The Ob/Gyn Center at Bethesda North Hospital

Nadia Khan, Summer 2013

This summer, I had the amazing opportunity of working at the Bethesda North Ob/Gyn Center. The clinic is staffed by residents who report to a different attending physician each shift. They see an underserved patient population, in that half of their patients are on Medicaid and the rest do not have insurance that covers obstetrics. Patients sign up for an OB contract that covers a normal pregnancy and costs $2500 for a vaginal delivery and $3000 for a Cesarean section. For any other expenses, they can receive an 85% discount if they are eligible for financial assistance. The clinic has a financial counselor on staff to speak with the patients about their best options. They also have a dietitian, multiple care coordinators, one specifically for the Spanish-speaking patients, social workers, a nursing staff, and a wonderful front desk crew. Everyone at the clinic works together to deliver the best care that they can provide.

During my summer, I quickly learned the ins and outs of the clinic. I began by shadowing the residents who would see patients, present them to the attending physician, come up with a plan of action, and return to tell the patient. After observing for a few days, I was able to see patients on my own, take their history, present the patient to the resident, work together to come up with a plan, and return to speak with the patient. I was able to improve and practice my Spanish speaking abilities by talking to many of the patients in Spanish. I was also able to perform routine procedures, such as measuring fundal heights, listening to fetal heart tones, performing pelvic exams with a speculum and digital exams, examining wet mounts, and using an ultrasound. One afternoon every week, the center has a colposcopy clinic, so I was able to observe many biopsies and LEEPs and counsel patients on irregular Pap smears, HPV, and cervical cancer. I even had the opportunity to go to the Bethesda North hospital a few times and was able to scrub in on a few Cesarean sections, observe other procedures such as a circumcision and a Foley bulb cervical ripening, and see patients in triage.

Overall, it was a well-rounded experience, as I received great clinical experience as well as a better understanding of how to serve the underserved. I encountered many eye-opening patients, who not only had medical problems but also had many difficult social and/or financial situations. Throughout my summer, I worked on a few different projects to help the clinic and their patients. The staff was very appreciative of my efforts, and I am thankful to everyone at the clinic and to the Urban Health Project for allowing me to have as fulfilling an opportunity as my summer at the Bethesda North Ob/Gyn Center was.