Today's Christian Doctor - Summer 2012

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editorial

by David Stevens, MD, MA (Ethics), CEO

An Elephant Size Issue

Use your smartphone to read the historical articles or visit www.cmda.org/reflections

I was amazed! I didn’t know elephants could play soccer, basketball, polo, dance, golf and do innumerable other things, but what really blew me away at an elephant show in Thailand was their painting. I don’t mean slapping paint on paper as Elephas maximus modern art. Their art was well . . . beautiful. One elephant used multiple colors to paint a mother and baby elephant while another created a landscape and a third used soft strokes to form a flower.

After the show, Jody and I climbed steps to a high platform to get into a howdah for a long ride on the elephant through the jungle that was guided by a mahout sitting on our elephant’s neck. Along the way we stopped at elephant “fast food restaurants” where women on high platforms sold us bananas or sugar cane to keep our ride happy.

And you wanted to keep your elephant happy! Unlike horses which avoid stepping on people, elephants will intentionally or accidentally crush feet or other human body parts. That is why they were trained for war and even to execute criminals in the Middle East and Asia during ancient times.

Health professionals are a great deal like elephants. You didn’t qualify for your training because you were dumb; on the other hand, being smart wasn’t enough.

You had to be disciplined and focused as well. While your friends in undergraduate school were out on the town having fun, you were in the library studying. You honed those considerable abilities to a new level when you started medical school.

In large part, these characteristics make you so good at what you do every day.

Unfortunately, what makes you such a good healthcare professional can also be your greatest weakness when it comes to balancing your practice and your family. Like a nineton elephant, you can inadvertently injure and sometimes crush your relationships with your spouses, children, staff and friends.

In these days, it seems like there is a conspiracy to cause your downfall. You have to see more patients in less time. The paperwork, phone calls and exponential growth in knowledge constantly clamor for your attention. Regulations change daily. Finances are tight.

You are squeezed on every side.

So you fall back to the methods that got you through tough times before. You work harder and longer as you try to become more efficient. Your whole life gets out of balance to the point where you are reeling and staggering, and you end up injuring what you value most.

I know. I’ve been there.

It is time for a fresh assessment and a reprioritization. It is time to take a new hold on the brush stroking the story of your life and paint a different picture, a balanced picture, giving proper weight to the most important things. Read on. That is what this issue of Today’s Christian Doctor is all about. As we continue our year-long theme of “Reflections of the Past in Today’s Spotlight,” we’ll be taking a look at topics relevant to helping you paint that new picture. Using historical articles as our inspiration, we’re looking at topics like medical marriage, the medical family, dentistry, malpractice and women in medicine and dentistry from today’s perspective. Don’t forget, you can read the historical articles at www.cmda.org/reflections or scan the included smart tag with your smartphone.

Let me encourage you as you start fresh.

Remember, even a nine-ton elephant can learn to balance on a small ball and you are smarter than an elephant! ✝

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contents Today’s Christian Doctor

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VOLUME 43, NO. 2

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Summer 2012

The Christian Medical & Dental Associations® Changing Hearts in Healthcare – since 1931.

Connected 13 toStaying Today’s Medical Family

We Safer from Medical Malpractice 25 Are in the 21st Century?

by Omar Hamada, MD, and Tara Hamada, MD Establishing the groundwork for a solid Christian family

17 The Marriage Viewpoint

by Ed Read, MD, and Debby Read, RN Studying medical marriages from all angles

by Wendy B. Kang, MD, JD Examining the changes in healthcare affecting today’s malpractice suits

31 Revisited: The Dentist’s Necessary “Ought”

by Peter E. Dawson, DDS The expanding subject of dentistry’s professional ethics

Women in Medicine: 21 Answering a Calling from God

by Autumn Dawn Galbreath, MD, MBA, and Nahid Hotchkiss, PhD Facing the unique problems encountered by women in medicine

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Transformations Classifieds

egional Ministries Northeast Region Scott Boyles, MDiv P.O. Box 7500 Bristol, TN 37621 Office: 423-844-1092 scott.boyles@cmda.org

Connecting you with other Christ-followers to help better motivate, equip, disciple and serve within your community Midwest Region Allan J. Harmer, ThM 9595 Whitley Dr. Suite 200 Indianapolis, IN 46240-1308 Office: 317-566-9040 cmdamw@cmda.org

Western Region Michael J. McLaughlin, MDiv P.O. Box 2169 Clackamas, OR 97015-2169 Office: 503-522-1950 west@cmda.org

Southern Region William D. Gunnels, MDiv 106 Fern Dr. Covington, LA 70433 Office: 985-502-7490 south@cmda.org

Interested in getting involved? Contact your regional director today!

TODAY’S CHRISTIAN DOCTOR®

transformations

EDITOR Mandi Mooney EDITORIAL COMMITTEE Gregg Albers, MD John Crouch, MD Autumn Dawn Galbreath, MD Curtis E. Harris, MD, JD Van Haywood, DMD Rebecca Klint-Townsend, MD Robert D. Orr, MD Debby Read, RN VP FOR COMMUNICATIONS Margie Shealy AD SALES Margie Shealy – 423-844-1000 DESIGN Judy Johnson PRINTING Pulp CMDA is a member of the Evangelical Council for Financial Accountability (ECFA).

TODAY’S CHRISTIAN DOCTOR®, registered with the U.S. Patent and Trademark Office. ISSN 0009-546X, Summer 2012 Volume XLIII, No. 2. Printed in the United States of America. Published four times each year by the Christian Medical & Dental Associations® at 2604 Highway 421, Bristol, TN 37620. Copyright © 2012, Christian Medical & Dental Associations®. All Rights Reserved. Distributed free to CMDA members. Non-doctors (US) are welcome to subscribe at a rate of $35 per year ($40 per year, international). Standard presort postage paid at Bristol, Tenn.

Postmaster: Send address changes to: Christian Medical & Dental Associations, P.O. Box 7500, Bristol, TN 37621-7500.

Undesignated Scripture references are taken from the Holy Bible, New International Version®, Copyright© 1973, 1978, 1984, Biblica. Used by permission of Zondervan. All rights reserved. Scripture references marked (KJV) are taken from the King James Version. Scripture references marked (MSG) are taken from The Message. Copyright© 1993, 1994, 1995, 1996, 2000, 2001, 2002. Used by permission of NavPress Publishing Group.

Scripture references marked (NASB) are taken from the New American Standard Bible®, Copyright© 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995 by The Lockman Foundation. Used by permission. Scripture references marked (NIV 2011) are taken from the Holy Bible, New International Version®, NIV® Copyright© 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission. All rights reserved worldwide. Scripture references marked (NKJV) are taken from the New King James Version.

Copyright© 1982 by Thomas Nelson, Inc. Used by permission. All rights reserved. Other versions are noted in the text.

For membership information, contact the Christian Medical & Dental Associations at: P.O. Box 7500, Bristol, TN 37621-7500; Telephone: 423-844-1000, or toll-free, 1-888-230-2637; Fax: 423-844-1005; E-mail: memberservices@cmda.org; Website: http://www.joincmda.org.

Transformations: Bringing CMDA’s vision statement to life within the pages of Today’s Christian Doctor.

This section focuses on highlighting the inspirational and personal stories and testimonies from our members and ministries. It will truly show the impact that CMDA is having on healthcare and the world through your words, through your comments and through your experiences. It is our hope that you will read these transformations and be inspired to be transformed yourself.

Local Chapter Meets With U.S. Congressman The Tri-Cities TN/VA CMDA Chapter recently held an evening of food and fellowship at CMDA’s headquarters in Bristol, Tennessee. Congressman Phil Roe, MD, served as the guest speaker for the event to discuss the latest developments in Washington, D.C. regarding healthcare right of conscience. The event offered local students and practicing physicians the opportunity to discuss this important topic on a personal level with their state representative.

Presently representing the first congressional district of Tennessee in Congress, Dr. Roe is a leader in community involvement and public service. He serves on three House Committees which directly allows Phil to address and influence many issues important to healthcare professionals and students.

Dr. Roe is a native of Tennessee and now resides in Johnson City. He earned a degree in Biology with a minor in Chemistry from Austin Peay in 1967 and he earned his medical degree from the University of Tennessee in 1970. Upon graduation, he served two years in the United States Army Medical Corps. As a physician, he established himself as a leader in healthcare while running a medical practice in Johnson City for 31 years.

Additionally, Dr. Roe served as the Mayor of Johnson City from 2007 to 2009, having previously served as vice mayor from 2003 to 2007.

For stay updated on the latest developments in the fight to protect healthcare right of conscience, visit www.cmda.org/washington.

If you are interested in submitting articles to be considered for publication, visit www.cmda.org/publications for submission guidelines and details. Articles and letters published represent the opinions of the authors and do not necessarily reflect the official policy of the Christian Medical & Dental Associations. Acceptance of paid advertising from any source does not necessarily imply the endorsement of a particular program, product, or service by CMDA. Any technical information, advice or instruction provided in this publication is for the benefit of our readers, without any guarantee with respect to results they may experience with regard to the same.

Implementation of the same is the decision of the reader and at his or her own risk. CMDA cannot be responsible for any untoward results experienced as a result of following or attempting to follow said information, advice, or instruction.

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transformations CMDA Member Awards

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2012 Educator of the Year Award – Dr. Bruce MacFadyen

2012 Missionary of the Year Award – Dr. Bruce Dahlman

Dr. Bruce MacFadyen has spent his career as a surgeon and his life as a follower of Christ focused on serving as a bridge to lead others to Christ. He has been a contributor to multiple educational roles through the course of his lifetime of service in academic medicine and medical missions.

He graduated from Wheaton College in 1964, and from Hahnemann Medical College and Hospital in 1968. He completed his residency in General Surgery. He served as Chairman of Surgery at the Medical College of Georgia, and is now transitioning to Professor of Surgery at the University of Texas Medical School in Houston part-time to spend a large proportion of his time teaching surgery at mission hospitals. His academic career spans more than 40 years, and he has written many articles in surgical journals, edited two surgical textbooks and served as the editor of two surgical journals. He’s also received multiple awards for his teaching excellence in addition to being considered one of America’s top surgeons. Dr. MacFadyen uses his medical skills to further the kingdom through patient relationships, mentoring students and teaching on the mission field.

