The Center for Cardiovascular Disease in Women works with Dr. Mandeep Mehra, co-director of the BWH Heart and Vascular Center, and physician leaders across the areas of cardiology, interventional cardiology, cardiac testing, cardiac surgery, vascular medicine, electrophysiology, cardiovascular wellness, and the Department of Obstetrics and Gynecology to develop programmatic opportunities in areas of cardiac care influenced by sex-specific differences. Established programs include: Women and Arrhythmias, led by Dr. Usha Tedrow, the Women’s Interventional Cardiology Diagnostic Health Initiative, led by Dr. Jane Leopold, the Cardiovascular Disease and Pregnancy Program, led by Dr. Anne Marie Valente (cardiology) and Dr. Kathy Economy (OB/GYN); and the Cardiometabolic Health and Pregnancy Program, which provides a comprehensive, integrated approach to reduce long-term risk and complications for women with preeclampsia and gestational diabetes, led by Dr. Ann Celi (internal medicine), in collaboration with Dr. Louise Wilkins-Haug (OB/GYN), Dr. Ellen Seely (endocrinology), and Dr. Johnson (cardiology). Dr. Johnson is also working with Dr. Dale Adler, and BWH hospital leadership to pursue a regional collaboration with other institutions interested in implementing our model of a comprehensive and integrated approach to cardiovascular disease in women across the lifespan.
Directed by Dr. Elinor Mody, the Women's Orthopaedic and Joint Disease Center provides comprehensive care for women with bone and joint pain caused by arthritis, joint disease, sports injuries, and other orthopaedic issues. This multidisciplinary center draws upon the expertise of faculty focused on women’s health and sex differences in rheumatology (Dr. Mody), orthopaedic surgery (Dr. Elizabeth Matzkin, an expert in women’s sports medicine and orthopaedic injuries), endocrinology (Dr. Carolyn Becker, a master clinician with particular expertise in osteoporosis, and Dr. Meryl LeBoff, an expert in bone metabolism), internal medicine (Dr. Bethany Block, an expert in the medical complications of eating disorders, which significantly impact bone and joint health and predominantly affect women), nutrition (Dr. Jill Pluhar) and physical therapy (Sharon Alzner, MPT).
The Women’s Sports Medicine Program was founded in 2012 by Dr. Matzkin, surgical director, who was jointly recruited by the Department of Orthopaedics and the Division of Women’s Health. The Women’s Sports Medicine Program offers comprehensive care for women with musculoskeletal sports injuries and concerns, including competitive athletes, recreational athletes, and women who want to become more active. The multidisciplinary team includes a diverse set of specialties able to treat a full range of joint, muscle, and ligament injuries as well as to work with patients on injury prevention through specific training and treatment. With support from the Division of Women’s Health, Dr. Matzkin has launched an associated research effort focusing on issues such as the female athlete triad and ACL tears, which are more prevalent in women.
The Division of Women’s Health has been working closely with Dr. Gary Strichartz, Professor in the Department of Anesthesiology and a principal investigator in the Pain Research Center, to form the Women’s Pain Group. The Women’s Pain Group has brought together scientists, clinicians, and various other professionals across multiple departments at BWH and local health care organizations in order to explore the biological, psychological and sociological reasons for gender and sex-dependent differences in pain. By working together and using a multidisciplinary approach, this group hopes to discover mechanisms that underlie sex-related differences in how women process pain and develop procedures and treatments for the prevention and relief of chronic and severe pain in women. To jumpstart the development of this collaborative network, the Connors-BRI Center, the Pain Research Center, and Dr. Gary Strichartz, as director of the Women’s Pain Group, together hosted a conference on pain in women in the spring of 2014. This event illuminated the different providers and clinicians working on this topic and highlighted important projects and findings around gender and sex-dependent differences in pain. Since the conference, members of the Women’s Pain Group have been working together to move forward various distinct areas of research, including sex-differences in post-operative pain, mechanisms of pain relief by intravenous lidocaine, and the role of oxytocin in pain relief.
The Women’s Mental Health Program at the Fish Center for Women’s Health was the first fully embedded model of mental health care within a multispecialty practice at BWH. Led by psychiatrist Dr. Deborah Knudson-Gonzalez, the program provides short-term intervention and ensures patients are connected with the long-term mental health services they need. The program includes full-time clinical social workers, serves as a primary training site for the Women’s Mental Health Fellow, and is an integral part of the overall BWH Women’s Mental Health Program in the Department of Psychiatry led by Dr. Hadine Joffe. The mental health team of psychiatrists and social workers are key contributors in the Fish Center’s pilot program, Care of the Complex Patient, a program designed for physicians to develop coordinated care plans across primary care and specialties for shared patients with complex illnesses and co-morbidities.
