Articles, Blog

Why Patients Aren’t Informed About Mammograms

August 26, 2019


[Music] and the mammography Wars rational thinking can be easily lost yes mammograms are big business bringing about 7 billion dollars a year but it’d be a bit too cynical to believe that the pushback from mammogram critics stems only from the self-interest of radiologists and breast surgeons whose daily bread depends on the continuation of routine mammogram screening it just makes intuitive sense that mammograms should work but that’s why we have science so we can put things to the test we owe it to our patients to be evidence-based rather than faith based they deserve an objective analysis of the data we’ve done a dismal job of accurately informing the public and the question is why well one reason is that the doctors themselves aren’t in forms for example survey radiologists found that 96% overestimated a middle-aged woman’s risk of breast cancer in one sneaky study researchers called up gynecologists and pretended to be a concerned family member asking for a phone consultation about the benefits and harms and mammograms although all the gynecologists appear motivated and concerned with sufficiently answering our questions they simply appeared to lack the information as well as knowledge of how to communicate information on medical risk when doctors meet numbers we cannot take for granted the ability of physicians to understand and interpret data and use it to the best advantage of the patient an educational blind spot for physicians identified more than 80 years ago in this study for example 151 practicing physicians were asked a series of multiple choice and true and false questions to gauge their practical understanding of some key concepts and they failed miserably only cut 55% correct only about 20% more than they would have gotten just randomly guessing if doctors don’t understand health statistics how can they possibly counsel patients properly there was a famous study in which 100 physicians were asked what the chances were of a woman actually having breast cancer if her mammogram came back positive they gave him all the numbers so they could you know do the math and 95 out of a hundred not only got it wrong but spectacularly wrong off by thousand percent even doctors at Harvard had a problem faculty staff and students at Harvard Medical School were asked a simple question and 82% got it wrong and that was a few decades ago though in an updated survey in Boston only 77% got it wrong an average of about 3000 percent off demonstrating medicines continued discomfort with math only 12% of thousands of OBGYN residents were able to correctly answer two simple questions on medical statistics what will the uninformed 88% of these residents say when their first patient asks about her chance of truly am a breast cancer given a positive mammogram and what’s particularly frightening is that in some studies those doctors most confident in the restaurants were farthest away from the correct response so they didn’t even know that they didn’t know all these studies document the same phenomenon a considerable number of physicians are statistically illiterate that is they do not understand the statistics of their own discipline so when physicians say they don’t have time to fully inform patients about the benefits and harms of a test maybe that’s a good thing if they don’t know what they’re talking about instead they may just talk about the benefits and skip the whole harms part and so we shouldn’t be surprised when 9 out of 10 women say harms from mammograms what harms while often greatly overestimating the benefits whereas in fact the benefits and harms may be so evenly balanced then maybe we should just inform women and let them make up their own minds but that’s not what you hear from ad campaigns they just tell women to do it overstating the benefits sometimes ignoring arms all together using persuasion instead of education fear guilt whatever it takes it’s easy to sell screening just magnify the benefit minimize the harms keep the actual numbers under wraps I mean studies have randomized hundreds of thousands of women to get mammograms or not to put it to the test what’s the point if we’re not going to share the results we spend billions on these clinical studies but failed to ensure that patients and physicians are communicated the results in a transparent manner maybe women should tear up the pink ribbon the campaign for honest information how else can women make informed decisions instead we get hospitals putting on like mammogram parties maybe in addition to the appetizers they should serve women balanced information to chew on as well [Music] you

36 Comments

  • Reply Johannes Anttila March 9, 2018 at 1:21 pm

    Another mammogram video. I don't even have boobs 😅

  • Reply O K March 9, 2018 at 1:22 pm

    Yikes. A bit off topic: I spent 20+ of my almost 40 years going to doctors for a number of issues including depression, chronic pain, and epilepsy. The lack of knowledge on the part of the majority of those physicians was stunning. Had I not done my own research, I might still be on tons of medication and believing that I had little choice. It’s not uncommon for doctors (and pharmacists) to fail to educate people about side effects, which are often more problematic than the underlying condition. I am not surprised by this information, but it’s still frightening. Subbed.

  • Reply D Master March 9, 2018 at 1:32 pm

    How many more episodes of mammograms to go. For something completely different ancel keys and his fraudulent data finally debunked. Proof that saturated fat causes less cardiovascular disease then vegetable oils. https://youtu.be/KRxUCVB-gAA

  • Reply Maple Flavor March 9, 2018 at 1:34 pm

    thanks

  • Reply M S March 9, 2018 at 1:36 pm

    Perform a search on depopulation- nothing personal but we’re all being exterminated.

  • Reply M S March 9, 2018 at 1:39 pm

    Is it time yet for a review of C60 and it’s amazing health benefits?

  • Reply best move March 9, 2018 at 1:59 pm

    Dr. Greger is obsessed about saving boobs.

  • Reply Bumble Bee March 9, 2018 at 2:31 pm

    This one hit home for me as I work and play in the same playground you discuss…I have loved this series. I am well-informed about this now, and I feel more empowered.

  • Reply na' ah mean? March 9, 2018 at 2:43 pm

    about like circumcision ……. don't want to miss that $$$$$$$

  • Reply Shari T March 9, 2018 at 2:51 pm

    Thanks for posting! 'Let the buyer beware'

  • Reply Jigglypoop97 March 9, 2018 at 2:57 pm

    I know this is an important topic, but these are getting a bit tiresome.

