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Gotham’s healthcare system is a bold pioneer predating our nation

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Breast health leader: Bellevue Hospital Center is the only Health + Hospitals hospital offering microvascular-free flap reconstruction.

BY SHAVANA ABRUZZO | The colonials were still 40 years away from declaring independence from the British when the Publick Workhouse and House of Correction opened a humble, six-bed infirmary in 1736 on the site of present-day City Hall that eventually became America’s oldest continuously operating hospital.

Bellevue Hospital Center, once a small pest house built on a patch of land leased from Kips Bay Farm to prepare for a yellow fever epidemic, is an acute-care, general hospital where the president and visiting world leaders are treated if they become sick or injured in the Big Apple, and its team of experts are steering the flagship institution of NYC Health + Hospitals — the nation’s largest municipal healthcare organization — to new triumphs.

The Harvard-educated chief of breast surgery, whom Caribbean Today magazine hailed as one of the “10 Top Caribbean Born Doctors In The U.S. You Should Know,” is a fierce medical gladiator looking out for the ailing like a lioness minding her cubs.

“The patient can be assured that he or she is receiving the highest level of care by a dedicated team of doctors, nurses, and support staff,” says Dr. Kathie-Ann Joseph, also an associate professor of surgery at NYU Langone Medical Center, whose innovations include piloting a navigation program in districts where cancer rates are high and screening rates are low, and creating a community tumor board allowing clinical staff throughout the health system to present and discuss interesting, difficult, or unusual cases.

EXCELLENCE IN BREAST CARE

The American College of Surgeons awarded Bellevue’s breast care services a Center of Excellence accreditation in 2014, the highest form of clinical and quality care recognition for breast cancer centers in the country, thanks to a highly skilled breast team dedicated to providing quality, customized care.

“We have patient navigators that speak several languages, and survivors that help our patients get through what can be a very scary and stressful situation,” says Dr. Joseph. “We do what we can to make the process easier for our patients.”

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FULL RANGE OF MULTIDISCIPLINARY CARE

The hospital’s full range of multidisciplinary care includes:

• Neoadjuvant therapy (chemotherapy prior to surgery) for locally advanced breast cancer.

• Genetic counseling, nutrition, and psychological support, and services such as massage, legal aid, and financial services.

• Nipple-sparing mastectomy and tissue-based reconstruction. 

• Survivorship clinics.

Bellevue is also a leader in repairing the space left in the body after the cancer has been removed.

“We are the only Health + Hospitals hospital that offers microvascular-free flap reconstruction,” says Dr. Joseph, who strives to provide patients with the best options — sometimes against all odds.

Once a patient who was diagnosed with recurrent breast cancer needed a mastectomy, but she was too thin for a tissue-based reconstruction of the breast mound and did not want an implant, the physician recalls.

“Rather than just telling her she was out of options, our plastic surgeons put their heads together, spoke with other colleagues, and tried a new procedure called a breast-sharing procedure, transferring a portion of her unaffected breast to create a new breast,” she says. “The woman was thrilled, and she is doing well.”

HEALTH PLAN THAT CARES

Medical bills can add to the trauma, but MetroPlus Health Plan — NYC Health + Hospitals’ health services plan — tries to defray the tribulations of breast cancer with a wide range of affordable plans, with premiums as low as $0 to $20 per month and no-cost screenings.

“For most of our MetroPlus members, the majority of breast cancer care will be covered by MetroPlus, though a few members may have copays, depending upon their type of insurance plan,” says Dr. Kathie T. Rones, the deputy chief medical officer and a breast cancer survivor. “Under the new Affordable Care Act, screenings such as mammograms are free of cost to members, so there is no reason for women, even of limited means, not to be screened.”

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MetroPlus’s long history of supporting breast health includes sponsoring and walking in Making Strides Against Breast Cancer.

“Many of our staff, including myself, have walked to raise awareness and funds for this important cause,” says Dr. Rones. “As a doctor, and a 20-year breast cancer survivor myself, I realize how critical screening and early detection are.”

Bellevue Hospital Center (462 First Ave., off E. 27th St. in Kips Bay, 212-562-5680). Clinical breast exams and mammograms offered on Thurs., Oct. 20 and Thurs., Oct. 27, 9 a.m.–2 p.m. in the Atrium. A breast education forum will be held on Thurs., Oct. 27 at 12:30 p.m. in the hospital’s Farber Auditorium (for info, call 212-562-4516).