Newsnight Maryland; 422; Women's Health

A. Real No Smoking signs start popping up in Montgomery County bars then improving women's health. Plus a check on the condition of Maryland's hospitals. This. Is. Maryland. Good evening. You won't see any gas trays and there should be plenty of no smoking signs starting in January 2002 at all bars and restaurants and hotels in Montgomery County. Today the County Council passed a smoking ban that makes Montgomery County the first in the state to expand no smoking rolls to all public places. NEWSNIGHT Maryland correspondent Benita Billingsley tells us opponents call it too extreme. While supporters are celebrating the decision. Smokers in Montgomery County can light up in restaurants and bars from now until January 1st 2002. After that they'll have to abstain or step outside. That will make Montgomery County's no smoking laws. The

strictest in the state. Opponents say they don't understand why current state laws aren't good enough. Those measures call for accommodation of nonsmokers and smokers basically saving tables for both parties. And we see no reason why. But again we can only should go in another direction from that you don't accommodate people in a public health situation or somebody had TV wouldn't accommodate him would you do public health and that's what government is about and that's what the council is a governmental agency. And they're dealing in a public health issue. Small print supporters are proud of their list of endorsements which include. Any organizations along with the last three county executives and former Surgeon General C. Everett Koop But opponents say they represent Montgomery County businesses and taxpayers. The county has invested over three quarters of a billion dollars in revitalization efforts in Silver Spring. Not to mention the similar efforts in Rockville and Gaithersburg. And clearly this measure is going to do no good and be of no help

in not only retaining businesses but attracting new ones to Montgomery County. County Council members who won the band in a five to four vote say they'll find ways to boost economic development and they hope this move will serve as a model to the rest of the state. I think it's a victory for the workers and for the patrons who are these are just fabulous. And I am not as convinced about the dark consequences that some of the rest pro-terrorist ever suggested about this approach. It's not a worker health versus worker pocketbooks it is not economic revitalization vs worker health that we have a proud history in this county and in this country of being able to do both at the same time and I think that's the message they were trying to send. Next week they say they'll make that message official when they vote again in their roles as members of the Board of Health. That way the smoking ban will apply to the entire county with no exceptions. I'm Benita Billingsley reporting for Newsnight Maryland.

The first National League exhibition dedicated to women's health issues is opening at the Maryland Science Center in Baltimore. We'll take you there in just a moment for tonight's discussion with Camilla Carr and our panel of experts but first NEWSNIGHT merilyn correspondent Karen Allen introduces us to the exhibit in tonight's Marilyn discoveries. Do you know what the number one killer of women is. Heart disease. What do you know about osteoporosis. Do you know what a breast lump feels like. You can find the answers to those questions and more at the 3000 square foot three point two million dollar exhibit opening Friday at the Maryland Science Center. It's the first of its kind dedicated exclusively to women's health. To many it's long overdue but to be able to come and interact actually with with exhibits that show you what's going on with your body and your breast is extraordinary. It's extraordinary. I mean it's it's an idea whose time has come long ago I mean you know they're paying attention to women now and young women my

grandchildren my granddaughters will have the benefit. Knowing is you know for years women were left in the background. Noni is a breast cancer survivor who tells her story on tape in the exhibit. But you can do more than just watch and listen. You can try to detect breast lumps yourself in the breast model's various station show you what smoking does to your lungs. You can see what osteoporosis does to your bones. There's a section on birth control and sexually transmitted diseases geared especially towards teenagers and for older women the latest on hormone replacement therapy. There's also a section on eating habits and body image. What would you change about yourself if you could. Almost all the displays here at the exhibit are interactive. For example I'll bet many of us women would take better care of our hearts if we saw just how hard it is for the heart to pump blood through a clogged artery.

