A Winning Formula

At 50, Deb Cohen began feeling constantly bloated and lethargic. A busy law professor at the University of the District of Columbia, the Fells Point resident had delayed her annual visit to the gynecologist. She just figured her body was changing because of menopause.

She was right about that, but didn’t know the half of it: Her symptoms were being caused by a 3.5-pound, 19-centimeter cyst, part of which was cancerous.

“The symptoms were there, I just had no clue,” Cohen says. “No one talks about menopause and what it will be like. My body was changing, and it never dawned on me that it was cancer.”

It was, in fact, Stage III ovarian cancer. So Cohen turned to what she had come to regard as her trusted team of doctors at The Weinberg Center for Women’s Health and Medicine at Mercy Medical Center, where she had been treated multiple times, beginning with the 2009 removal of a lump in her breast. To treat the cyst, she was referred to Neil B. Rosenshein, a nationally renowned ovarian cancer specialist and director emeritus of The Weinberg Center.

“I’ll never forget sitting there pre-surgery listening to him as he read the list of things that can go wrong, tears running down my face, thinking, ‘Okay, I’m signing my life away.’” But there was no one else she would trust more with a scalpel. In June 2014, Rosenshein successfully removed the cyst. “He’s an amazing man,” Cohen says.

Cohen remains close to him to this day, and continues to return to Mercy for her six-month checkups, even after moving to D.C. in 2015.

“I’m the luckiest unlucky person,” she says. “I had great health care, great doctors, and lived within a mile of Mercy—you don’t get any luckier than that.”

Mercy’s center does stand out, however, for blazing the trail.

The Mercy center on which she has relied is part of a historically recent health care trend of dedicated female-focused care—such women’s centers have popped up all over the country, and Baltimore now has more than half a dozen. But they raise the question, why not just go to Marcus Welby General Hospital? Because the need for such targeted care stems from biology.

“We have estrogen receptors on every organ in our body,” says Wen Shen, a gynecologist specializing in menopause medicine at The Johns Hopkins Hospital. “And you’re trying to tell me a man’s body works the same?”

And, as in the case of Cohen at Mercy, Shen says the menopause transition is when a lot of medical conditions start kicking in—issues with heart health, bone health, and brain health.

“These are all related to the lack of ovarian hormones because of menopause,” says Shen. For instance, studies have shown that women suffering from severe hot flashes are more at risk for high blood pressure and heart disease.

“The whole list of every medical specialty you can think of, I can come up with an issue in that specialty that is post-reproductive related,” Shen says.

That’s why, building on the national trend, she’s spearheading the creation of a women’s health center at Hopkins that will focus on post-reproductive years, and looking for funding to make it a reality. “We need to be able to help women specifically. Men have been getting good advice and care, because all the research is based on them. Women have been sort of short-changed when it comes to a lot of their medical care.”

Mercy’s center does stand out, however, for blazing the trail: It’s celebrating its 25th anniversary, making it the oldest dedicated women’s health center in the region. It launched the center in 1994, during a period when hospitals around the country started turning to female patients as a niche in an increasingly competitive and tumultuous market. Mercy polled local women and took cues from the best women’s health centers across the country to develop its own version, eventually investing more than $40 million in the project with the goal of consolidating all the medical services in one location.

Other Baltimore-area medical centers pursued similar concepts, spawning more such women’s centers in the past 25 years (see below), but each boasts different strengths. However, a common motivation is to make health care one-stop shopping for women.

At Hopkins, oncologists have often referred patients to Shen to manage symptoms caused by radiation or chemotherapy. “Then I’ll find out that they have high risk for heart disease, that they have osteoporosis, and I refer them to specialists,” she says.

But that can mean a lot of appointments, often at different locations. And one trend doctors are seeing is that working women are developing some of the same attitudes toward wellness that men have always been blamed for—such as ignoring symptoms, procrastinating, and toughing it out because they’re too busy with work and family.

With the average age of menopause’s onset at 51 (and the average women’s lifespan at 81 years), menopause is hitting at a critical time—often at the high point in careers, when women are caring for their own families and sometimes their aging parents as well.

“Today’s woman is so overburdened it’s very hard for her to do all this,” says Shen of the many appointments required to get holistic care. That’s where a women’s center steps in.

“I’m the luckiest unlucky person . . . I lived within a mile of Mercy.”

“A multidisciplinary center is like a one-stop shop. At 9 a.m. you’re going to see the oncologist, at 10 a.m. the rheumatologist, at 11 a.m. the cardiologist,” Shen explains. “The vision is to make it really efficient for the patient to get the care that she needs. Because if she had to make all these appointments with different doctors located on different campuses, across different months, requiring repeated time off from work—that’s a challenge.”

Besides having different strengths, such health centers can also target different markets. As newer hospitals such as Greater Baltimore Medical Center and MedStar Good Samaritan followed their patients to the suburbs, Mercy doubled down on its urban location on St. Paul Place, hoping to capitalize on the hundreds of thousands of nearby commuters, more than half of which are women.

The move attracted Rosenshein from The Johns Hopkins Hospital. Rosenshein opened the center at Mercy and remains its director emeritus.

The Weinberg Center’s offerings, which include breast care, gynecology, plastic and reconstructive surgery, mammography, and radiation oncology, were originally scattered throughout the Mercy campus. In 2003, the hospital finally brought all the services together under one roof as Mercy cut the ribbon on a state-of-the-art, six-floor facility, made possible in part by a $10-million gift from The Harry and Jeanette Weinberg Foundation.

Rosenshein echoes that housing all the services together allows The Weinberg Center to provide patients with holistic care. “Most of the issues we have are interrelated,” he says. “People who have ovarian cancer are at more risk for breast cancer. People who have both have genetic issues that need to be addressed.”

