For Dr. Natasha Deshwal, medicine’s power to change lives is everything. Born in England and raised in Fredericton, Deshwal studied medicine at Dalhousie and worked in a Fall River family practice for years. After a car accident, she filled in for a while for another doctor (a position called a “locum,” in medicine), but eventually decided she wanted her own practice. She opened the Bedford Basin Women’s Clinic in 2010.
“While working in the walk-in clinics, as a family physician I was really very sad to see so many of our young girls and women coming through our doors for Pap smears,” she says. “And for some of the women it was the first time they had ever had a Pap smear. And it just seemed it was not the right environment. So I thought I might be able to do something that was a little more helpful for these women and a little more comfortable.”
Halifax Magazine spoke recently with Deshwal about her practice, what she loves about her work, and why it’s important to give power back to patients.
What is the philosophy behind this clinic?
For us it’s all about empowerment… when you leave, the questions you came with were answered… I need to make sure you understand what’s going on, that we have a plan in play. So if we don’t have an answer today, we’re going to do this, this and this, and that will help guide us in determining what’s going on, thus guiding our treatment plan. Any positive test results obtained while the patient is at [our clinic] is our responsibility to ensure follow-up is done and not left to be the responsibility of their family doctor.
What’s the response your from your patients?
They are absolutely thrilled. And I constantly find that humbling. I had a lady come in once and she was really unhappy we weren’t taking family patients. She said, “I don’t know why I am here.” And my receptionist said, “I think you should keep your appointment.” And she came in and said, “Wow, that was the best appointment I had.” The fact that I can make a difference in someone’s life, that’s what this is all about.
What do we need to do to fix health care?
We have amazing doctors here in the province and I think we are so fortunate and blessed to have those doctors. And I’d really like to see those doctors be able to stay. I hear that constantly from patients that we don’t have enough family physicians. It really saddens and breaks my heart that our young doctors are leaving because they don’t think they have the opportunities here. And sometimes the grass looks greener on the other side, but I think we have so much to offer. I just hope the doctors’ practices that are struggling to survive can hold on until more doctors arrive.
What is right about our health-care system?
We can still access our health care, in what I still think is a timely fashion. Our patients can pick up the phone and make their own appointments at Bedford Basin’s Women’s Health Clinic and Mill Cove [Family] Medical to see us. For example, if they wish to have their Pap smear done, they can book it and we will do it if they meet the current N.S. guidelines or if there are circumstances indicating that it should be done. It does not mean that patients can call a specialist’s office and that they will be seen. They will still need a referral from the family doctor in those situations. We do have, in some cases, long wait times. However, we know from our family practice side, for example if someone was seeking a surgical consult and were willing to travel, we can send them to Truro or Amherst even. There are ways to help within the system and knowing what to do, I think, is really important. So I don’t think our system is at a total loss, despite what people say at times.
Do you teach patients to take control of their own health, too?
Yes. Part of it’s not just knowing that your Pap is now going to be once every three years if you are over the age of 21 and are sexually active, have had normal Paps in the past, and if there an adequate negative screening history in the previous 10 years [which means three or more negative tests] or if you have either had a minor abnormality on a Pap which resolves spontaneously or an abnormal Pap referred for colposcopy, but not requiring any treatment or a negative tissue diagnosis for an abnormal Pap. It’s also about learning the other parts of your health care. So if you’re sexually active, let’s talk about your sexual health. Let’s make sure that if you’re in a new relationship, you know that condoms are really important as are making sure you’re getting screened for chlamydia and gonorrhea. But it’s about the other things: are you exercising? How’s your calcium intake? Those things are just as important as getting a Pap smear done on a timely basis but many people don’t know that. Sometimes it’s about having the time to sit down and ask all of those questions. It’s a lot of information, but at the end of my day, if people walk away with one thing they didn’t know before, I consider that a success.
What is your long-term plan for the clinic?
More doctors. I think you should come here to work because most everyone who’s worked here has loved it here. There is very little turnover. It’s a very laidback environment. There is no hierarchy between the doctors and the staff. Our staff treat us with respect and we treat them with respect. We have a great support staff and we appreciate how much work our staff do for us. It’s a very friendly work environment with the staff and also between the doctors themselves and I think that’s what makes us work so well. When I arrive here in the morning, I always open the door and say “hi” to my ladies. And that is like clockwork. They know that. Everyone, all the family doctors and specialists in the clinic here are, really caring about their patients. I don’t think you can go wrong coming to work with us.