Table 5 Example clinician quotations regarding interventions to address referral inequities

Increased education for primary care clinicians about B-PREP services and referral processes

“More education and tools that would help primary care physicians understand their patients’ risk of breast cancer, and support them in conversations with patients…along with that, understanding of B-PREP itself.”

“Ongoing education to providers about the services is helpful and necessary, recognizing that we are at the end of a fire hose of information coming from all different places in primary care…sometimes we are not aware we could be under-referring, or we could be making inappropriate referrals.”

“Clarifying the referral process…if we understood it better, we would refer better.”

Marketing beyond main hospital practices

“They can do a better job marketing themselves…within the Brigham Hospital system, periodically coming and visiting a practice, and saying, this is what we do.”

“A marketing strategy that makes sure that at least all of the primary care practices know what’s there, and what added value that would be (for patients and providers).”

“(Our Community Health Center) has a mammogram van every two months in our parking lot. I could imagine somebody from B-PREP coming here, and maybe not once every two months, but in association with that day.”

Strategies to make it easier for clinicians to assess risk

“If you could figure out a way to calculate a breast cancer risk score…on all patients, and then flag that information for doctors, and say: this is elevated and your patient might be a candidate for prevention, or increased surveillance testing, increased screening, or all (of the above)…click here for more information, or click here to refer your patient to the B-PREP clinic, (this would be helpful).”

“You need to be supporting PCPs in doing cancer risk assessments on all their patients, not just patients who ask about it.”