As she looks forward to her retirement, physician, author, and advocate Rebecca Booth, MD, also looks back, reflecting on thirty-five years of caring for Kentucky’s women
LOUISVILLE The one field of medicine Rebecca Booth, MD, FACOG, did not want to enter was obstetrics and gynecology. According to Booth, “OB-GYN was the one thing I was sure I didn’t want to do. I really wanted to have what I thought would be a balanced lifestyle. I was very interested in having a family, and I felt that OB-GYN would be prohibitive. So, I tried desperately to talk myself out of it.”
Booth could not escape her fascination with everything related to female health, however, and found herself captivated by each aspect— pathology, physiology, pharmacology, and surgery—of the specialty. She says, “I just had to get honest with myself; my energy flowed so naturally into OB-GYN that it was a calling stronger than anything I’d ever felt in my life.”
That calling led Booth to a thirty-six-year career in women’s health as an author, advocate, and co-managing partner at Women First of Louisville, an all-female medical practice with board-certified physicians who provide the most comprehensive and innovative care to females of all ages. Now, in her “Goodbye Year” as she nears retirement, Booth looks back at the amazing journey that led her to this point.
Booth joined Women First directly following her completion of a medical degree, residency, and internship at the University of Louisville School of Medicine. In Booth’s third year of residency, Christine Cook, MD, signed on as residency director. Cook was a pioneer in reproductive endocrinology, including in vitro fertilization (IVF), and a champion for other female physicians. To connect her residents to other women practicing in the community, Cook started a book club. It was there that Booth met Rebecca Terry, MD, who had the dream to start an all-female practice of “women for women” with the goal of helping the community overcome outdated fears and garner faith in females in medicine.
That dream became a reality with what is now Women First, which Terry cofounded with Sarah Cox, MD. Shortly after its founding, Booth joined the practice with fellow resident Mollie Cartwright, MD. She states, “It was 1989, and we just started straight out of finishing residency. On the promise of the future growth of the practice, Molly and I took a very low competitive starting salary on the assumption that we would have an opportunity to grow, which we did. So, it took a leap of faith.”
Women First: The Early Years
Success for Women First of Louisville, then named Terry, Cox, Booth, Cartwright, and Warren, started almost immediately, and they quickly grew, adding services such as in-office mammograms and ultrasound. Traditionally, most OB-GYN practices were focused primarily on obstetrics, instead of gynecology. Booth explains, “The women in our community were attracted to an all-female OB-GYN practice, so I would say that unique factor was a big draw. And, once we were able to add ancillary care, that expanded our practice and moved us into a situation where we were making it easier for women to get the preventive care they needed. This type of medicine as prevention was gaining steam in healthcare.”
Another feature that set Women First apart and aided with their expansion was their early adoption of advanced practitioners; they were one of the first practices in the region to hire a physician’s assistant. Currently, they have 13 advanced practitioners and nine physicians/ surgeons. Booth says, “When you begin to support the office flow with advanced practitioners, it allows the board-certified physicians to focus on non-office advancements, such as surgery or physiology, and to begin to develop niches that can enrich the overall practice.”
“We were one of the first in the region to bring mammography in-office, and we do it as part of our annual ‘well care’ exam. Our goal was to increase compliance with screening recommendations. And we see that compliance has markedly increased,” says Booth. “Our appointment staff facilitate scheduling. Most of our patients are very interested in being proactive with their breast cancer screening.”
“It’s been a real gift to me that we are able to offer this service to our patients,” says Booth.
Women First: Always Innovating
Along with her burgeoning career, Booth was still committed to achieving a work-life balance that included having a family, as were all of the physicians at the practice. To accommodate this desire, the practice adopted a rotating call, which was highly unusual at the time. This meant that deliveries were performed by whichever physician was currently working, meaning patients had to accept that any of the doctors could be the one delivering their infant, depending on when they went into labor. “It was a very new concept at the time. The catch was that we had to be similar enough that our patients would feel comfortable with any one of us,” Booth states.
