5 - Application
1. Making medicine a ministry
If we are
to consider medicine as a ministry, we must consider what it means to minister.
A. Maintaining
a good attitude
Phil. 2:14-16: Do all things without grumbling or disputing;
so that you will prove yourselves to be blameless and innocent, children of God
above reproach in the midst of a crooked and perverse generation, among whom
you appear as lights in the world, holding fast the word of life, so that in
the day of Christ I will have reason to glory because I did not run in vain nor
toil in vain.
When we
have a good attitude and do not complain, we stand out as lights in a dark
world. Complaining and quest for “fairness” are the norm in our society. But
God never said that life would be fair. In fact, He went as far as to say that
we are blessed when the world is unfair to us (Matt. 5:11-12). Therefore He calls us to accept the circumstances
that are beyond our control, work hard, and be thankful for all that He has
given us. Besides, it is often in these times of hardship that we truly see the
power of God in our lives. When we live this sort of life, people notice, and
God is glorified. We need to take on this attitude in the clinic, in the
hospital, and on call.
B. Our
demeanor: extending compassion
Christ
felt compassion for people. This compassion was often his motivation for
preaching, healing, and feeding the 5000 (Matt.
14:14-21). As healers, we are called to have compassion on our patients. As
sinful human beings, we don’t have an ounce of compassion in us. Therefore, it
is imperative that we stay rooted in Christ, maintaining our relationship with
Him, so that He can extend His compassion through us.
Before we
even talk to a patient, our actions portray an image that the patient discerns.
If our actions do not match our words, then our words will fall on deaf ears.
What are some ways that we can communicate God’s compassion through our
actions?
1. Look
at the chart before going into the room. You will then be able to call patients
by name, address their chief complaint, and know past medical history. Because
you know about them, they will feel that you care. Furthermore, you will now
not be reading the charts as the patients are trying to talk to you.
2. Sit
down. No matter how much time you spend in the room, sitting conveys a feeling
that you are spending time with your patients and not rushing.
3. Orient
yourself toward your patients and look at them while they are speaking. This
body language shows them that you care about what they are saying.
4. Touch
your patients. Physical contact during the physical exam conveys compassion and
self-sacrifice since you are touching an “untouchable” sick person. Jesus
touched lepers as He healed them (Mark
1.40-42).
C. Humbling
ourselves:
Christ
commanded us to humble ourselves before Him and others. We as leaders are to
take the part of servant:
Matt. 20:26-28: But Jesus called them to Himself and said,
“You know that the rulers of the Gentiles lord it over them, and their great
men exercise authority over them. It is not this way among you, but whoever
wishes to become great among you shall be your servant, and whoever wishes to
be first among you shall be your slave; just as the Son of Man did not come to
be served, but to serve, and to give His life a ransom for many.” (See also Matt. 23:11-12, John 13:5-17).
We can
carry out this command in our relationships with our patients, our
subordinates, and our coworkers. We should never use our position and status as
reason to look down upon others or consider ourselves too important to do the
most menial tasks.
Rom. 12.3: For through the grace given to me I say to everyone
among you not to think more highly of himself than he ought to think.
Suggestions
for doctors and residents:
If a
nurse needs help with patients or cleaning a room, do it.
As an
upper level resident, help the interns and medical students with some of their
busy work if they are getting behind.
Consider
letting your staff call you by your first name.
D. Bearing our
patients’ burdens:
to your
patients. But think what the other nurses or staff would think when they see
you ministering in such a way. It could be quite a testimony to your coworkers
as well as your patients.
E. Being
vulnerable:
“The
doctor is effective only when he himself is affected. ‘Only the wounded
physician heals.’ But when the doctor wears his personality like a coat of
armour, he has no effect.” Carl Jung
2 Cor. 1:3-7: Blessed be the God and Father of our Lord
Jesus Christ, the Father of mercies and God of all comfort, who comforts us in
all our afflictions so that we will be able to comfort those who are in any
affliction with the comfort with which we ourselves are comforted by God.
We must
share ourselves with our patients. This is not easy, since our human nature
tells us to be closed and therefore safe. We are taught that the doctor-patient
relationship is a one-way street. However, Biblical relationships require
openness on both sides. Through sharing our pain and afflictions, we minister to
others in their affliction.