And I never knew that women and heart attacks. And that is just men. You know my father died of a heart attack. Women didn't. And I think that women's bodies it was all taboo no artwork depicting women's body types and visions of women's health are spread throughout the exhibit. Hopefully opening up young minds to question and debate. EVERYTHING IS OUT IN THE OPEN. It's wonderful. We're not so afraid to talk anymore. Mansour prayed to speak out saying we are women here are whatever. The exhibit is here until the end of August. Then it will tour the country for the next five years. I'm Karen Allen. NEWSNIGHT Marilyn. Welcome everyone we're here at the Maryland Science Center and it's been a jam packed day full of information regarding women's health. And joining us tonight are three of the key players in today's exhibition and also conference you may you might want to call it. And to my left is Mary Junko from NIH. Then Dr. Neil Rosenschein from Mercy Hospital and Stephanie Radcliffe who is who heads

exhibits at the Science Center. Mary I would like to begin with you. And that is how is our perception of women's health changed over the past 10 years ever since in an age became. Targeted to women sell particularly well traditionally Camilla. The idea about women's health was that women's health pertained only to women's reproductive health. Now the reality is that the average woman in this country lives to the age of 86. And so she spends about a third of her life in the post man apostle of yours. And that new reality is now reflected in the new approach that the NIH has taken to women's health research. We're now looking at women's health and wellness across the entire lifespan from childhood through adolescence the reproductive years and the post reproductive years of a woman's life. Dr. Rosenschein How do you approach your patients now. Do you approach them in a different way your female patients and let's say 10 or 15 years ago or just based on the on the new research.

Certainly I think we've all learned a lot in the last 10 years. Last decade I think there are many more important issues to be addressed there are so many more examples. Well I think we have you can start with simple screening tests. Now we have to be much more conversant about what's available for women for screening for cervical cancer. There are new tests that are available that may be beneficial to those certain individuals. There are new tests for checking for osteoporosis. There are new many new drugs that are available for osteoporosis. What about ovarian cancer. What advances have been made. Well I think many of the advances in ovarian cancer are come at the therapeutic end. We don't know much more about appropriate surgery for women who have advanced ovarian cancer. How to be appropriately aggressive with surgery and ovarian cancer. And now many more drugs that are available that will enhance survival for the ovarian cancer patient. And we've even gone out to immunotherapy for ovarian cancer. So some very striking things in the treatment and we'd

like to do more in prevention terms in detection and detection. And that really is one of our biggest challenges at the present time. Stephanie how do you see this exhibit empowering women I think Karen alluded to that but particularly as a woman what was your impression. Well I learned in a minute's amount of information in developing this exhibit over the last three years and what we really wanted to do was put information in the hands of women so they can be actual better partners they can take control of their health and be better partners with their health care providers. So we wanted them to come and learn more information. Ask questions and continue to learn as much as they can about their health and to be in control of their health care. Speaking of being in control of disseminating information Mary there is a perception a public perception that when it comes to the NIH it's strictly research and that research pretty much stays within the NIH and it's disseminated to other research scientists and other physicians.

But that is not true. No it isn't. In fact many of the institutes within the National Institutes of Health have very extensive communications and public outreach programs including the Office of Research on women's health which has supported this exhibition as a way of reaching women with up to date scientifically sound information about ways that they can preserve their own health by simply taking better care of themselves by eating right by getting enough exercise by getting the proper diagnostic screening exams that could help them detect or prevent such things as cervical cancer and certainly breast cancer. Dr. Rosenschein what about this relationship between doctor patient. Do you see that it's changing there was a time when a doctor was considered almost a god and you didn't question your doctor. You just particularly women you just accepted whatever information was given you. Well I think things have changed clearly and that's where the importance of this exhibit is. I

think I've always thought knowledge is impairment. Reading is empowerment. Knowing what the issues are is empowerment. And this exhibit brings that to a very clear point. Women must know the issues and less go to their physicians with a certain base of knowledge to get the optimal care without a base of knowledge. You are always going to come away less than in less than optimal situation. So the importance of this exhibit is to give women the opportunity to understand the importance of these issues and then to discuss it with their physician. We were talking earlier with I was talking rather with some other women and we decided that for us our major issues are breast cancer and our weight. When heart disease is the number one killer of women in this country and it's lung cancer that's the number one cancer killer. How do you get that message a message across a lot of patients. I think again an exhibit like this and programs like this carry that message very clearly.

