Dear Doctor,

Thank you so much for referring your patient to us.

They had a lot of medical coordination needs and we really appreciate the referral.

Thank you for knowing they needed help.

Please understand that this part I do gets ugly most of the time.

The mess, the wound underneath, the deep rotting spot that causes these barriers and gaps to care are tender to touch, and they oftentimes are guarded with mighty weapons of defense.

Thank you for understanding the time it takes to build relationship here before you’ll see tangible and lasting change.

Thank you for remembering that no matter how much “healthcare has shifted”—how you really help the heart of another has not…

It takes time, compassion, patience, and consistency to keep showing up.

It takes hard conversations that are invasive and difficult.

Thank you for understanding that there’s a whole full time job worth of work behind that 3rd no show appointment when we are following.

Thank you for understanding that we did tell them what needed to be done. We told them why the appointment was necessary, but they don’t have a car.

They had to use the gas money to pay the light bill.

Their phone got turned off and they missed their scheduled ride.

The grocery costs have inflated so much, they had to use the gas money they had to drive to the food bank instead of your recheck visit.

Thank you for seeing the canyon dividing them from success right now.

Thank you for teaching them about their medical diagnosis in simple terms, and don’t make them come to see you just to come, when there are obstacles like these in play.

You see, the medical plan of care set out before a patient is just one part of the equation. Behind most every child, is a parent. A parent who is trying to work a job, pay the bills, put groceries in the cabinets and do right to take care of their children.

Thank you also for remembering that every single medically complex child you see has another doctor for every sub-speciality they have to see also asking them to do almost everything you are…

Not only that, they have brothers and sisters that need things, too….

And for most, it gets to be too much.

The weight suffocates and paralyzes.

There are basic life needs that are becoming more and more real in 2026 than ever to try to continue to support, and it’s getting hard out here.

Thank you for taking a step in their path for a second.

Thank you for being patient, unrushed and thorough in the visit when they come in to talk to you— thank you for seeing them, actually seeing their story.

Because behind every child, is a family, just like yours, and mine.

Warm Regards,

Your Nurse Case Manager