Focusing on Women's Health
ddressing the medical needs of women is fast becoming
a top priority at the University of Miami. To that end, the School
of Medicine recently recruited Leo B. Twiggs, M.D., as the new
associate dean for women's health. The former chairman of the
Department of Obstetrics and Gynecology at the University of
Minnesota, Dr. Twiggs will coordinate all women's health services
across the University's medical departments under an umbrella
project known as the Women's Health Institute. Dr. Twiggs recently
discussed his vision of women's health services at the medical
center with Lisa Sedelnik, director of publications at the School
LS From a historical perspective,
what changed in the medical profession for it to take a closer
look at women's health care?
LT The change occurred with the paradigm shift from the
disease model of medical care (caring for a person and their
specific disease) to a broader concept of health care. With the
scientification of medicine and the various scientific advancements
made in the 20th century, the medical profession began to reevaluate
this disease model concept. This broader concept of health care
involves taking care of the whole being by examining a person's
physical and mental functioning, as well as the environment in
which he or she lives and works. It also encompasses other aspects
of health care such as prevention, the environment, the social
relationships with the family (or lack thereof), and related
LS With such a visible
affirmation of the school's new commitment to women's health,
first by naming you as the associate dean for women's health,
what is your vision for this new directive at the medical center?
LT The idea is to create a virtual institute, which over
time, will allow us to tap into a multidisciplinary group of
experts and specialists, not just from the medical school, hospital
and clinics, but from the entire University and its community.
More specifically, the Women's Health Institute will integrate
all women's health programs at the University of Miami/
Jackson Memorial Medical Center under one system. This system
will allow us to create a network of resources and services for
our patients across all medical disciplines. It will help us
build comprehensive clinics where women can get treated or find
valuable information about a number of ailments that specifically
affect them. The institute also will facilitate the research
and education missions of the school and hospital by providing
a recognizable administrative identity.
LS From an informational
standpoint, the concept of women's health, especially in terms
of providing comprehensive services under one umbrella, is new.
How will you successfully market this idea internally?
LT Once we build a group of interested faculty members,
we will invite individuals to participate in a multidisciplinary
advisory group. This group will meet on a regular basis and determine
where the opportunities for research and clinical care are and
how to pool together our resources to meet these opportunities.
We also will work closely with Jackson Memorial Hospital and
the Public Health Trust, under Ira Clark's leadership, to further
develop the clinical outreach sites. The University of Miami
Medical Group is looking carefully at community outreach sites
and their related community networks, and we will continue to
work together to develop that further. Part of the institute's
mission is to provide education to these community sites so that
we can increase the standard of care for women needing our services.
LS You've been instrumental
in raising significant amounts of money for a cancer center chair
at the University of Minnesota. Do you plan to implement similar
fundraising projects here?
LT We not only raised money for a cancer center chair
in Minnesota, but we were successful at the medical school level
in focusing the upcoming campaign to include a significant women's
health component. That's already happening here. A number of
philanthropic organizations at the University of Miami/Sylvester
Comprehensive Cancer Center, such as the Papanicolaou Corps for
Cancer Research and the Women's Cancer Association of the University,
have already been successful in raising money. These organizations
may also help us raise funds for the institute, as well as other
things. We don't want the institute to compete with our other
programs. Our mission is to create a center that is inclusionary,
not exclusionary. We want to facilitate interaction, interdisciplinary
care, and fundraising. That is our goal.
LS How will the creation
of such an institute have a significant impact on the delivery
of health care to patients?
LT The School of Medicine and Jackson Memorial Hospital
have long made it a part of their mission to deliver quality
care to the community. The community supports us with its tax
dollars, so it's imperative that we deliver care to our taxpayers.
For many in the community, though, going to a big hospital may
be inconvenient, if not impossible. So in response, we want to
build a community network to the underserved that facilitates
access to such clinics. Also, we will work diligently to elevate
the standard of care at these sites so that patients receive
top quality health care.
LS Supplemental psychosocial
treatment has proven to increase the well-being of many patients,
including women. Will this type of treatment play an important
role in the Women's Health Institute?
LT The medical center and the University have taken a
lead in the psychosocial aspects of women's health under the
leadership of Dr. Carl Eisdorfer in the Department of Psychiatry
and Behavioral Sciences and Dr. Carlos Sandoval of the Courtelis
Center for Research and Treatment in Psychosocial Oncology. When
you look at what is happening in this area, there is a lot of
excitement and rightfully so. There is already a critical mass
at the University in women's health. My role will be to facilitate
the interaction. That's another reason why I am here. If we can
facilitate interaction across disciplines and across the University,
then we should be able to define a system that will be nationally
recognized for its excellence in research and education of health
Coming from Minnesota, you are going to find South Florida
a more ethnically diverse community. How will the Women's Health
Institute address the needs of this population?
LT The fact that South Florida is such an ethnically diverse
place is one of the great opportunities about my new position.
Miami is at a hemispheric crossroads, and the people coming and
going here make it an exciting place in many aspects. It also
is a place where organizations and funding institutions want
to develop their mission and goals. More research studies and
clinical trials need to be conducted so that we can figure out
what is happening with underserved care as well as with ethnically
diverse populations. Our job is to act as a funding catalyst
for such communities.
LS How will women's health
be integrated into the curriculum?
LT It already is being integrated. The medical school
has taken a lead in making women's health part of its core curriculum.
In fact, the new curriculum, which Mark O'Connell, M.D., senior
associate dean for medical education, is developing, is expected
to be implemented in August 2001 and will have a women's health
component to it. Many people have already come to the conclusion
that including women's health topics in the classroom is the
right thing to do, and they are moving forward with it. Hopefully,
I will be able to facilitate that across different disciplines--medicine,
psychiatry, family practice, pediatrics, adolescent medicine,
OB/GYN, and others. The concept of women's health is here to
stay and we want to support it as best we can and have the University
of Miami recognized for its leadership in this area.