Taking Care of the Caretaker

Women’s health clinics grow in Madison as new niches stress the value of health and wellness for both patient and doctor

Photo: Doctors Kate Sample, Karla Dickmeyer and Mary Stoffel at Madison Women’s Health, the practice they opened in May.

Walking into the new Madison Women’s Health on Research Park Drive, you might mistake it for a spa.

A welcoming fireplace in the middle of the waiting area awaits patients checking in for appointments. Windowed views from the fourth floor give the newest women’s medical clinic in Madison a wow factor. Juice and other beverages are complimentary, and a children’s play area welcomes kids and grandkids who inevitably tag along on visits.

The spacious office, which opened in May, illustrates a growing trend in health care—women in Dane County have more choices now than ever, as health care providers expand service offerings in non-clinic-like settings. These women-centered businesses are the latest wave in an ongoing trend toward niche care in a variety of medical specialties. Local hospitals and clinics have been renovating and building medical facilities to accommodate more and different kinds of care for a number of years, from orthopedics and cardiology groups to plastic and reconstructive procedure centers to neighborhood-based primary care with an eye toward prevention.

In 2001, Frederic Melius, Julie Schurr and Michael Cardwell became the first group of doctors specializing in obstetrics and gynecology to open an independent clinic in the area. Now a second physician group—Mary Stoffel, Karla Dickmeyer, Kate Sample and Beth Weidel—has branched out from the established Associated Physicians to launch the new Madison Women’s Health practice.

“Health is more than just medicine for women,” says Stoffel of the “whole woman care” concept behind the new clinic.Jenny Hackforth-Jones

To fill the void, Associated Physicians, a multidiscipline independent clinic operating in Madison for more than sixty years, added three new doctors to its ob/gyn practice in May. Joining veteran practitioner Jenny Hackforth-Jones were Laura BergLaura Berghahnhahn, JoDee Brandon and Barbara Burns.

“It has revitalized our whole clinic,” says clinic manager Barbara Schneider of the change. “Everyone has a new sense of energy.”

Chris Queram, president and CEO of the Wisconsin Collaborative for Healthcare Quality, sees what’s happening here as a broader move toward specialized care. Meriter in Madison, for example, opened a new pediatric and orthopedic clinic in Middleton this year.

Barbara BurnsNationally, the number of clinics specializing in treating women has been growing steadily for about twenty years, according to a 2007 study commissioned by the U.S. Department of Health and Human Services Office on Women’s Health.

“It’s pretty well known that women tend to be much more attentive to their personal health needs than men. Statistics bear that out,” says Queram. “Also women tend to be the primary decision maker in health care matters for their partners and children. It’s a very attractive market demographic.”

So attractive that there are some 3,600 women’s health centers in the U.S. serving 15 million women, according to the Office on Women’s Health study. The report says the trend is “probably based on market analysis indicating thatJoDee Brandon women-oriented services would attract women and their families to new and coordinated services, resulting in better health.”

Although the study notes a lack of information about the makeup of these centers, it suggests about one quarter operate for-profit centers, which are more likely to be located in suburban areas. They tend to offer services for women, by women, that are more preventative in nature and that attract the next generation of patients.

“These centers appear to be meeting a need for a population of women seeking care in a more female-friendly setting,” the study says. “Women’s health centers are particularly effective at providing preventative care for women, and studies have found that women who choose to attend such centers tend to be younger and are more likely to prefer female doctors.”

A Win-Win for Docs and Patients

Choosing a provider today means deciding more than just where to get a Pap smear and pelvic exam, or who is best suited to deliver your baby.

When it came time for Rachel Cannistraro to look for an obstetrician-gynecologist after moving to Madison from Champaign, Illinois, she went straight to the experts—she plugged into the active Moms in Madison message board.

“As I was thinking about my next birth, it was important to me to find doctors that were supportive,” says Cannistraro, who was seeking a successful vaginal birth after her first child was delivered by Cesarean section. “I found information that all the doctors at Associated Physicians supported that.”

Although Cannistraro went to an independent women’s clinic in Champaign, that wasn’t a deal breaker. Finding a woman doctor, however, was essential. “It’s kind of nice with an independent, because you get a different atmosphere. It seems a little less clinical, which is nice but not the reason I’ll go to a clinic,” she says. “I wanted a woman because I had a traumatic experience with my first birth and thought she could probably understand where I was coming from.”