I think it's striking. You know the amount of damage smoking does to men and women. And I really think that has to be made clear especially in in these types of programs what is some of that societal because particularly with body image we are always I mean we're bombarded with these super thin elegant models wearing these fabulous clothes and you know our ideal is to be you know like a hundred ten maybe five eleven or six feet so don't you have to change the societal outlook as well. Clearly I think what we're interested in is good sound health practices doing things that are not destructive. You know you don't smoke you don't drink excessively. You eat well. I think the things that we all know for years doing things in moderation. You don't overdo it. You don't over exercise but you understand the issues and that's why I think this exhibit is very important and one of the things that we really want to do when we develop

this exhibit is not just give biological information. Once we began to learn about this we really realized how important it is to allow people to step back and really look at these societal influences that do influence what motivates us to do certain things and so that was very clear for us as we wanted women to tell their own stories we wanted to sort of show society for what it does to us in some cases and also give you some good biological information we really want you to think differently about your your own health after you've been visited this exhibit and we really want you can't do it in a vacuum. Society absolutely does have an effect on us and we need to acknowledge that so we can step back and do something. And I think this type of program in Paris again that's an excellent word. Women to go to their physicians and challenge their physicians challenge them about osteoporosis. You know make sure their physician is doing the testing that's appropriate for that woman making sure she gets the appropriate medication and counseling. So it really is a partnership if you want the

best health product. It's a partnership. And this program goes a long way to establishing that partnership for women between the patient and physician. Mary I don't mean to put you on the hot seat here but since you are with the NIH What do you think the major health issue for women is. Is it lack of information. It's partly lack of information. It's also partly the fact that I think many women do accept the idea as to which Stephanie and Dr. Rosenschein were referring earlier that if they're rail thin that means they're healthy Well that isn't necessarily true. And I attest a major prevention study underway called the Women's Health Initiative. It involves about one hundred sixty five thousand women postmen appalls and women across the United States and 45 different communities. And we're looking at the way that post menopausal women can preserve their health and it doesn't necessarily mean they have to be real fun. Then what it does mean is that they eat a healthy diet that they get regular exercise and that they truly become partners with their physicians in terms of taking care of

themselves and getting the proper diagnostic exams on a regular basis. She mentioned becoming partners with your physician Dr. Rosenschein. What advice can you give to women so that they will learn how to become partners with their physician into. Granite. You have to have some knowledge. But suppose you go into your doc and you just take it you don't know anything. Well I think you need to go. You need to be in a relationship where it's an open relationship where you can express your concerns. Now we've all expressed concerns about osteoporosis heart disease smoking. But there are other issues for example. Yes a lot of talk about that very frequent issue that I encounter in our practice. I think in last you have an opening for that patient to discuss things and she's comfortable with the relationship. You're not going to get to what is most important for at that point. And some women the most important issue at that point in her life is depression. She's going through some difficult times either in her relationship with her

husband or her family. But unless that individual is open you won't be able to really get to what is important for her at that point as to your process as an important for at that point. We need to deal with the issue of depression so she can then go on to really caring for these other issues. So I think in the last and most important I guess ingredient to me is an openness and a freeness in this doctor patient relationship where it's an equal relationship it's not. Tilted in one way or another a truly balanced relationship where someone can come and feel comfortable enough to say you know I'm really having some problems I'm really struggling at this point and this is the issue right it doesn't have to. You don't have to say that to a psychiatrist I mean you can go to your gynecologist you can go to your your primary care your family practitioner and say those things and then they can refer you to a specialist. But the important thing for women to know is that depression is one of the most treatable emotional or affective illnesses that there are drugs that really make a difference

