Roundtable Discussion on Women's Health
with the 2006 Excellence in Women's Health Award Winners
May 19, 2006
On May 19th, 2006, the Jacobs Institute hosted a roundtable discussion with the Excellence in Women's Health Award winners, Susan Wood, PhD, Carol Evans, Paula Johnson, MD, MPH, and Janet Lawson, MD, FACOG. Moderated by Bonnie Erbe, the host of PBS's To The Contrary, the award winners discussed progress in women's health, family leave, heart health, preventive medicine, the payment system, medical malpractice, over-treatment, and reproductive health.
Bonnie Erbe opened the discussion by asking panelists if they believed that progress had been made in women's health. Dr. Wood commented that while there was a lot to be proud of in the last 20 years, such as the inclusion of women in clinical trials, "we are not where we want to be." Drs. Lawson and Wood noted that ground had been lost in the area of reproductive health. Dr. Wood noted that the abortion wars of 15 and 20 years ago are still occurring today. Ms. Evans did note progress in women's health. She recalled that when the Working Mother Magazine's Best Companies list was first implemented in 1986, the focus was on daycare and some flexibility with hours and telecommuting. Now, companies focus on health and wellness, recovery from childbirth, and elder care.
The discussion then moved to the subject of family leave. Dr. Johnson commented on the idea of family leave, noting that in Massachusetts there was a bill to provide paid family leave and that "women's health is not just about health and healthcare." She discussed the challenges of work issues to women's health and the role of women as caregivers not only for their immediate family, but also for their parents and in-laws. Dr. Lawson additionally mentioned the challenges of the "sandwich generation." Dr. Johnson also noted a need to work state by state on maternity leave issues. Ms. Evans responded by describing new employer initiatives in this area, phase back programs and pre-maternity leave. As part of phase back programs, women gradually work up to returning to work full time over approximately 6 months. She also discussed that Eli Lilly provides 1 month leave for women before giving birth in order to prevent unneeded stress.
Ms. Erbe then asked the panel about progress in women's heart health, leading the panel to discuss the importance of, and difficulties associated with, preventive medicine. Dr. Wood responded that there had been progress in research and knowledge in the area of heart health, but in regards to translating knowledge into practice, there is still a "wide open field of work to be done." Dr. Johnson noted that while awareness is increasing, women still seem to fear other diseases more than heart disease. Additionally, Dr. Johnson indicated that heart disease treatments are often "based on a male model" of the disease. Dr. Lawson responded regarding progress in women's heart health by noting that the Surgeon General said that deaths 100 years ago were often the result of bad luck, but that "now the things that kill us are our bad habits." She reflected on the importance of educating patients about their health and encouraging them to take an active role in their health and health care. She also advocated a holistic and comprehensive approach to health.
Dr. Johnson identified a key problem for preventive care within the health care system: "prevention doesn't pay" in terms of reimbursement. Dr. Johnson stressed that measures must be taken to change this. Dr. Lawson noted the challenges to changing the current payment system. Prevention is hard to sell to legislators because "it's not sexy" and it takes years to see results. Dr. Wood concurred that measures need to be taken to make prevention an attractive option. Ms. Evans noted that some companies pay their employees to lose weight and advocate other healthy practices amongst their employees. However, Ms. Evans also commented that women often take the role of health manager within their families and that within this role, women often put their health concerns below those of their families.
Ms. Erbe next moved to legal issues. She asked the panelists if the health industry had gone overboard in responding to the threat of litigation. Dr. Lawson indicated that the expectations of the public often result in litigation, and that the public must be educated about realistic goals. The issue of litigation threats led to an audience question regarding over-treatment by medical professionals afraid of litigation. Dr. Wood noted that there are cultural and financial explanations for over-treatment and that "there's a pill for everything." Dr. Lawson also commented that everyone wants to get better faster, which is leading to an overuse of antibiotics and increasing the odds of antibiotic resistance. Both Dr. Wood and Dr. Lawson advocated increased patient education.
Overall, while the panelists noted various advances made throughout the years in the area of women's health, each indicated that there is room for even more progress in the future.