d forbid, someone close to a worker has cancer. (I have a close friend with cancer and I lost another to a lingering and excruciatingly painful cancer, so I write from personal experience.) I am concerned and, frankly, distracted. Fortunately I don't operate dangerous machinery. If my friend was my wife or a child, I would be taking time off to take the patient to treatments, and more time off helping them recover from the treatments.

You see, preventive medicine - including mammograms, pap smears, prostate exams, et al, - really is a risk management - business continuity issue.

As we apparently are nearing a national health bill, any recommendations to reduce preventive medicine can be expected to be embraced by the financially conservative; there is no question that the exams can be expensive.

The real question to ask is what is the real cost of reducing or eliminating these, and other, preventive medicine procedures?

It seems to me a "pay me now or pay me (more) later" situation.

But, I am not a doctor and I don't play one on tv.


John Glenn, MBCI
Enterprise Risk Management practitioner
Hollywood/Fort Lauderdale Florida

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