and that there is no need for anybody to be depressed. The best way I can put it that we now have so many treatments and interventions that can help men and women to overcome this debilitating illness. And. Once they overcome it then they are free to adopt the other kinds of changes in their lives that can keep them healthy over the long term. Stephanie I see you nodding over there. Well again this is one of the issues that I learned about from. Research in this exhibit when were starting to work then I'm going to find out that one out of four women in their lifetime may suffer from depression from depression and that that women more often than men I mean this is again one more thing that I think awareness really helps even if it's not for you it's your friend you're from another member of your family. So I think again it there's a lot of issues here that we really put on the table and we hope that women walk away at least a little more aware.

Doctor do you think women are now being taken a lot more seriously than they were in the past before there were some doctors who would say well I have a pain for example. Oh it's just in your head. And a lot of. Potential heart problems were were totally mis diagnosed because that's not that was a man's disease. Now I think that there's always going to be relationships between doctors and patients which aren't what we would like to see Cheri. But I think what we're trying to say with this exhibit. And with the programs are being put forth is every patient should be taken seriously. If someone presents an issue you must take it seriously. You must try to find out what is really the concern for that individual. And when they express chest pain or a headache. You really need to sort out the issue. In my particular practice you know you know I have to understand where the individual is as a whole to give that person really the best quotes

health product and give her the best opportunities for good health. I really need to know where she is. And I think what I would say to the audience and to everyone here is really for women to get a good base of knowledge get in a relationship with a physician where she can be very open and candid. And then she will walk away I think with the best opportunities for good health in the future. Mary. Do you have any final words. Well simply that I hope that people in Maryland will come to the Maryland Science Center the exhibition is open until August of this year and it's a wonderful opportunity for women and their families to learn about how they can keep themselves healthy. And it's not just for women. I have there. It's also for men in fact men can learn a lot here right. Absolutely. OK. Honestly I've learned a lot. Ah well Dr. Rosen John and Stephanie and Mary thank you so much for joining us. Thank you. Thank you. And back to you. Thank you Camilla. On to other things in Newsnight now what's Perdue doing to clean up chicken waste.

The answer next in the Maryland is. And in tonight's newsmaker segment we'll check on the condition of Maryland hospitals. News from around the area today hospitals and paramedics are in favor of a proposal that would prohibit HMO patients away from the Nine one one. The bill was prompted by reports that Kaiser Permanente is starting its own emergency system. The Maryland Department of Natural Resources is trying to convince federal officials that money is needed to eradicate nutrients from the black water National Wildlife Refuge on the eastern shore. AT&T says Bell Atlantic is over charging for junior customers. One hundred twenty five million dollars annually in fees the local telephone service provider charges to long distance carriers. Bell Atlantic says the fees have been reduced over the year. And everything to do with her. Let me show you how to find the courage to face your money

and take charge of your financial future. Join the Army for the courage to be. 8:00 tonight here on NPT. In the Maryland BIZ TONIGHT Perdue Farms is making a big investment to change chicken litter into chicken fertilizer. Jeff has that story. I'm on hold for his operations on Maryland's Eastern Shore have been under fire from environmentalist over chicken waste. The spreading of that waste on farms as fertilizer boys linked by some scientists to fish Styria outbreaks in the water. Now Perdue Farms will spend more than five million dollars on new technology to turn that waste into a product that can be used by farmers beyond Delmarva but it takes the whole tree literally and it is contentious it in a belt tightening process in a pasture ization prices so it kills all bacteria. There's very little water as a result into a any organic pellet they

can be banned too. Choose on crop farming. It's an excellent source. Organic material sure most cost of transportation is still a big issue with this and Mr produce says government help with that cost might make this solution a bit more economical. Now on a totally unrelated subject how about a big bowl of cow Krispies for breakfast. The Orioles third baseman will have a cereal named after him to raise money for charity. A New York Company famous fixin's is behind the product but will not release the name until Major League Baseball gives its ok. The company also makes Flutie flakes which have generated about a million dollars for research on autism callus Krispies or whatever they're eventually called will support the Kelley encounter rippin educational foundation. That is today's Marilyn bits. Cost cutting downsizing and mergers familiar moves in the corporate world.

