As a solo owner of a private medical obstetrics and gynecology practice, the last two and a half years have been a surreal existence in a life of emotional extremes.
At the beginning of the pandemic—before we had information or vaccines—I felt that I, like many physicians, was doing exactly what we always do. We take care of people, showing little regard for our own personal health and safety. We care for our patients the best we can in the way we had taken an oath to do. We wore heavy and uncomfortable protective equipment and we knowingly exposed ourselves to patients who were sick without really considering how this could affect us.
I watched COVID-19 take a toll in those early days; it was mostly a financial burden for me as we slowed down to almost a complete halt for months. No patients meant no income. Things were looking grim. Many practices closed. Many doctors stopped working. I didn't because I felt that this was going to be temporary. As long as I could pay my staff and see the patients that needed to be seen—people didn't stop having babies—I felt that I could and I should keep my doors open. We adjusted. We cleaned. We masked.
As time went on, we were luckily boosted by loans and grants (with endless paperwork for applications and even more for forgiveness) and I thought, "How could I close now? Things are about to get better!" So again, we kept going.
More time passed. Vaccines became available and my office staff and patients were divided on this issue, as was the rest of the country. There was so much bad information out there that no one knew what to believe. I lost office staff. I lost patients. The new waves hit and conditions that had seemed better for a while got bad again. My practice once again was in jeopardy of closure. Once again, we pared down, cut hours, cut some staff, and protected ourselves. I tried again for loans. I am still only one person, and with the second and third waves I started to wonder whether we would be able to forge on. Patients were (mostly) supportive, although waiting a long time for an appointment or finding the office closed when in need of a prescription refill caused some upset.
This most recent COVID-19 wave has hit my office exceptionally hard, infecting a large number of patients, almost all of my office staff, and some of my family. It was not at all unusual for us to see a patient only to have her call us later with the information that she now had a positive test. It was only a matter of time.
I love what I do. But I am tired. Everything is a balancing act. I weigh the positives against the negatives and as long as the positives still come out on top, I will stay. These last two years the balance has swung dangerously close to the negatives winning. But like the COVID-19 infection graph, it has always somehow rebalanced. A word of encouragement, a lovely thank-you note from a patient—these things have pushed the pendulum to swing in the direction of forging on. But falling reimbursements, disbelief in science, and decisions mandating how I practice increasingly falling to companies and people that have no interest in what is best for my patients create a constant and heavy weight on the negative side of an already precariously balanced scale.
This pandemic certainly seems to be something that will be ever-present and that few will escape. It has left casualties in its wake: the long-haulers, the acutely ill, the dying. I am hoping my small private practice does not become one of the fallen.
Dr. Rebecca Levy-Gantt is the owner and solo practitioner of Premier ObGyn Napa, a private practice in Napa, CA. She is also the author of Womb With a View: Tales from the Delivery, Emergency and Operating Rooms.
Disclaimer: The thoughts and opinions in the Frontline Voices initiative reflect experiences of individual ACOG members and do not represent official organizational opinions of ACOG.