When Karen London set up a resource center for women at Mercy Medical Center, she expected her biggest challenge to be finding obscure facts about hundreds of diseases. Instead, she's discovered it is getting the women to leave.
At a recent evening session on menopause, the center was so packed that women were sitting on window ledges and the floor. An hour after it was supposed to end, the discussion was going strong.
"Yes, there are the pamphlets on the walls that have been beautifully orchestrated by a marketer," Ms. London said. "But what it all comes down to is, we are just women who want our voices to be heard." That kind of pent-up demand has transformed the Women's Resource Center just as surely as it has driven, on a larger scale, Mercy's effort to become a leader in women's health.
The decision to go after female patients is a popular one for struggling hospitals looking for a niche in an increasingly tumultuous and competitive market. But few have launched as extensive an effort as Mercy, which hired the Gallup Organization to poll women who live and work downtown, sent a team around the country to visit the best women's centers and spent more than $10 million to create its version.
"They've done far more than most hospitals," said Mary Anne L. Graf, president of Health Care Innovations, a Utah consulting firm that focuses on women's health and worked with Mercy.
Now Mercy's Center for Women's Health and Medicine offers everything from a program for sex assault victims to experts and services on conditions such as incontinence and osteoporosis.
Carolyn Brown, 39, is a government worker who has taken advantage of classes on meditation and weight loss. She calls the center an oasis. "They make it convenient," she said. "You need something that's going to help you in day-to-day life."
Mercy's latest move was luring Dr. Neil B. Rosenshein, one of the nation's top gynecologic cancer specialists, from Johns Hopkins Hospital. He has brought in thousands of patients since his arrival in July, sending diagnostic labs into overdrive. Mercy hired extra workers to handle biopsies and bought a second $800,000 machine to do more computerized axial tomography (CAT) scans.
Not so long ago, Mercy -- once among the most popular places for Baltimore women to have their babies -- had slipped off the radar screen. Revenues were up and down during the 1980s, and there was little money for capital improvements and new equipment. Mercy's linoleum floors and faded yellow walls couldn't compete with amenities at hospitals such as Greater Baltimore Medical Center, which followed the patients to the suburbs in the 1960s.
Many within the hospital complained about Mercy's decision to remain downtown.
But planners began to realize that the St. Paul Street location put Mercy within reach of 180,000 commuters in a 10-minute radius, 52 percent of whom were women. News was beginning to emerge that women had been neglected in medical research. And the hospital's founding group, the Sisters of Mercy, had made the care of women a goal.
Officials learned that three-quarters of health care decisions in the United States are made by women, accounting for two-thirds of all health care dollars. Women buy 59 percent of prescription drugs. For instance, Greater Baltimore Medical Center, which has roots as a women's hospital, has continued to build much of its business on women. Seventy percent of the hospital's inpatients are women, and 62 percent of outpatients are women.
For Sister Helen Amos, Mercy's president and chief executive officer, the trends intersected at one point: women's health. "We knew it wasn't original, but if we were going to do this, we had to distinguish ourselves."
So Mercy officials hired Gallup, which produced a 324-page report. They discovered that about a third of the women, mostly in the 18-to-34 age group, had no regular source of health care. Ninety percent of the women wanted a newsletter and referrals to health services.
Mercy officials spent $8 million to renovate three floors of the high-rise hospital, creating modern rooms with hardwood floors. Because heart disease is the No. 1 killer of women, they installed a $2 million laboratory to do cardiac catheterization. They named Dr. Deborah J. Barbour -- a rarity in that she is a female cardiologist who also does invasive work such as catheterizations -- to head coronary care. She gives lectures to other physicians and the public to promote awareness, and encourages women to enroll in heart studies.
"Women really fall through the cracks," said Dr. Barbour, adding that many of the women who work downtown, such as part-time employees and divorced women, have no health insurance.
As Mercy's effort developed, there were growing pains. Some within the hospital didn't understand why women's health should get so much attention. They questioned the cash outlays.
But now, officials are beginning to count tangible results.
At a time when other hospitals' occupancy rates are declining because of the increase in outpatient procedures, Mercy's has increased about 10 percent in the past year. Admissions are up about 14 percent, from 2,700 in summer 1994 to 3,100 this past summer.
Some of that is because of successful recruitment of Dr. Rosenshein, 51, whose list of published studies is 12 pages long.
"It was like signing Cal Ripken to play on your Little League team," said Gary N. Michael, vice president for marketing and communications.
Bolstering the team
Dr. Rosenshein demanded valet service at the hospital because many of his patients are elderly. His accommodations include a patients' locker room and an ultrasound machine so tests can be done in his suite.
Such requests probably would have taken months to work out at larger hospitals, or ones that are part of an alliance. But Mercy -- unusual in its independence -- moved fast. Officials knew they had a big fish on the line, and Dr. Rosenshein had other offers.
Dr. Rosenshein works 13-hour days. Sometimes he has two operating rooms going at once.
Helga Patrick of Reston, Va., routinely travels to Mercy to see Dr. Rosenshein. "I got more answers from him in 20 minutes than I did in three sessions at Georgetown," said Ms. Patrick, 33. When her ovarian cancer resurfaced, she was told she needed a colostomy and would lose her bladder.
But Dr. Rosenshein operated on her and managed to avoid the colostomy and save her bladder. After chemotherapy, she is doing well.
Sister Helen looks back to Holy Saturday, the day before Easter 1992, the day her prayers were answered.
That day, Maryland's legislature approved $1 million to expand neonatal intensive care. It was the nest egg that helped spur the women's health effort.
Said Sister Helen: "It was a sign from heaven, if you will."