Rethink Imaging

EP 13 • February 20, 2025

Legislating Change: How Dr. Amy Patel is Shaping the Future of Breast Imaging

Featured Guest

Dr. Amy Patel, MD

Medical Director, Breast Care Center · Liberty Hospital •

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Dr. Amy Patel, Medical Director of the Breast Care Center at Liberty Hospital, joins host Chris St. John to talk about where breast cancer screening legislation meets patient care. She traces her path from a small rural town in northwest Missouri to leadership in breast imaging advocacy, starting with testimony in the Massachusetts legislature just one year out of training. Back in Missouri, she helped pass three critical laws: annual 2D and 3D screening mammography coverage starting at age 40 in 2018, coverage for above-average-risk imaging in 2020, and diagnostic breast imaging without copays or deductibles in 2023. Neighboring states are following, and the precedent keeps spreading.

The conversation then turns to what still stands in the way: uninsured and underinsured patients, insurance loopholes, and the absence of sweeping federal legislation. Dr. Patel explains how state programs like Show Me Healthy Women and hospital foundation funds close coverage gaps, why the Find It Early Act and the Access to Breast Cancer Diagnosis Act matter, and how a 2020 social media push brought patient stories straight to Missouri’s Senate Finance Committee. Her advice for clinicians is practical: advocacy can start with a coffee meeting or a site visit with a state legislator. Early detection is the payoff, since finding a cancer under a centimeter puts survival probability near 100 percent.

Host

Chris St. John

Host, Rethink Imaging / Imalogix •

Featured Guest

Dr. Amy Patel, MD

Medical Director, Breast Care Center · Liberty Hospital •

Watch the Episode

Key Takeaways

Missouri passed three critical breast imaging coverage laws: annual 2D and 3D screening mammography starting at age 40 (2018), coverage for above-average-risk patients (2020), and diagnostic breast imaging without copay or deductible (2023).
Guidelines without coverage fall short. Dr. Patel’s test is simple: a recommendation only matters if insurance actually pays for the exams it calls for.
Two federal bills, the Find It Early Act and the Access to Breast Cancer Diagnosis Act, would extend coverage nationally. Passage is uncertain in a budget-neutral Congress, but reintroduction is expected and advocates keep pushing.
State programs like Show Me Healthy Women (Missouri) and Early Detection Works (Kansas), paired with hospital foundation funds, cover uninsured and underinsured patients who fall through legislative gaps.
Grassroots tactics work: coffee meetings and site visits with state legislators, patient stories, and a 2020 social media push that produced more than 40 letters to the Senate Finance Committee helped get the high-risk imaging bill passed.

Full Transcript

[00:00:02] Amy Patel: Welcome to Frame by Frame Rethink Imaging, a podcast by Imologix. Here, we explore the intricate world of medical imaging, aiming to dissect the field and inspire both professionals and curious minds alike. I’m your host, Chris St. John. Today on Frame by Frame Rethink Imaging, we are so excited to welcome doctor Amy Patel. She currently serves as an associate of radiology at the University of Missouri Kansas City and as the medical director of the Breast Care Center at Liberty Hospital, now part of the University of Kansas Health System. Doctor Patel is also an affiliate member of the University of Kansas Cancer Center, where she serves on their health policy committee, and she currently holds the position of president of the Missouri Radiological Society. With a career dedicated to advancing breast imaging and empowering women to take charge of their breast health, doctor Patel has become a strong voice in legislative advocacy. Today, we will discuss her advocacy efforts, the importance of legislative change in mammography access, and how policy can help improve patient care and outcomes in breast health. Welcome, doctor Patel.

[00:01:12] Chris St John: Thank you. Thanks for having me.

[00:01:13] Amy Patel: Yeah. Thank you so much for being here, and thank you for sitting through my, like, slightly verbose introduction. Yeah. Just to dive right in with you, doctor Patel, you’ve had a fascinating career in radiology with focus on breast imaging. What inspired you to specialize in this area, and how did your interest kind of evolve over the years?

