Join internationally recognized cardiologist Paula Johnson, MD, MPH, to lunch-and-learn at the Bastyr University Spring for Health Luncheon on May 12, 2015, at the Seattle Fairmont Olympic Hotel.
Proceeds of the event go toward defraying the cost of uncompensated care for low-income patients who visit the University’s teaching clinic, Bastyr Center for Natural Health, in Seattle.
Dr. Johnson not only offers an expansive list of credentials, but also is passionate about creating a more equitable focus on women’s health, and on the specific ways in which women experience disease. Dr. Johnson serves as chief of the Division of Women’s Health at Brigham and Women’s Hospital, is a professor of medicine at Harvard Medical School, and a professor of epidemiology at Harvard School of Public Health. Her most recent research focuses on the impact of U.S. health care reform on women.
Dr. Johnson brings a broad range of experience as a physician, researcher and expert in public health and health policy to bear in the effort to transform the health of women. Her passion for improving women’s health care led her to found the internationally recognized Connors Center for Women’s Health and Gender Biology, where work centers around improving women’s care — by better understanding the often profound differences in health between men and women.
In her eye-opening 2013 TED talk “His and Her Healthcare,” Dr. Johnson discusses how women and men are not simply biologically distinctive, but in fact different down to the most basic cellular and molecular levels. This is a far-reaching concept when it comes to the practice of medicine as a whole, but in particular, it means that there are crucial ways in which women experience disease differently than men.
Dr. Johnson asks us to consider a simple, but powerful question: Why are we often leaving women’s health to chance?
“We know that every cell has a sex,” she says in the TED talk. “We know that these differences are often overlooked. And therefore we know that women are not getting the full benefit of modern science and medicine today. We have the tools, but we lack the collective will and momentum.”
Dr. Johnson spoke with us in advance of her talk at Seattle's Fairmont Olympic Hotel.
Why is it so important to acknowledge the biological differences between men and women, and differences in how they experience disease?
Most people are shocked to learn the statistics. Most people assume that this work is already done, that this science is done; they assume that health care is based on evidence. That’s why this is an equal rights issue. It’s our right to have accurate science that represents the people who pay for it — this isn’t about government agencies, these are our tax dollars at work.
Both women and men need to know this data. Improving women’s health is important to improving men’s health. Accurate science and accurate care is only achieved by including both women and men, both male and female cells, and if we get an average from that science — well, the average is the wrong answer for both groups.
At the least, we can surely populate studies with adequate numbers of women, be cognizant of racial and ethnic minorities, and really think about the impact and the interaction of sex, and race, and ethnicity, and socio-economic status. That’s something that is critically important in clinical science and clinical research.
How can we work toward including more women and minorities in medical research?
We need to view women’s health in the same way that we think about any other cause that’s important to us — as no less than an equal rights issue. Women’s health is an equal rights issue as important as equal pay. And it’s an issue of the quality and integrity of science and medicine.
Do you think natural health care or naturopathic doctors might be in a unique position to address differences in the response to disease between men and women?
Let’s ask how men and women are different within a naturopathic setting, and how a more holistic approach might have particular insight into women’s health. Too frequently medicine today is practiced in a way that is broken down only by organ systems and we forget that those organs are connected, and they live in a body that is part of the world, and part of their environment. That holistic vantage point is important, is adaptable, and provides a confluence with how we think about women’s health.
How might students help improve the state of women’s health care?
Students are the next frontier, the next wave of professionals, and can be the drivers of change in education. They can play an important role in moving the agenda forward. We can begin by asking some questions: Where do sex and gender differences exist in curricula, how do differences in sex and gender appear in natural medicine? Where are the areas we do or don’t have evidence?
Where do you see leverage points for change?
It took a law in 1993, driven by a bi-partisan group of legislators, led by women, to recognize that there were these huge gaps [between how men and women are studied, and how they experience disease]. It became clear that almost all clinical studies were done on men. It’s a great thing for us to recognize that informed policy-makers can make decisions that drive change in critically important ways. We can be pretty cynical about policy, but great things can be achieved in terms of health and well-being.
There are still huge gaps that need to be addressed. Through advocacy, through doing the science, through legislation, how do we make a difference so that the next generation is not having this discussion, and science — and the application of science — is done not only accurately, but we are creating clinical models that are evidence-based?
What keeps you inspired?
Every time I can think about how this gendered lens makes a difference, in identification of risk, in the way that I treat patients, in the way I approach patients and their outcomes — that’s an inspiration to me. I’m constantly reminded of what we don’t know.
And that’s where the inspiration lies. This is real. This isn’t an intellectual exercise, it’s not research for research’s sake. It’s a service to people — including men, and including the next generation.
This interview has been edited for length and clarity.
You can hear Dr. Johnson speak at Bastyr’s May 12 Spring for Health Luncheon, from noon to 1:30 p.m. at the Seattle Fairmont Olympic Hotel.
Dr. Brendan Smith, ND, discusses the more holistic approach to diabetes and cardiovascular care that the Bastyr Clinic for Natural Health offers patients.