After decades of ignoring the differences between men and women, some hospitals are smartening up and offering programs specifically tailored to the health issues of women our age. Here, the top spots for treatment—and, if these facilities are too distant, advice on finding the best programs near you
Heart Disease: Cedars-Sinai Medical Center, Los Angeles
After her own research documented problematic gender differences in the symptoms and outcomes of heart disease, cardiologist C. Noel Bairey Merz, MD, founded the Women’s Heart Center at Cedars-Sinai Medical Center, the largest nonprofit hospital in the western U.S. Last year, the WHC also opened an Advanced Preventive Women’s Clinic for women with menopause symptoms who have or who are at risk of heart disease.
The goal for both the clinic and the heart center is to quickly translate state-of-the-art science to women’s care. For example, the Women’s Ischemic Syndrome Evaluation study, led by Bairey Merz, found that women who have an abnormal stress test and chest pain but no serious artery plaques are nonetheless prone to heart attacks. Though women in that category are usually assured by their doctors that all is well, at Cedars-Sinai these patients are now given a coronary angiogram to further investigate their condition.
What to look for closer to home Check out the government’s Web site, hospitalcompare.hhs.gov, to find institutions meeting widely accepted standards for heart care (such as giving most heart attack patients angioplasty within 90 minutes of ER arrival). Look for a place that employs cardiologists dedicated to treating women, sponsors conferences on women’s heart health, and maybe even underwrites gender-based research, says New York cardiology specialist Nieca Goldberg.
Bone Health: NewYork-Presbyterian Hospital, New York
Women with clear evidence of osteoporosis are generally treated with drugs. But experts can disagree on how to handle patients who show signs of bone thinning that hasn’t reached a critical stage—a category that includes many postmenopausal women. That’s why personalized care is offered at the Toni Stabile Osteoporosis Center at Columbia University’s NewYork-Presbyterian. With 10 researcher-physicians on salary, “We have the luxury of scheduling 60-minute appointments for new patients, with 30-minute follow-ups,” says director Ethel Siris, MD.
Because the doctors are aware of or, in some cases, have conducted the latest women’s bone research, they understand the nuances involved in interpreting the bone density tests performed by the center’s four DXA machines. (The center also has an experimental imager called the high-resolution pQCT.) “We evaluate the full DXA report hot off the printer, not just the summary,” Siris says, so the physicians can detect any (rare) machine errors that don’t make sense. The data, combined with other risk factors, helps them decide whether a woman needs medication.
What to look for closer to home Because the doctor’s judgment plays a key role in making the right treatment decisions, you want a facility with a dedicated bone health program. Inquire, too, if the technicians who conduct the DXA scans are certified by the International Society for Clinical Densitometry. “Problems in the positioning and quality of measurements—which affect treatment decisions—are more likely with someone who doesn’t do these scans regularly,” says Subhash Kukreja, MD, codirector of the bone health program at the University of Illinois Medical Center.