Greetings from the Chair...
James R. Woods, Jr., M.D.
Henry A. Thiede Professor & Chair
Department of Obstetrics & Gynecology
February 22, 2006
Women’s Health
Women’s health historically has progressed from a focus on the conditions related to the female reproductive tract to now include the diverse set of conditions that affect women differentially, such as depression, heart disease, osteoporosis, breast disease, and dermatologic conditions. As well, it has been recognized that women are often the decision-makers about health care in the family; thus, attracting women to URMC will likely attract their children and other family members.
The University of Rochester Medical Center is well positioned to adopt this broader perspective about the provision of women’s health care. Our mission must be to advance women’s health across the generations. We must strive to be the preeminent provider of women’s health care spanning the geographic area from Cleveland, Ohio to Albany, New York, recognizing that women will travel for cure, but not for prevention. Our focus should therefore be on treatment of illness for patients geographically distant from us, and for both prevention and treatment for those closer in. This vision mandates an appreciation of the synergy between University faculty and community physicians, the importance of teaching women’s health care to care providers and the public locally and nationally, the value of focused basic and clinical research, the need to establish financial stability within our health care system through fund raising, and the merit of providing quality health care irrespective of race or socioeconomic status.
Patient Care: Strategic planning for women’s health care must take into account the changing demographics that drive market segmentation, size, and share, thus providing a roadmap for aligning health services with health needs. Nationally and regionally, the volume of obstetrics is in decline while the cohort of older woman is increasing rapidly. Within the ten country Finger Lakes region, for example, obstetrical deliveries have declined from 16,041 in 1998 to 14,168 in 2005. Although statistics on gynecology cases are not available regionally, the national population of women over 65 doubled from 1950 to 2000 and is expected to double again by 2050. For those women over 85, the population will triple between 2000 and 2050. These demographic changes will significantly impact how we design our system for the delivery of women’s health services.
The University of Rochester must speak to women’s health with a single voice. To this end, URMC Women’s Health must be a partnership between Highland Hospital and Strong Memorial Hospital. The Department of Obstetrics and Gynecology bridges Strong Memorial Hospital and Highland Hospital. The two hospital Women’s Advisory Councils offer a valuable asset for community advice on expanding women’s services, and for more effective fund raising. Partnerships across departments—ob/gyn, psychiatry, medicine, dermatology, and surgery—are also critical to provide complete women’s health services.
Thus, our plan is to build programs that take into account the aging population, such as advanced gynecologic surgery, menopause, urogynecology, and pelvic floor disorders. Ideally, these programs should be juxtaposed with programs in osteoporosis, breast care, mental health, cardiology and dermatology. Over the past two years, detailed plans have been developed for a facility that brings these elements together, along with our major programs in high-risk pregnancy, reproductive endocrinology and in vitro fertilization, and reproductive ultrasound services, in an ambulatory campus. These plans now point to the opening, in August 2006, of a new outpatient Women’s Pavilion in Henrietta. This Pavilion will represent a tangible presence and centralized home for URMC’s women’s health care services.
Education: The principles of women’s health must be taught locally and nationally. Medical student teaching in women’s health at the University of Rochester begins in the first year and progresses naturally through all four years of training. Our residency in Obstetrics and Gynecology is one of the leading programs in the United States and competes successfully for residency candidates with institutions of very high profile in the field. Serving the public need for education, in 2005 we established a year-long monthly lecture series at the Jewish Community Center (JCC), and are partnering with the JCC in August of 2006 to provide medical lectures at their annual three-day Women’s Retreat on Seneca Lake. Regionally we now webcast our Grand Rounds to hospitals in Western New York, Northern Pennsylvania, and (soon) eastern Ohio. This technology allows us to educate other medical institutions on women’s health and must be expanded. Nationally, Strong Perifax, an internet-based weekly educational program for obstetric care providers, currently reaches 570 hospitals and 12,700 participants and is poised in 2006 to go worldwide.
Research: Clinical and basic research should drive our identity nationally. In the past few years we have ranked between 8 and 14 among obstetric and gynecologic departments for NIH funding. We must aim higher. To do so, during these times of restricted funding, we must identify our strengths and build on them. Specifically we have national recognition in autism, reproductive epidemiology, polycystic ovarian disease, endometriosis, and preterm premature rupture of the membranes. Those areas of emphasis must be expanded. Our current K-12 training grant (Women’s Reproductive Health Research Grant) supports our development of an elite group of clinician-scientists dedicated to research in women’s health.
Entrepreneurship: Women’s health requires that we recognize and realize out-of-the-box opportunities--medically, educationally, and geographically. Expanding the Center for Polycystic Ovarian Disease creates a link to ongoing studies in the metabolic syndrome. Establishing the Center for Reproductive Epidemiology expands the number of graduate students in the field and in turn generates additional funding opportunities. Our Center for Autism is already recognized world-wide. The development of a Center for Pelvic Floor Disorders between our Department, Urology and Colorectal Surgery establishes a unique entity enjoyed by only a handful of medical universities nationwide.
Community Health: Our community responsibilities as teachers and care givers must address the needs of the underserved in the city of Rochester and the Finger Lakes region. Toward this end, expanding women’s services at Anthony Jordan Health Center and aligning them with Westside Health Center, both federally funded health clinics in downtown Rochester, provide consistency of care and opportunities for innovative treatment for the underserved. The development of the Renaissance Center in downtown Rochester offers a unique opportunity to place a health care venue in the heart of the city, alongside the Monroe Community College downtown campus and the new Regional Transit Service terminal, bringing the most accessible health care to our community’s underserved women.
Development: The Department of Obstetrics and Gynecology currently has two endowed chairs (the Henry A. Thiede Chair, and the James R. Woods Chair). We have initiated fund raising for two additional endowed Chairs that are over 50% complete. To accelerate our fund raising, we will hire or contract with a Department officer this year to help us focus on Women’s Health.
Conclusion: We are at a unique moment in the evolution of women’s health care in Rochester. The University of Rochester has the creativity, the care providers, the community support and the expertise to establish itself as among the very best in the country. Now is the time to meet that challenge.
For more information on Dr. Woods, click here |