A lifetime member of CMDA, he is a member of the Continuing Education Committee, previously was the surgical dean for the CMDE conferences and served on the MEI Commission for many years. He is also a founding member of PAACS, serving as chairman of the commission for a number of years. In this role, he helps develop residency programs in African mission hospitals to address the challenges of healthcare and medical missions in one of the neediest parts of the world.

Working as a rural family doctor and a medical faculty member in the U.S. and serving as a missionary doctor, administrator and teacher in Kenya for the past two decades, Dr. Bruce Dahlman is committed to the importance of education, mentoring and discipling both at home and on the mission field. He was raised in a strong Christian home in Minnesota and learned about missions at an early age. He graduated from the University of Minnesota Medical School in 1981, and completed his residency at the University of North Dakota School of Medicine in 1984. Dr. Dahlman and his wife Kate have three children.

In 1992, Dr. Dahlman and his family answered God’s call to serve at AIC Kijabe Hospital in Kenya. His duties have varied at numerous locations, including overseeing teaching units, writing grants, establishing an ICU, contributing to relief work efforts, providing supervisory efforts to national teaching hospitals and much more. He was an integral participant in outreaches among the Maasai that have multiplied into several thousand believers in a dozen churches and a primary school serving more than 500 children.

He continues to serve cross-culturally with positions in both the U.S. and Kenya. At the University of Minnesota, he is mentoring immigrant physicians from underrepresented communities. Both Bruce and Kate also serve as AIM International Health Ministries Advisors. He serves as the Development Director for the Institute of Family Medicine, focusing on fundraising and recruiting family medicine educators to assist in East African residency teaching.

Dr. Bruce MacFadyen and his wife Rosemary accepted the Educator of the Year Award from Dr. John R. Crouch, Jr. (right).

CMDA President Dr. John R. Crouch, Jr. (right) presented the Missionary of the Year Award to Dr. Bruce Dahlman.

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Editor’s Note: The following awards were presented at this year’s CMDA National Convention.

These articles are excerpted from the actual award citations which can be viewed at www.cmda.org/2012awards.

2012 Servant of Christ Award – Dr. Carroll Stone

2012 President’s Heritage Award – Dr. Pete Dawson

Dr. Carroll Stone’s testimony of faith in Christ is spiced with 56 years of practice experience and wisdom, the platform upon which he has influenced his colleagues, his profession and the world around him.

He met his wife Althea while attending Wheaton College and graduated from Boston University School of Medicine in 1946. He took his post graduate medical training in the U.S. Navy where he attended the Navy Deep Sea Diving School and the Submarine School in Connecticut. During the Korean War, he supervised the newly formed Navy Seals in the training and use of scuba gear.

After the war, he began a private practice in Massachusetts. Eleven years later, he and Althea felt God’s call to move with their five children to Oxford, Mississippi. During his tenure in Oxford, he served in many capacities, including chief of medicine for 10 years, director of home health and hospice departments and others. In 1996, he became the medical director of Oxford’s VA nursing home, which he directed until retiring in 2004.

He has pastored the Covenant Church of North Mississippi since being ordained in 1979, and was a volunteer chaplain at the Mississippi State Penitentiary for 10 years. In 1993, Dr. Stone made his first mission trip to China, subsequently invited by the Chinese government to return. Since then, he has led 10 teams to the Sichuan province to teach Western methods to Chinese professionals. A lifetime member of CMDA, he established a CMDA chapter in Oxford where he serves as president.

Dr. Pete Dawson shares a parallel desire with CMDA to spread the gospel to the world. He holds a prominent position to influence the dental community, and he focuses on using that opportunity for God’s glory. Considered by many to be the most well-known name in the field of dentistry, Dr. Dawson’s dental career spans more than 50 years.

He graduated from Emory University School of Dentistry in 1954, and was quickly recognized as a leader in his field. He is the founder and director of The Dawson Academy in St. Petersburg, Florida, a teaching center where active clinicians from all dental specialties combine their expertise to search for better understanding of dental diagnosis and treatment. Since its establishment more than 40 years ago, thousands of dentists from around the world have attended his seminars. He is the author of Evaluation, Diagnosis, and Treatment of Occlusal Problems, the alltime bestselling dental textbook.

Dr. Dawson married his wife Jodie in 1957. They had both been raised in religiously observant homes and raised their four children to follow that same path in the hope of earning their way into heaven. They both came to realize that they had never fully understood the message of the cross. After years of biblical study and fellowship, his faith grew to become the central theme of his life. That new Christ-centered purpose helped him to understand that his position in the dental profession placed him in a unique situation to share his faith with others. He now incorporates his faith into his work and lectures.

Dr. Carroll Stone received the Servant of Christ Award, but was not able to attend the convention.

Dr. William Poston accepted the award on his behalf (inset).

Dr. Pete Dawson received the President’s Heritage Award from Dr. John R. Crouch, Jr. (right).

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transformations Using Encouraging Scripture in a Medical Practice

by William D. Black, MD For 32 years, I practiced Nephrology and Internal Medicine in my hometown of Knoxville, Tennessee. I’ve been a CMDA member for more than 10 years. To create continuity I often did primary care on my patients with chronic kidney disease. On one occasion, I referred one of my patients for physical therapy. The next time I saw him, he told me about a conversation he had with the woman helping with his physical therapy. When she found out I was his doctor, she began to share the story of her husband’s illness.

Many years before, her husband sustained a terrible crushing accident while on the job, resulting in multiple injuries including Acute Renal Failure. With all our powers of modern medicine, we were able to keep him alive for about a month. When he died, his wife was very angry with God. She had five small children she was going to have to raise by herself. She decided she was going to give up on God. Although she never shared these negative thoughts with me after her husband died, I gave her a list of encouraging Bible verses. These were passages I had collected from Scripture readings in church, verses heard over Christian radio and passages I gleaned from my own private devotions. The references were:

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The Scripture passages touched her heart, and she decided not to give up on God. She told my patient all her children were now grown, saved and attended church. She attributed the spiritual welfare of herself and her children to that small list of verses I happened to give her in passing.

We so often don’t appreciate how random acts of kindness and spiritual encouragement can have eternal significance. Our patients and their families offer daily opportunities for us to use the practice of medicine as a ministry for Christ. For more information about ways you can incorporate your faith into your practice, visit www.cmda.org/PAR to see the resources CMDA makes available through Prescribe-A-Resource.

CMDA Receives 4-Star Rating

In Memoriam

Earlier this year, CMDA was honored to receive a four-star rating from Charity Navigator, the nation’s leading charity evaluator for assessing the effectiveness of non-profit organizations. Out of the 1.6 million charities in the United States, only 1,410 charities received this designation. This honor is unique because charities can’t apply for it. Charity Navigator objectively reviews the financial statements and tax filings of non-profits around the country, determining those that have the lowest overhead and return the highest percentage of gifts to program beneficiaries.

In addition to this latest rating, CMDA is also a member of EFCA, the Evangelical Council for Financial Accountability. As a member, we receive accreditation by faithfully demonstrating compliance with established standards for financial accountability, fundraising and board governance. We remain dedicated to being good stewards of the resources Christ has given us. As such, we apply that principle to our fundraising efforts and are committed to the highest standards of integrity.

When you contribute financially to CMDA, we know you place your trust in us. We value that trust and remain focused on honoring it through the work of our various ministries. For more information about contribution options, please visit www.cmda.org/giving.

Ann Swaidmark Macaulay went to her heavenly home on Friday, February 17, 2012. A loving wife, mother and friend, Ann had a deep love for the Lord and was a consistent Christ-like example to everyone she met.

She was preceded in death by her husband Rev. Sidney Stuart Macaulay in 1991.

Prior to his death, Sid was a Regional Director for CMDA (formerly CMDS) for many years and also served as the editor of the Christian Medical Society Journal for almost 10 years. Together, they touched many lives through their ministry.

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transformations . . . on Campus “I see CMDA as a source of light in our medical school.

Our training to become physicians is incredibly valuable, but it requires an immense amount of energy and emotion.

In this high-stress atmosphere, it is easy to lose sight of what really matters. CMDA is, I believe, a group that can help bring encouragement to those who are weary.”

– An M3 Student “I met with a potential first year leader who discussed with me the amount of growth in his spiritual life due to relationships formed within CMDA. He’d pretty much gone off the deep-end during college, but since joining CMDA he has seen God do amazing things in his life.”

– A Midwest Associate Staff Member

. . . in Public Policy “I’m glad to see some traction finally coming from all your work on the issue of human trafficking. The medical community is such an important group to get trained on this issue. I don’t know if I shared that I gave a talk a few months ago to the emergency medical staff of a hospital in Columbus. I gave it on a Friday, and that weekend, because of my talk . . . a victim of trafficking was identified and freed! It really happens all around us!”

– A CMDA member

. . . in Families

Seen

& Heard

“CMDA really changed our lives. Our first real experience was attending a CMDA conference at Deer Valley Ranch here in Colorado. We took our three youngest daughters with us and enjoyed a week long spiritually nourishing and restful and relaxing time. We met other great CMDA families and formed some great friendships. The things we learned through the powerful speakers helped us through many difficulties and dilemmas in medical practice. They also equipped us to help patients and better understand our role in their medical care. Personally, we grew in our walk with God. I know that I am a much better and wiser person from what I learned.”

– A CMDA member

the CMDA voice

“I loved it . . . challenged me . . . allowed me to refocus and rekindle my marriage, it truly was enriched.”

– An attendee at a Marriage Enrichment Weekend “What a wonderful time to be with others who love the Lord and desire to improve their marriages.”

