WOMEN IN WHITE COATS
The growing number of women doctors expands patients' choices

By SUSAN SHEFFLOE SPEER

B?efore women won the right to vote in the United States, they were legally practicing medicine. And today their numbers are growing. As of 2003, nearly half of medical school graduates were women — 49.2 percent.

And many observers of the medical scene believe that women bring their own special qualities — a talent for nurturing, an ability to talk about feelings with patients and co-workers — to the profession. They give patients greater choices when choosing a physician. Here, meet several women practicing medicine in the Denver area.

Karen Leamer, M.D.
Pediatrician
Children’s Medical Center
If you ask Karen Leamer why she enjoys being a pediatrician, her answer comes quickly: “It’s the kids. They just light up the room.”

Leamer is part of a busy downtown practice — the Children’s Medical Center — that has been a fixture in Denver since the 1930s. “We were here before pediatrics was even a specialty,” she says. “We’ve seen generations come through here.”

And that’s the other part of Leamer’s job that she finds particularly enjoyable. “I get to see the cycle again and again. It’s really special to hear parents tell their kids that this is where they saw the doctor when they were little,” she says.

It’s that generational aspect that adds dimension for her. “When you’re a pediatrician, you’re not just treating kids, you’re addressing the whole family,” she explains. “I take a lot of time reassuring parents and helping them solve problems. There’s a lot of psychology and a real emotional aspect to it, which I like — it’s not all diagnosis and treatment plans.”

Though many medical practices followed their patients as they migrated to the suburbs, the Children’s Medical Center stayed put. “There was pressure to move to outlying areas, but we had partners who were committed to serving kids in the city,” Leamer says. “One of the magic things about this practice is that it runs the socioeconomic gamut. From children of local celebrities to homeless kids, the parents’ questions and the kids’ health problems are the same. It’s the great equalizer.” Through alliances and foundation grants, Leamer and her partners are able to offer care to more disadvantaged kids who might not see a doctor otherwise.

That aspect of her practice has placed Leamer in a child advocacy position. She’s active in the local chapter of the American Academy of Pediatrics and has worked to rally pediatricians to affect legislation on children’s health care issues. “I didn’t plan to be in this role; it’s a pleasant surprise,” she says. “It’s a great way to augment what I do day to day. I have a chance to affect change for a larger group of children.”

Leamer didn’t consider medical school until she was studying biology at UC-Boulder. “I loved science; then I realized that I knew what a kidney cell did, but I had no idea what the whole kidney was supposed to do,” she recalls. She had considered specializing in internal medicine, primary care, hematology or oncology when she began moonlighting in pediatrics, where she’s been ever since.

Leamer’s day begins early, with hospital rounds to check on newborn patients. She usually arrives at the office around 8:30 a.m., where she stays “until the last patient is seen.” Pediatric clinics schedule a lot of appointments; it’s not unusual for Leamer to see 20 to 30 patients each day. In those few minutes between patients and into the early evening, Leamer returns phone calls to parents who’ve called earlier in the day with questions about their kids’ health.

It’s an unpredictable schedule, which Leamer says can be hard on her two children — Sammy, 8, and Abby, 12. She protects Mondays, which are reserved for being a mom. “My daughter is in middle school, and she needs more of me right now,” she says. Leamer tries to keep it in perspective: “There’s nothing more rewarding than motherhood, but being a physician comes in a close second.”

Leamer says that the relationships with most of her patients (and their parents) are more collaborative today than when she was just starting out. “Doctors used to be a lot more paternalistic and the information was top-down,” she says. “Now, people have easy access to information on the Internet, and they want to talk about what they’ve found. Sometimes we learn together.”

Patricia Fahey, M.D.
Family Practice
“We care for people of all ages here. Womb to Tomb, as the saying goes,” says Patricia Fahey. As a family practice doctor, she sees just about every kind of medical situation in her small suburban practice in Centennial.

“I see babies and grandmothers and everything in between,” she says. Fahey likes the variety and the generational aspect of her specialty, and the fact that she’s often the touchstone for many of her patients, even if they must see other specialists in certain circumstances.

