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Dr. Kathie-Ann Joseph is currently an assistant professor of surgery at NYU Langone Medical Center and one of the top breast cancer surgeons in the country. Exposed to health disparities among the poor as a medical student at Columbia, Joseph aims to eradicate barriers to good healthcare amongst women. With these goals in mind, she works as the medical director of Breast Services at NYU Langone and serves on various committees, including the American Cancer Society’s Harlem Cancer Control Coalition. The Eye sat down with Dr. Joseph to discuss Obamacare, care options for underserved women, and yoga as treatment.
Do you think the recent health care legislation will decrease the cost of health care for women?
I hope it can. On one level, there is never one easy solution. I think that improving access to health care will certainly help. If women lack insurance, they’re not going to be able to get that mammogram that will allow them to detect that breast cancer at an earlier state. Education is another, because educating women about breast cancer and the need to go for a mammogram— these two go hand in hand. It’s something I spend a lot of time doing—educating women about breast cancer—because there’s this fear in some women in some communities about cancer—so people feel that once they get that cancer diagnosis, it’s a death sentence.
What do you do to educate women?
Anywhere anyone asks me to give a talk, I usually will go and give a talk. In a church, at a conference, or so forth. I also have my own annual conference that I had organized several years ago—I think we’re in our eighth year—that targets women of color. Every year we have really distinguished speakers, survivors, that come and speak in very plain language about breast health, breast cancer. And that really seems to be a good way, one good way, to get the message out. Also to remind women that being uninsured doesn’t mean you can’t get a mammogram. There are free screening facilities to get a free mammogram, and many women are unaware of that. Especially with the economy being the way it is, many women are unemployed, they don’t have insurance, they’ll skimp on their health.
What are you working on now?
We’re looking at services that can help [women] with their aftercare—some of the things that can help them with their symptoms after they’re treated with breast cancer. We’re starting a study right now, which is a yoga program. It’s looking at how yoga will improve their spiritual and physical well-being. There have been other studies that have looked at that in the general population, but in this population we have here at Bellevue, it’s pretty much Hispanic and Asian, and the majority of our patients don’t speak English. We get used to treating our patients, doing the surgery, doing chemotherapy, and sending the patients on their way. But this is a patient conformation that is primarily uninsured or underinsured, who don’t speak English and may not have a lot of emotional and social support as they go through their cancer treatment. We’re trying to develop other systems that can provide them psychosocial support, emotional support.
Did Columbia influence your decision to help these people?
Definitely. I had an opportunity to work at a private hospital, but also working at other hospitals like St. Luke’s- Roosevelt in Harlem, where you had patients who were not so well off, more challenging patients, really helped me give me a better appreciation for the type of work that I do now.
How do you mean, “challenging patients?”
I was in medical school in the early ’90s, and that was a time [when] HIV was more rampant, AIDS, TB. These patients were very sick, and the residents really required a lot of our help as medical students. I think that that gave me a sense at that time, being interested in public health. Medicine is more than just seeing a patient in the office, giving an exam, and writing a prescription. It’s also about what you can do to help society on a broader level.
I had an opportunity to work at Harlem Hospital and work with a doctor who was studying to be an epidemiologist, so she ran a clinic that was doing free breast and cervical cancer screenings. She was doing mammograms and CAT scans. I think that was the first time it hit me that there were all these women over the age of 65 who had never had a mammogram or a pap smear before.
This was when I was in college, and so I hadn’t yet started medical school, but that was my first introduction to the health disparity. We are in New York City, one of the richest cities, yet we have these communities where we have these health gaps. These women have been coming to the health system, yet no one questions why they’ve never been offered these tests. And this still happens, and I’m not sure why, and it still happens in certain communities, and I think these are the questions that remain to be answered.
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