[00:01:31] Chris St John: Sure. So as many people that know me well, I come from a small rural town in Northwest Missouri, and I thought that I was going to go back home, practice primary care with an emphasis on women’s health. Because, uh, there was such a paucity of women physicians growing up. I just didn’t really see, you know, women physicians. We had one at the time when I was growing up. So I really saw the disparities from a very early age, and I was asking my parents lots of questions like, you know, why is she the only woman physician in town? You know, things like that as both of my parents were also in health care before they retired. And so I went to medical school. I was fortunate to get accepted to the six year medical, uh, school program at the University of Missouri Kansas City. Again, still on my trajectory to go back home. And one of my best friends, his mother was a breast radiologist in Saint Louis. And he said, you know, I know you wanna go back home, but maybe you should go do a rotation with her. See if you like it. It might have all the elements that you want as a practicing physician. So I said, okay. So I went and did an elective with her, and I just never looked back. It had all the elements, breast imaging, that I was looking for. The patient interaction, the advocacy piece of how you can make a difference in a patient’s life and save their life when it comes to breast cancer. Just the procedural aspect. I like to do procedures, but also interpreting at the workstation and just having just really interesting cases come your way. I mean, I just found breast imaging to be very intellectual. And so from there, I just kind of shifted gears, and I was fortunate to match into radiology. And then I ended up doing my residency at the University of Kansas in Wichita, and then I actually went back to Saint Louis, uh, Washington University in Saint Louis where I had done that elective as a medical student to do my breast imaging fellowship. So that’s sort of how it all culminated, but my love and passion for women’s health really never waned. And just, you know, now, you know, I feel like the my practice of breast imaging has evolved and making sure there’s equitable access to care for all patients regardless of gender. I wanna make sure that everyone has access. So that’s sort of how my story came to be and how my practice has evolved over the years.

[00:03:42] Amy Patel: Amazing. You know, we’re gonna get more into your advocacy work regarding MAMO legislation. But can you tell me a little bit about how you move like, transitioned or shifted your focus from clinical practice to more advocacy work?

[00:03:58] Chris St John: Sure. So I started at my career right out of fellowship at practicing at Beth Israel Deaconess Medical Center in Boston, Massachusetts. And very quickly, one of my colleagues who is now, you know, he’s she’s a beloved friend and mentor, doctor Priscilla Sainitz, uh, she chaired the mammography committee for Massachusetts Radiological Society. And she said, you’ve gotta join our state society. You’ve gotta get on our committee. I want you to get involved. Because she knew I had a little bit of interest in advocacy and health policy. You know, I grew up like a political junkie, uh, because of my dad. And so she’s like, I want you to see if you like it. Um, I’d already been vociferously involved in the American College of Radiology as a trainee and a fellow. So she said, you know, maybe you’ll like this. And I just I loved it. And so I had a really awesome opportunity just one year out of training to testify in the Massachusetts legislature with her as we advocated for coverage for women for diagnostic breast imaging without co payer deductible. So that was the first, I think, pivotal moment in my career where I realized, wow, you know, what we do can make a difference. Now it took many years for that legislation to pass, but it finally passed, you know, across that finish line last year, which was wonderful to see. And I’m no longer in Massachusetts, but it’s so wonderful to see the sweat equity that doctor Slindon has put in, multiple others, Susan g Komen, Dana Farber. And so that’s really where it all came from. And so when I had a wonderful opportunity to go back to Missouri to practice to build a comprehensive breast program, policy was quite lacking in Missouri and I know we’ll be getting into that. So I was really able to use those skills that I cultivated and I was able to acquire in Massachusetts due to wonderful mentors like doctor Slant and bring that skill set to Missouri, uh, so that we could pass really critical legislation for access to care for Missouri women.

[00:05:48] Amy Patel: That’s amazing. So you kinda just dove right in from the beginning.

[00:05:52] Chris St John: Yes. Hell,

[00:05:54] Amy Patel: yeah. I’m here for that energy.

[00:05:55] Chris St John: I mean, that’s kind of my thing. Go big or go home. Right? So

[00:05:58] Amy Patel: Absolutely. Okay. Doctor Patel, could you discuss the significance of the bills you helped pass Missouri ensuring that diagnostic breast imaging is covered by private insurers without co pays or deductibles?