Family practice doctors are shrinking in number, and Fahey acknowledges that fact with concern, seasoned with a practical understanding. “Family practice is still a necessary specialty. It’s good to have one doctor who knows about all of your conditions and can make recommendation on that knowledge of your medical history. Most young doctors are choosing other specialties largely because of financial issues. Kids come out of medical school with enormous debt, and they’re in a position where they’re forced to choose specialties that pay more just to make it,” she observes.

Fahey is a sole practitioner, but she shares office space and resources with another family practice doctor. One of her biggest surprises as a sole practitioner is the attention she must focus on the business aspect of her practice. “They didn’t teach the business part of being a doctor when I was in medical school,” she says. She’s learned that part of it through practical experience, but admits it’s a little overwhelming sometimes. When the last patient has left the office at the end of the day, it means that Fahey still has a couple of hours of work ahead of her, from follow-up calls to patients to updating charts and handling office management requirements.

The Chicago native spent her early years as a doctor working in urgent care clinics and moved to Denver in 1984, where she continued as an urgent care physician until she started her own practice. She says several factors played in her decision to become a doctor. “Our family doctor was beloved in our community, so I always had a good impression of that kind of doctor,” she says. Going to a Catholic school, she explained, she was like most young girls, thinking she’d become a nun. “As a Catholic girl back then, you weren’t exposed to women in any other sort of profession,” she says. She was the girl in the neighborhood who always found herself in the caretaker role. “You know, kids with skinned knees, injured birds,” she says.

As a teenager, a television commercial about joining the Peace Corps resonated in Fahey, and she was moved to find a profession where she could help people. She recalls, “My mom was a teacher, and I’d watch her working late at night, with a stack of papers on the dining room table. I didn’t want to do that.” Fahey never made it to the Peace Corps, but as a medical resident, she discovered that she liked the variety that family practice offered.

Fahey’s practice focuses mostly on outpatient care, which is a shift from when she first became a doctor. “There is so much we can do now without having to hospitalize,” she says. For the patients who do need hospital care, though, another trend has developed to change the rhythm of family practice. “In the Denver area, family practice doctors do a lot less inpatient care now,” she says. An emerging subspecialty called “hospitalists” has stepped in to care for patients who are admitted to the hospital. “They’re doctors from a variety of specialties — internal medicine, pulmonary, you name it. Their job is to care for your patient during a hospital stay,” she says.

Fahey calls the trend a gradual evolution, based on a practical need. “We don’t have many medical residents in local hospitals. The hospitalists are up-to-date on critical care issues, and they provide an immediate connection when things change during a patient’s hospital stay. The patient doesn’t have to wait until the primary care physician answers a page and gets to the hospital,” she explains. Fahey says the change hasn’t eliminated urgent calls in the middle of the night, but she doesn’t have to respond until the morning.

The other change for Fahey is that she stopped performing obstetric services a few years ago, a decision she still talks about with a little regret. “I loved delivering babies, and I really miss that,” she says.

Fahey has made peace with the notion that she won’t be superwoman, and it’s advice she’d readily give to any woman weighing a medical career and family options. “I clearly imagined I’d be able to do more,” she says. “I’ve learned that there are always trade-offs. You have to decide where you want to make those concessions.”

She hasn’t forgotten about the Peace Corps commercial. Her dream of helping underserved populations — wherever they might be — is still there. “As my kids get older, I want to devote more time to community service,” she says. “I might help with indigent clinics close to home, or maybe I’ll start looking for a way to do mission work in a Third World country.

“There’s this saying, that medicine is more of an art than science. It’s true. A lot of times, people expect action from doctors but it’s not something we can always be perfect at. The human body is unpredictable, and it’s complicated. We can’t control everything. There are some things we can’t fix or prevent, no matter how much we want to,” she says.

Jean Martin, M.D.
Emergency Medicine
HealthONE Centennial
As an emergency room doctor, Jean Martin has pretty much seen it all. And she’ll be the first one to tell you that her job is nothing like a TV show. As the director of emergency services at HealthOne in Centennial, Martin oversees the flow of patients who need urgent medical attention. Although the injuries range from the severe to the not-so-serious, few are accompanied by the heart-pounding drama that makes medical shows such a hit on television.

“When it’s something really serious, the ER team goes into react mode. You don’t think about it until later,” she says. “The only time you panic is when you’re the one on the gurney.” Martin has spent her career in emergency medicine, first in the Army and then in the civilian world. She’s also married to an ER doctor, which, Martin says, gives them plenty to talk about at the dinner table.