– An attendee at a Marriage Enrichment Weekend

Website Directory Transformation

Equipping

Campus Ministries cmda.org/student Chapel & Prayer Ministries cmda.org/chapel Community Ministries cmda.org/ccm Dental Ministries cmda.org/dentist Medical Malpractice cmda.org/mmm Side By Side cmda.org/sidebyside Singles cmda.org/singles Specialty Sections cmda.org/specialtysections Women in Medicine & Dentistry cmda.org/wimd

Christian Doctor’s Digest cmda.org/cdd Conferences cmda.org/meetings Doing the Right Thing cmda.org/rightthing Donations cmda.org/donate Human Trafficking cmda.org/trafficking LifeSkills Institute cmda.org/lifeskills Today’s Christian Doctor cmda.org/tcd Weekly Devotions cmda.org/devotions

Voice Service Center for Medical Missions cmda.org/cmm Global Health Outreach cmda.org/gho Global Health Relief cmda.org/ghr Medical Education International cmda.org/mei Membership joincmda.org Pan-African Academy of Christian Surgeons cmda.org/paacs Placement cmda.org/placement Scholarships cmda.org/scholarships

American Academy of Medical Ethics ethicalhealthcare.org Washington Office cmda.org/washington Freedom2Care freedom2care.org

Social Media Blogs cmda.org/blogs Facebook facebook.com/cmdanational Twitter twitter.com/cmdanational YouTube youtube.com/cmdavideos

. . . in Practice “Several months ago, you talked to me on the phone about an [unexpected clinical complication]. It was very helpful for me to be able to talk to you and have you pray for me. She was grateful for the phone call I gave her the next day. Thanks again for your helpful insight and conversation and prayer. You really helped me out that day. Keep up the good work! And God bless you for your faithfulness and kindness!”

– A CMDA member “I shared Dr. Adolph’s story at the beginning of our management meeting yesterday afternoon with our other three committee members. It seems we are facing a lot of the same situations that he describes, although we haven’t yet ‘come out the other end.’ I’m not usually a real emotional guy, but I had a hard time holding it together as I shared with them about God’s faithfulness in this prior situation, and our need to trust in His faithfulness in ours. It set a really good tone for our four-hour marathon meeting that followed, which was the most productive and healthy management meeting that we’ve had since I’ve been here.

Thanks for your encouragement and for putting together The e-Pistle, and please keep up the good work.”

– A subscriber to the Center for Medical Missions’ e-newsletter, The e-Pistle “Truly it was a sheer delight to be with you all Saturday morning—it was EXACTLY what we needed! We really appreciate you following up with us and extending your help and service to us. You know, these past four years of dental practice building has been a great challenge.

We didn’t always make the godly choice or moves led by the Holy Spirit’s leadership—mainly out of impatience and being in reactive mode. Yet, one thing we realize is this, it ALL belongs to God anyway.

Now more than ever, we want to bless and honor our Lord with all He has entrusted to us—no matter what/who it may be.”

– An attendee at the CDA Prayer Breakfast at the Hinman Dental Meeting

Have you been

transformed?

Are you

transforming others?

We want to hear from you Send your transformation story, letter or photos to communications@cmda.org or to P.O. Box 7500, Bristol, TN 37621.

Please include an email address for us to contact you.

We want to hear your story It can be a simple comment about a CMDA ministry; it can be an account of your experiences on a missions trip; it can be a profile of a member who has had a huge impact upon you; it can be photos from a campus meeting; it can be statistics showing how your trip served the needy; it can truly be anything— we want to see how your work is making a difference.

. . . in Missions “We have always felt that this vision would be fulfilled years down the road, maybe 10 years from now. However, God has impressed upon us that the time is now. I felt this so strongly during my time at the Discover the Joy conference. As you spoke, I felt such a stirring of the Holy Spirit.

I fought back tears the entire time, sensing an urgency to pursue God’s calling to medical missions NOW . . . not 10 years from now.”

– An attendee at CMDA’s Discover the Joy conference “Serving on this mission trip with my husband was an unforgettable experience. It encouraged me to seek what God has in store for us as a couple, challenged our self to step up beyond our comfort zone and offered us a practice to give each other grace.”

– A resident on a GHO trip to Nicaragua

We want to hear your ideas Do you have a great idea for Today’s Christian Doctor?

Send your ideas to communications@cmda.org.

Transformations showcasing the impact of CMDA one story at a time

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1950s

1960s

1970s

1980s

1990s

2000s

2010s

1957

1940s

1957

In This Year . . . Around the World - Dwight D. Eisenhower was inaugurated for his second term as President of the U.S. He suffered a stroke later that year.

- Andrei Gromyko became foreign minister of the Soviet Union. The same year, the Soviet Union launched Sputnik 1, the first artificial satellite to orbit the earth.

- The FBI arrested Jimmy Hoffa and charged him with bribery.

- The Treaty of Rome established the European Economic Community (now called the European Union).

- Britain tested its first hydrogen bomb which failed to detonate properly.

- U.S. Senator Strom Thurmond set the record for the longest filibuster with his 24-hour, 18-minute speech railing against a civil rights bill.

- Both West Side Story and The Music Man had their first performances on Broadway.

- The U.S. military sustained its first combat fatality in Vietnam.

In This Year . . . at CMDA - The name was Christian Medical Society, the headquarters were based in Chicago, Illinois, Delburt H. Nelson, MD, served as President and J. Raymond Knighton, Jr., was the Executive Secretary. Due to rapid growth, the headquarters were relocated to a larger office in Chicago.

- CMS was present and active on the campuses of 66 medical schools.

- Regions continued to develop family conferences, and the third annual family conference was held at Deer Valley Ranch.

- About one-fourth of the membership was missionary doctors, and total membership was 1,838.

- A subscription to the bi-monthly published Christian Medical Society Journal was $1 per year.

- Plans were being developed for a new mission strategy which became the forerunner of today’s short-term medical missions trips.

StayingConnected to Today’s Medical Family

by Omar Hamada, MD, and Tara Hamada, MD

Battling the pressures in today's culture to maintain a balance between career and family

Use your smartphone to read the historical 1957 article

Use your smartphone to read the historical 1972 article

or visit www.cmda.org/reflections

I

n some ways, things have radically changed since the “Leave it To Beaver” and “My Three Sons” concepts of the traditional family from the 1950s. Yet, in other ways, things have remained the same.

Regardless, many challenges are being waged against the traditional American family today. With each passing day, the slow but steady advance of tangible threats grows. While some of these threats are easily recognizable, others seem to run under the radar as insidious characteristics of our culture that are eventually accepted as normative. These affect the medical family just as much as they do any other family.

What exactly is a medical family? Why even make a distinction? Is it just the same as any family where one or

both parents have a demanding job? As most physicians have moved away from the grueling and always-on-call life of a solo family doctor, is there still a difference between a medical family and a business executive’s family or an accountant’s family or an attorney’s family?

As Christians and as physicians, many of us hope that there is a difference. We felt a sense of calling into the field of medicine, and we hope that high ideal carries over somewhat to the rest of our lives including our children—so that they understand why we work so hard. And so, we attempt to straddle the delicate balance of spending enough time with our families, and at the same time trying to influence our children to have a servant’s heart that focuses on others in the midst of a “me”-oriented

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Staying Connected to Today’s Medical Family 14

culture. Our generation is blessed with a multitude of options concerning this balance of career and family, but it is not always easy to determine which option is best for our current season of life.

When Dr. Armand Nicholi wrote on this subject in “The Crisis of Family Disintegration” in 1972, there were many new threats to the traditional family—more ubiquitous and enticing television programming, dualearner marriages, the women’s liberation movement, the awakening of the sexual revolution and a cultural shift in family versus individual values.

He referenced a study of child-rearing practices that showed a “progressive decrease” in the amount of contact between parents and their children. So he asked the question, “What makes parents so inaccessible to children?”

As a psychiatrist, Dr. Nicholi specifically spoke to Christian physicians about priorities and avoiding the “famous father syndrome,” in addition to the absent mother. He describes this syndrome as, “. . . the father is held in awe, is distant and gives the child everything but himself. He is so busy providing materially for them . . . that he neglects his family’s emotional and spiritual needs.” Dr. Nicholi cited this decrease in contact as the cause of various maladies seen in his psychiatric practice. Interestingly, he also noted that the only country where children spent less time with parents than the United States at that time was England.

England was also the only country that exceeded the U.S. in violence, crime and delinquency, a statistic that creates an alarming correlation.

I believe many physicians did heed his advice to carefully consider where their families ranked in priority, and listened to his suggestion that loving our neighbor first and foremost includes loving our families well.

However, our families are still very much in danger in our current culture, perhaps now more than ever. It is up to us to continuously re-examine, through prayer and Scripture, where in our families we need to focus on being more actively counter-cultural.

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The beauty of the medical family today is that it can be so varied in regard to career paths and work situations.

There are families in which the father stays home and the mother works full-time, as well as the more traditional families with the father working and the mother staying at home. There are families where both parents work outside the home as physicians, or where one parent is a physician and one parent works in another professional field. We see shift work, outpatient only, inpatient only, academic faculty, part-time, locum tenens and any number of other combinations.

The flexibility we now have that enables us to forge our own road in our professional and personal lives is an amazing blessing. The challenge is to live fully open to how God would lead us to experience His blessing in our current season of life.

Many factors in our cultural lives have likewise changed since Dr. Peterson wrote his article “The Father: God’s Surrogate” in 1957. However, in his article, Dr. Peterson didn’t focus on those cultural factors influencing families; instead, he highlighted the authoritative role of the father in the family. And that is one thing that has not changed with the passing of time. Just as God continues to remain the absolute authority in our lives, the father remains the authority in his children’s lives. One important constant to remain mindful of is Dr. Peterson’s statement, “. . . as I am secure in my relationship to my heavenly Father, my children will be secure in their relationship to me . . . . My children mirror my spiritual relationship with my heavenly Father.”

The most vital and yet easiest step to neglect as we strive toward success in medicine and family is staying connected to our heavenly Father and effectively communicating this connection to our families. How many wonderful parenting or medical books do I consult, and how many wise and godly friends or colleagues do I email before I remember to lay my current challenges and stressors at His feet? It is wonderful to have access to the resources we have available, but He will often narrow our search for a diagnosis and solution to our personal problems if we will but ask. He reminds me

admittedly not a perfect family with perfect people, I am personally at a loss to think of even one who has gone astray. Dr. Rad Andrews, a general surgeon in Memphis, Tennessee, was recounting some of the things his mother and father did to ingrain the love of Christ in him and his siblings; the same techniques he and his siblings strive to ingrain Christ’s love in their own children. His parents, the late Dr. “Chubby” Andrews and his widow Margie, taught their children to love the Lord with all their hearts. Rad said that everyone knew his dad was a physician, but recognized that the Lord was more important to him than the practice of medicine. Dr. Chubby Andrews was fearless as a follower of Christ in front of his peers and his patients; though some people made fun of him for his faith, he was not ashamed to live out the gospel in a very public manner. He lived a life of enjoyment recognizing that whatever was happening around him and in his own life, there was always time for family, for grace and for joy. Though he was a very wellrespected and busy surgeon, he preferred to be at home than at work and made every attempt to ensure this was the case. He would make his rounds early in the morning, then return home to have breakfast with

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frequently that my parenting is usually more about His growing me than it is about me growing them. I am beginning to think He gave me four children because He knew it would take me a while to learn each lesson!

