AAP Voices

My husband of 25 years has been telling me for weeks to share my story. I have not wanted to share because I knew the tears would start flowing, just like they did seven weeks ago when I sat 6 feet apart from my two nurse practitioners and told them I had cut their pay.

As a small business owner of a previously thriving primary care office in a medically underserved area, I knew what it was going to take to survive. And I did not want to do it. I did not want to go through it. But I knew I had to, and I knew that I would for my patients, for my staff and for my family.

There have been days when I thought: “I do not know how much longer I can stare at this computer. But then I told myself: “Yes, you do.” However long it takes. However long my patients need me to cry with them or laugh with them, have their kids show me their forts and their pets. The safety and health of my patients and my staff have been my priority.

But the business piece cannot be ignored. If I do not “fight that fight” there will be no Pediatric Junction left. We have been through some hard times over the last 15 years. I have fought breast cancer, had two of my four babies, borrowed money, skipped paychecks, survived a flood — all while doctoring here. So, I told myself that COVID will not take me out.

After I work long hours missing the joy of patient contact, I go home exhausted. I talk to my staff about infection control every day so that we can safely see our well exams. I remind everyone that this health care cannot stop. I reassure our families about our safe protocols and urge them to keep their vaccine visits. Most do, as I am blessed to have a trusting relationship with my patient family.

I daily have to analyze my revenue, my payroll, my expenses, to see how much longer I can be here for my patients. I daily have to go through an algorithm of which mask, how many masks, which gown or scrub jacket, how much distillery made hand sanitizer can I get just to be able to keep my doors open.

It is a blessing that COVID rarely causes serious disease in children. But I shudder to think what will happen to my patients if I am not here to do what we are doing: essential well exams in the morning, virtual exams all day, and sick visits or parking lot exams in the afternoon.

We continue to diagnose urinary tract infections, pneumonia, strep, ear infections. We continue to treat dog bites, burns, fractures. We triage increasing calls for injuries and ingestions. We are refilling patients’ asthma controllers and reviewing their asthma action plans to make sure they have what they need at home.

We are answering questions, not just about COVID, but about breast-feeding, tantrums, sleep problems, developmental milestones and constipation. We are seeing our teens with anxiety and ADHD needing medications adjusted. We are seeing one to two newborns a day for their first pediatrician visit.

So how is it that a small, well-established pediatric practice in central Texas has been overlooked for financial assistance? How is it that we are expected to continue to provide care to thousands of patients but with half of the staff due to our revenue plummeting overnight? How is it that my bank of a decade is unable to even increase my line of credit because they are too busy with COVID crisis funding? How is it that there isn't full universal coverage of telemedicine for both sick and well patients so we can stay connected to our families?

I have told myself I have to quit asking why or how. This is my life right now. I have thousands of wonderful patients. I have two brave, strong nurse practitioners. I have a dedicated staff that courageously comes to work and follows my lead. With help we can continue our mission of keeping children’s health on the right track!

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