Maria Gonzaga was well into her 30s and had been working in health care administration when she had a career revelation. A desk job and arguing with insurance companies just was not fulfilling to her.
The New Jersey native realized that what really interested her and made her truly happy was being able to help patients directly, in a more personal way. Thus, she decided to become a doctor and took the Medical College Admission Test, entering medical school in 2003.
"There are a lot more people who apply to medical school than actually get in," said Gonzaga, 50, of Filipino descent. "I think the number's something like 45,000 a year sit for the MCAT, and 17,000 actually get admission. But it was a big commitment and a big change."
That journey ultimately led her to Columbus about 18 months ago, where she launched a private obstetrics/gynecology practice near Midtown Medical Center, delivering babies at the hospital that's a short walk from her office.
The U.S. Bureau of Labor Statistics estimates there are nearly 22,000 OB/GYN physicians in the U.S., working in various offices, facilities and hospitals. The mean national annual wage for the profession, according to the BLS, is $214,750.
The Ledger-Enquirer visited with Gonzaga recently at her office on Tenth Avenue, discussing her job, why she chose Columbus to start a practice, and what it's like bringing babies into the world. This interview has been edited a bit for length and clarity.
So your mother is a doctor in New Jersey?
She's a pediatrician. She's 76 and still working. We can't get her to stop. That's the reason why she won't move (to a warmer climate).
Becoming an OB/GYN physician is a long process. In the end, why did you choose Columbus as the place you wanted to be?
Yeah, you've got four years of undergrad, four years of med school, four years of residency. Some residencies are longer, like neurosurgery, which is seven. Internal medicine is only three ... But I had had enough of the cold weather in New Jersey and I was like, I've got to go somewhere warm. I had a lot of family in California, so I moved there. But the medical marketplace and the cost of living was very, very high there. After a year of practice, I was like, yeah, I really need to look for a different opportunity. I did a national search and one of the things in my criteria is there couldn't be any snow. (laughs) And I needed to be relatively close to an airport because my parents are still in New Jersey, and the rest of my family is out in California and in Las Vegas.
Did you have multiple locations on your relocation list?
I did, but Columbus was the one that rose to the top ... There was another city in California, plus there was also a job in Fort Wayne, Indiana, and then one by the Quad Cities (a metro area in northwest Illinois and southeastern Iowa) that I was entertaining at that point in time.
What did you like about Columbus?
Actually, it was my Realtor that sold me on the city itself. It's a large enough city that has all the basic things I needed for everyday kind of things. But it's in very close proximity to Atlanta, if I needed to go there, and also very close proximity to the airport ... I do like the Savannah area, and I'm planning on getting down to Panama City pretty soon.
As an obstetrics-gynecology physician, do you tend to bond with patients after seeing them over a period of time?
Yes, and it's nice because you can actually be with people throughout a great portion of their adult life. I see all ages. I start with teens, and young adults, people that are in their reproductive years, and then all of the way up to menopause. I haven't been here long enough to have established that yet, but that's one of the things I hope to do is be able to help people transition through different stages of life.
You're not part of Columbus Regional Health?
No. I have privileges at Columbus Regional, but I'm not a Columbus Regional-employed physician. I'm private practice. This is my company.
What about St. Francis Hospital, which delivers babies now?
I do not deliver babies there.
Why is that?
I don't know. I haven't been in this town long enough. When I got here, that's when they first opened (the baby delivery unit). I was brought here through a Columbus Regional recruitment kind of package. And I like delivering at a hospital that has a Level 3 NICU (neonatal intensive care unit) that can take babies all the way down to 23 or 24 weeks, and that have 24-hour NICU services.
I don't know that much about St. Francis ... I'm sure that there are some (doctors) in the community that deliver at both, but it's kind of hard for me right now because I've gotten so busy. I don't want to be (in the predicament of needing to be) in two places at the same time, because you never know.
How often do you deliver babies?
It depends upon the month. For me, it can be as few as four to six (a month), and I'm anticipating between 14 and 16 later in the summer.
Is that a boom because of the holidays and people simply being together?
We think there's a little bit of the holiday baby thing. Babies that are conceived between Thanksgiving and Valentine's Day, all of those babies deliver sometime between June, July, August, all of the way through October.
What's a typical day like for you? Is it flexible?
It can be flexible if I need it to be. But, typically, if I have any patients in the hospital I'll see them in the morning before I head over to the office. My office hours generally start at 8:30. We can have patients scheduled all of the way to 5 most days, and depending upon how late we're running, it can be until 6 or 6:30. We have one late day, which is Wednesday. I think our last scheduled appointment that day is 5:30 or 6 ... I operate on Thursdays. I do any of my planned surgeries on Thursdays.
What types of surgeries?
Any kind of GYN surgeries, I do them on Thursdays in the afternoon. Planned (baby delivery) C-sections, we generally try to do in the morning before office hours, at 7 or 7:30. The unplanned you can't plan. The vaginal deliveries you can't plan. They come when those babies want.