  • Reply Eelke Aptroot March 9, 2018 at 3:00 pm

    I checked out that '"simple" question and I totally understand why almost half of the participants went for the wrong answer. So basically that means that 98% of all treatments ever executed were unnecessary, if that's true then it's still a miracle that only 2 women died from the treatment for every 1 that was saved…

  • Reply Vegan For The Animals Ⓥ March 9, 2018 at 3:18 pm

    Great series, Doc (and team)….now we need to get this info out to the general public….that's the tough part….

  • Reply Maureen K March 9, 2018 at 3:57 pm

    Thank you so much for this clarification!

  • Reply Sunghee Lee March 9, 2018 at 4:59 pm

    Thank you, Doctor Greger and the team. Fantastic work as always!

  • Reply farm country March 9, 2018 at 5:10 pm

    IMO Dr G is far too easy on the medical establishment. My own personal experience and the experiences of countless people sharing via internet (e.g. ChrisBeatCancer), is doctors actively push back against any information that could jeopardize their revenue. I mention Chris Wark because many he's interviewed share their oncologist's reaction to informed patients. Hostile would be an understatement.

  • Reply Terry Moore March 9, 2018 at 5:20 pm

    Having one mammogram was enough for me, how can 100 pounds of pressure and radiation be good for any living thing !

  • Reply Christy M. March 9, 2018 at 6:46 pm

    Thank you for this series. If only I can get my friends to view it. They hold the medical establishment in such high regard that any other voice goes unheard.

  • Reply Deb Stay Blessed March 9, 2018 at 6:53 pm

    Hahaha 😂 doc missed his calling. This is hilarious. No this is terrible. The situation is terrible Over 80% getting stuff wrong? Seriously, this makes me think twice about relying on someone's opinion white coat or not I do my own research to make an informed decision. Thanks Dr Greger peace and prayers.

  • Reply Jeena Bittenbender March 9, 2018 at 7:10 pm

    Awesome series

  • Reply D Master March 9, 2018 at 8:31 pm

    To become a doctor all you need is be good at remembering facts for an exam. You don't need any critical thinking skills or maths ability. That's why Engineers can get to the root course of a problem where as doctor's haven't got a clue.

  • Reply Celina K March 9, 2018 at 9:42 pm

    2:35 I could do that one in me head as (1 out of 1000 and 50 out of 1000) so 1 out of 50. For fck sake, how do they get that one wrong

  • Reply Michael Hammer March 9, 2018 at 10:16 pm

    I am a subscriber to your channel and own both of your books! Could you please disprove the content in this video scientifically : https://youtu.be/OqvwEJ2dFdU

  • Reply B A March 9, 2018 at 11:07 pm

    Dr. Gregers , we don't have the capacity to check evidences so we can use only faith and semi-evidence, now where to put our faith and whom to believe? it all boils down to faith at least for simple people like us… I believe you

  • Reply Jon The Mad Scientist March 10, 2018 at 3:15 am

    you're still on mammograms!!

  • Reply Swaaagquan March 10, 2018 at 8:18 am

    I know several doctors, they're terrible at maths. Don't trust them to handle your statistics.

  • Reply patty 8873 March 10, 2018 at 10:34 am

    Also watch Dr. Pam Popper’s videos about mammograms. None of this information is new to me…I’m just glad Dr. Greger has addressed this. Kudos to him!

  • Reply Jamie Maidment March 10, 2018 at 2:49 pm

    I agree that this is important information, but I thought your focus was on NUTRITION? Love you, Greger, but I'm longing for some nutrition videos!
    If you're exploring some other health care topics now, could you do a video on fluoride supplementation? And maybe one on childhood vaccines? I know you get asked about these things quite a lot. Thanks 🙂

  • Reply 47retta March 10, 2018 at 5:06 pm

    Very important series! So many are fooled by the mammogram issue and treatments for breast cancer.

  • Reply Mark Biddy March 10, 2018 at 10:55 pm

    great work…but some people…maybe a lot of people don't want to be responsible for decision making. they leave it to the "professionals" (i.e. a savior) and assume they know what they're doing while the patient lives an ignorant yet blissful life. people do tend to shirk their responsibilities when they are paying someone else to think for them – alas, the facts should be laid bare, not a pretty smoke screen. love your work mike – keep popularizing that science!

  • Reply kuriosites March 10, 2018 at 11:58 pm

    As a nurse, my experience is that doctors usually discuss risks as they relate to their own experience (e.g., "there's a possibility of a punctured lung but I've never had one."). In their defense, I know most doctors are really busy and so they're likely prioritizing their energy where they think it's most important. Let's just persuade the patient to sign a consent for the course of action that I truly believe is the best thing for them.

  • Reply Matthew Byrne March 11, 2018 at 2:50 pm

    whats healthier tap water bidet or regular (bleached white) toilet paper

  • Reply reinux March 11, 2018 at 7:04 pm

    77% of docs getting classic Bayesian question wrong… uh…
    Now I'm scared as hell.

  • Reply Eman Camilleri March 16, 2018 at 8:43 am

    In layman terms we are really fuc*ed up guys.

  • Reply Mir Schultz April 4, 2018 at 6:31 pm

    Dr. Greger, doing public service interestingly as usual. Thank you, sir.

  • Reply beautiful20106 December 27, 2018 at 3:09 am

    All drs are greedy
    Don’t trust them
    They want surgery , chemo , drugs to get them rich

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