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Following a hospital merger so challenging that it required federal intervention, Dr. Stacey Rosen found herself in a tricky situation.

Leaders of the integrated system wanted doctors and nurses at all facilities to use the same protocols. This essentially meant implementing the larger system's standards across the smaller system.

Leadership also decided the cardiology division would go first. And that Rosen would be in charge.

She was coming off maternity leave when she switched hospitals. Yet the real obstacle was that her new staff pushed back at the new way of doing things – frequently, often fiercely. After 18 months of it, Rosen came home one night and told her husband, "I can't do this anymore."

Once she had that out of her system, Rosen did what she'd always done. She remained focused on her unwavering principles of doing what's best for patients and doing what's fair. Then, she got things done with steely resolve, smarts and moxie.

She made it clear that egos and office politics didn't matter. All that mattered was improving and extending lives. Holdovers willing to put patients first got to stay. Those who didn't were replaced by people who did.

Once she was surrounded by like-minded teammates, statistics showed her division was saving more lives than before she took over. All because everyone prioritized what mattered most: patients.

"Over time, we created a better environment for our faculty, trainees and staff, as well as improving patient outcomes," she said. "The evolution of the department is one of the things in my career that I'm most proud of."

While this anecdote sums up a lot about Rosen, it's incomplete. Because it omits the defining focus of her career: women's health.

Rosen became a cardiologist when it was widely believed that women's hearts were the same as men's. Once she began treating patients, she could tell that wasn't always true. Then along came studies verifying it. A new field began to emerge – slowly, often facing the kind of pushback from skeptics reminiscent of what she'd already dealt with.

Again, she didn't care about egos or politics. She just wanted to improve and extend lives.

Following the same playbook of doing what's best for patients, doing what's fair and getting it done with steely resolve, smarts and moxie, Rosen has not only become a driving force in the field of women's heart health, but also in expanding knowledge and raising awareness about all aspects of women's health. After a dozen years of helping run Northwell Health's Katz Institute for Women's Health in New York, she became its executive director early last year.

As of July 1, Rosen began another opportunity to shape health care in a profound way. She started a yearlong tenure as president of the Ãå±±ÊÓƵ.

"Stacey makes things happen through her vision, leadership and sincere desire to help people," Ãå±±ÊÓƵ Chief Executive Officer Nancy Brown said. "No matter whether she's talking to a boardroom or on a morning talk show, her knack for delivering difference-making insights resonates with everyone."

Molded to be a difference-maker

The path to who Rosen is today – why she does what she does, and how she does it – is easy to trace.

It starts at the very beginning. With her parents.

Both grew up in New York City. Her dad wanted to be a doctor, her mom a lawyer. But times were tough. All that training would take too long and cost too much. So both became public school teachers. (They met on a blind date in high school, marrying at the start of their careers.)

Dad eventually became a middle school principal, first in Queens, then on Long Island. On top of his administrative duties, he also taught history.

Mom taught reading in an under-resourced part of Brooklyn, Bedford-Stuyvesant. It broke her heart seeing so many kids reading below their grade level. Knowing that part of the problem was a lack of access to books, she led fundraisers to stock classrooms with books the students could take home. She later trained other reading teachers, passing along her passion as much as her know-how. Another layer to this is that for much of her long career, she commuted for about an hour each way from Long Island in a carpool with three other similarly devoted teachers.

"That's really the kind of house I grew up in," Rosen said. "They valued integrity and education. Most of all, my parents were doers."

Rosen was their first of two children; her brother, Fred, arrived three years later.

In middle school, she started thinking about what to do when she grew up.

As much as she respected teachers and teaching, she wanted something bigger than her own classroom or school.

Because fairness meant so much to her, she imagined becoming the ultimate arbiter of right and wrong: a U.S. Supreme Court justice.

Because she thought of herself as "a science and math nerd," she considered engineering or medicine.

She pursued medicine first for a simple reason. Her local hospital allowed middle school girls to volunteer as candy stripers.

She found the doctors to be smart and thoughtful. She loved the buzz of activity in the hospital. Her interest piqued, she wanted to be part of a bigger hospital. That's how she wound up spending most Sundays during high school in the children's life center at Memorial Sloan Kettering Cancer Center in New York City.

As a teenager hanging out with kids being treated for cancer, she absorbed a lot. While the bad times were devastating, the good times made it all worthwhile. This included understanding the full scope of what it means to be a doctor.

The best ones served patients and families with compassion. They fought the injustice of disease with knowledge and skill. They gave voice to the voiceless. And, because this was a teaching hospital, they trained medical students.

"That's the whole package," she thought.

She was so eager to launch her career that she went to Boston University for a six-year program combining undergraduate studies with medical school.

