Medicine: A Quality-of-Life Center
Lifestyle issues are the focus of boutique Hadassah clinics that treat a variety of patients, from professional soccer players to children with ADHD.
A couple no longer sleeps together because of the husband’s loud snoring. A 9-year-old boy is teased about the heavy single eyebrow stretching from one side of his face to the other. A woman never wears skirts because of unsightly varicose veins marring her legs.
They are among the approximately 10,000 people who have flocked to Hadassah Optimal since it opened in July 2005—from soccer players and adventure travelers to the short-sighted, stressed, overweight and hyperactive.
“We offer lifestyle medical services to healthy people—and healthy people don’t want to be in a hospital,” says Yossi Ben Yakar, administrative director of Hadassah Optimal, The Center for Quality of Life and Aesthetics.
Resembling a stylish club more than a hospital, Hadassah Optimal is located in a complex opposite Jerusalem’s bustling Malkha Mall, occupying one story of a tall, glass-fronted building that stands amid flowers, fountains and manicured lawns. The elegant look spills over into its interior, which features teakwood accents and subtle lighting, vanilla-scented candles, oversized sepia photographs of tulips and fountains of water trickling over large, round pebbles.
“Improved quality of life can significantly upgrade health and well-being,” says Dr. Shmuel Shapira, deputy director general of the Hadassah Medical Organization, dean of the Hadassah–Hebrew University Braun School of Public Health and Hadassah Optimal’s director. “Hadassah Optimal gathers lifestyle medical services under a single nonhospital roof, staffed by Hadassah experts whose approach is holistic and fully integrated. This not only improves or solves lifestyle issues. More importantly, it is a much-needed source of income for the Hadassah Medical Center—for patient care, for research and for teaching.”
Hadassah Optimal, which brings in about $4.8 million a year, is unique in Israel and unusual elsewhere. Its birth dates back seven years to a business venture proposed by Optics Doron, an Israeli optometry chain. The chain’s owner, Roni Kaufman, suggested a partnership to perform Lasik surgery, a technique introduced into Israel by Hadassah. Lasik polishes and reshapes a patient’s 20-micron-thick corneal cap to produce clear vision with no need for eyeglasses.
The partnership was created, with Hadassah’s senior ophthalmologists operating on the seven applicants deemed medically suitable out of every ten who apply. Its popularity led to the opening of offices—called Hadassah Optimal, The Center for Lasik Surgery—in Tel Aviv and Haifa.
“The medical and financial success of these institutes sparked the idea of a quality-of-life center,” says Amitai Rotem, HMO marketing director. Hadassah Optimal was born as a private body, headed by Kaufman and owned by Hadassah. All members of its treatment teams are senior Hadassah clinical staff.
“It is a wonderful idea to provide services for healthy people outside a hospital setting,” says Hazel Haberer, who lives on a kibbutz near Jerusalem. “I sought help for crippling pain in my jaws after a dental treatment that went wrong. I felt very secure in the hands of Hadassah doctors.”
Hadassah optimal is built on interrelated clinics,” says Rotem. “One, for example, is for travel medicine, where travelers are immunized and medically advised. Another, with separate sections for adults and children, treats attention deficit hyperactivity disorder. We have clinics for sports medicine, for sleep disturbances [primarily snoring] and for obesity.” Cooking classes, led by Hadassah physician Rani Pollack, who trained as a chef at Le Cordon Bleu in France, teach healthful, appetizing eating as well as how to create menus for weight loss and for those living with diabetes, celiac and Crohn’s diseases.
There are procedures to remove skin stains, flesh out wrinkles and uproot unsightly body hair. Effective alternatives to aggressive surgical stripping of varicose veins are offered, and benign enlarged prostate glands are shrunk by radio waves. Complementary medicine is available, from acupuncture and homeopathy to auriculotherapy, mesotherapy and osteopathy. Mind-body techniques—reflexology, shiatsu, tui na and qigong—are used to combat pain, reduce weight, cope with difficult conventional medical therapies and quit smoking.
“Our most subscribed areas are snoring, hair removal and vein stripping,” says Ben Yakar, who managed small private medical centers in the Tel Aviv area before coming to Hadassah Optimal in early 2007.
It is believed that 20 to 30 percent of people snore loudly enough to disrupt their own sleep (leaving them constantly tired) and that of their partners (often resulting in separate sleeping arrangements).