[00:06:10] Chris St John: Sure. So we were really fortunate to pass three critical pieces of legislation in Missouri. And I say we because it truly is a team effort. I mean, you can’t pass this legislation without multiple factions involved, areas of expertise, you know, multiple, you know, elected officials and the Missouri legislature really championing our efforts. So the first critical piece was screen mammography coverage. So prior to us passing this bill in 2018, insurers were only required to cover two d screening mammography every other year beginning at the age of 50. And once this bill passed in 2018, they were required to cover screening mammography annually uh, both two d and three d mammography starting at age 40 in accordance to the American College of Radiology recommendations. So that was huge because the legislation hadn’t been amended since the early nineties. So that was really a huge victory for us. So that was the first thing. And what was really great to see is once we were able to get that bill passed, the Kansas insurance department started covering these mammograms annually at 40, three D, and two d for Kansas women. So that was awesome to see that happening, you know, just right next door. So then in 2020, we were able to pass critical breast imaging legislation for above average risk patients in accordance to the American College of Radiology recommendations. And that was wonderful, uh, because we had so many women who are above average risk that weren’t having their screenings covered by insurance. Uh, so that was a huge victory. And then in 2023, we were able to get diagnostic breast imaging coverage without co payer deductible, uh, passed, which was also just an incredible feat. So we were able to get these three pieces passed and, you know, over the years, we have really tried to tighten up the language. We’re currently sort of working on tightening up the language with the last bill that just passed to ensure that there are no loopholes so that all patients are covered appropriately.

[00:08:08] Amy Patel: That’s amazing. And how like, do you see any signs that it’s setting a precedent for other states or

[00:08:14] Chris St John: regions? Sure. So what’s been really wonderful to see is many, many states are passing now legislation when it comes to above average risk, supplemental screening, diagnostic breast imaging. Uh, so it’s been wonderful to sort of see more and more states passing this kind of legislation every year. You know, just recently, New Hampshire passed similar legislation. Iowa passed similar legislation. So we’re starting to see this really take flight. Because, unfortunately, in this country, we still don’t have sweeping federal legislation. So until we’re able to get to that point, it’s really upon the states to take charge and to pass these pieces of legislation, uh, for their patients so they can have access in accordance to the recommendations that we make.

[00:08:59] Amy Patel: Yeah. Absolutely. Amazing. We don’t have to keep this in the episode. Let me just say, like, you speak with such passion about this. I just really appreciate listening to you talk. I just wanted to say that. So as an advocate for equitable access to breast health services, how do you start to address the disparities in mammal access, particularly among underserved or at risk populations?

[00:09:25] Chris St John: Sure. So, you know, these are the questions that keep me up at night that, you know, we’ve made such great progress with patients who have insurance and the appropriate imaging that they need. But what about if they’re underinsured? What about if they’re noninsured? What about those women? And that’s what keeps me up at night. So it’s really important that health systems have, for example, priorities that are focused on helping these women. And often, there are state programs in which health systems can collaborate with to help these patients. So for example, in Missouri, we have a state program called the Show Me Healthy Women program. And the Show Me Healthy Women program covers patients that need all breast imaging needs if they meet the 200% poverty level. Order for these patients to receive this access, they have to go to a facility that is a Show Me Healthy Women provider. Now in the past, it is quite difficult to become a Show Me Healthy Women provider. There’s been a lot of hoops to jump through. You know, some health systems just don’t think that, you know, the juice is worth the squeeze, which I totally understand. There’s so many hours in a day. There can be barriers to becoming a provider. But luckily, for example, in the state of Missouri, the Show Me Healthy Women board is really working on making sure that health systems and health centers who want to be a provider, that red tape is eliminated so that they can provide access for these patients. Uh, so next door in Kansas, we have similar program called Early Detection Works. So as more and more health systems, if they can prioritize having collaboration, being a provider of these particular state entities, they can really help address a lot of these issues for our under insured patients. Additionally, having collaboration with your hospital foundation is imperative too if you are working at a hospital system. So when I assume the roles medical director at Liberty in 2018, I quickly met with our hospital foundation. And I said, you know, I wanna set up some sort of health fund for patients who need access to breast cancer care. And we’ve been really fortunate over the years to have a really robust fund where if, you know, we have a patient that shows up that doesn’t have insurance, we just pick up the phone, call the foundation, and tell them the situation, and we’re able to go through the appropriate, uh, steps to make sure these patients are covered. So for example, next Wednesday, we’re having sort of a Valentine’s theme, uh, screening day, and anyone can come and get their screening mammogram regardless of insurance status. And those patients who show up who don’t have insurance will be covered by the Liberty Hospital Foundation. So that collaborative approach too can really help and it works, you know. People say, like, oh, you know, you’re talking about this program. Well, I’m living proof that, yes, it’s hard work. But collaborating with these sort of entities, you can provide true tangible access to care for patients. So these are some ways that we’re working on trying to improve access for patients, but I know that there are so many other organizations out there where health systems and health centers can collaborate. These are just a couple that we’re doing and we’re striving. For example, for Show Me Healthy Women, we’re striving to become a provider currently to make sure that patients have access. And in the meantime, we have our foundation to lean on so patients don’t have to be turned away.