The refocusing has been more than a business decision for the hospital: It goes back to the mission of its founders, the Sisters of Mercy, who opened a refuge for homeless and abused women in Dublin in 1827.

This year, The Weinberg Center hit several milestones, including the 5,000th da Vinci robotic surgery performed by gynecologic surgeon Dwight D. Im, medical director of the Neil B. Rosenshein M.D. Institute for Gynecologic Care at Mercy.

By chance, Deb Cohen’s one-year checkup with Rosenshein was scheduled on the exact anniversary of her surgery. So she decided to celebrate. “I stopped to pick up a bottle of champagne for my anniversary, and I picked him up one, too,” she recalls. “I said, ‘We’re going to be celebrating tonight. I don’t care what your family celebrates, but you should, too.’”

Now, she’s sharing her story to encourage other women to listen to their bodies. “I knew three or four women who [also] got this, one who died from this,” Cohen says. “I look around and think, ‘God, I was lucky.’”

Several other hospitals in the metro area have created women-centric health centers. Here’s the short list:

→ LifeBridge Sinai Hospital of Baltimore

2401 W. Belvedere Ave.

Part of LifeBridge Health, Sinai Hospital is home to the Louis and Henrietta Blaustein Women’s Health Center. Opened in 2005, this 24,930-square-foot center consolidated women and infant services and includes 32 labor, delivery, and recovery rooms, two operating rooms, three triage rooms, three post-anesthesia units, and three high-risk/extended stay rooms.

Best known for: Serving the needs of women during labor and after delivery, the women’s health center also houses the Institute for Maternal-Fetal Medicine, which offers prenatal testing and counseling for high-risk pregnancies, diabetes, and genetic problems. The center also houses the Jennifer Gandel Kachura Neonatal Intensive Care Unit, a level III facility for newborns needing specialized care; and nutritional counseling, exercise courses, and other educational resources.

→ LifeBridge Northwest Hospital

5401 Old Court Rd., Randallstown

Equipped with the most up-to-date technology, Northwest Hospital’s Herman & Walter Samuelson Breast Care Center provides women with advanced screening and treatment options for holistic breast health in a spa-like atmosphere. Launched in 2010, the hospital’s Women’s Wellness Center offers obstetric and gynecological services to women alongside general health and wellness resources.

Best known for: One of Northwest Hospital’s centers of excellence, the Samuelson Breast Care Center employs dedicated breast-specialized experts including a radiologist, surgeon, and mammography technicians.

→ The Johns Hopkins Hospital

600 N. Wolfe St. and other locations

Obstetric and gynecological care at Johns Hopkins dates back to 1889, when Howard Kelly founded the department. Today, the center is well-respected in a wide range of areas, from family planning to fetal therapy and gynecologic cancers.

Best known for: Today, The Johns Hopkins Hospital is known for its Endometriosis Center, providing women with cutting-edge solutions for individualized endometriosis care, including minimally invasive and robotic surgery techniques to remove endometrial lesions while maintaining fertility. To treat heart disease, which is the No. 1 killer of women, and which often has different symptoms than those found in men, Hopkins is home to the Women’s Cardiovascular Health Center at the Bayview campus and at Johns Hopkins Cardiology in Columbia. It combines advanced medical treatment with a whole-body approach to preventing and managing heart disease, using a multidisciplinary team of experienced cardiologists with fitness, nutrition, and mental health experts.

→ MedStar Franklin Square Medical Center

9000 Franklin Square Dr.

Women’s Health Services at Franklin Square Medical Center offers a full range of obstetric and gynecologic care, staffed with attending and resident obstetrician/gynecologists, sub-specialists in maternal-fetal medicine, nurse midwives, women’s health nurse practitioners, ultrasound technologists, gene counselors, social workers, and registered nurses specializing in women’s health.

Best known for: Delivering more than 700 babies each year, the center specializes in high-risk pregnancy care for mothers and babies with medical problems and other complications. The center offers patients the latest technology and treatment options for regularly scheduled well-women appointments, as well as acute care, contraception, management of Pap smear abnormalities, screening for sexually transmitted diseases, medical and surgical management of abnormal bleeding, including minimally invasive options, and mid-life and menopausal symptom management.

→ University of Maryland Baltimore Washington Medical Center

301 Hospital Dr., Glen Burnie

Women’s Services at the Baltimore Washington Medical Center include pediatric care, treatment for a wide range of women’s health issues, and labor and delivery. Its state-of-the-art surgical suite offers da Vinci Robot-assisted, laparoscopic procedures for abdominal or vaginal hysterectomies.

Best known for: The Pascal Women’s Center offers spacious labor, delivery, and recovery rooms with whirlpool tubs, private postpartum patient rooms, and dedicated operating rooms for Cesarean births. The on-site Center for Advanced Fetal Care office, Neonatal Special Care Unit, and childbirth education classes round out resources for growing families.

→ Greater Baltimore Medical Center

6701 N. Charles St., Towson

GBMC provides a full spectrum of women’s health services, including labor and delivery, obstetrics, and gynecology, on the main campus as well as throughout the community, and a level III-B Neonatal Intensive Care Unit.

Best known for: For women needing close monitoring during pregnancy, the 12-bed Mangione High Risk OB unit, adjacent to the delivery suite, provides specialized maternal-fetal care. It’s one of the only in the region that consolidates all prenatal services, inpatient care, and antepartum testing in one location to promote a seamless continuum of care. Its Division of Urogynecology and Reconstructive Pelvic Surgery includes doctors who are specially trained to diagnose and treat disorders of the pelvic floor. The Uterine Fibroid Center at GBMC is one of only a few centers in Maryland that provides a comprehensive approach to treating fibroids, a condition that affects 77 percent of women.