She chose emergency medicine as a specialty as a resident and got her early experience at some of the Army’s largest hospitals. “I’ve gotten a good sense of how to react in an emergency,” she says. In the beginning, it wasn’t always easy. “I had to confront my fears about how I would react to a situation,” she explains. “I’ve learned to do things one step at a time.”

Martin always liked science, and she studied anthropology as an undergraduate at the University of Wisconsin. “I liked genetics and blood types, but I wanted to work with people,” she says. Being a doctor seemed like the best way to do that. She also looked at it from a practical standpoint. Her mother raised Martin and her sisters as a single parent, making ends meet on a teacher’s salary. “I wanted financial independence. Being a doctor seemed like a secure choice. Emergency medicine was a good fit, and the pay scale is a little higher than some other specialties,” Martin says.

Emergency medicine also offers Martin a flexible schedule, which is a benefit to her husband and three children, ages 16, 13 and 10. Even so, she worries about striking the right balance. “I’m a perfectionist, so I feel guilty if I’m not doing everything for the kids, and everything as a doctor,” she confesses. Martin and her husband have worked alternating shifts since they got married. “One of us is always available to the kids,” she says. Emergency rooms operate on a shift schedule — when you’re there, you’re working, and when you’re off, you’re really off. Martin likes that aspect of it.

Martin admits that she, like most people in emergency medicine, is a bit of an “adrenaline junkie.” She likes the pace of the ER, and the fact that anything could come through the doors at any time. “We’re on the front lines of life and death,” she says. “Most cases begin and end here — it’s good to have closure,” she says.

So, Martin says, she was a little surprised when she was interested in the director of emergency services position. “I wasn’t planning on having that kind of job; it’s a lot of administrative work, and most ER doctors don’t want to push paper,” she says. She’s discovered that she likes that administrative aspect of the work: “It offers balance and even more flexibility, which my family likes.”

One thing Martin says she’s learned after 20 years in the ER is that no matter how different people might seem on the outside, we are all essentially the same. “From prisoners to pro athletes to drunks to whatever … I’ve seen them all. People are all the same, really,” she says. She also takes some of the situations she sees to heart. “You have cases that stay with you forever,” she says. “There was a 16-year-old boy who came in, who was in a motor vehicle accident and died from his injuries. As I examined him, I saw braces on his teeth … and that really got to me. I said to myself, ‘Your parents had all these plans for you … you got dressed up to go out tonight … and you never made it.’”

As Martin walks out of the ER at the end of another day, she says that what she usually hopes for is a satisfying day. “For the most part, our patients ended up better than when they came in,” she says. “We touch a lot of lives here. I have to stop and appreciate that sometimes.”

Debra Minjarez, M.D.
Reproductive Endocrinology
Colorado Center for Reproductive Medicine
Debra Minjarez always knew she’d be a doctor. “I was 7 years old, and I just knew. I never thought of doing anything else,” she says. Today, she’s a reproductive endocrinologist at the Colorado Center for Reproductive Medicine, where she helps patients work through infertility issues. She explains, “Stress levels for infertility patients are statistically higher than cancer patients.” Minjarez describes the experience as a roller coaster ride: “There are moments where my patients are on top of the world one day, and devastated the next.”

Minjarez says she takes a lot of it home with her. “I have an emotional investment in my patients. Being on that ride along with them makes me a better physician,” she says. She strives to make infertility treatments a positive experience, but she knows she can’t help everyone. “I’m most touched by patients who didn’t get pregnant but are still grateful for everything we did,” she says. “That means a lot to me.”

Every patient has a story, and Minjarez says infertility is still a difficult topic for some. It’s a sensitive issue, and on top of the emotional aspect, some patients come from social or cultural backgrounds where it’s a taboo subject. “Some patients don’t understand the reproductive process, and in some cases, they may not understand how their bodies work,” she explains. She uses charts and pictures reminiscent of high school biology class in some situations, but she acknowledges many of her patients now come better informed, thanks to the Internet. “Infertility problems create a loss of control, which creates a desire to research and learn,” she says.