I think of the many challenges we agonize over in our families—which shifts and hours to work, how we educate our children, how to have the critical five meals together every week, etc. While these details are important, they are greatly overshadowed by the importance of how we are daily walking with Him. If I allow Him to bathe me in His grace so that it overflows and spills over my children and my spouse, the impact of His presence in our lives will dwarf the fact that I missed dinner last night. Through this time spent in His presence, He will also gently guide us in making all those other numerous decisions at the proper times and in the proper ways. As we learn in Deuteronomy, the first step in godly parenting is inscribing His Word on our own hearts and the hearts of our children.

A great example of this comes to mind. I was talking to a friend of mine recently who comes from a strong Christian family that extends back several generations and now counts several hundred direct descendants in the “immediate” extended family. Though they are

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his family before leaving for work once again. And he strove to make sure that he returned home every evening to have dinner with his family.

At the same time, Rad said there was harmony at home between his mother and father with regard to his dad’s work. Margie recognized that sacrifices had to be made, and she supported her husband wholeheartedly in his quest to provide for his family while at the same time ministering to his patients and others he came into contact with through medicine. The strength of their marriage, and consequently their family, came from Margie’s support, honor and respect of her husband.

She ran the home and was always available for whatever needs arose, while being willing to not work outside the home. The Andrews family also ingrained the love of Christ in their children by maintaining periodic weekly or twice weekly family devotions and prayer.

Those times of family devotion were just as important as eating together at breakfast or dinner. It was their dedication to remaining connected with their family that made such a difference.

Of course, times have changed, and now we no longer can always have a “traditional” family structure.

But what can we learn from successful medical families who have come before us and from the Scriptures to assist us in shaping a strong Christian medical family for the sake of the gospel? Perhaps prioritizing our own personal relationship with the Lord and with our family, as well as living a life of grace, love, honor and respect, will go a long way in helping us maintain a godly home.

The family is under attack. It is disintegrating and the pressures do not avoid Christian or medical families. In fact, they are probably greater. Unfortunately, when pressures mount, we tend to dive into our work even more intently. By changing our focus and making an effort to stay connected more with the Word and with our families, perhaps we can strengthen our families so

that they are built on the Rock instead of on shifting sands.

“Hear, O Israel! The Lord is our God, the Lord is one! You shall love the Lord your God with all your heart and with all your soul and with all your might. These words, which I am commanding you today, shall be on your heart. You shall teach them diligently to your sons and shall talk of them when you sit in your house and when you walk by the way and when you lie down and when you rise up” (Deuteronomy 6:4-7, NASB). ✝

Omar Hamada, MD, and Tara Hamada, MD, are both graduates of the University of Tennessee College of Medicine. Omar is an OB/Gyn and Family/ Sports Medicine physician, the Chief Medical Officer of Advon Healthcare, an ordained minister and a combat veteran of the U.S. Army Special Forces (ABN). He also has an MBA from Vanderbilt and is completing a Masters in Theology at Columbia Biblical Seminary. Tara is a Med/Peds physician who works PRN at Mercy Children’s Clinic in Franklin, Tennessee. She spends most of her time pouring her life into their four children ages 3-12 and running a home in Brentwood.

She is also an active part of Community Bible Study.

They are active members at Fellowship Bible Church in Brentwood and believe that though our calling may be what we do every day, our sole purpose is to advance the kingdom of Christ in all that we do.

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1960

In This Year . . . Around the World - U.S. Senator John F. Kennedy was elected as the 43rd President of the United States.

- The U.S. announced that 3,500 American soldiers would be sent to Vietnam.

- Women were given the right to vote in Switzerland.

- The U.S. Food and Drug Administration announced it would approve birth control as an additional indication for Searle's Enovid, making it the world's first approved oral contraceptive pill.

- The most powerful earthquake on record with a magnitude of 9.5 occurred in Chile.

- Following the admission of Hawaii as the 50th U.S. state in 1959, the new 50-star flag of the U.S. was first officially flown over Philadelphia, Pennsylvania.

- Harper Lee published To Kill a Mockingbird which later won a Pulitzer Prize for the best American novel of 1960.

- Several African nations declared independence from France, including Chad, Niger, the Republic of Congo and Cote d’Ivoire.

In This Year . . . at CMDA - The name was Christian Medical Society, the headquarters were based in Chicago, Illinois, William A. Johnson, MD, was President and J. Raymond Knighton, Jr., was the Executive Secretary.

- The field staff department was formed to help with the union of student work and the emerging ministry among practicing doctors.

- Staff members attended the American Medical Association’s one-day Conference on Medical Missions to discuss assisting medical missionary work.

- A subscription to the quarterly published Christian Medical Society Journal was $1 per year.

- CMS became internationally involved in the founding of the International Congress of Christian Physicians.

The Marriage Viewpoint

by Ed Read, MD, and Debby Read, RN

Does your marriage help or hinder your vocation in medicine and your relationship with God?

Use your smartphone to read the historical 1951 article

Use your smartphone to read the historical 1960 article

Use your smartphone to read the historical 1967 article

or visit www.cmda.org/reflections

G

eorge MacDonald, mentor to C. S. Lewis, penned these words many years ago: “The highest calling of every husband and wife is to help each other to do the will of God.” While most of us would wholeheartedly agree, we struggle to apply this principle to the unique challenges of medical marriages. Few professions have the myriad of obstacles facing a vibrant marriage that a medical career brings. At the same time, medicine is a vocation with great potential benefits—both to the couple and the lives they touch—as God works through their union. How crucial it is for us to focus on helping each other be all God has intended for us to be as individuals and as a couple.

We were married in 1973, three days before Ed started medical school and during Debby’s junior year of nursing school. Since then, we have had numerous opportu-

nities to personally experience the delights and difficulties of a doctor’s marriage. Early on, we observed three out of eight marriages fail among the group of residents Ed trained with during school. We began to seriously consider the goals for our own marriage. God worked in our lives to burden our hearts for medical marriages, as well as to give us a deep desire to have the relationship exclaimed in Psalm 34:3, “Glorify the Lord with me; let us exalt his name together.”

We fully admit we have made countless mistakes along the way and appreciated the grace of God and the wisdom of His Word to get us back on the right course.

Throughout our marriage, Scripture has reminded us to respond to one another in a way that honors God. “Be completely humble and gentle; be patient, bearing with one another in love. Make every effort to keep the unity of C HRISTIAN M EDICAL & D ENTAL A SSOCIATIONS

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the Spirit through the bond of peace” (Ephesians 4:2-3).

God continues to teach us through real-life examples of couples who have successfully navigated the roadblocks standing in the way of a strong medical marriage.

We’ll be examining three articles previously published in the Christian Medical Society Journal. Through these historical articles, we can glean insight from those who have traveled this path before us, and we can also examine ways those same truths still apply today despite the many changes in our culture over the years.

In “The Doctor’s Home and His Own Matrimonial Problems” published in 1951, Dr. Paul Tournier began, “A pure and holy life . . . . Such is the terrible demand of our vocation. We can help a patient solve his problems only in the measure in which we solve our own, especially if it is a marital problem.”

He understood the need to balance the scheduling demands of this profession with the necessary time to solve conflicts at home. Dr. Tournier summed this up when he stated: “To come to this absolute unity which the Bible speaks of, the two spouses must consecrate an indispensible minimum of time to each other, which many doctors do not wish to reserve for their wives. Let us confess this. It is more flattering to run continually in the face of all the distresses than to chat intimately with a spouse who knows the faults which the public does not know and of which she wants to free us . . . [the doctor] has an excellent means of quieting his conscience, if it reproaches him of neglecting his wife. The time during which he is away from her, he persuades himself, is not for himself but for the benefit of others to whom he is devoted.”

A vicious cycle begins with a struggle over the amount of time spent together versus apart. Our fastpaced culture and the fact that more women are pursuing careers, including careers in medicine, makes the following advice of the author even more crucial today: “The important thing is to search for God’s plan for our lives for the organization of our

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time. And when one is married, it cannot be searched for alone.” The doctor cannot sacrifice his or her spouse to the profession and the spouse cannot criticize and resent the time spent away. Instead, they both need to seek with their hearts to allow God to accomplish His plans in their lives as individuals and as a couple. Tournier rightly said: “It is not then a question of systematically sacrificing our family to our vocation nor the reverse, but a sincere search for the will of God in each instance . . . . It does not suffice to give some time to one’s wife—it is necessary to give oneself truly to her.”

We find this to be quite evident in our own marriage.

As we seek to take the time to truly share our lives and reconcile with one another, we find we are more prepared by God to use the difficulties in our lives to help others facing similar issues. Our healthy “couple time” greatly enhances our “vocation time.”

While Dr. Tournier offers the perspective of a husband physician, “I’m Glad I am a Doctor’s Wife,” by Rose Van Reken in 1960, gives us the wife’s perspective. How we wish we had the opportunity to sit and learn from this couple about how to have a godly medical marriage!

She showed in the opening paragraph that she understood the calling to unity when she wrote: “I am sure that near the top of the list of my many blessings I would put my husband, who

Rose understood the ministry her physician husband had in his career. She also discerned ways she could minister to him in the difficult balance he had in his life.

“What about you, his wife—the one who stays at home, the one who is alone much of the time. His practice, his patients, have first claim on him morning, noon, and night.” Wise advice followed for this struggling wife: “Remember, he doesn’t like these interruptions any more than I do. My complaining isn’t going to make his work any easier. Feeling sorry for myself is no solution. After all, he is the one who has to go out. His work demands this service from him. It is not that he loves me less or that he loves his patients more. A doctor’s hours are just uncertain, unpredictable, and unlovely.”