F. Addressing
more than just physical needs.
Remember
the biopsychosociospiritual model, which is based on the Biblical concept of
shalom, or wholeness. Here are some examples of how you can practice medicine in
a more holistic way:
The
History: The ministry of listening
1. Admission
and new patient H&P’s: Expand the social history. Ask about employment,
marriage, children. Ask what religion, denomination, and church they belong to.
Ask them if religion is an important part of their lives. Ask if they pray and
read the Bible regularly. Ask them what gives them purpose, hope, and peace.
2. New Ob
exam: Again, expand the social history. Psychological and spiritual aspects can
be added. Find out how the patient and her partner feel about the pregnancy.
What are their hopes for a family? Bridge into spiritual questions, such as
whether she is going to church, and if she is praying for the baby and the
pregnancy. Find out the father’s spiritual beliefs and his spiritual
leadership in her life.
3. Well-child
visits: After the typical questions such as sleeping and eating habits, inquire
about the home structure. What kind of family support does the child have? Is
there a father in the house? Are the parents married? How is the couple adapting
to a new child? What type of discipline do the parents plan to use? Ask if the
family is going to church, if they pray together, and if they read the Bible or
Bible stories to the child.
4. Routine
visits: Inquire how the patient has been doing. If they just mention the chief
complaint, then after you have discussed that, ask them how things are going in
their work, or with their family.
Write down pertinent information such as place and
type of employment, and the names of the spouse and children. Ask and write down
what hobbies they enjoy. This helps in future visits to establish a stronger
bond.
You should already know whether the patient goes to
church from the initial history. Ask how church is going, whether they are
growing spiritually. Write that down. Ask if they are praying and reading the
Bible, and if they are getting much fellowship. Ask them if these practices are
fulfilling their spiritual needs.
Ask if there is anything for which they would like
prayer. Write it down. Offer to pray right then.
Assessment
and Plan: The ministry of proclaiming
Based on
the above history, you can get a good idea about a patient’s social,
psychological, and spiritual health. We may have little direct impact on social
aspects, but we can certainly work to heal psychological and spiritual illness.
Often these changes then improve the social situation as well.
In terms
of a spiritual assessment, you could even write a separate problem in the
problem list, marked “Spiritual,” and
make a quick comment on where the patient currently is and what you might plan
to help him or her grow in that area. Comment on any counseling you rendered and
whether you prayed with the patient. Specific spiritual counseling might
include:
1. Adults:
a. Share the gospel if appropriate, encourage involvement in a local church or
group of believers, encourage time reading the Bible and in prayer.
b.
Carry a list of verses applying to a variety of situations, and write
down one or two applicable verses, maybe on a prescription pad.
c.
Keep a list of good Christian books to recommend according to the
particular need.
d.
Recommend a particular book in the Bible, such as one of the Gospels for
a nonbeliever.
e.
Give out tracts or Bibles to nonbelievers.
2. Ob
visits: a. For the sake of time, the first visit doesn’t have to include
everything. For example, you can get the history and maybe get a quick
ultrasound on the first visit. Then on the next visit do the pelvic exam and
blood work.
b.
Give out a Christian book about pregnancy on the first visit.
c.
Pray with the patient about the pregnancy.
d.
Encourage the patient spiritually.
3. Well-baby
visits:
a.
Advise the parents to pray and read the Bible to their child.
b.
Discuss with them about the need for the child to develop a strong moral
code.
c.
Give out Christian parenting books such as Baby
Wise.
d.
Recommend Christian videos such as Veggie
Tales instead of regular TV.
Certain circumstances may warrant sharing the
Gospel. Since different patients are in different places spiritually, the
particular method in which you share the Gospel will vary. Furthermore, it does
not have to all occur during one visit. An example given by William Fay in his
book “Share Jesus without Fear” includes the following questions and
appropriate responses:
1. Do
you have any spiritual belief?
2. To
you, who is Jesus?
3. Do
you think there is a heaven or hell?
4. If
you died, where would you go? If heaven, why?
5. If you knew your beliefs were wrong, would you want
to know?
