Dr. Littleton noted that Houston has a large population of women who don't qualify for indigent or other charity care and therefore get no care. This question will take a lifetime of study to answer. For women, we know that a strong support system is key. Dr. Smith commented on efforts at Harvard and in Massachusetts in general to make radical changes to address and publicize the effects of abuse on women and children. They've made curricular changes, program changes.
Violence is a determinant for many of the problems in women's health.
Dr. Reiser suggested we contact the university and review their materials. Specialists and generalists should know the differences in physiology of men and women and how to treat illness in the different genders. We shouldn't have to create a new field to treat women's issues when existing practitioners should be doing that job already-we just need to teach them that men and women are different and they must learn what those differences are. Ms. Booker asked how nurse practitioners relate to the issue of women's health as a subspecialty. Dr. Littleton responded that nurse practitioners focus on the whole woman, mental, spiritual, physical, emotional, in treating them.