She clearly knew how to do her part in the marriage team by making their home a safe haven. She stated, “Cheerfulness and happiness should prevail so that the man who steps into the door at night will find welcome relief from the complaints and symptoms he has been listening to all day.”

It is interesting to note that relationship needs and the struggle to meet them have remained much the same over the years. This is in stark contrast to how very rapidly some other aspects of medicine have changed.

Technology has transformed how medicine is practiced; however, connecting with others in a meaningful way continues to remain at the core of who we are as people created in the image of God. The joys and challenges of balancing these relationships continue to lead us to God and His Word for wisdom. In order to be healthy spiritually and emotionally, we thrive on our relationship primarily with our Lord and secondarily with our spouse.

As a couple in a medical marriage seeks to care for one another and make their relationship a priority, they are often more fulfilled as individuals and in finding they are more effective in ministering to others.

But a strong marriage isn’t the result of simply the individuals’ viewpoints. The health of a marriage is based on the marriage relationship. In “Marriages That Last” from 1967, John F. Cuber and Peggy B. Harroff studied five different kinds of marriage relationships

still relevant today. (Please read the historical article for a complete listing.)

The Devitalized Marriage describes the marriages we often see today where daily demands have squeezed the life out of the marriage. It is characterized by a couple who used to be in love, but now “little time is spent together, sexual relationships are far less satisfying qualitatively or quantitatively, and interests and activities are not shared.” The fifth marriage is the one we all desire, the Total Relationship. It is characterized by few areas of tension because the: “differences which have arisen over the years have been settled as they arose . . . the primary consideration was not who was right and who was wrong, only how the problem could be resolved without tarnishing the relationship.

When faced with differences, they can and do dispose of the difficulties without losing their feeling of unity or their sense of the vitality and centrality of their relationship.”

The Marriage Viewpoint

is a Christian medical doctor. First and foremost, he is one who loves the Lord, and then he is engaged in the practice of medicine which to me is a noble and wonderful profession. Not only can he offer help, comfort, and relief to those suffering from bodily ills but he also has a great opportunity to say a word for his Lord just when people are often most ready to receive it.”

Fortunately, wherever you may find your marriage on this list, there is great hope for improvement as we seek God’s Word for guidance. Ephesians gives us direction, “Do not let any unwholesome talk come out of your mouths, but only what is helpful for building others up according to their needs, that it may benefit those who listen . . . Get rid of all bitterness, rage and anger, brawling and slander, along with every form of malice.

Be kind and compassionate to one another, forgiving each other, just as in Christ God forgave you” (Ephesians 4:29-32). “However, each one of you also must love his wife as he loves himself, and the wife must respect her husband” (Ephesians 5:33).

Controlling our tongue, forgiving, loving and respecting—these are indeed potent prescriptions for a godly C HRISTIAN M EDICAL & D ENTAL A SSOCIATIONS

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way to a healthier relationship.

To reach this level, we must remind ourselves that marriage is a divinely designed institution. God created the husband and wife union before giving “work” to do. Seeking His priorities is definitely best, but certainly not easy with our busy lifestyles. What creative plan can you implement to restore your marriage if it is struggling or to enrich it if it is already vibrant? One practical solution we began several years ago has been extremely helpful to us. We set aside one hour every Sunday evening to look at each other’s schedules for the week and pray together. Expectations are much more realistic when we are aware of the tasks already on our “plates” for the week. We are sure to fit in time with God and one another before our busy schedules squeeze out these crucial priorities. The sweet time of prayer that follows sets the stage for a week much better balanced and certainly more God-honoring.

We encourage you to read these three historical articles in their entirety as they remind us that the time pressures of a medical career 60 years ago still exist today. In fact, they are even more pronounced today, causing us to earnestly seek God in restoring balance.

CMDA has great resources to aid us in this pursuit, including Marriage Enrichment weekends, book resources, the Side By Side ministry and staff members who come alongside medical couples through Campus & Community Ministries.

How blessed we are to have God’s Word as the guide for our medical marriages. Add to that how grateful we are for the wisdom of godly couples and the enriching

resources available today. These teach us how to have a union that fulfills us personally, and also allows us to be a light for Christ in a profession and a culture that desperately need to see Him. Our humble, unconditional love toward our spouse reflects Christ, our perfect example. Let us encourage one another to build marriages that strive to help each other do the will of God as we seek to glorify Him. ✝

Ed Read, MD, and Debby Read, RN, were married in 1973, three days before Ed started medical school and during Debby’s junior year of nursing school. Debby earned her bachelor’s degree in nursing from University of Delaware in 1975, and began her career as a pediatric nurse. Ed graduated from Jefferson Medical College in 1977, and completed a Family Medicine residency at the Naval Hospital in Jacksonville, Florida. In 1985, he left the Navy to practice fulltime in Emergency Medicine in Pennsylvania. In 2003, Ed and Debby moved to Virginia to become Area Co-directors for CMDA’s Campus & Community Ministries on the Medical College of Virginia campus. Ed still practices medicine parttime, and Debby is the author of Prescription for the Doctor’s Wife. They have five children.

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1975

In This Year . . . Around the World - Margaret Thatcher became Britain’s first female leader of any political party.

- In response to the energy crisis, daylight savings time commenced nearly two months early.

- The Cambodian Civil War ended, prompting a mass evacuation of Phnom Penh and the infamous genocide known as the Killing Fields.

- The Vietnam War ended as Communist forces from North Vietnam took Saigon, resulting in mass evacuations of Americans and South Vietnamese.

- Jimmy Hoffa was reported missing by the Teamsters Union.

- NASA launched the Viking 1 planetary probe toward Mars.

- Lynette Fromme, a follower of jailed cult leader Charles Manson, attempted to assassinate U.S. President Gerald Ford, but she was thwarted by a Secret Service agent.

- The Irish Republican Army was outlawed in the United Kingdom.

In This Year . . . at CMDA - The name was Christian Medical Society, the headquarters were based in Oak Park, Illinois, Marvin R. Jewell, Jr., MD, was President and Haddon Robinson, DTh, PhD, was the Executive Secretary.

- During the year, CMS participated in two symposiums: first, a symposium on demonology; and second, a symposium on the ethical implications of human engineering.

- The quarterly themed editions of the Christian Medical Society Journal focused on women in medicine, occultism, sexuality and psychiatry and Christianity.

- A subscription to the quarterly published Christian Medical Society Journal was $3 per year.

Women in Medicine: Answering a Calling from God

by Autumn Dawn Galbreath, MD, MBA, and Nahid Hotchkiss, PhD

Almost 40 years later, do women physicians still feel isolated in medicine?

Use your smartphone to read the historical article or visit www.cmda.org/reflections

I

n 1975, the Christian Medical Society Journal published an article titled “The Physician and Her Husband” by Merville O. Vincent. Many of us were just children pretending to play doctor during recess at school when this article was written. At that time, Harvard Medical School had only been admitting female students for 30 years. So it’s easy to say that many of the questions raised in this historical article and many of the problems women in medicine faced at that time are now obsolete and outdated for today. And yet, its subject matter remains troublingly pertinent to many of the professional struggles female physicians face today. It’s shocking to realize how relevant the topic is almost 40 years later.

The world tells us we’ve come a long way since 1975; on one level, this is hard to dispute. The statistics have cer-

tainly changed. At that time, medical schools were composed of 20 percent women and the physician workforce was 10 percent women, compared to 50 percent and 33 percent, respectively, today.1 But when you consider the questions the author poses, it highlights just how stagnant we have been in the areas mattering most. For example, Dr. Vincent states, “Female physicians have received comparatively little attention (in research on physician well-being), and their husbands have been virtually ignored.” This has not changed since this was originally written. More importantly, Dr. Vincent addresses one central question, “Do women physicians have unique problems that are not experienced by other working women, or if married, by other working wives?” That query remains a critical question today. Christian women C HRISTIAN M EDICAL & D ENTAL A SSOCIATIONS

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physicians feel they have been called by the Lord into medicine, and yet these unique problems remain unresolved and are a source of unending angst.

Foremost among the unique problems faced by women in medicine is an ongoing crisis of professional identity. Though women are now generally accepted as professional and intellectual equals in the workplace, they remain subject to a different set of expectations from those governing their male counterparts. For example, though women and men are expected to carry the same workload in a medical practice, women physicians have been shown to have patients with more complex psychosocial issues, requiring 21 percent more time per patient.2 Additionally, women are approached differently by their patients who expect more nurturing behavior and more time from women physicians as compared to men.3 In addition, women continue to experience gender discrimination in the workplace.4 They are frequently treated with less respect by staff as compared to their male colleagues.5,6,7 For example, staff members often fail to address women as “doctor,” leading to patient confusion and misunderstanding.

Furthermore, the practice of medicine has been shown to be more emotionally exhausting for women than for men. Studies in physician burnout show that men offer cognitive empathy to patients, while women offer emotive empathy which takes a bigger personal toll.8 Consequently, a woman with the same patient volume ends a day more depleted than her male counterpart. That burnout is expounded upon by other circumstances. GE Robinson reports that women may be professionally accepted by their male colleagues, but they remain isolated in terms of social events and career networking.9 As a result of the lack of clarity in their professional identities, women physicians experience twice as much burnout as their male counterparts.10 More significant are the findings that women in medicine sustain 2.5 percent more stress than male physicians. This is lessened by 45 percent when receiving help from home and 50 percent support from colleagues.11 This rate of burnout can be mitigated by the presence of a senior female physician serving as a mentor.12 However, the very same struggles of professional identity and the incumbent schedule stressors make these mentors less available to invest time shepherding others.

The struggles continue outside of work as women physicians battle with traditional gender role expectations in their marriages, families and churches. Even when they work the same number of hours as their male colleagues, women perform 50 to 75 percent of the housework and childcare.13,14,15 This creates “role strain” in trying to do too much, to the detriment of marriages and personal time. Barnett, Garieis and Carr reported that women who worked their preferred number of hours achieved the best work and family outcomes.16

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When a woman physician feels pressure from her workplace to put in more hours, she feels further divided between her calling at home and her calling as a physician. That is why receiving support from both colleagues at work and family at home is critical to preventing burnout and keeping women in practice.17 However, women in medicine are often the primary income earners in their families, adding even further psychological stress. When husbands are unemployed or underemployed, the wives can feel pressure to perform, while the husbands feel marginalized.18 In Christian circles, this critical issue is often condemned rather than addressed, leaving these couples without tools to resolve the problem.