The professional path begins

Set on becoming a doctor, the question was what field she'd go into.

Not pediatric oncology; that was too emotionally draining. She was open to pretty much everything else.

Then she dissected a heart.

After that, the question was what type of cardiologist she'd become.

Seeing as Rosen is clearly a doer who loves a good challenge, it makes sense that she would take on heart disease, the No. 1 killer around the world.

And, considering her mom's influence, it also makes sense that she wanted to spend her resident years in the cauldron of a big-city municipal hospital.

"I thought that was not only where I could do more good, but I would probably get better training," she said.

She got her wish, all right, landing at Montefiore Hospital in the Bronx in July 1985, just as the AIDS epidemic was spreading rapidly through that community.

With far more patients to treat than supervisors to offer guidance, Rosen often had to make rapid decisions, many with life-or-death consequences.

She found Montefiore so invigorating that she stuck around for an extra year to serve as chief resident.

Overseeing and teaching a staff of her peers, while also caring for patients, all while dealing with the office politics inherent to being in leadership, was "an awesome responsibility." Sometimes too much. Trying to be the smartest person in the room, she often doubted her abilities.

Still, as with her time in the cancer ward, the good far outweighed the bad. Even the confidence crisis helped; she learned to trust herself more.

"I loved those four years," she said. "I loved the community, I loved the impact, I loved getting to know the patients. I loved being part of a team that felt we were all in this fight together."

During that time, she also fell in love, marrying Dr. Mark Silverman. ("One of my interns in the CCU," she said, smiling.)

Next it was time for her fellowship training.

After doing more with less at Montefiore, Rosen wanted to see what it was like to be part of a system with a different patient population. She certainly got that at The New York Hospital-Cornell Medical Center (now known as Weill Cornell), where patients included former President Richard Nixon.

She was on duty the night one of the hospital's top donors arrived after fainting at the Met Gala. Rosen wasn't sure whether there were certain do's and don'ts she had to follow while treating this woman. Then the lead cardiologist told Rosen, "She's like any other patient." That meant Rosen had to ask how many drinks the woman had and then give her a complete, thorough physical exam.

Rosen's extra year in fellowship focused on echocardiography. She parlayed that into an impressive first job: assistant director of the echo lab at another elite health care system in New York City, Mount Sinai.

She showed up to her first day of work seven months pregnant with twins.

She and her husband, a dermatologist, spent the next few years juggling the start of promising careers and the start of their family.

They eventually realized they didn't want to raise their kids in Manhattan. They wanted to raise them on Long Island, where they both grew up. That meant taking jobs there, too.

In late 1994, Rosen became director of the echo lab at North Shore University Hospital. Her Mount Sinai colleagues insisted she was hurting her career trajectory. She didn't totally disagree.

She can laugh now at how wrong she was.

Finding a new focus

One of the first people Rosen met at North Shore was the director of nuclear cardiology. She was the only other female cardiologist on the staff and she happened to be a fellow BU alum; they'd been only a year apart but had never met.

Rosen and Dr. Jennifer Mieres clicked right away.

Among the many things they had in common was a troubling observation. Too many women were being sent home from emergency rooms because they weren't having the same heart attack symptoms as men, only to get back in the nick of time – or, worse, not. Their anecdotal evidence fit a landmark statistic that had emerged about a decade before, around the time both were graduating from BU: More women were now dying from heart disease than men.

"Jennifer saw the reality of those statistics in the stress-testing lab, and I saw it in the echo lab," Rosen said. "That just blew our minds. Talk about unfair, underserved and unvalued."

They began volunteering on women's heart health projects and attending conferences. Because it was an emerging field, they quickly befriended the first wave of leaders, including the matriarch, Dr. Nanette Wenger.

Along the way, Mieres gave a stress test to a woman who produced documentaries. Mieres and that patient went on to co-produce "A Woman's Heart," which aired on PBS in October 2001 and was nominated for an Emmy Award.

"That was a little bit of combustion for us," Rosen said. "It showed us the importance of storytelling."

Mieres went on to produce more documentaries. Mieres and Rosen co-produced the documentary "Ms. Diagnosed," which premiered in 2020.

In 2018, the duo co-authored "Heart Smart for Women." (An updated "Heart Smarter for Women" published in 2022.)

Their book came out just as Rosen was finishing what became a 10-year run as chief of the cardiology division of the smaller of the tertiary hospitals aligned in the merger. She spent the next three years as associate chairman of the department of cardiology. Over those 13 years, she also ran the cardiovascular fellowship program.

In 2012, Rosen got the chance to focus all her efforts on the part of medicine she'd come to care about most. She became vice president of women's health at the Katz Institute for Women's Health.

Her boss? The founding leader of the institute … Jennifer Mieres.