What type of GYN surgeries are you talking about?
I do a lot surgery for abnormal uterine bleeding. There are minimally invasive surgeries that don't require any kind of incisions. I do a lot of endometrial ablations, a lot of diagnostic procedures to see what's going on inside the uterus. And we do hysterectomies as well, if the patient has failed previous conservative measures. I do them microscopically and open, traditional abdominal. I don't offer robot at this time.
In your practice, you encounter different types of people and lifestyles?
It's amazing. Here, we kind of take all comers. So I have a lot of different people, different economic backgrounds, social backgrounds. It's diverse and actually really nice. I also have a lot of military people and my military folks come from all over the country. They have very different experiences, very different needs.
Is insurance as big of a headache for you as some doctors?
Not as much, because that's what I did in the past. So I at least have a basic understanding of it. And it's not so bad here in Columbus, the insurance environment. It's not heavy HMO, yet, as opposed to California, which is a very rough environment for physicians.
California is heavily regulated?
It's just that it's so controlled by the HMOs (health maintenance organizations) and physicians have very few options and very little negotiating power in terms of what they're going to get paid.
What's the toughest part of your job?
As a physician, it's having to deliver bad news, because most of the things we do are pretty happy. But when they're sad, it's really very sad.
Such as people losing their babies?
Yeah, those are always tough when a mom loses her child, at whatever gestational age. In your mind, you kind of think it's really hard if the baby is close to term, which it is. But it's equally hard for the mom who may be in her second trimester. She's already bonded with that baby. She's already had thoughts and hopes and dreams and wondered about the baby. Or someone who's had recurrent loss.
You offer patient education in your office. What do you cover in general?
The thing that I talk about most is probably the purpose of a pap smear (which checks for cervical cancer). It's amazing to me that 95 percent of women -- it's all different backgrounds -- really don't know why we do a pap smear, what we test for. People think it's an all-encompassing diagnostic test, when it's really not. And there have been a lot of changes in the way we administer pap smears and how often we do them. Patients still don't understand why they have to do them or how frequently they have to do them. So I spend a lot of time telling people that. Because it's their bodies, they should understand why we do things to them.
What's the most rewarding or enjoyable aspect of your job?
I love baby deliveries. It's a privilege to be part of a family's most cherished moment, to watch the emotions on the parents' faces the first time they see their babies, and the first time they hold their babies. It never gets old, ever.
Is it pretty much a breeze or is there risk involved with child birth?
There's lots of risk. Child birth used to be the number one cause of death in women. With every pregnancy, every delivery, I have two patients. I have the baby and I have the mom, and I'm just trying to ensure that everybody stays safe. A lot of it depends upon what the mom's medical problems are.
What else do you discuss with women as part of your practice?
Birth control, STD precautions, especially in young people. There's family planning, what to think about before you even start to want to have a baby, what you can do to help ensure a good, healthy pregnancy from the get-go. Things like pre-natal vitamins beforehand, making sure that you don't have any diseases that have to be treated, making sure that all of your medical problems -- high blood pressure, diabetes -- those kinds of things are all well controlled before you even attempt to conceive.
And the obvious, no alcohol ...?
Oh, yes. And no smoking, no drugs.
Finally, do husbands come in with their wives for appointments?
A lot of them do. It depends, though. Military guys, if they're deployed or out on assignment, they'll come in as soon as they can. But I have some husbands who come to every single visit.
They just want to know what's going to happen with the pregnancy process?
Yes. And they should. It's their baby, too. They need to understand what the pre-natal process is and what they can expect.
Every month, on Saturdays, I have a child-birth education class. It's taught by one of my nurses and she'll go over what to expect with pre-term labor and labor, what we do in the delivery room, what kind of instruments we use, what it means if you're going to have a C-section, and what that recovery is going to mean. We talk about lactation, or breast feeding. I'm a big breast-feeding advocate. And we teach them how to bathe the baby, change the baby. We do that every month and it's for the mom and the dad.
Name: Dr. Maria Gonzaga
Hometown: West Orange, N.J.
Current residence: Columbus
Education: Mt. Saint Dominic Academy in Caldwell, N.J.; Union College in Schenectady, N.Y.; Rutgers University for post baccalaureate -- New Jersey Medical School in Newark, N.J.; internal medicine internship at University of Colorado; and obstetrics/gynecology residency at University Hospital in Newark, N.J.
Previous jobs: Worked in health care administration for many years before entering medical school in 2003; practiced as an OB/GYN in Orange County, Calif., for one year before coming to Columbus
Family: Parents, Fernando and Zenaida (mother is a pediatrician still practicing in New Jersey at age 76), with three younger siblings (one sister and niece living in San Diego and two brothers in New Jersey)
Leisure time: Enjoys playing golf, spending time with a house full of her family when she get the opportunity to visit them, traveling and rooting for the New York Giants football team; also really enjoys taking advantage of local events here in Columbus, such as Riverfest, seeing Swan Lake at the RiverCenter, and even just going to Market Days on Saturdays when she has time