[00:12:43] Amy Patel: That’s so incredible. And one of the things that I talk about coming from restaurants a little maybe too much on this podcast, but having spent so long in the service industry, one of the things I’ve noticed, right, is some folks sometimes being not wanting to make too much money because there’s, like, this little dead zone where you can’t get the help and the access to care that you need because you make slightly too much, but not quite enough to pay for the actual care itself. I don’t know. It’s really inspiring to hear about programs like this that don’t leave dead zones. You know?

[00:13:16] Chris St John: And, you know, you make a great point. I mean, we live in one of the wealthiest countries in the world, and it’s so sad to me to think that a patient has to think that way. Like, I can’t make this much because if I make this much, I’m not gonna be covered for x, y, and z when you shouldn’t have to be that way. Right? And so, you know, I think it’s really incumbent upon health systems and health centers to come up with alternative solutions, particularly for those patients who are kind of in those gray areas.

[00:13:44] Amy Patel: Right. If folks were interested, like, what steps can be taken to help ensure that more legislation is passed to address these inequities?

[00:13:53] Chris St John: Sure. So, you know, it can start as a very simple conversation with your state elected official in the region. Reaching out, meeting for coffee, having them come have what’s called a site visit at your hospital system. So we’ve hosted many elected officials at our health system and particularly in our breast center to show them, you know, who we are as radiologists, the integral role we play in breast cancer care, what does a breast radiologist do? And they’re pretty blown away because a lot you know, we have to remember that a lot of members of congress at the federal level, elected officials at the state level, a lot of them don’t even know their radiologist is a physician. So that’s, like, the first step to make them realize that we are doctors. And then once we share with them what we do and the role that we play, they’re completely blown away. Wow. I didn’t know that you’re such an integral part of the multidisciplinary breast cancer care team. So having that initial meeting, really having them understand what you do is important. And then sharing with them patient stories, issues that you’re facing in the clinic. Because they’ll ask, like, so what are the challenges you’re facing in the clinic? And you gotta share it with them. And, you know, what’s really great is I truly feel that our elected officials, you know and don’t mean to get too political, but I do think when it comes to issues such as breast cancer care, I do think that in specifically in Missouri, we have a very bipartisan effort, you know, really blown away by this and I’m really grateful. And they want these patients to have access. So really sharing with them the issues can really spark, you know, a flame that, you know, I wanna champion this. I wanna help this physician. I wanna help this team make sure that these patients have coverage. And, consequently, we’ve seen a wonderful bipartisan support on this issue in Missouri. And I really feel because of that camaraderie of with both sides of the aisle for this issue, we’ve been able to get all of this breast imaging legislation passed.

[00:15:46] Amy Patel: That’s incredible and, honestly, pretty inspiring nowadays. Your advocacy work also extends to earlier surveillance for women at high risk for breast cancer, and this is something you’ve been talking about. First of all, just from my edification as someone who does not live in this world, can you talk a little bit about what makes a woman higher risk or makes a person higher risk for breast cancer and explain the rationale and the role that legislation plays in ensuring these people receive the care they need without the financial barriers.

[00:16:20] Chris St John: Sure. So we recommend that any woman of any color is risk assessed by age 25, and there are risk assessment tools out there that can calculate a patient’s lifetime percent risk of breast cancer. If the patient is deemed twenty percent or greater lifetime risk, they’re considered above average risk. And then if that’s the case, we recommend the American College of Radiology and the Society of Breast Imaging recommend annual breast MRI from the ages of 25 to 29, and when they turn 30, in addition to that annual MRI, screening mammography alternating every six months. So the premise of this is because, you know, we are obviously wanting to catch cancer sooner, particularly in those who are above average risk for breast cancer. And you might have seen, you know, in the media recently that we are finding more breast cancer in younger patients and cancer in general. It’s just younger and younger and younger.

