You scheduled your son’s flu shot and picked up medication for the baby’s eczema. You finished the report you’ve been preparing for work, and you made an appointment at the retirement community for your mom. You even bought a new box of Frontline for the dog since tick season is coming. Then, after days of trying to shake that nagging feeling that you forgot something, it suddenly comes to you.
You forgot about you. You need a mammogram, a gyno exam, and a routine physical. And that’s before you start unraveling the stress that’s weaved its way into a tangled mess between your ears. “Women are not only the caregivers, but we often make healthcare decisions for everyone in our lives, often to the exclusion of ourselves,” says Randi Protter, M.D., the medical director of the Capital Health Center for Women’s Health in Hamilton, N.J. “We’re doing the soccer and gymnastics, so busy keeping everything aloft—the piece that is often missing is taking care of yourself. My goal is to offer a place where you can get your health services in a way that is easy, convenient, and facilitated. Let us make your appointments for you.”
Dr. Protter was first approached by Capital Health CEO Al Maghazehe in 2010 to create and run Capital Health’s Center for Women’s Health—an idea that hadn’t completely come to fruition at the time. The concept—comprehensive care for women—stemmed in part from watching the women in his life put their own health on the back burner. “If you look at other places, women’s health comes down to Ob/Gyn programs. That’s not what I wanted,” Maghazehe says. “I wanted to create a situation where we get women into the program, educate them, and help them navigate their health. We would focus on prevention rather than intervention, unless it was absolutely necessary.”
After a two-year search, Dr. Protter became the ideal fit to turn Maghazehe’s vision into reality. After graduating from MIT with a degree in biology and doing genetics research for several years, Dr. Protter had decided she wanted to become a doctor. “In my last year of medical school at Rutgers Robert Wood Johnson Medical School, I did a rotation with a brilliant internist named Nayan Kothari, M.D., who helped me fall madly in love with internal medicine, and I knew that was going to be how I spent my career,” says Dr. Protter. “It made so much sense to me to be able to take care of every aspect of the body rather than a particular aspect of the body.”
During her residency at the University of Medicine and Dentistry of New Jersey’s Internal Medicine/Primary Care residency program, Dr. Protter had the chance to blend internal medicine and primary care, which was somewhat outside the norm. And then something else clicked. “More and more it was the women in my clinic who were coming to see me, and I loved the idea of taking care of women,” she says. She then received additional and special training in women’s health.
After finishing her residency, Dr. Protter became the medical director of a women’s health center in Somerset County and was charged with turning it into a more full-service clinic. She was empowered to care for patients more holistically, addressing all their needs with help from other medical experts. “To be able to take care of a significant number of problems—from depression to diabetes to painful sex disorders—made so much sense to me,” Dr. Protter says. “The patients benefited because they got one person, one place, one facility they could look to as their medical home.”
A Holistic Approach
In 2010, when they began drawing up plans for the Center for Women’s Health, Dr. Protter knew it had to be a full-service facility, one that simplified and customized health care. Capital Health held focus groups with local women to make sure their vision was in line with the public’s needs. Then they began what was, essentially, the realization of a dream for Dr. Protter.
Designed by a female architect, built by female construction workers, and decorated with art from local female artists, every aspect of the center had women’s fingerprints. “It has those details, like changing closets in the rooms and courtesy curtains so no one is walking in on you,” Dr. Protter says. “Those nuances make it a comfortable place for women to come.”
A person to handle all the patient’s appointments and schedules—punctuated Maghazehe’s original idea. In practice, this translated into a Patient Navigator, which is becoming a signature of the center’s innovative approach. “It’s the navigator’s responsibility to keep patients on track,” Maghazehe says.
In fact, the Patient Navigator (or concierge) makes all the appointments recommended by the doctor such as for follow-up testing and referrals to specialists. “If they need to see a podiatrist and a sleep medicine consultation, the concierge makes all the arrangements and makes sure their insurance covers them,” Dr. Protter says.
Another pivotal aspect of the service provided by the Center for Women’s Health is time. Unlike many doctor practices nationwide that shuttle patients in and out in minutes, the center’s staff takes their time with each individual. “To get the information you need, you have to take the time. Healthcare in general has taken appointments that once started out as an hour and reduced them down to 20 minutes to then to 10 minutes, and in some cases 5 minutes. I can’t say hello in that time,” Dr. Protter says. “Women will give you the information, but you have to ask them the right questions and give them the time to answer. Our goal is put together a health map of sorts.”
The Center for Women’s Health is full-service and covers the full spectrum of women’s health—they do everything from preventative medicine (immunizations, physical exams, blood tests, and electrocardiograms) to gynecologic exams to procedures (biopsies and wart and mole removal) right in the office. However, it’s also Dr. Protter’s goal to care for the whole patient and utilize the Capital Health network of doctors as effectively as possible.
In a recent case, Dr. Protter saw a patient for a routine check up who expressed concern that her heart rate was going up too quickly when she was exercising. “She is really fit and had been wearing a heart-rate monitor when she worked out. While she was in the exam room with me, I called [Kristopher Young, D.O., FACC, the director of the Chest Pain Center at Capital Health] and went through the scenario,” she says. “The patient went home and got her sneakers, and within two hours she was in his office on a treadmill getting a stress test.” In the patient’s words: “During my last visit, Dr. Protter called a colleague on the spot to discuss the matter, which led to an almost-unheard-of same-day specialist appointment.”
“That was an incredible success of healthcare,” Dr. Protter says. “Someone came to me with a problem, and by the end of the day she had her answer.”
Body and Mind
Now that word has begun to spread about the quality of care at the Center for Women’s Health, the number of patients has swelled—last year they saw 4,600 patient visits. To serve the influx without sacrificing quality, Dr. Protter handpicked two full-time doctors and a nurse practitioner to add to the practice. “As my program grows, I’ve been given the flexibility to hire additional talented health care providers,” Dr. Protter says. “It’s incredibly important that we are top-notch medically. That’s what’s going to make us top tier.”
Since the center’s goal is to take care of the whole person, Maghazehe also gave Dr. Protter the green light to add programming and services that go beyond the X’s and O’s of typical health care. It starts in the facility itself. For example, you won’t find Us Weekly in the “music sanctuary,” a specially designed waiting area and resource room where patients can enjoy music and aromatherapy. Instead, you’ll find selections such as The Happiness Project, Food Rules, and I Am Malala.
In addition to health services, the center offers yoga, acupuncture, and special programs such as a sexuality symposium each spring—all in an effort to serve women as complete human beings. “If someone shows up with a weight problem, we’re not just trying to help them lose weight,” Maghazehe says.
That’s why, for example, the medical history form patients fill out before their first exam is five pages long, filled with personal questions, including, “Would you like to talk to a counselor about quitting tobacco, alcohol, or drugs?” “People ask me, ‘is that necessary?’ The answer is yes. Medical problems tend to overlap. So a woman who is depressed who also has a painful sex disorder—it’s a vicious cycle. It’s all connected,” Dr. Protter says. “To be able to look at the entire picture is a much better way to take care of a patient. You can really take the time to get to the root of the problem.”
It can also prevent problems, which is why, Maghazehe says, you’re likely to see many more Capital Health practices go this route. “This is a model for the future because the idea is high quality, low cost, and it’s about keeping people healthy,” he says. Whatever is down the road for health care on a large scale, at the Center for Women’s Health, the future is now.
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