Dr. Julia Cron knew early in medical school that obstetrics and gynecology was where she belonged. But it wasn’t until after she started practicing that she realized there weren’t many doctors focused on the reproductive health needs of younger patients.
“Transitions are hard, and adolescence is one of the hardest transitions,” says Dr. Cron, who is Site Chief of the Department of Obstetrics and Gynecology at NewYork-Presbyterian Lower Manhattan Hospital and Vice Chair in the Department of Obstetrics and Gynecology at Weill Cornell Medicine. “When I was young, people didn't talk a lot about sexual and reproductive health. I’m happy that it is becoming more normalized, and people are recognizing the value of seeing a gynecologist early in the teen years.”
It was the desire to help patients through the vulnerable stages in their lives that motivated Dr. Cron to subspecialize in pediatric and adolescent gynecology, while still providing the full spectrum of OB-GYN care. Below, Dr. Cron shares with NYP Advances how that passion began and what continues to fuel it.
When did you know that you wanted to pursue obstetrics and gynecology?
Right out of college, I worked at the American College of Obstetricians and Gynecologists in Washington, D.C. I basically answered the phones and filed paperwork, but I was around all these amazing OB-GYNs and learning about what they did. This was during the Clinton administration when they were trying to pass health care reform, and it was the first time I recognized the interplay between medicine and policy. When I went to med school, I tried to keep an open mind when choosing a specialty, but I couldn’t help but compare everything to OB-GYN. So, in the end, that’s what won out.
I like that it’s such a diverse specialty where you can do so many things. We are primary care providers. We are surgeons. We do a lot of mental health care. One day I’m in the office, one day I’m on the labor floor, and one day I’m in the operating room. We treat a wide variety of patients and medical conditions.
Why was it important for you to include adolescents within the scope of patients you care for?
My interest in pediatric and adolescent gynecology specifically came about when I was new in practice and wound up seeing a lot of young people. I quickly realized how much I liked it and wanted adolescents to be a focus of my practice. I learned as much as I could about treating this demographic and was excited when the American Board of Obstetrics and Gynecology (ABOG) decided to offer a focus practice designation in pediatric and adolescent gynecology. I have this designation and am so happy ABOG chose to recognize this important part of comprehensive health care for young people.
My goal is for my patients to include me in the circle of trusted adults with whom they feel comfortable. I see the benefit when parents give their child the ability to have a private relationship with a physician or health care provider, so they aren’t only getting information from their friends or the internet. There is good information online, and health care providers can help people find it and dispel some of the myths out there; that’s something I focus on addressing. I steer my adolescent patients toward web sites that are teen-friendly but also have evidence-based, accurate, and correct information.
You’ve authored papers on a range of clinical research and professional topics. What’s something particularly memorable that you’ve written about?
From a clinical perspective, I worked on a study with a medical student about contraceptive use among adolescents going through cancer therapy, and we found that a lot of physicians caring for these patients weren’t asking them about their birth control needs — only about a third of patients were receiving sexual health counseling. Adolescents in general face significant barriers in accessing reproductive health care, and we were able to identify an opportunity to improve outcomes for a subset of adolescents facing particular health challenges. This study exemplified something I have seen in practice — that just asking the questions and starting the conversations about what some consider sensitive topics has potentially huge benefits, particularly for populations who face barriers within the health care system.
On the professional side, inclusivity for physicians with disabilities and chronic medical conditions is a topic that is personally meaningful for me. I am a breast cancer survivor — I’ve been cancer-free for nine years — so I know it can be a challenge to decide whether to discuss your own health issues. Several years ago, one of my mentees and I wrote an editorial commentary about it and were guests on a podcast where we discussed our experiences as a medical educator and a trainee. We talked about the impact of disclosing personal health information while reflecting on our individual stories. Fortunately, there is a lot of work that's being done to advocate for doctors with chronic medical conditions and disabilities, adding to the evidence that the more diverse the health care workforce is, the better the care we can provide collectively to diverse patient populations.
What drew you to working at NewYork-Presbyterian and Weill Cornell Medicine?
The diversity in New York carries over to the diversity at NewYork-Presbyterian — it’s really second to none. I love that NYP values a diverse workforce, because I wholeheartedly subscribe to the philosophy that a wide range of thoughts and perspectives make up a better team.
One of the other big reasons why I came here was because the Chair of our department, Dr. Laura Riley, has a vision for caring for women throughout their lifespan. I liked that she values the clinical side and individualized patient care, but also sees the big picture and thinks about how research, innovation, and system changes can provide the best care for our patients.
What inspires you as a physician? What keeps you going when the job gets stressful?
Seeing the energy, enthusiasm, and commitment of the next generation of doctors is part of what keeps me going. Especially when it comes to the attack on reproductive rights, I see that the young people in our field are tirelessly committed to providing the full scope of evidence-based reproductive health care to all patients. Adolescents in particular face access issues, and while the FDA’s approval of the first U.S. over-the-counter birth control pill will have an important and positive impact, the fact that access is being devalued in some places is still quite terrifying to me. But I feel energized and inspired by the advocacy of so many in OB-GYN, particularly those in training and new in practice. I think that's why a lot of people are attracted to our field, because to be an OB-GYN is to be an advocate for your patient.
"My goal is for my patients to include me in the circle of trusted adults with whom they feel comfortable."
Instances where I realize that I’ve made a difference in someone’s life, even in the small ways, is also super-powerful. For instance, several months ago, I got a message that said something to the effect of: “This isn’t a question, I just want to thank you for asking the sensitive questions in a caring way.” When I get a comment from a patient, a colleague, a student, or a resident that demonstrates that I’ve personally impacted their life for the better, that “thank you” is powerful. Those one-on-one interactions are what keeps me going.