Scheduled to deliver her second child last spring, Cannistraro followed Weidel to her new practice at Madison Women’s Health. She was not only happy with her own doctor but was also comfortable with all doctors in that practice, any of whom could attend at her delivery.
Cannistraro’s consumer preferences represent a growing market for women’s health care services—a win-win for both patients and doctors. Madison’s higher-than-average education level of the population and relatively stable employment allows physicians to carve out a niche for themselves and also to tailor their work environment in a way that satisfies their own health and well-being, too.

Bill Dickmeyer, practice manager at Madison Women’s Health, says his market projections point to continued growth in employment as well as the oft-touted quality of life that draw young people. Think Trek Bikes, Epic Systems and the University of Wisconsin. “Madison really has a lot going for itself that keeps people here,” he adds.

Once the business decisions were made to incorporate, Stoffel says she and her partners paid attention to details women would notice. Exam room amenities like cloth gowns and dimmable light switches add to patient comfort. In the near future specialty services are projected to include on-site exercise and weight-control classes, as well as stress-management programs.

“It sounds like a marketing line, but we keep coming back to the fact that we want to provide women a different kind of care. There are only so many ways you can do a pelvic exam, but if I can make a woman more comfortable, that’s what we’re talking about,” says Stoffel, explaining that these “taking care of the caretaker” services focus on helping patients manage lifestyle choices that affect overall health.
The 16,000-square-foot clinic provides the practice’s fifteen employees with the space they need to do their job, as well as perks like an employee exercise room and treadmill desk. Doctors don’t have individual offices, but rather a communal desk area with comfy chairs to facilitate conversation and collaboration. In time, Stoffel says they hope to have a primary care physician join the practice.

That’s something they left behind at Associated Physicians, a clinic that provides a host of services at its Regent Street facility: internal medicine, family practice, cardiology, gastroenterology, general surgery, obstetrics and gynecology, pediatrics, nutrition and physical therapy. The clinic also runs yoga classes for women and plans to add more complementary health offerings in the future.

“I think this is the model of medical care that will endure,” says Hackforth-Jones.

Schurr, whose clinic is in Fitchburg, attributes the growth in women’s specialty clinics to “patient demand for different kinds of care or different options and also physicians taking more of the leadership in how they want to deliver care.” Schurr and her partners came from UW Health, the largest health care provider in the area.

It’s not unusual for doctors at some organizations to see forty to fifty patients a day, says Schurr. Now, she sees about twenty to thirty, and still has time to help manage operations. In 2005, for example, Schurr and her partners decided to buy new equipment to offer patients
four-dimensional ultrasound, making them the first clinic in the area to have the technology.

“We were able to decide how we wanted to deliver care and construct our office templates and our call schedules so that we can devote adequate time to patients,” Schurr says.

Laura Berghahn, who joined the Associated Physicians’ ob/gyn group in May, describes a similar process as she decided to move from her practice of eight years at UW Health’s East Towne Clinic. “I asked what will keep me wanting to work for the next twenty years and it’s a relationship with people. I wasn’t getting job satisfaction from seeing this number of patients or doing that number of procedures.”

Meg Gaines, founder and director at the Madison-based Center for Patient Partnerships, believes there’s good evidence that having clinics with an expertise is good for patient health. But, outside of reproductive health-focused facilities, she doesn’t necessarily see a medical reason for woman-centered clinics.

“I don’t think they’re a cure-all and I don’t think they’re done because of some fundamental need,” Gaines says.

Still, having the option of a specialized women’s care facility is good for the patient if it’s good for doctors, says Cannistraro. “It’s important for doctors to enjoy what they’re doing and to be able to do what’s important to them. If it makes doctors happy, that will make patients happy.”

There could be more “whole health” clinics emerging, adds Queram, who calls this type of facility specializing in primary and preventive care part of one of the “megatrends” emerging from federal health care reform.

“Reform is increasing the emphasis on primary care, so in that regard this may be a precursor to other efforts to design services that target patients for more comprehensive prevention services.”

Lynn Welch is a Madison-based freelance writer.

 

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