Reading screening mammograms – Attitudes among radiologists and radiographers about skill mix

Introduction: Because of shortage of personnel for the Danish mammography screening programme, the aim of this study was to investigate the attitudes of radiologists and radiographers towards a future implementation of radiographers reading screening mammograms. Materials and methods: Seven combined phenomenological and hermeneutical interviews with radiographers and radiologists were performed. Stratified selection was used for sampling of informants. The interviews were analysed against theory about quality, organization and profession. Results: Quality related possibilities: radiographers do routinely measure the performance quality, radiographers obtain sufficient reading qualifications, and skill mix improves quality. Quality related obstacles: radiologists do not routinely measure performance quality. Organization related possibilities: shortage of radiologists, positive attitudes of managers, and improved working relations. Organization related obstacles: shortage of radiographers and negative attitudes of managers. Professional related possibilities: positive experience with skill mix. Professional related obstacles: worries about negative consequences for the training of radiologists, and resistance against handing over tasks to another profession. Conclusion: Attitudes towards radiographers reading screening mammograms are attached to either quality-, organisational or professional perspectives. Radiographers are capable of learning to read mammograms at sufficient performance level but routine measurement of performance quality is essential. Resistance against skill mix may be caused by an emotionally conditioned fear of losing demarcations. The main motive for skill mix is improvement of the utilization of resources. No evidence was found regarding the organisational and financial consequences of skill mix. Despite of this all radiologists and radiographers experienced with skill mix were strong advocates for reading radiographers.