Health care is constantly evolving. To learn more about the changing landscape for women's health, we sat down with Dr. Johanna Warren, M.D., interim director of the Center for Women's Health. She shared her background, what drew her to women's health, and what she sees for its future.

Tell us a little about yourself, your hobbies, and your family.

I grew up in a small town in upstate New York. It was much more rural than suburban. This has really defined how I think about community. My husband is from New York City.  We compromised and moved to Portland in 2003 for me to complete my residency training at OHSU. We fell in love with Portland and have made this our home. I have an 11-year-old daughter, two Alaskan Malamute puppies and a cat!

What made you want to become a doctor?

I didn’t always want to be a doctor. I did always love science. I think the combination of science and service to a community really led me to medicine.

Why did you choose to focus on family medicine, and women’s health, in particular?

I chose family medicine because it just “fit” for me. It is rooted in community health, and dabbles in most areas of medicine.  I was really drawn to the variety of patients I see, what conditions I care for, and most of all, how diverse the day-to-day work is.  Patients come in for a huge array of reasons – and I get the first stab at trying to understand what they are feeling and describing, what their diagnosis is, how severe and acute it might be.  I would be bored if I saw patients with similar diseases or a single system of disease all day long. 

After a few years in practice, I felt more and more drawn to the care of women across their lifespan, from adolescence through the reproductive years and beyond. Women play unique roles in families and in communities.  Keeping them healthy is critical!

There is a huge amount of work to be done in science and in medicine to understand both health and disease for women. Women are not the same as men – from presenting symptoms of disease (think about how heart disease can show up so differently in women than men!) to drug metabolism (the drug Ambien was on the market for years before it was widely learned that the metabolism is greatly different in women, leading the FDA to change the maximum dose recommended for women) to the role women play in the health of their families and the decision-making we know women do for the health and health care of their families.

We know the last two years have been especially challenging. Can you speak to how you think the COVID-19 pandemic has affected women’s health?

There is a fair amount of literature about the burden of additional home and work duties the pandemic has placed on women in general. I worry we are just starting to scratch the surface.  Many women have put their own needs aside and focused on those of others. We have not seen women complete many screenings for diseases – from office blood pressures to lipid panels to mammograms and colorectal cancer screenings. Further, I worry that the pay gap and work opportunity gaps are widening, with the attention units of women being pulled in many directions. Finally, we are social beings! We miss the communities we have built and the interactions with friends, colleagues, and peers.

What do you think are some of the unique challenges that women face when it comes to health care in 2022?

I think women will continue to play catch-up for 2022 and beyond – with their own health, with their careers, and with the health and education of their children and families.  I see an emphasis on commitment to in-person education, which may take some pressure off women and families, but we will learn that kids are farther behind socially, emotionally, and academically due to the pandemic. 

When women are ready to come in for their own health visits, I worry that our health care systems will not be able to respond in a timely manner. For example, we have saturated our mental health services for therapy and counseling in the Portland area. We are continuing to play catch-up from the devastating effects of COVID, and we see reduced access to many healthcare services, from physical therapy to colonoscopies to specialty medicine visits.

How does the Center for Women’s Health answers some of those challenges?

The focus on women and their health remains strong.  Like most, we are actively working on how the clinical operations of the current Center for Women’s Health can emerge from this pandemic stronger than when we entered.  We have an evolving leadership team and strong partners across OHSU. 

Our community of providers shares the same commitment and philosophy around caring for women and developing the science behind gender differences in medicine.  We are seeing more unique research on under-emphasized and poorly-understood diseases, and we are funding these research endeavors whenever we can.  We are starting to integrate behavioral health across the arc of the women’s life – from adolescence through primary care, pregnancy care, menopause, and beyond.  Our health system is becoming more of a system; as we partner with OHSU Health Hillsboro Medical Center and Adventist Health, we gain access to more likeminded clinicians and grow our communities. 

What are you excited about, when you think of the future of the Center for Women’s Health and women’s health care, overall?

I am hopeful for the future.  There will be change, but change brings hope.  We are starting the conversations – locally, regionally, nationally – around gender equality (and inequalities), in medicine and beyond.  Asking the right questions is the first step in truly working toward gender-affirming and gender-specific care.