The feeling of being torn between two worlds is magnified when a women is of child-bearing age.19 Dr. Vincent wrote that “pregnancy does differentiate men from women. Women in medicine should not have to ask for special consideration for this fact. Rather, the medical system should take this difference into consideration.” That statement remains true today as the system continues to treat pregnancy as it did in 1975.

Women in medicine are often demeaned by their partners, fellow residents, supervisors and others during pregnancy.20 Women can be shamed when taking time off related to pregnancy, with comments such as “This is singularly poor timing,” in response to preeclampsia and emergent induction. Similarly, motherhood and

careers. This only increases the isolation they feel. One woman physician summarized this dynamic, “It is easier to be a Christian in the healthcare marketplace than to be a professional woman in the church.”

It is not just those women who are married with children who encounter struggles as single professional women often face added pressure as well. They can be targets for extra responsibilities at work. They are volunteered for committees and extra projects more freely since they “don’t have other obligations.” The church can also impose a similar burden, not realizing the overall workload being pushed on the individual. Church leaders sometimes compound this isolation by questioning the woman’s calling into medicine, stating it will

decrease her prospects of marriage.21 In addition, single women in medicine regularly report difficulty in dating relationships as some men are intimidated by their careers or schedules.

Men married to female physicians also find a void in the church where they feel isolated from the other men.

As physicians, their wives “tend to be industrious, ambitious, aggressive, independent, and individualistic.

These traits seldom fit society’s mold for the ideal woman”—and fit even less within the church’s mold.22 Therefore, husbands of physicians feel that much of the church’s teaching on marriage does not apply to the specifics of life with their physician wives. They feel marginalized in the church and do not know where else to go for the tools they need in their medical marriages.

These are just a few examples of the challenges Christian women physicians experience together with their husbands and families. Their careers follow a far different path than their colleagues. Their patients expect more out of them. Their marriage endures distinctive conflicts. Their parenting style is unique due to their professional responsibilities. Their time is spent in vastly different ways than others. The list goes on.

So what can each individual woman who experiences her own set of unique challenges and struggles do to remain committed to her calling in medicine? These individual experiences are so varied from one another that simple and standardized solutions for a group are rarely helpful to us as individuals. Although constructive support from colleagues, families and the Christian community can be helpful, it is up to the woman physician herself to examine and address her own assumptions and expectations regarding her roles.

To help in this introspection, we can offer a few suggestions we’ve gained from both research findings and personal experience that we hope can be helpful: - Recognize that a successful career in medicine is more like running a marathon than a sprint.

- Prioritize self-care as essential to enduring in medicine without burnout. Schedule regular time off for spiritual, physical and emotional development.

- Regularly triage activities to live in congruence with personal and family values.

- Respect your need for support in the various roles you play.

- Acquire healthy skills in requesting, delegating and hiring help where needed to negotiate a division of labor in housework and childcare that supports healthy family functioning.

- Develop assertive communication skills to promote family cohesion and a satisfying marital relationship.

- Negotiate patient volumes and scheduled work hours with a realistic assessment of the needs of C HRISTIAN M EDICAL & D ENTAL A SSOCIATIONS

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childcare responsibilities are often met with disapproval when women are criticized for taking time away from work, even when their children are ill.

When it comes to the church, women physicians often feel like an anomaly as Christian women are criticized for taking time away from their children at all.

However, church teaching typically addresses the needs of women who are functioning in traditional gender roles, not acknowledging the additional and unique needs professional women experience. These women are then left with solutions that don’t apply to them, and their needs remain unmet. Often women physicians report they are excluded from the community of women in their church when the other women learn about their

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your patients. While it may result in decreased income, recognize that seeing fewer patients may be the key to your personal well-being.

- Acknowledge that you will often not be able to meet the expectations of those around you.

Prayerfully make decisions consistent with God’s expectations, regardless of other competing pressures.

In today’s environment, women fill an important place in the practice of medicine, offering skills and perspectives that patients increasingly demand. In the historical article, Dr. Vincent conducted a survey of 62 female physicians to gain insight into the topic. At a time when women were not considered to hold such an essential place in medicine, it is valuable to note that 92 percent felt medicine was a wise choice for them and they would choose the same career path again if given the chance, despite the problems and challenges they faced in the medical field.

While we may not have conducted a survey of today’s female physicians, we are certain that statement remains true today. As female physicians, we can say from personal experience that medicine is still the wise choice.

We value the struggles and difficulties we face on a daily basis in our workplaces, our homes, our marriages and our communities. Along with God’s guidance, those struggles and difficulties shape and mold us into who we are today. They fashion us into today’s Christian female healthcare professionals, depending on our faith in Christ to serve both Him and our patients. Medicine as our vocation is a calling from God, and it is a calling we would answer again if given the chance. ✝

Autumn Dawn Galbreath, MD, MBA, lives in San Antonio, Texas, where she works as a Medical Director with Texas MedClinic.

She earned her MD from the University of Texas Medical School at San Antonio and her MBA from Auburn University. She is married to David Galbreath and they have three children, ages three to 13.

Nahid Hotchkiss, PhD, is married to Jack Hotchkiss, MD. They have three adult sons and live in south Denver, Colorado. She has a private practice and is an independent consultant on physician wellness and women in medicine for Kaiser Permanente.

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Bibliography Statistics in original article are from Canada. Today’s statistics are essentially equivalent for U.S. and Canada.

McMurray, JE, et al. “The work lives of women physicians.” Journal of General Internal Medicine.

15(6):372-80, 2000 Jun. 3 Mast, MS. “Dominance and Gender in the Physician-Patient Interaction.” Journal of Men’s Health and Gender. 1(4):354-358, 2004 Dec. 4 Shrier, DK, et al. “Generation to generation: Discrimination and harassment experiences of physician mothers and their physician daughters.” Journal of Women’s Health. 16(6):883-94, 2007 Jul-Aug. 5 Pringle, R. “Nursing a grievance: Women doctors and nurses.” Journal of Gender Studies. 5(2):157-68, 1996.

6 Zelek, B and Phillips, SP. “Gender and power: Nurses and doctors in Canada.” International Journal for Equity in Health. 2:1, 2003 Feb. 7 Schmalenberg, C and Kramer, M. “Nurse-physician relationships in hospitals: 20,000 nurses tell their story.” Critical Care Nurse. 29(1):74-83, 2009 Feb. 8 Shanafelt, TD, et al. “Relationship between increased personal well-being and enhanced empathy among internal medicine residents.” Journal of General Internal Medicine. 20(7):559-64, 2005 Jul. 9 Robinson, GE. “Stresses on women physicians: Consequences and coping techniques.” Depression & Anxiety. 17(3):180-9, 2003.

10 Op. cit., McMurray.

11 Op. cit., Robinson.

12 Coombs, RH and Hovanessian, HC. “Stress in the role constellation of female resident physicians.”

Journal of the American Medical Womens Association. 43(1):21-7, 1988 Jan-Feb. 13 Myers, MF. Doctor’s marriages: A look at the problems and their solutions. New York, NY: Plenum, 1994.

14 Sotile, WM and Sotile, MO. The medical marriage: Sustaining healthy relationships for physicians and their families. Chicago, IL: American Medical Association, 2000.

15 Maass, VS. Women’s group therapy: Creative challenges and options. New York, NY: Springer, 2002.

16 Barnett, RC, et al. “Career satisfaction and retention of a sample of women physicians who work reduced hours.” Journal of Women’s Health. 14(2): 146-153, 2005 March.

17 Op. cit., McMurray.

18 Op. cit., Myers.

19 Op. cit., Sotile.

20 Hutchinson, AA, et al. “Pregnancy and childbirth during family medicine residency training.” Family Medicine. 43(3):160-5, 2011 Mar. 21 Hotchkiss, NF. Personal communications in psychology practice with women physicians.

22 Op. cit., Robinson.

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1977

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1977

In This Year . . . Around the World - The world’s first personal all-in-one computer was demonstrated at a trade show in Chicago, Illinois. Later that year, the first Apple II computers went on sale.

- Jimmy Carter succeeded Gerald Ford as the 39th President of the United States. Later that year, Carter created the U.S. Department of Energy.

- “Roots” began its phenomenally successful run on ABC. Star Wars opened in cinemas, becoming the highest grossing film of its time.

- Spain had its first democratic elections after 41 years under the Franco regime.

- Women Marines were disbanded, and women were integrated into the regular Marine Corps.

- Elvis Presley performed his final concert in Indianapolis, Indiana. Later that year, he died in his home in Graceland at the age of 42.

- The last natural case of smallpox was discovered in Somalia, making the eradication of smallpox the most spectacular success of vaccination and modern medicine.

In This Year . . . at CMDA - The name was Christian Medical Society, the headquarters were based in Oak Park, Illinois, John H. Lindberg, MD, was President and Haddon Robinson, DTh, PhD, was the Executive Secretary.

- The third Servant of Christ Award was presented to Gustav A. Hemwall, MD. - A search committee was in the process of searching for a new location for CMDA’s headquarters.

- A subscription to the quarterly published Christian Medical Society Journal was $4 per year.

- The quarterly themed editions of the Christian Medical Society Journal focused on malpractice, crises, the family and prescriptions for families.

Are We Safer from Medical Malpractice in the 21st Century?

by Wendy B. Kang, MD, JD

Malpractice suits continue to be affected by today’s societal and legal forces Use your smartphone to read the first historical 1977 article

Use your smartphone to read the second historical 1977 article

or visit www.cmda.org/reflections

H

e was shocked at the attorney’s letter. A patient who had seemed pleased with her care was suing him for reckless and wanton negligent care. After the initial denial, his anger flared. He had done everything right! Or had he? He began replaying his previous encounters with the patient through his mind. He began to feel that other physicians and nurses were questioning his competence. Sleep became elusive. Thoughts of suicide crept in. Why had God allowed this evil to invade his life?

