Why So Many Women in Bergen County Are Rethinking Their Relationship with Healthcare
- Apr 8
- 3 min read
Updated: Apr 8
By Dr. Karen Hart
Since I moved to Harley Street Medical and began scheduling longer visits with patients, I’ve noticed a shift in our conversations.
They want to understand their results, not just to be told that everything looks “fine.” They’re thinking about the next decade, not just the visit in front of them. And their trust in the traditional care system — one that feels designed to minimize these conversations and get them out the door — has been evaporating.
A growing number are asking whether the care they’ve been receiving is actually designed to help them stay well, or mainly to respond to problems after they’ve arrived.
One patient of mine captures this shift well. A healthy woman in her forties, she came in for a routine physical with no urgent issues. She told me that her mom had recently had a heart attack. It was a jarring event that left her concerned about her own cardiac risk. We spent most of the visit assessing her own cardiac risk factors, delving into a more extensive family history, and discussing the potential options to decrease her risk with medication and lifestyle changes. We were able to thoughtfully review what extra testing might be helpful, while avoiding those that were unlikely to provide useful information. She left with a deeper understanding of her current cardiac risk, ways to lower that risk, and how to more deliberately manage her health going forward.
The clinical details vary from patient to patient, but in many traditional practices, there is not time to address acute issues while also building a long-term treatment plan. A patient arriving for a routine physical with substantive questions about her history and long-term risk is, in the prevailing model, a scheduling problem. The appointment simply wasn't built for it.
Many women are recognizing the gap between what they need from their healthcare and what the standard model is designed to deliver, and they're looking for something better.
When I talk to other practitioners, they share their patients’ frustrations. The traditional primary care model is not designed for depth. When managing a panel of 2,000 or more patients in 10 or 15-minute increments, there simply isn’t time for the thorough, ongoing conversation that real preventive care requires. It can leave physicians on the back foot. This is no criticism of individual physicians; most of us entered medicine precisely because we wanted those conversations. It’s a structural problem, and patients are smart: they know it should be possible to get more out of their visits.
In a smaller, membership-based practice, what changes is time and access. A patient who has a question in March doesn't need to wait until her scheduled visit in June. She can reach her physician directly and discuss her concerns with someone who already knows her history. The availability and more frequent contact transforms the nature of the relationship.
It also expands what's clinically possible. A physician who stays in contact with a patient between visits, who knows about the stretch of poor sleep or the new symptom that didn't seem worth an appointment, has a much fuller picture to work with than one who sees her briefly once a year.
Good primary care is longitudinal. The annual visit is one data point, but what happens in between is often where the more useful information lives. A physician who has followed a patient across years and life stages is in a far better position to respond to emerging issues than is one who is meeting her for the first time.
It’s worth asking whether the structure of your care is actually working for you. For many women, a different approach is more available than they realize.
Dr. Karen Hart is a physician at Harley Street Medical in Ho-Ho-Kus, NJ, specializing in personalized, preventive internal medicine. She joins HSM from the Valley Medical Group/Prospect Medical offices, having been named a Top Doctor by Castle Connolly and a Top Internist in Bergen County by Bergen County Magazine every year since 2017.
If you’d like to learn more about concierge medicine or Harley Street Medical, please email inquiries@harleystreetmed.com, call (551) 284-4044, or visit our website at www.harleystreetmed.com/nj.
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