“Once the cause of the snoring has been diagnosed and possible treatments recommended, the snorer talks things over with one of our counselors, who advises and then accompanies her or, more usually, him, through therapy,” says Ben Yakar. “All our clinics have advisers. Snorers, for example, may be recommended a dental plate, a mask or radio frequency [which burns the palate, nose, uvula or base of the tongue to reduce the tissue so air can enter more easily]. It’s a decision that must be carefully made.”
One patient who agonized over what to do eventually decided on a dental plate. Some months later, it broke. When replacing it, he ordered two. “It stopped me snoring and gave me back my life—and my wife!” he said. “I can’t risk being without it again.”
Causes of snoring, however, can be unrelated to breathing. “With stress, weight and diet all potential triggers, an integrative, multidisciplinary center like ours has an edge,” says Ben Yakar.
He cites ADHD in children as another such example. “Treatment can be dietary, psychological, pharmaceutical, with complementary medicine or by combining any of these,” Ben Yakar says. “We offer them all—the only place in Israel to do so—along with diagnosis, follow-up and even liaison with the child’s school.”
Or take obesity and stress. “In someone overweight, with high blood pressure or high cholesterol, quality of life plunges,” Ben Yakar notes. Whole families sometimes come to Hadassah Optimal—obese parents with obese children—to learn new eating habits (such as sitting down together for family meals) and the importance of regular exercise.
For many, excess body hair is as shattering to self-confidence as obesity. “We get people coming here in long sleeves and pants in the heat of summer, their heads down, because of superfluous body hair,” says Ben Yakar. “They never go to the beach and are often mercilessly teased.”
Hadassah’s plastic surgeons examine hair quality and skin color to ensure the growth doesn’t signal disease. The hair is then removed, usually with a pulsed-light laser (IPL).
A new tool, the IPL enables physicians to vary the intensity of the beam—a flexibility that produces more customized treatment and better, safer results.
Lasers, in this case the Palomar YAG, are also used to remove skin pigmentations and, frequently, tattoos—often from newly religious Jews to whom they have become a source of shame because of a halakhic prohibition against tattooing. And the Endolaser is one of three ways in which varicose veins are extracted at Hadassah Optimal. The other two are phlebectomy, which punctures minute holes into the vein, and the injection of special material into the veins; all three are half-hour procedures.
“When they return for follow-ups, women who have spent years hiding veined legs under jeans are often wearing miniskirts,” says Ben Yakar.
Professional soccer players also come to Hadassah Optimal. Russian-born billionaire Arkady Gaydamak, who bought the Beitar Jerusalem soccer team in 2005, was the first to sign his club with Hadassah Optimal to test and monitor the health of his players, including the youth members. Hapoel Tel Aviv has since followed suit.
Hadassah Optimal’s sports medicine director, Dr. Naama Constantini, is one of the first practitioners of sports medicine in Israel and chairs the country’s Olympic Committee Medical Commission. Her team comprises orthopedists, physiotherapists and dietitians. They work not only with athletes, but also rehabilitate those with leg (particularly knee) injuries and design exercise programs for obese, diabetic, cardiac and osteoporotic patients.
“As well as physiotherapy and fitness training, we do stress testing and ECGs and measure fat percentage and distribution, metabolic rates, energy expenditure and oxygen consumption,” says Rakefet Azrieli, a sports medicine therapist. “We run a busy clinic and look forward to enlarging it.”
Early next year, Hadassah Optimal will expand its floor space from 6,996 to 12,916 square feet. “We already handle 1,500 patient visits a month, 600 of them newcomers, and expect this number to continue growing as we become better known,” says Rotem. Last March, the Tel Aviv branch was expanded to become a quality-of-life center.
All this justifies the commercial venture, whose framework and services are different from those offered at Hadassah hospitals. Services are not automatically covered by Kupat Holim, the national health insurance; patients pay out of pocket and are reimbursed on a case-by-case basis.
HMO considered long and hard before opening Hadassah Optimal.
“We decided to go ahead both because we strongly believe that quality of life is as important to well-being as good health and because of the income we can generate for Hadassah,” says Rotem. “Bringing our physicians, with their credentials and knowledge, into a multidisciplinary center effectively enhances healthy lifestyles…for many people.”
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