The Ob/Gyn Center at Bethesda North Hospital

Sarah Friedberg, Summer 2012

I chose the Urban Health Project for the chance to participate in a student movement. I learned about UHP at a research symposium, and was immediately inspired. Like many of my peers, I came to medical school with the expectation of doing an intensive research project for the summer after my first year. However, the prospect of service learning with Urban Health Project excited me. It is an incredible thing, for medical students to come together to create and maintain an organization like this.

My summer at Bethesda North OB/Gyn center in Montgomery was as varied as it was rewarding. At first, I shadowed and observed. Within a few days, I learned the flow of the clinic and knew everyone by name. Then, I functioned as a med student on a rotation. I saw patients myself, taking histories, measuring fundal heights, listening to fetal heart tones, preparing wet mounts, and performing physical exams. I'd then present patients to the residents and we'd return together to ask follow up questions and to perform the procedures. The residents taught me to do pap smears, pelvic exams, and ultrasounds. I also witnessed several colposcopies, biopsies, and LEEPs. As the summer moved forward, I got to know many of the OB patients and followed them into their surgeries and labors. I even had the chance to close the surgical wound on a DaVinci robot surgery. In this way, I was able to participate in all facets of OB/Gyn care.

Bethesda North is a clinic that serves an urban, underserved population of incredible variety. Roughly 40% are uninsured while 50% are on Medicaid. The rest of patients have insurance with no maternity care. About 60% of the patients I saw were minorities, of whom 40% were Hispanic. As such, this was a great opportunity to practice my Spanish. To better serve the community, the clinic offers its services at an 85% discount. The care coordinators, dietician, social workers, and financial counselor work together to give underserved patients the services and care that they need.

I also had the chance to conduct a pilot study for a long-term hospital quality improvement project. In hopes of decreasing the high rates of no-shows at the clinic, I called patients to remind them of their appointments. Calls were placed the afternoon before appointments were scheduled. After two weeks of this, no-show rates decreased by about 25%. This success motivated a two-week trial of an automated calling service. If this keeps no-show rates low, it will be implemented long-term.

Above all, I am proud to have been a part of the Urban Health Project as a social movement. Being in clinic was inspiring and affirming for me, but I hope that my presence equally affected the clinic staff, residents, and patients. I hope that they see how my generation, through projects like this, will change the way medicine is practiced. I hope that they recognize our group's dedication to serving the underserved, and that this interest someday results in change to the political and social climate of healthcare. I am now confident in pursuing my interest of serving the underserved, knowing that my peers will be doing the same.