Being Maryland's hospital system Cal Pearson the president of the Maryland Hospital Association is here with a look at the State of the state's hospitals. Welcome. Thank you. What are some of the key issues confronting Maryland's hospitals these days. Bob we've always thought of the key issues in health care being quality. On one hand the cost on the other hand which is very important for consumers in access to hospital care is the third Those are really the three legs of the school and there are some some major issues related to all three of those things to hospitals the health care system itself is changing so much in the past decade in the past few years. How are Maryland's hospitals keeping up with that and adjusting to that. Are there for example too many hospitals now in Maryland. Will the issue of excess hospital capacity is a legitimate one. The good news is that length the stay in hospitals is going down in admissions are going down because of advances in health care. And that's that's holding

down the cost of care. What that's creating is hospitals are diversifying into outpatient services beyond the traditional focus of a hospital. So yes indeed there are too many hospital beds for the future and well we'll be dealing with that issue in the coming legislative session. Can you talk a little bit about that what are some of the agendas that you have in the legislature one of the major agenda is the need for overall regulatory reform in the state of Maryland we have five different health care related regulatory agencies. There needs to be some structural consolidation there is as well as changing a functions as we our health care system matures and changes. That's really the major agenda. Should hospitals be more have more independence from state agencies than they do now. Well yes and no. We need to have continuing public accountability of hospitals and health care so that we we make sure that the public is well served by our health care organizations. By the same token as managed care continues to grow and we have

extra real pressures on health care costs quality and access a lot of that can be self regulated more than in the past. How do Maryland's hospitals stack up against other states in terms of quality and access. Well we have a very unique approach to access to hospitals in Maryland under our all payer system. Every person in the state whether they're insured or not can receive hospital care. And there really is no question asked I mean the other payers step in and pay their fair share of that hospital costs. That's unique in the country. So we have great access to care on the quality side. I also think we have excellent quality hospitals in the state. All the hospitals are accredited fully by the Joint Commission which is the first litmus test. And then beyond that if you've seen the recent U.S. News and World Report report on hospitals we have five of the leading hospitals in the country from that report. We have many hospitals that are accredited with commendation I could go on and on.

There will there be fewer hospitals in Maryland in the future is that an inevitability that there will be fewer hospitals that most importantly there will be few less inpatient bed capacity but as I said earlier hospitals are evolving organizations so many many are evolving into ambulatory care type programs many into long term care types of services so there's a greater diversity of what a hospital means but that yes there will be fewer hospitals and less capacity in the future. I'm guessing that an individual in Maryland or any state might wonder looking at all of these changes that are happening might wonder well is there going to be room for me in a hospital someday. What do you say. What we need to build enough capacity into the system for those situations like even now in January-February there are more people that require hospitalization than during other parts of the year so we need that kind of flexibility and the nice thing is that hospitals can staff up and down.

Based upon the needs for particular parts of the year and particular events that occur. Will hospitals still be the big industry that we see now the big employer. I mean it's a huge employer. What is huge we have there's a tremendous positive effect from hospitals in the state of Maryland. We spend we contribute about six point five billion dollars to economies all over the state of Maryland. Local economies about 3.5 billion of that is in salaries. One out of every 34 employed Marylanders works in a hospital so it's a significant part of our economy. And that that is going to continue in the future. You think so. I do. I do believe Mr. Pearson thank you very much for joining. You're very welcome. And thank you for watching Newsnight Maryland tonight. Tomorrow should parents be told before pesticides are sprayed on school grounds. That's it for NEWSNIGHT. Have a good night. Thank you.

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