[00:17:14] Amy Patel: I know. I’m 33 and I I think three of my friends this year have all gotten diagnosed with some form of cancer. Some breasts, some not. But

[00:17:23] Chris St John: yeah. Yeah. And it’s devastating. And then we know particularly in certain, uh, factions that, uh, for example, black women, they tend to have more biologically aggressive cancers known as triple negative breast cancers. We know that white women are more likely to be diagnosed with breast cancer, but black women are forty percent more likely to die from breast cancer. And in Missouri, it’s actually forty six percent, so it’s higher than the national average. So having these recommendations in place are so imperative. And so having that insurance coverage for the recommendations we make for imaging is even more imperative. Because like I always say, you can make any guideline or recommendation, you know, until you’re blue in the face. But if there is no insurance coverage for these patients or those who are uninsured, if there’s no coverage for these patients, like, what is the point of making all these recommendations? What is the point of the guidelines? We have to have some sort of access and coverage for these patients.

[00:18:17] Amy Patel: Yeah. Absolutely. I’m still new to having, like, an insurance plan that does something. And, honestly, like, I still am waking up to the fact that I’m like, oh, I can go to the doctor. Like, this is great. And now being here in this whole health care world, it’s like, I feel spoiled.

[00:18:33] Chris St John: Yeah. And, you know, we know if we can detect a cancer at its earliest notice. So if we can detect a cancer that’s less than a centimeter in size, your survival probability is almost a hundred percent. So that’s why we stress early detection so much. And it’s not just saving a patient’s life. If we can find a cancer when it’s very tiny, very millimetric, that leads to less invasive treatment for the patient as well. So it’s not just about mortality, but it’s morbidity for the patients as well, And they have better outcomes. So there’s a reason, you know, that we recommend what we recommend. And so it’s been, again, really wonderful to see these guidelines be issued. It’s been great to see access to care for patients in multiple states through legislation, but the work certainly isn’t done. There’s a lot of states that are not covered, and the goal is to have sweeping federal legislation for all patients.

[00:19:21] Amy Patel: That’s amazing. So doctor Patel, you talked a lot about sweeping federal legislation. Is there anything actually on the way or anything moving?

[00:19:32] Chris St John: Yes. So last legislative session, there were two pieces of federal legislation that were introduced. The Find It Early Act and the Access to Breast Cancer Diagnosis Act. Both are very similar pieces of legislation, but the a b c d act has a little bit of a narrower scope of insurance coverage. But the goals of these pieces of legislation is to ensure that there is coverage for women who need access to diagnostic breast imaging without co payer or deductible supplemental screening and those who are high risk as well. So there’s a lot of pieces involved with coverage. And so, yes, you know, as a result, it will be a very costly bill if one of these pieces passed in a political climate where congress is trying to achieve budget neutrality. It is gonna be difficult. I mean, I’m very bored. I’m a straight shooter when people ask me, you know, what are the odds of this getting passed? The odds of it getting passed last year obviously did not get passed. There is no reason why these pieces won’t get introduced this legislative session, but we need to be realistic that there’s a good chance they won’t pass again. But that doesn’t mean we don’t keep trying. So we know that last September, the FDA MQSA, you know, there was a final rule that took effect in terms of us having to notify patients about their breast density. I mean, that was something that we advocated for for decades. And it finally came to fruition where all 50 states have to employ this now. So, you know, I’m cautiously optimistic that at some point, we will have sweeping federal legislature for patients when it comes to these types of life saving examinations that they need. It just might take time, like anything, when it comes to congress and advocacy. Again, I’m cautiously optimistic, but it takes a village. We all will need to come together and continue our coalition building to advocate for these pieces of legislation so that at least one piece does finally pass.

[00:21:22] Amy Patel: Yeah. Absolutely. I mean and even once laws are passed to ensure mammal coverage, like, there’s going to be a bunch of challenges involved in implementing them across different insurance providers and health care systems.