Medical malpractice lawsuits continue to plague physicians who strive to provide the right care for

patients. At the height of the medical malpractice crisis in 1977, two articles were published in the Christian Medical Society Journal to explore both sides of the issue. “Is the Law to Blame?” by George Chapman focused on the legal aspects creating the crisis, and “Physicians Can Heal the Hurt” by C. Gene Wheeler concentrated on advice for physicians to overcome malpractice struggles. Both articles emphasized that nothing is more sacrosanct than the patient-physician relationship, but societal and legal forces are eroding this bond.

There are four elements to the tort of negligence under which medical malpractice falls. By agreeing to care for

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Medical Malpractice in the 21st Century 26

a patient, the physician takes upon himself the duty to provide care that is considered standard, that which a reasonable physician under similar circumstances would do. When that duty is breached and the doctor is the proximate or foreseeable cause to the patient’s injury, the patient becomes the plaintiff and should be compensated for damages. Defense attorneys try stopping any cause of action by proving non-existence of duty, breach or direct cause of harm by the physician.

Medical experts on opposing sides duel to be the more credible agents to sway judge and jury. The plaintiff’s attorneys working on contingency fees hope for monetary sums from which they might take 30 to 50 percent before the patient receives any payment. The physician feels powerless, bewildered by legal maneuvers and professionally isolated.

As a lawyer, Mr. Chapman’s article pointed out several legal principles which he believed contributed to the increase in medical malpractice cases. He stated, “. . . key changes in our local court system and substantive law have produced the flood of lawsuits being filed against physicians, hospitals and nurses.” He went on to explain these changes such as the loosening of the statute of limitations to allow more time for discovery of a mistake, such as a lap sponge left inside a patient. This would appear to be fair to the patient, especially if the physician had the information and intentionally withheld such knowledge from the patient. Another change was the loss of charitable immunity which exposed physicians who worked at non-profit hospitals to be sued. In addition, the “Captain of the Ship” legal doctrine made the physician responsible for negligence of those under his or her supervision. The right of patients to be informed of

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the risks versus benefits of treatments created more litigation whereby patients alleged lack of informed consent. As a result, courts became more unwilling to give out summary judgments whereby cases were dismissed as a matter of law. Matters of fact had to be sorted out by a jury with the help of expert witnesses. The use of national standards of care instead of community practices allowed physicians from outside the locale to be more willing to testify.

The majority of medical malpractice cases are based upon 19th century common law. General principles from previous court rulings regulated subsequent decisions; this is the legal principle of “stare decisis.”

Judicial precedents are difficult to change dramatically.

Hence the four elements of medical malpractice remain intact, as well as most of the changes Mr. Chapman discussed.

On the other side, Dr. Wheeler wrote his article about malpractice from his perspective as a surgeon.

He focused on how malpractice affects healthcare professionals, and offered advice for maintaining a high level of care despite government and legal intervention. He urged physicians to protect the patient-physician relationship while also protecting their freedom to work in a free market status. He also urged physicians to practice as if they did not carry malpractice insurance. He encouraged good patient rapport and setting aside $40 to $200 weekly into a trust fund to settle legal claims. He advocated spending time discussing alternative treatments and seeking patient participation to arrive at mutually acceptable solutions. He also claimed that all physicians should “consider giving up any government payments [they] might be receiving.”

Most readers would agree with Dr. Wheeler that excellent communication with patients is a key to avoiding lawsuits. However, few of us can agree to give up government payments given the high proportion of Medicare and Medicaid patients we serve. A dying breed is the physician who is a “self-employed businessman” able to maintain a solo practice with fee-forservice reimbursements.

Since these articles were originally published, many changes have taken place. Common law was supplemented by statutory law, mostly at state levels. The definition for “standard of care” evolves so constantly that “elusive” might serve as the best definition. Physicians have a duty to use reasonable care and diligence, based upon national specialty standards, in caring for their patients. Consent for treatment must be informative and also include risks versus benefits as to alternative forms of treatment, including non-treatment. In some states, information the patient would regard as material to decision-making appears to be as important as what physicians think relevant. Increasing recognition of patient rights, including the right to make

sive medicine. Evidence does not support such practice; physician perceptions do. According to a 2011 New England Journal of Medicine article analyzing data from a single medical liability insurer profiling 40,000 physicians of 25 specialties, 7.4 percent of physicians had a claim annually. By age 65, 75 percent of physicians in low risk specialties and 99 percent in high risk fields are projected to face a malpractice claim. The reassurance to physicians comes from the fact that the high likelihood of claims does not result in payments. Annual rates of claims leading to indemnity payments ranged from only 1 percent to 5 percent across specialties. Awards in excess of $1 million occurred in less than 1 percent of all payments.1 Dr. Wheeler’s suggestion in 1977 to set aside $40 to $200 weekly might create personal fiscal deficit in paying today’s average indemnity of $274,887.

Just like technology changed the way medicine is practiced, it changed malpractice. The disturbing trend for future medical liability revolves around electronic health records (EHR) and social media communications with patients. By now physicians are aware of “Dr. Flea” who ranted online about his ongoing medical lawsuit, unaware that the opposing attorneys were equally internet savvy. His lack of professionalism necessitated a quick court settlement.

The American Medical Association established a policy that physicians should not use electronic communications to establish a patient-physician relationship.

Once established in person, then the physician must decide on protocols and policies to communicate with patients who want to use the internet.

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autonomous decisions, has expanded the doctrine of informed consent such that state laws now specify which possible risks must appear on consent forms for procedures.

The medical malpractice “crisis” of the mid-1990s, whereby physicians were hard-pressed to find any professional insurance coverage, forced states to attempt “tort reform.” Success at state level is limited. However, statutory laws instead of court rulings have been placed on: (1) qualifications of medical experts who must be actively practicing in their particular specialty; (2) pre-screening medical panels to review merits of claims of malpractice; (3) arbitration panels before court trials; (4) statutes of limitations; and (5) creation of pooled state funds to compensate patients.

The most contentious changes result from attempts to cap the damages patients receive as compensation for harm suffered. California passed the Medical Injury Compensation Reform Act (MICRA), now touted as the perfect model for a federal medical malpractice reform. Non-economic damages to cover such “losses” as the plaintiff’s pain and suffering, loss of consortium or emotional distress are limited to $250,000.

Contingency attorney fees were placed on a sliding scale rate, also being capped at 40 percent. As a result, California stabilized its healthcare climate by reining runaway damage awards. Other states able to pass similar legislation also witnessed positive changes, all of which help patients in having access to healthcare.

Unfortunately, medical liability cases are not going away. Until some federal level of tort reform is achieved, physicians will continue to practice defen-

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Medical Malpractice in the 21st Century 28

Using social media and maintaining electronic health records can be a boon or a bane. Traceable electronic footprints can be “discovered” in federal civil cases, and they may support or weaken the case against the physician. For instance, patients may assume their new physician will review the volumes of “easily accessible” medical records from a previous healthcare entity. Should the physician be liable for some obscure piece of data buried in the EHR?2 The verdict is still out.

Electronic records may affect standard of care; thereby affecting medical liability. Many computer systems have clinical decision support systems to assist physicians in diagnoses. National practice guidelines may also bind physicians into defined tracks of patient management. Departure from such systems or guidelines may be construed as evidence of negligence. Following such algorithms may cause the physician to arrive at incorrect diagnoses and face allegations of medical malpractice. Additionally, it has been postulated that EHR systems will become so customary that failure to use EHR can be considered a breach of a physician’s duty of reasonable care owed to patients.

Life as a practicing physician is not any easier in the 21st century than it was in 1977 at the height of the medical malpractice crisis. Physicians must fight against social forces to hold onto a sacred bond of trust with patients. Decreasing reimbursements from health insurance entities, unrealistic expectations of patients and society to have risk free healthcare, 15 minute increments of patient face time while the physician’s hides behind a computer screen studying records— these factors do not bode well for medicine. But physicians have a continuing duty to their patients to do what is right despite the possibility of being sued.

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A registered letter arrives and your world as a physician crumbles. What should you do?

Pray to the Great Physician, our Heavenly Father who is in control of all things. Read the letter again to fully understand its contents. If it truly concerns a possible medical malpractice allegation, inform your insurer. You will be provided an attorney to guide you.

Remember you have friends in CMDA who will pray and support you. CMDA’s Medical Malpractice Ministry is ready to serve you. You are never alone to walk through the valley of the shadow of death. ✝ Bibliography 1 Jena A, Seabury S, Lakdawalla D, Chandra A. “Malpractice Risk According to Physician Specialty.” New England Journal of Medicine 2011:365: 629-636 2 Mangalmurti S, Murtagh L, Mello M. “Medical Malpractice Liability in the Age of Electronic Health Records.” New England Journal of Medicine 2010:363: 2060-67

Wendy B. Kang, MD, JD, is Clinical Professor of Anesthesiology at the University of Texas Health Science Center at San Antonio. She is board certified in Anesthesiology with additional certification in Pain Medicine, both of which she uses in reducing surgical and postoperative pain in patients while teaching residents and medical students.

She obtained her law degree from Southern Methodist University School of Law while practicing full-time as a physician. She passed her Texas State Bar in 1993 and promptly put herself on inactive status as attorney, preferring to nurture the patient-physician relationship as influenced by law, medicine and ethics.

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1950s

1960s

1970s

1980s

1990s

2000s

2010s

1981

1940s

1981

In This Year . . . Around the World - The Iran hostage crisis ended as the U.S. and Iran signed an agreement to release 52 American hostages after 14 months of captivity.

- Three workers were killed and five were injured during a test of the Columbia space shuttle. The space shuttle was later launched, marking the first time a manned reusable spacecraft returned from orbit.

- U.S. President Ronald Reagan was shot in the chest outside a Washington, D.C. hotel by John Hinckley, Jr. - Sandra Day O’Connor became the first woman to be nominated to the U.S. Supreme Court, and she later became the first woman to sit on the court.

- Charles, Prince of Wales, and Lady Diana Spencer were married in London. More than 700 million people watched the wedding worldwide.

- France abolished capital punishment.

- The first American test-tube baby Elizabeth Jordan Carr was born in Norfolk, Virginia.

In This Year . . . at CMDA - The name was Christian Medical Society, the headquarters were based in Richardson, Texas, James A. Peterson, MD, was President and Donald F. Westra, JD, was the Executive Secretary.

