A Day in the Life of a PA in Outpatient Obstetrics and Gynecology

PA Melissa Rodriguez is Passionate About OBGYN and All Aspects of Women’s Health

March 7, 2022

By Melissa Rodriguez, DMSc, PA-C

President of the Association of Physician Assistants in OB-GYNAPAOG, Melissa Rodriguez, DMSc, PA-C, encourages PAs to consider specializing in obstetrics and gynecology (OBGYN). Here she describes her passion for obstetrics, gynecology, and women’s health, and what a day in her practice looks like.

Melissa Rodriguez, DMSc, PA-C

Obstetrics has been my passion since I can remember. Caring for women during their pregnancies and bringing life to this world was the only career I ever considered seriously. My initial goal was to go to medical school and become an obstetrician and so my college track was pre-medicine. Then, while working as a medical assistant in urology, I met PA Elizabeth Rothstein. She was smart, well-rounded, practiced in different medical specialties, and had a breadth of knowledge. It was refreshing to see a competent and humble provider who connected so easily with patients of all backgrounds. It was a different breed of medical provider with pure compassion and versatility.

I immediately researched all things PA related, joined the AAPA, and began my transition. I remember being asked about my career goals before graduation from Hunter College (CUNY) and I was excited to share that I was going to be a PA and, one day, be president of the AAPA. My faculty advisor had no idea what a PA was, and I could feel the condescension. I vowed then to advocate for this profession full force so that everyone can see how fantastic these PA providers can be.

The day I received my acceptance letter to the University of Medicine and Dentistry of New Jersey (now Rutgers University), I was ecstatic and called my mother first. I remember her voicing her congratulations and then sharing the news that my aunt had brain cancer. In that moment of shock, I was devastated but had a newfound resolution to become a PA and be trained as a generalist that allows me to be knowledgeable and transition into any specialty. Within three grueling and amazing years, I earned my master’s in science degree and began my first job as an OBGYN PA.

Good preparation in OBGYN clinical rotation
Thankfully, my OBGYN clinical rotation prepared me for the high-acuity state of obstetrics. Even the uncomplicated births had an air of trepidation to them, which comes from knowing all the possible complications. Emergency cesarean deliveries, fourth degree lacerations, shoulder dystocia, and massive blood transfusions provided a bird’s eye view to all the glorious and challenging experiences this field offers. I had wonderful preceptors who took the time to explain, allowed us to participate, and made us feel welcomed and that we had really made a difference. It was a great experience.

Rodriquez with patient.

In my first job, I worked with Zeidy Flores, PA-C, the chief PA and program director for the Montefiore Medical Center OBGYN PA Residency program, and a leader and advocate for OBGYN PAs. I then transitioned to Maternal Fetal Medicine for several years until I returned to Labor and Delivery. Currently, I work in an outpatient OBGYN position where I have my own panel of patients in obstetrics and gynecology, and I also continue to assist in laparoscopic and robotic gynecologic surgeries.

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My daily schedule includes a wide variety of patients. Since I am proficient in ultrasound, I often see pregnant patients on their initial visit and perform pregnancy confirmations. I also enjoy procedures, so I have quite a few during the week, such as colposcopy, IUD insertion/removals, Nexplanon® insertion/removals, endometrial biopsies, and I&Ds. Well-woman visits, infertility consults, and abnormal uterine bleeding are also common. Scattered throughout the day are endless questions and NST readings for pregnant women with high-risk issues needing additional monitoring.

One day in August 2021
During one day in August 2021, my schedule included:

7:30am                 Grand Rounds (virtual)

8:30am                 PA student discussion

8:45am                 New annual visit, exposure to HSV, requests STI testing

9:15am                 Established annual visit, discussed Kegel exercises

9:45am                 Return OB (ROB) 38 weeks pregnant

10am                     ROB 38 weeks, delivered

10:15am              Twins, baby A with severe IUGR, 29 weeks

10:30am              30 weeks, husband in the ICU with covid pneumonia

10:45am              New consult, irregular menses, dysmenorrhea

11:15am              Colposcopy plus biopsies

12pm                    Postpartum rounding: 3 postpartum day 1 patients, and one postoperative day 2 patient

1pm                       New, annual visit

1:30pm                 New, pregnancy confirmation 7 weeks 6 days

2pm                       IUD check

2:15pm                 ROB 36 weeks, GBS testing

2:30pm                 ParaGard insertion

3pm                       ROB 38 weeks

3:15pm                 New OB, 12 weeks, transabdominal US

3:30pm                 Mirena insertion

Providing a haven for patients with mental health evaluation and counseling

Rodriguez with son Joshua, nephew Noah and daughter Alissa.

The variety in the day-to-day visits is what keeps it interesting. The emotional connection and ability to help women with different concerns all day is gratifying. One aspect that is not easy to observe on a typical schedule is the mental health evaluation and counseling that is provided to all patients. We must provide a haven for our patients so that we can help, even when it feels impossible. Being aware of local resources and providing referrals as appropriate is also crucial. Addressing all forms of abuse and providing guidance in the office setting may be their only opportunity to request help.

Transitioning to life outside of work is made easy for me by my two children, Joshua and Alissa, ages seven and nine. They keep me busy playing games, watching Disney movies, and helping with their academics. We enjoy outdoor activities and spend our weekends in amusement parks, beaches, or relaxing at home. When I have some free time, I enjoy reading, working on PA advocacy initiatives and serving on several committees.

My overarching goal is to increase awareness on the benefits of allowing PAs to practice in all aspects of women’s health. We are knowledgeable in all aspects of medicine, capable of providing high-quality care, and can help address the looming physician shortage as well as the maternal morbidity and mortality crisis. I believe it is time to augment women’s healthcare and we are the solution.

Contact Melissa Rodriguez, DMSc, PA-C, at [email protected].

This article was originally published in December 2021.

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