[00:21:35] Chris St John: Yes. And you make a great point. So whenever, you know, a piece of legislation is introduced, whether it’s at the state level or the federal level, sometimes when you introduce it and then it gets passed, the way it’s written doesn’t always get carried out the way it was intended. So for example, we passed diagnostic breast imaging legislation in 2023. We passed the above average risk in 2020, but there’s still some patients who, you know, have insurance through Missouri and are getting denied. Well, under Missouri constitutional law, they shouldn’t be getting denied. But and I’m not saying, you know, that all insurance carriers, you know, I’m not trying to speak ill about all of them. But some insurance carriers do try to find loopholes to not cover these patients. I mean, those are the facts. And so, you know, we’re currently working on myself with, uh, representative Brenda Shields who is a huge champion in the state of Missouri. Diagnostic breast imaging legislation would not have been covered without her efforts. She’s incredible. We’re working together to shore up this legislation because we wanna make sure that there are no loopholes. I just got an email from somebody that found me online and said, you know, I know you’ve been involved with this legislation, and I have a patient, and she’s being denied. You know? What can we do? And this patient technically shouldn’t be denied. So, you know, it’s happening all over this day. This patient was in the St. Louis area. I’m over on the Kansas City side. So we’ve just gotta work together to improve that language. And so it will take time, you know, if we pass federal legislation, making sure that the legislation is being enacted the way it was intended, but it happens all the time. We just have to stay the course and make sure that we revise it appropriately to make sure that patients are covered.

[00:23:11] Amy Patel: Yeah. Absolutely. In addition to your legislative advocacy work, you have used digital platforms to help educate the public about breast health. What role do you think general public awareness and public awareness campaigns for that matter play in the success of this legislation?

[00:23:30] Chris St John: Yes. So, you know, I would say that these days, there’s some controversy about digital media. And, you know, patients are trying to figure out online what is truth, what is factual, what is fake. And that’s really concerning for us as physicians who are trying to get accurate information out there. Right? So, you know, I’ve been fortunate to be able to use my, uh, digital media presence and platforms, the social media platforms that I’m on, even my website, to try to educate patients as accurately as possible. And there is power in social media. So for example, when we were advocating for the high risk breast imaging legislation in 2020, the champion of that piece of legislation was senator Lauren Arthur. Uh, she was incredible. And we worked together to do this social media push. We testified in Jefferson City at the capital about this legislation. We pushed it out on all of our social channels. And all of a sudden, all these patients started flooding and commenting saying, you know, I am a patient who is denied. What can I do to help? What can I do to help? And so we had, like, over 40 letters to the, uh, senate finance committee that, you know, had the jurisdiction of pushing the bill forward or not or killing it to talk about their stories about how they were getting denied. And this all kind of was organically sprung from social media. So I really think that there is a utility in it. It can be used for good. Although, I know some you know, these days, a lot of people are trying to steer away from it. But I still think that there’s some positive utility in it. And this is a prime example of how we really used it for good, and we were able to get this bill pass the finish line and before the COVID shutdown in 2020. So we were just really, really elated.

[00:25:09] Amy Patel: Yeah. Are there any other additional reforms you are advocating for to address gaps in breast cancer detection and care?

[00:25:19] Chris St John: Yeah. So, like, you know, previously discussed, representative Shields and I are working on the existing Missouri legislation to sort of shore it up for all of these patients, for the patients, for screening, for diagnostic, for above average risk. We’re seeing the most issues with the above average risk patients and the diagnostic breast imaging patients, not so much the screening. So we’re kinda working on that, you know, shoring up the legislation, the language right now, uh, to make sure that there are no loopholes. So that’s the biggest thing we’re working on. And then, you know, with my role with the American College of Radiology, we’re obviously continuing to advocate for these these federal pieces of legislation. We’re watching it closely. Like I said, there’s no reason why Find It Early or ABCD won’t be reintroduced. And and from there, you know, through my role as chair of the Radiology Advocacy Network, you know, we last year, we did send out a call to action to our members about, you know, contacting their federal elected officials to support the Find It Early Act and to show that, you know, solidarity of our profession that we all support that sweeping federal BREST legislation. So, you know, anticipate we will do something similar this year and just continue to push forward. Again, it may not happen this year, may not happen in five years, but we’ll continue to push forward.