Minjarez had her own road to travel. As she grew up in El Paso, Texas, her parents worked hard with the hopes that their children would attend college. “My mom got married when she was 15, and my dad was a construction laborer,” she says. “They never went to college, but they always stressed the importance of education. They told me I could go to school anywhere I wanted, as long as it wasn’t in Texas. In a Hispanic family, letting a daughter leave home like that is a huge thing.” Minjarez chose Stanford for her undergrad, which was a world away from Texas. Later, she moved to Colorado and attended medical school at UC Health Sciences Center. “I always thought I would go back to Texas. I thought Denver would be this cold, snowy city, but my husband and I fell in love with Colorado,” she says. All through medical school, Minjarez thought she’d be a pediatrician. A third year rotation in OB/GYN changed her mind and set the stage for her path to reproductive endocrinology.

Minjarez begins her day eating breakfast with her kids. She’s seeing patients by 7:30 a.m. in one of CCRM’s clinics and also in the hospitals where she admits patients. She may see 15 patients herself, and another 25-30 of her patients are seen by her staff for routine visits. It’s a mix of new patients, procedures and follow-up visits. She compartmentalizes her schedule to be more efficient: Mondays and Wednesdays at the main clinic, Tuesdays at one of their other locations. Thursdays, she’s at Swedish Hospital for egg retrievals, and Fridays are reserved for surgeries. She’s usually home by 6:30 p.m. during the week, but she also works her on-call rotation every third weekend from 8:30 a.m. – 3 p.m. Saturday and Sunday.

On top of her regular schedule, Minjarez also finds time to lecture at conferences, and she’s a clinical instructor at St. Joseph’s, where she oversees OB/GYN residents through reproductive endocrinology rotations. “I’m committed to resident education. Medicine is a lifelong commitment to service. By investing that time with residents, I hope I set the example of commitment to patients, and what working in a private practice is all about,” she says.

Lisa Hunsicker, M.D.
Plastic Surgeon
Revalla Plastic Surgery
If there is one thing Lisa Hunsicker’s patients have in common, it’s that they are all looking for a change. Revalla, Hunsicker’s boutique plastic surgery practice in Littleton, specializes in breast surgeries and body contouring. “We’re not a big clinic, and we don’t focus on patient volume,” she explains. “We prefer to spend time with each of our patients, and staying small allows us to do that.”

In a time where TV reality shows promise complete transformations and volume clinics offer procedures at deep discounts, Hunsicker says the recent attention to plastic surgery has its good and bad sides. “It’s good in that people are more comfortable talking about plastic surgery. There’s a lot less stigma attached to having work done,” she says. “The downside represents that expectation of a total transformation — which never happens — and the idea that you can get a super makeover all done at once or get it done at a discount. I’m always shocked at how much risk some people will take with their bodies and their health, all because of a lower price.”

Hunsicker says that many of her patients come to her after they’ve been thinking about plastic surgery for a long time. “A lot of my patients know what they want. Others want more consultation so they know about their options. Others come in thinking they want to go a certain way, but they learn they have to do something else to get what they want,” she says.

Hunsicker trained in general surgery before she started narrowing down what she wanted to do. “I came out of residency trained on burns, hand surgeries and microsurgery, being able to move body parts down to the millimeter,” she says. Hunsicker moved on to reconstructive surgeries, particularly for cancer patients, and elective cosmetic surgery. “It’s a process of funneling down to what you really want to do,” she explains. Her practice today represents that narrower focus.

“Medicine has become more complex and more diverse — more specialized,” Hunsicker says. She saw a need to help physicians connect with each other, so she started a professional club for plastic surgeons.

Like most doctors, Hunsicker compartmentalizes her routine for efficiency. She has minimal office support, and her clinic doesn’t have a nurse — she prefers to see all of her patients personally. She sets aside certain days for new patient consultations. “I spend more time with new patients; I set at least an hour for each one,” she says. She reserves a day for surgeries and other procedures, which begin at 7:30 a.m., until the last scheduled procedure is finished. On her busiest days, she might see 12-15 patients, but she limits the number of patients she sees. “I don’t want to get too busy and compromise patient care,” she says.

Hunsicker balances her practice with the needs of her three kids, ages 6 months, 10 and 12. She is usually devoted to spending time with them when she’s not working. She also devotes time to mission trips, where she performs reconstructive surgeries for patients in developing countries. “It’s tough — there’s a lot that needs to be done,” she says. “Life doesn’t always balance, but everything gets prioritized. Sometimes one area crosses over into another. Medicine is more than a career, it’s a lifestyle. Some days you just have to set limits.”