Growing devotion to the Ãå±±ÊÓƵ

Early in her career, Rosen became a regular attendee at the Ãå±±ÊÓƵ's annual Scientific Sessions. As a fellow-in-training, she attended educational events the association hosted in Manhattan.

That was about the extent of her involvement with the organization until the mid-1990s, when she and Mieres began delving into women's heart health. Leaders at their hospital urged them to talk about it on behalf of the association.

Rosen joined her local board. Soon, she was speaking about women's heart health with everyone from homemakers to lawmakers. Her playful, plain-spoken delivery combined with the people skills honed over her diverse collection of workplaces clicked with all audiences.

The power and reach of the Ãå±±ÊÓƵ meant plenty of opportunities. Based on everything else in her life and career, it would've been more surprising if she didn't ramp up her involvement.

She became vice president of the local board, then president. She joined the regional board, then the national board from 2016-18. Next, she was asked to take on a role that could've had some of the same issues as consolidating the cardiology division post-merger.

The association was turning three regions near the Northeastern Seaboard into a single entity. While this merger was less acrimonious, some sensitivities had to be navigated. Rosen and the board chair planned to smooth things out in person by visiting each office.

Then the COVID-19 pandemic hit.

Shifting to a plan B of meeting by Zoom, she made it work. Association executives and fellow volunteer leaders were impressed. The best evidence came one day last summer, when former Ãå±±ÊÓƵ President Dr. Michelle Albert called Rosen with the news that she'd been named president-elect.

"I was blown away," Rosen said. "My volunteer work for the Ãå±±ÊÓƵ is one of the most important things to me after my family. I just think so highly of the organization because of their focus on everything that I think is important – not just the science, it's the focus on optimal health for all, patient participation and advocacy."

As president, she hopes to get more people talking about the differences between women's hearts and men's. Considering that women are 51% of the population, it's not like it's a niche subject.

She also wants to emphasize the need for men to take a close look at the differences. With women comprising only 20% of cardiologists, the burden can't fall only on them. Besides, the amount of work to be done means there are opportunities for reputation-making breakthroughs.

"Sex and gender need to be foundational to what we do," Rosen said. "Every study, every new device, everything we put in front of the Food and Drug Administration, every letter we write to a congressional subcommittee, all must ask and answer the question, 'What's different about women?' If we don't know, we need to study it."

The true loves of her life

When Rosen and her husband moved to Long Island, they had two kids, Max and Rebecca. Within a few years, the twins had a baby sister, Sarah.

Just as Rosen learned from her parents, her kids have learned from her.

Rebecca is an ophthalmic surgeon in Philadelphia. She was an intern at a Brooklyn hospital at the start of the COVID-19 pandemic, an unfortunate parallel with her mom's days as an intern as the AIDS epidemic hit the Bronx. Her husband, Alex, works for the city of New York, focused on financing affordable housing.

Sarah is a clinical psychologist in New York. She followed the path of her mom and grandma by challenging herself to start in tough situations: first among the diverse, under-resourced population at Bellevue Hospital, then kids with mental and physical limitations and now, fresh off earning her Psy.D., at a city agency in the foster care system.

Max, meanwhile, is in the world of banking and finance, also in New York. His wife, Julia, is a consultant. Their daughter, Mira, is almost 2 and has been an endless source of joy to the entire family (including Rosen's mom, who remains thriving at 86.)

Of the many values Rosen has modeled for her kids, what radiates most is her enthusiasm for everything that matters to her – from being their mom to saving lives.

That latter passion emerged repeatedly in the conversation for this story.

With the giddiness of a candy striper, she talked about hospitals being "magical places." Her explanation included marveling at an ecosystem that is buzzing at 2 a.m. with doctors, nurses and all sorts of supporting staff (cashiers, HVAC technicians, librarians) all hard at work, "all doing it to help sick people."

She described working with patients and what it means when they "trust you so much they share information they don't tell their spouses or other loved ones." Her conviction led to her receiving the Ãå±±ÊÓƵ's Physician of the Year award in 2021, one of many such accolades from a variety of outlets. (In 2018, she also received the association's Women in Cardiology Mentoring Award.)

Of course, 40 years into this career, she knows it's not always magical and people don't always trust her. She admits to sometimes being sarcastic and snarky and cynical. And that confession led to another anecdote.

"About a year ago, we were overbooked one morning and everyone was yelling at us," she said. "I was really losing it. Then my nurse practitioner and I gave the results of a stress test to a 70-year-old woman. She was so relieved. She kept thanking us and even hugging me. After that, my nurse practitioner said, 'You can live on that comment for a month.'"

Rosen smiled at the memory – because she did. Then she added: "As long as I have enough moments like those, I'll continue to say the greatest privilege is getting to wear a white coat."