If you
don’t ask all of the questions in one visit, write in the chart which
questions you asked and what the response was. Then in a subsequent visit,
continue where you left off.
G. Time
Incorporating
a more holistic approach to healthcare, listening, being compassionate; these
all take time. And a busy doctor just does not have that time. Are these all
hopeless dreams? How can we spend the time necessary to better take care of our
patients? Some ideas for doctors:
1. Limit
the number of patients seen in a day. Many doctors fall into the trap of
increasing their patient volume because of the allure of more money. True, we
need to make a living, but how much is enough? Do you have to make $120,000 per
year? Have you not lived on a much lower salary right in the past? Some people
do have loans to pay off, but even so, the should be able to by get by on 2/3 to
3/4 of what they could make in the interest of time with patients. Time
equals ministry.
2. Let
the nurses and secretaries take care of all the busy work. Let them fill out
paperwork for labs and consults. Let them look for and label medicine samples.
Delegating leads to more time with your patients.
These
ideas do not apply as well to health care providers who work for someone else.
In these cases, the employ has a quota of patients to fill, and so he or she
does not have the luxury of cutting back on numbers of patients. This reality is
especially true in fields like nursing, where there are often personnel
shortages, and hospitals want to staff as few nurses as possible for monetary
reasons. In these cases, there are several options:
1. Work
for a like-minded Christian physician practice that encourages spiritual
interaction with patients. Christian Medical and Dental Associations (CMDA) may
be helpful in such a pursuit.
2. The
only meaningful time you may have to spend with your patients is on your
off-time. I know it is very difficult when you are tired after a long day’s
work to stay even longer in order to minister healing. As can be seen in this
verse, physical healing was considered to be intimately connected with spiritual
healing.
H. Too much to
do?
Don’t
think that you have to carry out everything that we have discussed in every
patient encounter. CMDA holds a seminar called Saline Solution in which they present a method of ministry to
patients based on a concept called “faith flags.” In any given patient
encounter, the health care provider raises a few of these flags, as he or she
mentions faith-related words such as God, prayer, or church. Then the provider
gives the patient freedom to respond to such flags. As a relationship builds
with the patient, the provider can share more and more of the gospel. In this way,
he or she can minister to the patient slowly, in a non-threatening way, taking
little extra time in a busy practice.
2.
Challenging the current health care model
As the
health care crisis continues in America, Christian health care professionals
should lead any changes that need to occur. Most of the changes that we have
discussed have been within the context of the current medical system. But in
that system we will continue to face problems such as too little time for
ministry and working for people who discourage our ministry. So why not think
about some more radical changes, perhaps bringing us full-circle back to the
type of ministry that the early church engaged in. Here are some thoughts along
those lines:
A. If we consider ourselves
ministers of healing, should we charge money for our services?
We have
to earn a living somehow. How about raising support, as missionaries and
para-church workers do?
B. Should we
place ourselves under the authority of the church?
Physical
healing used to be a ministry of the church. Why not reintegrate health care
and spiritual health? Join the staff of a church. You would thus have great
freedom to spend more time with patients either in the setting of a clinic or
through house calls. You would also be able to minister in a much more holistic
manner to your patients.
In
closing, consider the following quote, written 450 years ago:
“It
becomes every person who purposes to give himself to the care of others,
seriously to consider the four following things: First, that he must one day
give an account to the Supreme Judge of all the lives entrusted to his care.
Second, that all his skill and knowledge and energy, as they have been given
him by God, so they should be exercised for His glory and the good of mankind,
and not for mere gain or ambition. Third, and not more beautifully than truly,
let him reflect that he has undertaken the care of no mean creature; for, in
order that he may estimate the value, the greatness of the human race, the only
begotten Son of God became himself a man, and thus ennobled it with His divine
dignity, and far more than this, died to redeem it. And fourth, that the doctor
being himself a mortal human being, should be diligent and tender in relieving
his suffering patients, inasmuch as he himself must one day be a like
sufferer.” Thomas Sydenham (1624-1689), English physician, scientist, and
author. He differentiated between scarlet fever and measles, described chorea
and gout, and introduced the use of cinchona bark to treat malaria.