Health's Most Innovative Hospitals 2022: The Cleveland Clinic

"What's missing?" "What's next?" These are questions gynecologists and other women's health docs at the Cleveland Clinic ask themselves all the time. That visionary spirit can be traced back through the hospital's history, says chief of staff Beri Ridgeway, MD. "[It's] been in our DNA from the very beginning."

The Cleveland Clinic certainly has a track record for breakthroughs in women's health. In the 1950s, for example, when radical mastectomies—which remove the breast, nearby lymph nodes, and part of the chest wall muscle—were routinely performed on women with breast cancer, George Crile Jr., MD, crusaded for more conservative alternatives (such as lumpectomies) that are widely used today. More recently, in 2019, physicians helped a woman who had received a uterus transplant from a deceased donor deliver her baby girl. That was a first in the U.S.

Quiet but Powerful

Medical innovations don't need to make splashy headlines to be life-changing for patients. Take genetic testing for cancers. Chad Michener, MD, gynecologic oncologist and interim chair for the Women's Health Institute, says that offering genetic screening to more women has had a "huge impact" on what he's able to do for his patients. "You're catching [the cancer] before it becomes a problem," he says. A woman might then choose to have chemoprevention or prophylactic surgery.

Dr. Michener is also excited about regularly offering a more effective treatment for advanced ovarian cancer, called hyperthermic intraoperative peritoneal chemotherapy. In this procedure, tumors are removed and drugs are delivered directly to the abdominal area to kill cancer cells that remain. Meanwhile, Dr. Michener's urogynecology team is helping women with pelvic organ prolapse (which often causes leakage) avoid a hysterectomy: "They've really been able to come up with ways that we can keep the uterus in place and still manage that prolapse," he says.

Cleveland Clinic docs are rethinking preventative care, too. They've nixed the Rx requirement for mammograms, to make them easier to schedule. They've also introduced CustomFit Physicals, tailored to a woman's particular life stage: A postmenopausal patient might receive screenings for heart disease and breast cancer, a Pap smear, and a bone density scan—all in one visit.

Looking Ahead

To answer the "What's next?" question, physician-scientists are conducting a wide range of medical research. One trial is testing a vaccine against triple-negative breast cancer, an aggressive form of the disease. Another is exploring vulvar electrical stimulation after vaginal childbirth; the hope is to prevent pelvic floor disorders (like prolapse) later in life. There's also ongoing research into transgender medicine, the mechanisms of endometriosis, and cervical cancer prevention among underserved women.

Another one of the Cleveland Clinic's missions is to help bridge the gap in knowledge on women's health, says Dr. Ridgeway. "Historically, what has been learned from studies with men has been applied to women— but we are physiologically very different. Honoring and understanding those differences is really important." Science is decades behind in research on the disorders and symptoms women experience, she says. "We need to catch up."

This article originally appeared in the January/February 2022 issue of Health Magazine. Click here to subscribe today!