Today we’d like to introduce you to Florence Rothenberg.
Hi Florence, thanks for sharing your story with us. To start, maybe you can tell our readers some of your backstory.
My current pathway evolved from my role as a physician but really sprang from having grown up in projects in Rockaway, New York (Queens), where I learned how hard it can be to overcome difficult life circumstances. As a cardiologist in Cincinnati, I could now see that these circumstances influence how much health a human being can have in this country. My patients who have access to healthy food and exercise are much more resilient to illness, whereas my patients who have limited access to healthy food and exercise are frequently on multiple medications, admitted to the hospital often for invasive procedures, and are much less resilient in the face of illness. I became frustrated because all I could do was prescribe more medications – medications they could not afford caused side-effects, and made compliance difficult. Once any patient struggled with the medications or doing the things necessary to promote their health, they were labeled “noncompliant” in charts – a label that is incredibly difficult to fight carries significant stigma, and is often victim-blaming. I had to do something to change this awful cycle. I tried many different pathways but ultimately learned about a group in New York City called Brooklyn Grange, who have now built three large-scale farms on industrial building rooftops in Brooklyn and Queens. I realized this could be a solution to health problems here because data shows that access to healthy food is foundational to good health. I am now converting the old North Church on Hamilton Avenue in Northside to the Heart of Northside, a community health center. Northside is one of the most diverse communities in Cincinnati (and one of the most delightful, in my humble opinion). We are raising funds for a teaching kitchen ($250K goal) and a rooftop farm ($2M goal). In collaboration with Brick Gardens, we are building a hydroponics suite to grow food for the community. We have many health-related small businesses working inside, all designed to improve the health of the community. The Northside Farmers Market takes place here every Wednesday starting at 4 pm, where they accept SNAP, WIC, and Produce Perks, and help people get enrolled. We are working with them to develop a blood pressure awareness and management campaign called “Normal in Northside” because hypertension is the strongest risk factor for cardiovascular disease, which remains the number one killer of all Americans. I am developing a cardiovascular risk awareness program so people can know where they stand and what they need to do to have the most impact on becoming (or staying) as healthy as possible. I look forward to working with all of you and making Cincinnati the healthiest city in America!
Alright, so let’s dig a little deeper into the story – has it been an easy path overall, and if not, what were the challenges you’ve had to overcome?
It has not been an easy pathway by a long shot. There is a lot about community engagement and business that is not taught in medical training. In fact, we are expected to have people come to us for care when in fact, the best care seems to occur when health comes to the people. The Barbershop Trial (NEJM 2018) has been pivotal for me because they showed that when a blood pressure management plan is created to fit the needs of the community, blood pressure control can be achieved and maintained. I am now working to develop solid and sustainable community relationships (if you know any human beings, you know how this can be difficult sometimes). I am becoming a businesswoman and community leader, which was also not anything I expected to become. As a woman coming of age in the 1970s, we were not taught to take risks or make difficult decisions. These have been things I have had to become comfortable with or just do even if I am not comfortable. I have made what others might call mistakes, but I am now learning that there’s only one way to learn – by doing. You can call them mistakes, or you can call them attempts that didn’t work. I prefer the latter! And to be honest, I am enjoying being a lifelong learner more than I anticipated.
Appreciate you sharing that. What else should we know about what you do?
I am a cardiologist and now specialize in prevention medicine. I have had a long and varied career, mostly involving the sciences. I am most proud of the discoveries I have made and the relationships I have made along the way. What sets me apart, perhaps, is my persistence. Being older now, I have the perspective to see that this is probably my most important attribute. As an example, I did most of my medical training in Texas. I moved there from New York because, being from a poor family, I couldn’t afford medical school in New York State. As a Texas resident, the tuition was more affordable. Being a woman in medicine back then was… interesting, and not in a good way. I fell in love with cardiology in second year medical school when challenged with cardiac physiology. I spent the good part of an afternoon trying to figure out pressure-volume loops, but once I finally understood what was going on, I was enthralled! I couldn’t wait to learn more. And everything I learned about the heart only made me want to learn more. But being a cardiologist in Texas, for whatever reason, seemed to be reserved for men who acted in a certain way. I had many people tell me, “You don’t look like a cardiologist,” or “You look more like a pediatrician,” or “You look more like a geriatrician,” whatever that means. Well, I know what that means. According to those people, men are cardiologists, and women are pediatricians and geriatricians. But I never gave up because I loved cardiology and could see myself being a cardiologist. Not only did I become a cardiologist, but I have also published in both basic sciences and clinical sciences; I teach, write, I practice medicine, and am now a businesswoman and community leader. In retrospect, I would say that knowing your own heart and taking care of it is the most important thing. No one else can do that for you.
Alright, so to wrap up, is there anything else you’d like to share with us?
We need a major transformation in how health care is delivered in this country, and we are all going to have to demand change. Our current system is focused on disease, not health. Hospital systems are most generously reimbursed for intervening on disease; if we reduce disease by promoting health, hospital systems can’t get reimbursed for the work of the providers. I am being very careful about my wording here because doctors are not the problem. Doctors spend at minimum of eleven years of training (four years of college, four years of medical school, and at least three years of residency) and come out at the end several hundreds of thousands of dollars in debt. Young doctors have to make a lot of money coming out of training to pay back their student loans, which fuels the choices many graduating doctors have to make. Since prevention medicine care as it is doesn’t provide the reimbursement for a visit that, say, a single surgery does, many doctors just graduating can’t choose a prevention medicine pathway. And if they do choose that pathway, these young doctors have to treat patients who can afford such care, and those who can’t are stuck in a disease-based system. It’s a terrible cycle that promotes intervening on disease after it is too late. We must demand a focus on health, which will involve a structural overhaul in how our communities are planned and built. Healthy food and exercise must be promoted and insisted upon, as these two things are essential to becoming and staying healthy. We can do this, Ohio!
Pricing:
- Currently not insurance-based for reasons noted above
- Goal is to accept insurance when infrastructure costs are more manageable
- We charge $300 for a new visit
- $75 for 15-minute follow-up visits
- $200 for 50-minute follow-up visits
Contact Info:
- Website: www.heartinbalance4health.com
- Instagram: Heart of Northside
- Facebook: Ounce of Prevention
- Other: www.foodforthoughtcincy.org
Image Credits
Alison Ford
Aaron Conway
