Table 1.

Methods Used By Primary Care Clinician Exemplars to Achieve High Rates of Mammography Screening in Their Patients

1. Make a commitment to provide prevention services, both personally and as a practice, focusing on the most important preventive services and making sure that all eligible patients are offered those services. Think about preventive services at every visit with every patient. Suggestions for critical adult preventive services include:
  1. Colorectal cancer screening for all ages 50 and older;

  2. Mammography for women beginning at age 40;

  3. Cervical cancer screening for women ages 18 to 65;

  4. Influenza vaccination for all ages 50 and older and anyone else who wants it;

  5. One-time pneumococcal vaccination for all ages 50 and older.

2. Use a clinician/nurse reminder system of some type such as:
  1. Preventive services flow sheet;

  2. Special mammography stickers for women older than 40;

  3. Preventive services reminder card that nurses complete.

3. Make the mammography appointment for the patient. (Don't ask the patient to do it.) Caveats include:
  1. Ask the patient what day and time would be best (before they leave the office) so that the appointment made by your office will be convenient for them;

  2. Discuss potential barriers with patients who have missed or delayed their mammograms and ask them what it would take to get them in for their mammography.

4. Use only 1 mammography center for almost all of your patients. Select the referral center based on the following:
  1. Appointments should generally be available within 2 weeks;

  2. Mammography center should always send a report to the patient and to you;

  3. Mammography center should let you know when patients miss their scheduled appointment;

  4. Mammography center should send a reminder to the patient every year (or as indicated);

  5. Mammography center should do further testing without bothering you for additional orders.

5. Schedule well adult examinations on a regular basis to catch up on any preventive services that have been missed.