[00:26:32] Amy Patel: Yeah. I love that. Just hearing you talk about this, how do you find the time in the day, doctor Patel?

[00:26:37] Chris St John: I mean, I think you just prioritize the things that you love and you avoid you feel so passionately. You know, I also have a 18 old at home now, which has really changed my life in so many ways, all for the better. But, obviously, now my life is more of a, you know, figuring out the pieces to the puzzle and making things work. But advocacy is just such a huge part of not just my, uh, you know, career, but really my life. I really eat, breathe, sleep this kind of stuff and health policy. So, again, you know, if you love what you do and you’re passionate about it and you feel like you know, I truly feel this is a calling. I feel like I’ve been put in this position to try to, you know, and use my skill set to try to help as many people as possible. And that’s just how it’s always been. You know? I grew up not, you know, with much money. We grew up poor. My parents immigrated here with literally nothing. And so I just always wanna try to help people and pay it forward. And like I said, I’m in a position to do it, so I’m gonna continue to soldier on and make advocacy a priority of my career.

[00:27:35] Amy Patel: And in hearing you talk about it, I can’t help but wonder and before I let you go, has there been a most rewarding moment of your advocacy work?

[00:27:43] Chris St John: So, you know, there have been so many really cool things, but, you know, I would say the coolest thing that when it happens to me is just patients reaching out. You know? I had a patient the other day that came into the breast center, and I was doing a procedure for her leading up to her breast surgery. And she grabbed my arm, and she just said, you know, thank you for saving my life. And those are the moments where you’re like, wow. You know? It really hits you. Like, I have been so fortunate to be recognized with different awards and, you know, I was the Kansas City Chiefs fan of the year in 2022 where they recognized me for my love of the team and with my, you know, the role that I played to reduce or to improve access to care to breast cancer disparities in the region. And I’ve written so many awesome things, but nothing can match. Just that human touch and just a patient, that tangible, thank you. You saved my life. Like, nothing is going to override that. And it’s such a joy and it’s such a privilege to take care of patients. And so, you know, for me, that’s really the most rewarding thing.

[00:28:44] Amy Patel: Yeah. Man, you’re gonna get me, like, mildly weepy for the first time on a podcast episode. I’m a crier, though. But, honestly, I feel like that is, like, a very beautiful little closing point for our episode, doctor Patel. Give you five extra minutes to get to your meeting. Doctor Patel, thank you so much for joining us today on Frame by Frame. Doctor Amy Patel is the associate professor of radiology at the University of Missouri, Kansas City. Doctor Patel, thank you so much for joining us on Frame by Frame. It’s been a pleasure having you, and, honestly, I’ll probably be staying in touch.

[00:29:20] Chris St John: Absolutely. Thanks for having me. This is so much fun, and thanks for being so flexible. I really appreciate it. Good.

[00:29:25] Amy Patel: Thank you so much. I will talk to you soon. Frame by Frame Rethink Imaging is brought to you by Imalogix. Here, you’ll find engaging interviews with thought leaders, experts, and patients sharing stories that showcase the transformative power of medical imaging. To discover how Imologix is rethinking imaging in health care, visit imologix.com. Be sure to subscribe to Frame by Frame Rethink Imaging on Apple Podcasts, Spotify, or wherever you listen. And from all of us here at Emalogics, thanks for tuning in.

Questions from This Episode

What breast imaging laws has Dr. Amy Patel helped pass in Missouri?
Three since 2018: annual 2D and 3D screening mammography coverage starting at age 40, coverage for above-average-risk breast imaging in 2020, and diagnostic breast imaging without copay or deductible in 2023. She is now working with Rep. Brenda Shields to tighten the language so insurers cannot find loopholes.
Is there federal legislation for breast cancer screening coverage?
Not yet. The Find It Early Act and the Access to Breast Cancer Diagnosis Act were both introduced last session but did not pass, and Dr. Patel expects them to be reintroduced. Until federal law passes, coverage depends on state-by-state legislation, which is why states like New Hampshire and Iowa following Missouri’s lead matters.
How can clinicians get involved in imaging advocacy?
Start small: join your state radiological society, meet your state legislator for coffee, or host a site visit at your facility. Dr. Patel notes many elected officials do not know radiologists are physicians, so showing them the work and sharing patient stories is often what turns them into champions.