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MLMIC Insight: Delays in Breast Cancer Care During the COVID-19 Pandemic
The COVID-19 pandemic has caused disruptions in the healthcare system in many ways. Resources have been diverted to care for infected patients, the public has been reluctant to seek care and treatment and, in some cases, this has resulted in care delays. A study, published in Breast Cancer Research and Treatment[1], has demonstrated a significant impact on cancer care and delays in treatment in the early part of the pandemic.
The researchers used a survey tool to query adult cancers survivors in the US regarding treatment delays during the pandemic. Forty four percent of the respondents indicated delays occurred in some aspect of their care. Respondents reported the highest delays in routine follow-up care (79%), surgical breast reconstruction (66%), diagnostic imaging (60%) and lab testing (50%).
There was no significant effect for race, insurance, site of care, or cancer stage. The only variable that demonstrated a significant result was age, with younger respondents reporting a higher frequency of delays than older respondents.
The study authors suggest their findings appear to demonstrate gaps in emergency preparedness that reveal our plans may address the crisis at hand while not providing for how to address the needs of not only cancer patients but those with chronic diseases as well.
The findings are of particular concern, given the fact that, on the basis of a National Cancer Institute model, tens of thousands of excess cancer deaths are predicted to occur over the next decade as a result of COVID-19-related delays in diagnosis and care.[2]
Timely follow-up for patients with potential diagnoses of breast cancer is essential. Claims alleging a delay in or failure to diagnose breast cancer are often difficult to defend. They frequently involve multiple providers, including the patient’s primary care physician, and OB/GYN along with the radiologist, and any surgeon who may have been involved in the patient’s care. As indicated in the 2018 CRICO benchmark report “Medical Malpractice in America”, breast cancer is associated with more than half of all failure to diagnose cancer cases. Likewise, in MLMIC’s own Million Dollar Claims: A Closer Look, we identify that breast cancer cases often impact younger patients, resulting in more significant claims payouts.
At MLMIC we recognize that failure to follow-up poses significant risk to both patients and providers. We encourage policyholders to review the following risk management tips with strategies to assist physicians and office staff develop and utilize effective approaches for the management of patient care:
- Tracking Test Results, a risk management tip on developing procedures that ensure diagnostic test results are received, reviewed and properly addressed with patients;
- Follow-up of Missed or Cancelled Appointments, a risk management tip on creating well-defined processes for provider notification and follow-up in situations of a missed or cancelled appointment; and
- Communicating and Following-Up Critical Test Results, a risk management tip on implementing policies and procedures to ensure proper management of patient test results.
[1] https://link.springer.com/article/10.1007/s10549-020-05828-7
[2] https://www.medscape.com/viewarticle/936210