- The organization celebrated its 50th anniversary and had more than 5,000 members.

- CMS’s founder Dr. Kenneth Gieser was honored with the Servant of Christ Award.

- After moving the headquarters to Texas in 1980, the financial situation was bleak in 1981. However, the financial deficit had been erased by the end of the year due to special funding programs, answered prayers and the efforts of many.

- The James S. Westra Memorial Fund was established as the first CMS endowment fund, encouraging students to serve on short-term mission trips.

- A subscription to the quarterly published Christian Medical Society Journal was $12 per year.

Revisited: The Dentist’s Necessary “Ought”

by Peter E. Dawson, DDS

Allowing professional ethics and Christian faith to guide your dental practice Use your smartphone to read the historical article or visit www.cmda.org/reflections

I

n 1981, Dr. Austin Robbins wrote that the dental profession was facing a major dilemma and a new emphasis was needed. “Not only must a dentist possess skill in ‘how’ and ‘why’ but in our modern society the ‘ought’ assumes an ever increasing role in dentistry’s ability to care for people’s needs.” In today’s dental community, that necessary “ought” is well-known as professional ethics. It is a topic that remains at the forefront of dentistry.

And it is a subject that is still expanding.

In the 31 years since “The Necessary Ought” was published, new demands for ethical patient care have been created by the transformation of almost every facet of

dental practice. The dentist-patient relationship is a sacred trust that is without oversight. Determination of need or choice of treatment is dependent almost entirely by the ethical commitment of the dentist to help each patient achieve optimal oral health. A reason that professional ethics is so critical to this process is because patients must trust their dentist to make decisions that patients are not knowledgeable enough to make for themselves. Furthermore, problems resulting from defective treatment are often not noticeable to a patient until damage is apparent later.

Advancements in materials and technology have made

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The Dentist’s Necessary “Ought” 32

it possible to perform more dentistry in less time. While these advancements also make it possible to set new standards of quality for aesthetically pleasing restorations, the ability to do more dentistry in less time opens the door for potential abuse. How new capabilities are translated into patient care is as varied as the attitudes of practitioners and their level of commitment to constant improvement.

Robbins wrote, “Admittedly [professional ethics] is an area difficult to define, difficult to teach, and even more difficult to assess.” More than ever, dentists today have an obligation to continuous learning. Every patient deserves the most up to date treatment available, and that requires professional attention to improved protocols for diagnosis and treatment.

The “tooth dentist” of the past, who ignored the relationship of the occlusion to the temporomandibular joints and the masticatory musculature, is as out of date as yesterday’s defective amalgam. The new capacity for higher productivity using CAD/CAM for instant restorations, Invisalign for simplified orthodontics or laser technology for periodontal treatment are marvelous improvements in the hands of dentists who understand the concepts of complete dentistry and strive for total

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masticatory system harmony. But for those practitioners who have not kept up, the new technologies enable them to mess up more mouths in less time.

So the “necessary ought” in 2012 requires dentists to become physicians of the total masticatory system. To do less is to short-change patients in regard to comfort, best aesthetics and long-term stability of the teeth. In addition, proper diagnosis of orofacial pain is a tremendously important facet of dental practice.

Failure to learn and use correct analysis methods for diagnosis of pain or dysfunction within dentistry’s area of responsibility can seriously compromise patient's comfort. It can also lead to unnecessary chronicity and even serious health issues if certain signs or symptoms are not recognized.

Physicians and other health professionals who do not have the training to determine if dental or masticatory system disorder is or is not a factor in head, neck or orofacial pain must be able to rely on the expertise of dentists. Dentists must accept this responsibility and must be certain of competence to fulfill it. With all the advancements that have been made in diagnostic capabilities, including imaging technology, it is an ethical responsibility for practitioners to stay current.

Every intelligent patient wants a healthy mouth. Every dentist has a responsibility to become proficient in helping patients either directly or indirectly to fulfill that desire and to at least know what treatment choices are available. Any practice that lets the pressures of inadequate time allotment dictate compromised patient care needs to reevaluate based on what is the right thing to do.

An ethical viewpoint of dental practice begs practitioners to establish a realistic schedule that permits every patient through time for a thorough examination. With current understanding of the relationship between periodontal disease and general health problems, it is unacceptable to assume there is no disease in the absence of patient complaints. Signs of a number of dental diseases precede symptoms and must be detected by careful examination. There is frequently no pain or discomfort associated with even severe wear, advanced caries or periodontal disease. If not detected early, the implications of delay frequently point to increased damage, greater expense and compromised results. Patients are rarely aware of signs that a careful examination can detect. Robbins was correct when he said, “Failure to achieve success cannot be attributed to a lack of knowledge. It is up to us, the practitioners, to decide if we will or will not perform what we know is in the best interest of the patient. Patients do not expect perfection but they do expect honesty. The ‘ought’ is up to us.”

The high-volume practice with too many

Peter E. Dawson, DDS, is a graduate of Emory University School of Dentistry. Early in his career, he made a commitment to evaluate every aspect of dental practice to learn ways to improve upon the accepted dentistry concepts or rationales. Along with extensive input from leading clinicians, that research stimulated many changes in patient care. It also resulted in authorship of three bestselling dental textbooks, as well as the formation of the Dawson Academy, a renowned training center that has provided continuing dental education courses for practicing dental professionals for more than 30 years. In addition, Dr. Dawson has lectured extensively worldwide both nationally and internationally. He served as a visiting professor at Georgetown University and Emory University, and has presided as president of three national dental academies.

Among his many honors, he cites the invitation to serve as a trustee of the Christian Medical & Dental Associations as the most special. His passion for encouraging health professionals to lead balanced lives that include a strong emphasis on Christian values is given exceptional fulfillment through a partnership with CMDA to expand the dental aspect of CMDA’s ministry.

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The Dentist’s Necessary “Ought”

patients and too little time for adequate care actually cheats its patients. It also deprives the doctor and the entire staff of the satisfaction of performing dentistry as it should be practiced with the kind of care that patients deserve and appreciate. Dentists who learn to properly control patient flow to a manageable level enjoy lower stress at work. They also have more balance in their lives if their practices are designed to fit their desired lifestyles, rather than vice versa.

As Christian dentists, the “necessary ought” we face doesn’t include just providing adequate care for our patients. Instead, our Christian faith upholds us to even higher standards. Our Christian principles guide our practice, our professional ethics and our desire for a balanced life. Thoughtful planning of practice life should and can allow for family, spiritual and recreational balance. In Colossians 3:23, Paul instructs us, “And whatsoever ye do, do it heartily, as to the Lord, and not unto men” (KJV). God commands us to do quality work because, as of ambassadors of Jesus Christ, our credibility is dependent on it. Our entire practice philosophy ought to be based on that principle.

If an overloaded work schedule is guided primarily by a priority to earn more income, it will not only diminish family priorities, but also time with the Lord and ministry commitments. A balanced life is a “necessary ought” that is more relevant than ever, as a secular world attempts to diminish the biblical values of a Christ-centered life. ✝

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classifieds

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Oral Surgeon – Illinois – Established 26-yearold practice looking for associate to become a partner. Great place to raise a family, close to Chicago, Milwaukee and Madison. Full scope, Implants, light trauma, laser, I-CAT, mostly fee for service. Guaranteed salary and benefit package. Fax CV to 815-877-4254 or email to os1161732@aol.com.

Dermatology – An independent dermatology practice in Kearney, Nebraska seeking a full-time or part-time dermatologist. Great potential for a busy practice in a wonderful family-centered community. Mission is not only to provide excellent dermatologic care but also minister to patient’s spiritual needs.

Currently one full time dermatologist treating an average of 35 to 40 patients per day.

Please contact Sharon Bond, MD, at 308440-3945 or sbbderm@charter.net, or Lori Grubbs, office manager, at 308-865-2214.

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Family Medicine – Mad River Family Practice is a progressive community-based family practice in west-central Ohio. Currently seeking a full-time family physician to join a practice founded on lifelong learners and forwardthinking clinicians. Enjoy the rewards of a full scope of practice in a supportive group environment. Our family physicians place strong emphasis on addressing spiritual needs, as well as physical and mental needs. Practice offerings include: a vibrant and long-standing practice with varied demographics, flexibility in style and range of family practice, opportunities to foster medical education among students in healthcare, a welcoming community in west-central Ohio, with easy commuting to Columbus and Dayton, Ohio and a competitive salary and benefits package. Contact Tara Wagner at tara.wagner@maryrutan.org or call 937-465-0080.

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Try a more relaxed setting in sunny Central Florida. No emergencies, quiet nights, time

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with family, yet good pay. Aging Christian orthopod seeks someone to take over “niche” practice as he nears retirement. Flexible hours and terms. Ideal location, great staff, great hospitals and surgery center nearby. Too good to be true? Call 407-292-8992 or email Sonia@RobertsOrthopaedic.com.

BE/BC Otolaryngologist – needed for wellestablished, busy two-man practice located in a Big 10 college town in Lafeyette, Indiana.

Excellent opportunity for fast track to full partnership. Our private practice includes: general ENT, head and neck, facial plastics and allergy. Onsite physician owned ASC, CT scanner and voice lab with video stroboscopy staffed by speech language pathology personnel. The audiology de-partment provides a full range of services staffed by AuD. Please contact Ruth at 765-477-7436. Send CV to 2320 Concord Road, Lafayette, IN 47909, or email lafayetteent@comcast.net.

Primary Care/Geriatric – Shell Point Retirement Community – We are one of the largest Continuing Care Retirement Communities (CCRC) in the country and are a non-profit ministry of the Christian & Missionary Alliance Foundation, Inc. Located in Southwest Florida, we are blessed with a beautiful environment in which to serve 2,200 residents. Our medical practice has an opportunity for a physician experienced in primary care, family medicine or geriatric specialty and has a calling to care for an elderly population. The practice consists of three physicians and one ARNP. This is a wonderful opportunity for a believer who wishes to practice in an environment where the love of God’s people is evident and where ethics and integrity are the norm.

Contact Karen Anderson, AVP of Human Resources, at karenanderson@shellpoint.org or visit www.shellpoint.org. DFWP/EOE.

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