With no family doctor, one woman felt compelled to lie to get a mammogram

A Fraser Valley woman felt compelled to lie about having a family doctor after she was incorrectly told she couldn’t get a routine mammogram without having one.

Mary Hughes is 70 years old and has been getting screened for breast cancer since she was 40.

After a patient has their first mammogram, BC Cancer sends annual reminder letters. Hughes has gone through the process for the past 30 years, but something was different this time: she didn’t have a family doctor.

Hughes is among the nearly one million British Columbians who are without a family doctor. She moved to Agassiz from Vancouver Island last summer and has been trying to find a doctor since then.

The process to book an appointment this year was routine until a BC Cancer agent asked Hughes for her family doctor’s information and she didn’t have any to provide.

“They said, ‘Well, then you can’t get a mammogram,’” Hughes recounted. “I said, ‘What, are you kidding me?’”

Out of fear of missing an opportunity to get screened, Hughes lied and said she was on a waitlist at a medical office she had already been turned away from. That was good enough for the agent and Hughes’ appointment was secured.

But disturbed by the need to lie, Hughes contacted The Current.

Hughes was misinformed, a Health Ministry spokesperson subsequently told The Current—though people do need to provide information for a health care professional to book a test. The province says people don’t need to be attached to a family doctor. If a patient doesn’t have a health care professional (doctor, nurse practitioner or naturopathic physician) to list at the time of booking their appointment they will be given the option to identify a walk-in or virtual clinic they regularly visit. They may also be told to visit the province’s online directories with information about doctors and medical clinics.

“An individual needs to be registered with a health professional in advance of getting a mammogram to ensure that the health professional has permission to review the results, and to manage the patient in the event of an abnormal screen result,” the spokesperson said in an emailed statement.

Hughes, though, wasn’t presented with any options when she was booking.

Agassiz is served by a mobile mammography unit, rather than a screening centre, and the clinic visited Agassiz last week. Hughes got her mammogram then. Now, like usual, she’ll wait a couple of weeks for a letter in the mail that will tell her the results of the exam. If the report is concerning Hughes said she would seek out a doctor at a walk-in clinic.

“I’m not gonna ignore it,” she said. “It’s better than not being able to get a mammogram at all.”

BC Cancer encourages women over the age of 40 to have a routine mammogram each year, especially if there is a history of breast cancer in the family.

Hughes is vigilant about getting screened each year, and not only because her mom had breast cancer. She also lost her husband to the illness.

“Men do get it too, you know,” she said. “He waited two years to tell me that he had a lump before it started hurting. It was behind his nipple. So it wasn’t very visible. In fact, it wasn’t—I never noticed it at all.”

Only in BC

BC is the only jurisdiction in Canada that requires a person to list a health care provider at the time of booking their mammogram, according to Jennie Dale, co-founder of Dense Breasts Canada.

Dale’s non-profit organization looks at the barriers to access screening across Canada.

She calls BC’s requirement to list a health care professional inequitable.

“Only 54% of women in British Columbia are getting mammograms,” she said. “It’s conceivable that the rate could be higher without this barrier.”

BC is ahead of other jurisdictions in other ways, she said. People are allowed to self-refer for a screening at the age of 40 and are told whether they have dense breasts. Dense tissue makes it more difficult to detect cancer during a mammogram.

“Mammograms are X-rays. And if you have dense tissue, it shows up as white on the X-ray, and cancer’s white,” said Dale. “So there’s a masking effect. So mammograms are not an ideal tool for all women. Although you have to have a mammogram because they can pick up calcifications.”

Hughes isn’t afraid to advocate for her health but she is worried for young families with busy schedules who might have been in her situation and delay getting screened.

“Me, I’m a pest,” she said. “I will definitely get it one way or the other no matter what I have to do.”