Mitzi Krockover, MD, on Addressing Gaps in Women’s Healthcare
From puberty to menopause and beyond, women move between providers, specialties, and systems that were not necessarily designed to connect, leaving many at risk of falling through the cracks of a fragmented healthcare system. The challenge is not simply adding more women’s health services. It is redesigning healthcare, research, and education around the way women actually experience health across their lifespans. “The lanes are a six-lane highway, not a two-lane highway,” says Mitzi Krockover, MD, Director of Women’s Health Innovation and Professor of Practice at Arizona State University College of Health Solutions.
The Gaps Appear at the Transitions
Some of the most consequential care gaps emerge at moments of transition. A young woman moving from pediatrics into adulthood may experience symptoms of endometriosis that are not recognized. During her reproductive years, pregnancy complications such as gestational diabetes, hypertensive disorders of pregnancy, or preterm birth may be treated as isolated obstetric events, even though they can signal increased health risks later in life. As she moves into midlife, she may continue to rely on her gynecologist for much of her care, even though gynecologic care is not a substitute for comprehensive primary care. At the same time, her primary care clinician may not have a complete obstetric history or recognize the long-term significance of those pregnancy complications as risks for cardiometabolic disease and other conditions.
Those transitions become harder when care is fragmented. A patient may move from primary care to multiple subspecialists without anyone coordinating the bigger picture. Others eventually leave the health system altogether because they feel their symptoms are not being taken seriously. That can drive women toward alternative providers and services simply because they want to feel heard. The problem, therefore, is much bigger than diagnostic delay or symptom dismissal. It is a structural issue involving the organization of care.
Closing the Gaps Starts in Medical Education
Krockover sees medical education as an important place to begin. Her vision is straightforward: medical students should routinely ask how a condition differs between women and men biologically, physiologically, and anatomically. “If we don’t know the answer, we know that we now have a gap,” she says. Healthcare education can prepare clinicians to recognize sex differences, understand a broader range of women’s health issues, and know when a patient needs to be referred or handed off.
The same principle applies to research. Sex differences need to be embedded in research design and reporting rather than treated as an afterthought. Without disaggregated data, treatments and clinical guidance can miss important differences in how women respond.
That concern takes on new significance as healthcare adopts artificial intelligence (AI). “AI is pulling from the obvious, from the available evidence,” Krockover says. “If the available evidence is incomplete or incorrect, the output that they’re going to give is already biased.”
Build Care Around the Whole Patient
Better women’s health also requires moving beyond the idea that healthcare alone determines health outcomes. “Nothing happens in a silo,” says Krockover, underscoring the ways lifestyle, environment, genetics, sex, gender, and other factors interact throughout a person’s life.
That philosophy shaped Krockover’s work building women’s health institutions, including the Iris Cantor–UCLA Women’s Health Center at the University of California, Los Angeles (UCLA), and a women’s health function at Humana. For her, creating a successful women’s health center or program starts with defining exactly what it intends to accomplish.
An initiative needs clear goals, measurable outcomes, institutional sponsorship and sufficient resources. Its leadership must have real decision-making authority rather than being asked to treat women’s health as an additional project. Interdisciplinary teams are equally important because women’s health crosses clinical specialties and is influenced by social determinants of health.
Just as important is the ability to iterate to respond to customer need. Krockover recalls acting as a “mystery shopper” at UCLA, testing everything from how quickly calls were answered to how patients experienced the system. The exercise underscored the fact that care design needs input from the woman receiving it, not just the institution providing it.
Innovation Can Help, But Evidence Still Matters
The growth of femtech, or women’s health technology, is creating new possibilities, particularly around menopause. New therapeutics, diagnostics, telehealth services and other products are expanding options for women who historically have had too few.
Innovation, however, does not automatically mean better care. Krockover cautions that the speed of the market can make it difficult to distinguish evidence-based solutions from products that have not been adequately validated. “Just because you heard it on TikTok, Instagram, or Facebook doesn’t mean that it’s good for you or that, again, it’s science-based,” she says.
For women navigating menopause and midlife health, that means innovation should be accompanied by scrutiny, clinical evidence, and informed conversations with trusted providers.
The opportunity extends well beyond menopause. Krockover points to osteoporosis, cardiometabolic disease and cognitive health as areas where women’s health innovation could have significant impact. Closing the research gap can improve diagnosis and treatment while giving innovators better evidence on which to build.
Fixing Women’s Health Benefits Everyone
The consequences of getting women’s health wrong are significant. Research gaps can lead to delayed diagnoses, ineffective treatments, and products that are later found to have different or adverse effects in women. Those gaps can also become self-perpetuating. If the underlying evidence is incomplete, clinical guidance can reproduce those shortcomings. If that guidance becomes embedded in digital health tools and AI systems, the effects can spread even further.
A recent McKinsey Health Institute analysis estimated that closing the women’s health gap could add at least $1 trillion annually to the global economy by 2040. The impact extends beyond healthcare costs: poor health can reduce women’s workforce participation and productivity and affect families and communities, particularly given women’s substantial caregiving roles. Closing the gap, therefore, benefits far more than women alone.
According to Krockover, the solution is not a single new women’s health center, product or investment fund. It is a more connected approach to healthcare, research, education and innovation, one that recognizes sex differences, listens to patients and measures whether systems are actually delivering better outcomes. It is ultimately a model for better healthcare for everyone.
The central question is whether healthcare institutions are willing to build the structures, incentives and evidence base required to make today’s increased attention to women’s health truly meaningful.
For further insights into innovations in women’s health care, follow Mitzi Krockover on LinkedIn.
Disclaimer: This article is for general informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. Readers should consult a qualified healthcare professional regarding their individual health needs, symptoms, or treatment options.
