Magazine selects top women's health centers

THE FIVE BEST WOMEN'S HEALTH CENTERS These are the five centers the editors of HEALTH Magazine feel best fulfill their criteria for quality care: Columbia-Presbyterian Center for Women's Health New York (212) 326-8540 Iris Cantor-UCLA Women's Health Center Los Angeles (310) 794-9830 Long Island Jewish Hospital-Ann & Jules Gottlieb Women's Comprehensive Health Hyde Park, New York (516) 390-9242 UCSF Women's Health, University of California at San Francisco (415) 476-0668 University of Pennsylvania Health System-Penn Health for Women Philadelphia (215) 662-2730

May 31, 1999
Web posted at: 12:20 p.m. EDT (1620 GMT)

ATLANTA (CNN) -- A patient entering Northside Hospital Women's Center in Atlanta may feel like she has walked into the lobby of a luxury hotel.

The four-story atrium is lined with commissioned paintings by a local artist.

Nurses' station countertops are edged in marble, clinic hallways are lined with ornate borders, carpets are richly colored and textured, lighting is muted.

The new facility may be the epitome of a women's health center for the new century.

"We know through our market research that women want to be in an environment that's residential vs. institutional. So they want a warm and comfortable atmosphere," said Melissa Sisson, a registered nurse and director of women's services at Northside Hospital.

The idea is hot. At last count, in 1994, at least 3,600 programs across the country called themselves "women's health care centers."

But is quality health care being delivered within the designer walls?

To answer the question, the editors of Health Magazine consulted physicians and experts in women's health to determine what's needed in a high quality women's health center. Their findings are outlined in the magazine's June issue.

Not created equal

"A lot of women's health centers are not how we defined women's health centers," said Barbara Paulsen, editor in chief of Health Magazine. "A lot of times you have a group of obstetrician-gynecologists and they're all women, and they get together and say, 'Let's call ourselves a women's health center.'"

To find the best facilities, Health Magazine homed in on three indicators of quality.

The first is a center where primary care doctors and specialists are under the same roof or close by.

That's what patients will find at Columbia-Presbyterian Center for Women's Health. The center in midtown Manhattan is considered the Cadillac of its kind.

"I think when patients come to a physician, they hope their care can be coordinated," said Dr. Elsa-Grace Giardana, a cardiologist and medical director of Columbia-Presbyterian Center for Women's Health. "They don't want to come to a physician and be told, 'You have to go across town' to see a specialist like a radiologist or dermatologist."

Giardana says it's comforting for women to leave their primary care doctor and go across the hall to have their mammogram, blood test or bone densitometry for osteoporosis, for example.

"That is extremely important, particularly when you consider how many women are working these days, and time is a prized possession," said Giardana.

The second criterion is to have one consolidated medical chart that all doctors can access easily.

"If our patient sees another doctor, the chart goes with the patient, so all the data is centralized," said Giardana.

Third, the center should be affiliated with an academic research center.

"We felt it was really important that the doctors be up-to-date on the latest research and be able to translate this into their patient's lives," said Paulsen.

The editors of Health magazine acknowledge that not all women live near women's health centers fitting their criteria.

"This is obviously an ideal picture for how health care should be delivered, and for most women it's not a reality yet," said Paulsen. "But the top women's health centers are on the cutting edge of delivering that kind of complete care."

Finding quality near you

To put together comprehensive care on your own, the editors of Health magazine say the key is to make sure you really like your primary care physician, whether it's an internist or gynecologist.

The need to have a caregiver who is receptive to your questions was first underscored in the 1971 book "Our Bodies, Ourselves," which demystified health care for women.

"You also want to make sure you're given enough time with your physician, which is getting harder and harder in a managed care environment," said Judy Norsigian of the Boston Women's Health Book Collective and co-author of "Our Bodies, Ourselves for the New Century." "Having this dialogue really improves outcomes."

That's why it's important for women to be educated consumers of health care.

"We found in our 1998 survey on women's health that those women who have more education and information about their health are much more likely to have discussions with their doctors about health issues such as hormone replacement therapy," said Karen Scott Collins, assistant vice president of the Commonwealth Fund, which supports and conducts research on women's health.

Marketing: Trend or fad?

Why are so many hospitals and medical centers opening women's health centers?

Besides addressing women's needs, Northside Hospital's Sisson admits it is a business decision.

"When you consider these two factors -- that the No. 1 reason for inpatient admission to a hospital is to have a baby, and second, women make 70 percent of health care decisions -- it makes good business sense," said Sisson. "So if you do maternity well, the women will return for their other needs."

Northside Hospital is one of the busiest labor and delivery hospitals in the country. It spent $36 million on the new facility, and several hundred thousand more to market its opening.

"We want to provide services for women of all ages, and we're confident we'll get a good return on our investment," said Sisson.

While most experts agree women's centers are a good idea and here to stay, not everyone is happy about the trend.

"Women, especially at midlife, are a very lucrative market being sought after, and one way you can draw these women in, who are especially busy, is to highlight one-stop shopping," said Norsigian. "This is obviously marketing to women who are insured, who are well-heeled. It's not marketing to low income women who are underserved and don't have access to services."

The Commonwealth Fund's survey found women are more likely to be uninsured today than five years ago. Almost one in five women under the age of 65 lacks health insurance.

What about the men?

All of the focus on women's health care needs may leave some wondering, "What about the men?"

"I think the emphasis on women's health care came because women's health in general is much more fragmented than men's," said Giardana. "Women go to one doctor for reproductive issues, they go to another for their annual mammogram, and another because they're concerned about heart disease, and another because their mother had Alzheimer's disease. And all of the things I mention are more common in women than men."

Experts say men indirectly reap health benefits from the focus on women's health. New research is highlighting differences between men and women and the need for gender-specific diagnosis and treatment.

Full circle

At the turn of the century, women had a life expectancy of 48 years.

Women's health centers were first established in the early 1900s, with a focus on maternal and infant health to combat high death rates.

As we come upon the year 2000, women have a life expectancy of almost 80 years.

Women's health centers for the new century focus on the whole woman and her health needs across that life span.