Leslie Capin, M.D.
Dermatologist
Cara Mia Day Spa
As a young girl, Leslie Capin was inspired by the altruistic stories of Albert Schweitzer. “I read all of those books, and I wanted to be one of those doctors who went to Africa to perform medical services for no reimbursement. I thought I’d live like a monk, ” she recalls.

Capin grew up in Nogales, Ariz., a small town along the Mexican border. “We celebrated all of the Mexican holidays, which always meant fireworks,” she explains. One such holiday changed Capin’s life: “My brother blew his hand off when a cherry bomb exploded in his hand.” The medical procedures that followed split the family. “My brother had 16 hand surgeries that were performed by a doctor in Los Angeles,” she says. “I went to Mexico to live with my grandparents.” Keeping tabs on her brother’s treatment fascinated her. “He had tendons transplanted from his toes and at one point, his hand was placed inside his stomach to grow new skin — it literally grew fingers for him. I really wanted to be a doctor after that,” she says.

Her interest in dermatology began as a microbiology major in college. As she went through medical school, she realized she needed to stay on top to get a coveted dermatology residency. “It’s competitive. Out of hundreds of applicants, a handful are accepted,” she points out.

Today, Capin’s practice takes her down two distinct paths. Her clinical dermatology practice treats patients for everything from acne to skin cancer. Her other practice, Cara Mia Day Spa, offers cosmetic dermatology services in a spa setting, a fast-growing trend in dermatology.

“Aging reversal is hot with baby boomers,” says Capin. “Consumers like what’s out there and they want more.” It’s that demand and the fact that emerging procedures are always on the horizon that make cosmetic dermatology exciting for Capin. She started Cara Mia eight years ago, just as cosmetic procedures were gaining popularity. It was a big step to take from her clinical practice. “It’s a huge financial investment and personal commitment,” she emphasizes. “Technology changes so quickly, so I knew if we were going to make this happen, we needed to stay ahead of the curve. Education is one of the most important aspects of our practice. I wanted to hire the perfect staff — everyone had to be committed to continuing education and customer service, and I wanted to have the best equipment and an M.D. on site at all times.”

Today, Cara Mia is a soothing, luxurious environment, where patients can get a quick chair massage or a skin care consultation before their appointment. Her clinical practice doesn’t attract the attention that cosmetic treatments receive, but Capin finds it just as meaningful. She sees a growing number of patients with skin cancer, as well as patients with less critical, but no less troubling problems, such as psoriasis and acne.

Capin is alarmed by the rise in skin cancer. “I used to see one or two malignant melanoma cases a month; now I see four to six a week,” she says. She’s so committed to early detection and treatment of skin cancer that her clinic offers free skin cancer screenings. “I can’t tell you how much we’ve picked up at those screenings,” she says. For patients who can’t afford treatment, Capin closes her medical practice at noon on Fridays to provide pro bono care.

Capin’s schedule is extremely structured. She splits her days between her three clinics. She is at her desk at 6 a.m., quickly going over her schedule for the day and catching up on paperwork and e-mail. Mornings are devoted to administrative issues from 6 to 10 a.m., which is typically filled with staff training sessions, management meetings and consultation with the other doctors and physician’s assistants. “Our staff meetings focus on medical education and customer service,” she says. “The team is the most important aspect of this practice. I don’t care how good I am. If my team isn’t great, that patient might not get to see me.”

She sees patients from 10 a.m. to 5 p.m., and may see 25-30 patients on a typical day. “I don’t double book,” she says. “I create gaps on my calendar and I schedule appropriately – I don’t like to get behind. It’s not fair to patients or to my staff.” She doesn’t necessarily advocate her approach to others thinking about a medical career. “I don’t sleep very much,” she jokes. “But anyone wanting to be a doctor has to be committed and willing to put in the hours to get where you want to be. Women can juggle family, job and community service. You don’t have to work 24/7 like I do, just mold it to what fits your life.” Capin points to a rising number of women physicians who choose a limited work schedule to devote more time to life outside the doctor’s office. “There are a couple of women in our practice who see patients two days a week. Carve out what you want, and make it happen,” she recommends.