The Women’s Lung Cancer Program is an innovative and interdisciplinary program for women with and at risk for lung cancer founded and led by Dr. Yolonda Colson, a thoracic surgeon, and supported by the Connors Center. Dr. Colson works in partnership with the Dana-Farber Cancer Institute (DFCI) and physician leaders in thoracic surgery, radiology, pulmonary, cardiology, anesthesiology, thoracic oncology, radiation oncology, and psycho-social oncology to further develop the DF/BWCC clinical and research collaboration. The program includes a focus on sex differences in risk, presentation, diagnosis, response to treatment and outcomes, and the particular needs of women diagnosed with lung cancer.
Last year, the Division of Women’s Health hosted a two-day AHRQ-funded conference co-led by Dr. Colson and Dr. Christopher Lathan, a thoracic oncologist and faculty director for Cancer Care Equity at DFCI, and directed by Dr. Therese Fitzgerald, director of the Women’s Health Policy and Advocacy Program of the Connors Center, to develop innovative pathways to address barriers to lung cancer care for vulnerable populations including women, black, elderly, low-income, and disabled patients. This year, the team was awarded a BCRISP grant from the BWPO to implement the innovative clinical pathways emerging from this work. The BCRISP pilot is designed to significantly shorten the length of time from initial suspicion of lung cancer to diagnosis and active treatment for the most vulnerable patients, while reducing costs by eliminating redundant visits and tests and avoiding patients lost to follow-up who subsequently present at much more severe stages of disease.
The Division of Women’s Health has been working with Dr. Colson, Dr. Chris Fanta, associate professor in the Division of Pulmonary and Critical Care Medicine and director of the Partners Asthma Center, Dr. Megan Hardin, leader of the Brigham’s Asthma/Maternal Fetal Medicine Program, and Dr. Barbara Cockrill, of the Dyspnea Center, along with other faculty in the pulmonary division to develop the Women’s Lung Health Program. The program focuses on areas of lung health where sex differences may particularly affect women, or affect women differently over the lifespan (puberty, pregnancy, menopause, aging), and includes asthma (Dr. Fanta and Dr. Megan Hardin), COPD (Dr. Hardin), pulmonary hypertension and dyspnea (Dr. Barbara Cockrill Gootkind), LAM (Dr. Elizabeth Henske), NTM infections (Dr. Manuela Cernadas), laryngeal disorders (Dr. Jayme Dowdall), and pulmonary genetics (Dr. Benjamin Raby). The group is working with Dr. Anne Fuhlbrigge, clinical director of the Division of Pulmonary and Critical Care Medicine, to further develop programmatic opportunities in women’s lung health in the coming year, as part of the launch of the Lung Health Center.
Working with the Department of Neurology, we launched a first-in-the-nation program for women’s neurology. Led by Dr. M. Angela O’Neal and with the support of Dr. Martin Samuels, neurologist-in-chief, the Women’s Neurology Program is an interdisciplinary and interdivisional program that brings together faculty who have clinical and research interests in women’s health and neurology. The program focuses on sex differences in medical evaluation, diagnosis, treatment, and outcomes in areas such as stroke, dementia, headaches, epilepsy, movement disorders, and sleep, including how hormonal and reproductive changes throughout a woman’s lifespan impact neurological health and disease. The program has expanded its collaboration with women’s health specialists in the Department of Psychiatry in partnership with Dr. Hadine Joffe, director of the Division of Women’s Mental Health and director of research development in the Department of Psychiatry at BWH. Dr. O’Neal has developed a significant collaboration with the Department of Obstetrics and Gynecology and the Department of Anesthesiology, conducting inter-departmental case conferences and education seminars to explore pathways for treating women with complex neurologic issues during pregnancy and delivery.
Led by Dr. Lilian Mahrokhian, a BWH primary care physician practicing at the Fish Center for Women’s Health, and in partnership with Dr. Ann Partridge, director of the Program for Young Women with Breast Cancer and director of the Adult Survivorship Program at DFCI, the Division of Women’s Health has developed a breast cancer survivorship program designed to improve the quality and efficiency of care through coordination of primary care and oncology care for women who have completed active treatment for breast cancer. The program is building clinical and referral pathways as well as expertise in survivorship care within internal medicine to successfully transition breast cancer survivors from their oncologists to primary care providers for their long-term comprehensive and follow-up care.
Dr. Linda Lee, director of Women’s Health in Gastroenterology at BWH, has collaborated with Dr. Thomas Clancy, a BWH surgeon, and others in the Division of Gastroenterology, to develop a pancreatic service at the Fish Center for Women’s Health to screen for, evaluate and treat certain pancreatic diseases with a particular focus on early identification of pre-malignant pancreatic cysts, which are significantly more prevalent in women and in some cases occur only in women.
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