Booth continues, “The typical model was by far more common. If you had a patient as an OB-GYN and she went into labor, you went into the hospital and delivered her even if you had a waiting room full of patients. Our
patients have never had to wait because we’ve been rotating calls from the beginning.”
This approach also allowed for a more balanced lifestyle amongst the partners, with each of the doctors strategically organizing their work life and family planning. The result: the five original partners of the practice had 15 children between them in the span of seven years. However, once Booth had her own children, she began to think of long-term gynecological health maintenance and what the next phases of life would hold physiologically. This led to conversations with other women and additional research; the information gleaned became the basis for a book on the topic, The Venus Week: Discover the Powerful Secret of Your Cycle at Any Age.
The Metaphor of the Venus Week
Originally published in 2008, but then updated and re-released in 2014, Booth’s book introduced the term “Venus Week,” which refers to the window of days each month when estrogen and testosterone are at their peak levels. It examines the hormonal fluctuations that occur throughout the month and how that influences the way women look, feel, and function. According to Booth, “The book came out organically from having multiple conversations with my patients who didn’t feel like they understood their hormones well, and also as an impetus for clinicians. Traditional medical school education was deficient in understanding and explaining the significance of female hormonal physiology.”
Both publishers and the medical community found the approach fresh and deemed it a breakthrough. Booth states. “We used a metaphor, the Venus Week, to explain what most women consider their best days hormonally in their cycle, to inform them of how to take charge of that dynamic, and how to apply it to their life every day.”
The book took Booth on a nationwide tour that involved stops at The Today Show, CBS.com, and SiriusXM Doctor Radio. In addition, she was quoted in various periodicals, including Shape, Glamour, Seventeen, Redbook, the Chicago Tribune, and Kentuckiana Healthy Woman. It has received praise from its wide readership as well. Booth has been surprised to find that some of her most positive reviews on Amazon have come from men who wanted to gain more insight into the physiology of the women in their lives.
Looking to the Future
When looking at the future of Women First of Louisville, advancements in reproductive health, and her own future, Booth has high hopes.
After years in senior leadership at the practice, Booth will remain dedicated to making certain Women First continues to grow and thrive. In her words, “I’m still very much immersed in making sure the legacy of our practice is well supported. We’re extremely fortunate at Women First that our younger GenXers and Millennials are willing and ready to carry on the legacy, and that has been the greatest gift. I know I’m leaving my patients…and all of our patients…in the hands of extremely talented women.”
This is imperative, as the field of OB-GYN is becoming even more vital with many women today receiving the most consistent medical care throughout their lifespan from their gynecologist. Women First of Louisville practices truly generational medicine. In Booth’s words, “The reason it’s relevant is because we’re on the precipice of an explosion in genetic medicine and since we, as OB-GYNs, see the mothers, daughters, sisters, infants, and even embryos, genetically, we have an opportunity to inform all of them with our medicine. OB-GYNs are in a very unique position to help with that mission.”
Despite the legislation now limiting the availability of women’s healthcare nationwide, Booth believes women have the potential to change the tide and take back their rights. She says, “We can look at this current time—and while very frightening with the fact that we have lost some reproductive freedoms—it is also an opportunity for women to speak through their votes about what they want for their bodies. And I am confident that the majority of women want reproductive freedom in this country, for all, in every state.”
Personally, Booth’s goal has always been to help women grasp that fertility and menopause coexist on the same biological clock. As most females are now living more years without ovarian function than with ovarian function, she wants women to embrace the importance of setting up an “ovarian retirement plan” in their twenties in order to reap the benefits throughout each stage of their life. “There hasn’t been enough work on metaphorical communication, in my opinion, to help provide anthropological explanations that are through the lens of natural selection, now that it is better understood,” Booth states. To remedy this, she intends to keep educating individuals through public speaking, writing, and employing other forms of media.
In closing, Booth says, “I’m hoping that I can continue to move the needle on helping women understand their physiology, because if it’s not understood, they cannot take charge. It is complicated, but it is understandable. That’s my passion…to generate tools to make female physiology understandable.”