By Melissa A. Walker, DO

“You Have No Idea”

One Doctor’s Journey to Address Disparity While Combatting Burnout and Judgement

By Melissa A. Walker, DO

Several months ago, I attempted to hire back to my practice a young lady who had worked for me two times in the past. The first time, I employed her after she did her medical assistant externship with me. She worked for a brief time and chose to quit because of some personal family problems. I recall this being around Christmas of that year. I remember this because my husband and I were in Dallas for a New Year’s wedding, and I called her during our trip to give her encouragement about her situation and to let her know how smart I thought she was and how I believed she had a destiny.

She cried over the phone and said that no one had ever spoken anything positive about her. She was the mother of several children, one of whom had severe disability. Weeks later, she reached out to me desiring her job back. I did not hesitate to hire her, because not only did my heart go out to her and her situation, I also found her to be a very skilled medical assistant. She worked for a short while but reported to me concerns about her son’s benefits being affected by her employment and therefore, she quit her job again.

Over the years, she would reach out to me randomly to say hello or to seek some proof of having worked at my office and admittedly, I continued to pray for her when she crossed my mind. I later learned that her son had passed away and attempted to contact her, but her phone number had changed.

With the COVID-19 pandemic has come an overwhelming issue of hiring and/or keeping staff. I initially thought it was because I have a small community practice and couldn’t offer the compensation that larger facilities could. I was soon enlightened by other colleagues from all over the country who work for larger groups and their concerns are the same. In the last several months, I have been a part of what I believe

to be either a bidding war amongst medical staff or being used as a patsy for those who need to show the social service agencies that they are attempting to be hired. Either way, the impact of The Great Resignation has left me and so many other small business owners in a whirlwind.

My frustration and her timing are the reasons I allowed the same young lady to come for a working interview and then offered her a more formal interview. She acted excited about being back at my office and stated that “she was waiting for me to call her.” I had set up for her to do a formal interview with myself and my part-time hiring manager. Before this occurred, she began requesting reduced work hours and other accommodations for her family situation. This seemed remarkably familiar, so I tried to work with her even though she had not been hired. When I told her that I would not be able to meet all her requests, she started crying and said that I was not being understanding of her situation and that she is a single parent now. I commented that I am as well and then she spoke something that totally shocked me. She said, “yes, but everyone wasn’t born with a silver spoon in their mouth….” I thought to myself, “you have no idea….” She did not take the job being offered but went online and posted a very horrible review of me and my practice. Thankfully, I was able to have the posting taken down, but the wound in my heart was very deep. For weeks, I wrestled with the thoughts about how I have spent my medical career serving the underserved, working to be a voice for the voiceless, giving services in my practice and sometimes with no financial compensation.

The thought that all doctors were “born with a silver spoon in his or her mouth” is such a false one. I know this for myself personally, but over a year ago; I had the opportunity to review some reflections that our learners wrote secondary to their participation in a Poverty Simulation (PS). This poverty simulation was done online but bears the same concept as those that are done in person and with other healthcare professionals. The goal of the PS is to place the participants in financial situations that cause stress and warrants their being creative to “make ends meet” with an extremely limited budget and with unsuspected family emergencies. With this practice, the participants should leave there with a greater appreciation for the struggles of those who are less fortunate. Many of the reflections voiced a greater sensitivity and understanding of those who struggle with poverty. I recall one learner wrote how he had judged a college roommate in the past for his struggles. He wrote how he had never known any financial struggles, so it was difficult to understand why his roommate always needed some kind of assistance. Many others reflected that the PS scenarios hit close to home for them. Many wrote about how even now as a medical student, they find themselves having to make modifications in spending to take care of their families with the money given for living expenses. Greater were the learners who felt the PS brought about feelings of inadequacy that they had not experienced in many years.

The online review by my former employee also introduced another phenomenon that I believe needs to have some serious reevaluation and oversight. This phenomenon is the online review process for doctors, medical practices, etc. No one takes in account that the writer of such reviews could suffer from mental illness, have substance use disorder, be fraudulent and so much more. Yet, he or she can go online and post the most horrendous things about doctors who are doing their best to preserve the health of their patients while preserving the life of their practices.

Larger hospitals use filters to help to dispel the negative reviews, but many doctors like me do not have the time or the ability to follow such reviews and are left to bear the burden of some angry patient’s wrath.

Even with all that I have written and shared with you, I would not give up my passion or compassion towards those who are the underserved and the marginalized of our community. I know that for every angry, vehement statement that has been made against me, a greater response of appreciation for my assistance is shown by so many. I therefore encourage any doctor who struggles with feelings of burnout and unappreciation to meditate on this scripture:

“Let us not be weary in well doing; for in due season we shall reap, if we faint not.” Galatians 6:9

Citations 1. The Great Resignation is a phenomenon that describes record numbers of people leaving their jobs after the COVID-19 pandemic ends. World Economic Forum, November 29, 2021. 2. “Speaker, ceremonies brighten Commencement 2000; Neurosurgeon shares his journey from poverty” UD Messenger, Volume 9,

Number 3, 2000. 3. “Online physician reviews: Patients are the ones who will suffer,” –

Kaci Durban, MD, Med Pages, August 20, 2017.

Melissa A. Walker, DO, MPA-HS, is a Primary Care Physician and Founder of Carol Clinic for Family-Centered Healthcare. She is an Assistant Professor at the University of the Incarnate Word School of Osteopathic Medicine and a member of Bexar County Medical Society.