Breast surgeon calls Englewood home

Dr. V. Merle McIntosh has been practicing medicine since 1994. A native of Aruba, McIntosh grew up in Grenada and now specializes in breast surgery at Englewood Hospital where she has practiced the last 10 years. As the final profile of prominent black community members the Suburbanite is featuring for Black History Month, McIntosh shared the highlights and challenges she faces daily in the health industry.

Q: How many years of schooling did you undergo to become a surgeon? And where?

A: I had four years of college at Hoftstra University and four years of medical school at the State University of New York Downstate Medical Center and five years of general surgery training at St. Luke’s Roosevelt Hospital in New York. And I did one year of a specialty fellowship in breast diseases at Faulkner Breast Center in Boston.

Q: How did you keep your eye on the end goal all that time?

A: Coming from the Carribbean, education was just one of those things you did. You went to school and did what you’re supposed to do. You set out to complete four years and then you move on to the next thing. It’s difficult if you get distracted from your goals but once you focus it becomes relatively easy.

Q: What would you tell a young person who may find the schooling daunting?

A: It takes time because it’s a lot of work but it’s not so hard it can’t be done and I think that is what young people need to understand. You have to carve out the time to do what needs to be done and if you do that it’s doable and you can handle it.

Q: Why did you choose to specialize in diseases of the breast?

A: During training you are exposed to all various aspects of surgery and certain areas interest you more than others. I felt this area was more than just surgery — it is dealing with women and all of their issues.

Q: What is a typical week like for you?

A: I see patients in the office two days a week and the other three days I’m in the operating room with everything from routine breast biopsies to mastectomies. A mixture of all types of breast surgeries but no cosmetic surgeries, no reconstructions.

Q: How do you help a woman handle the decision of undergoing a surgery as radical and life altering as a mastectomy?

A: For the average patient trying to separate themselves from a potentially life threatening illness puts it all in perspective. Even though it is very difficult to do they come to terms with it. For the most part women are very resilient and most women can handle things a lot better than sometimes we think they would. It is a matter of getting all the information and coming to terms with what has to be done. And a lot of times mastectomies are a patient’s choice because they feel medically that it would be the best thing for them to do.

Q: Under what circumstances may a patient opt to have a mastectomy even if the doctor hasn’t prescribed it?

A: A patient that is very high risk. If their mother or sister had breast cancer and they want to be proactive and do something before something happens. They are not sitting at home waiting for the inevitable but they go ahead and take charge. I find more and more women doing that these days.

Q: What are the risk factors women should be aware of?

A: The major risk factor for breast cancer is family history. A first degree family member — mother, sister or daughter. The concern in those cases is there is a genetic link to breast cancer. But the majority of cases are sporadic and that means we have no idea why this patient developed breast cancer. Patients may have taken hormones like estrogen or progesterone putting them at increased risk. But unfortunately because we can’t pinpoint one cause it’s very difficult to prevent. The best prevention is early detection. Patients need to be diligent about yearly mammograms and self exams to familiarize themselves with the breast. They are not looking for a lump but checking to make sure nothing has changed and if something has changed then have it checked out.

Q: How has the field of healthcare changed over the years? What challenges does it present to doctors and patients?

A: Healthcare is extremely challenging and it’s getting worse in terms of what the doctors have to go through with the insurance companies in order to provide care for their patients. So many doctors are dropping out of insurance plans and patients cannot find specialists to care for them because no one is accepting their insurance.

Q: Why are so many doctors dropping out of health insurance plans?

A: There are so many hoops you have to jump through with insurance companies. They deny tests for patients and their reimbursement costs are such that it costs more to run an office or make an appointment for patients then what you collect for that visit. It gets to a point where you can only do so much charity work before you have to close the office. The healthcare business needs a complete overhaul and hopefully we’ll see something done soon.

Q: How do you deal with your limitations? Wanting to help someone and seeing them not make it?

A: It is not easy, it’s very difficult to watch a patient going through the end stages when they may be in pain or suffering mental anguish not only for themselves but their family as well. There are tough days but like everything else you learn to take everything in stride and offer whatever words of comfort you can and support. You learn to deal with it.

Q: How have you changed as a doctor over the years?

A: In the business we’re in when I look at life in the grand scheme of things the little things we get upset about at the end of the day are really nothing. When I see what people are going through and how people’s lives just change in a moment with a diagnosis of a life changing disease. The majority of patients with breast cancer will survive — that’s the good news. But over the years the little things that used to bother me I don’t let bother me because I can count my blessings and enjoy good health.

Q: How have you overcome any discrimination you may have faced being both black and a female doctor?

A: There have been a few little things along the way but there hasn’t been a lot. It’s different coming from an area where you have not been discriminated against. You do what you have to do and if things happen you can ignore it and move on and that’s what I’ve been able to do. People would discriminate against you for many reasons. They could look at you and they don’t like you and many times it has nothing to do with race or gender. When you encounter someone who doesn’t love you, you just sort of keep going because that’s life.