Every year, I schedule my mammogram.

Every year, I walk in expecting a routine screening.

And almost every year, I receive the same phone call.

“We’d like you to come back for additional imaging.”

The reason is always the same: an area on my left breast that warrants a closer look.

Then comes the diagnostic mammogram. The ultrasound. The waiting. The worry.

And then the answer.

“It’s a cyst.”

The same answer I’ve received for years.

This year, however, there was a new twist. The additional testing cost me nearly $1,000 out of pocket.

As someone who works in healthcare, I understand the importance of breast cancer screening. Mammograms save lives. Early detection matters. Radiologists carry an enormous responsibility, and I would never advocate for reducing access to screening or ignoring suspicious findings.

But after more than a decade of repeating the same cycle, I found myself asking an uncomfortable question:

At what point does the healthcare system learn from the evidence it has already collected?

The Cost of “Just to Be Safe”

Healthcare often operates from a place of caution.

And in many cases, that’s appropriate.

Nobody wants to miss cancer.

But caution comes with costs that are rarely discussed.

There is the financial cost. Additional imaging is expensive, particularly for patients with high deductibles or coinsurance.

There is the emotional cost. The moment patients receive a callback notice, many immediately assume the worst.

There is the time cost. Additional appointments mean more time away from work, family, and other responsibilities.

And there is the trust cost.

When patients repeatedly hear the same message year after year and repeatedly receive the same benign result, they begin to wonder whether the process is truly providing value.

I know I did.

The Difference Between Detection and Value

Sometimes in healthcare, we confuse doing more with doing better.

Value-based care challenges us to ask a different question:

Did this intervention meaningfully change the patient’s outcome?

In my case, after years of diagnostic mammograms and ultrasounds confirming stable cysts, I have to wonder what new clinical information was gained.

The answer may not be none.

But it is difficult to ignore the fact that the conclusion has remained remarkably consistent for years.

That raises an important question:

Should a patient with a newly discovered finding be managed exactly the same way as a patient with more than a decade of stable imaging history?

I don’t believe that’s an unreasonable discussion to have.

A System Designed to Remember, Yet Often Doesn’t

One of the great promises of modern healthcare is data.

We have electronic medical records, digital imaging archives, cloud-based storage, artificial intelligence, and sophisticated analytics.

Yet patients often experience healthcare as if every encounter starts from scratch.

The history exists.

The images exist.

The prior reports exist.

The previous workups exist.

But too often, the patient’s experience feels like the system is rediscovering the same fact over and over again.

After ten years of stable findings, I wasn’t worried about what the ultrasound would show.

I was frustrated that the system seemed unable to remember what it had already learned.

The Patient Experience Matters

As healthcare professionals, we sometimes underestimate the emotional burden of uncertainty.

I understand breast imaging.

I understand risk.

I understand probabilities.

Many patients do not.

For those individuals, every callback can feel like a potential cancer diagnosis.

Every additional test creates fear.

Every delay creates anxiety.

If value-based care means anything, it has to include the patient experience alongside clinical outcomes.

The goal cannot simply be finding more disease.

The goal must also be reducing unnecessary burden when evidence repeatedly points in the same direction.

We Can Do Better

This isn’t an argument against mammography.

In fact, it’s the opposite.

I support mammography because it saves lives.

But supporting mammography does not mean accepting inefficiency.

It does not mean ignoring patient costs.

It does not mean repeating processes without asking whether they are still serving the patient.

Healthcare should always strive to improve.

We should continuously ask whether our processes are incorporating years of prior information effectively.

We should look for opportunities to reduce unnecessary anxiety.

We should evaluate whether repeat testing is generating meaningful new information.

And we should recognize that patients are not just images, reports, or billing codes. They are people who experience the cumulative effect of every appointment, every bill, and every callback.

Final Thoughts

My annual mammogram will always be worth it if it helps identify cancer early.

But after years of receiving the same answer for the same finding, I believe it is fair to ask a question that sits at the heart of value-based care:

When a decade of evidence points to the same conclusion, should the process evolve accordingly?

Because value-based care is not about doing less.

It’s about doing what matters most.

And sometimes the most important thing a healthcare system can do is demonstrate that it has learned from what it already knows.