Today's Christian Doctor - Fall 2008

Editorial

by David Stevens, MD, MA (Ethics) – Chief Executive Officer

What You and I Didn’t Learn in School How do you prevent embezzlement and what should you do if you catch a staff person doing it? How do you fire someone, understand a balance sheet, do a performance evaluation, or deal with a nurse who is not performing well?

No, you didn’t sleep through that class. They weren’t in the curriculum in medical or dental school.

Those topics and other business ones probably should have been added because they are some of the reasons why more and more doctors are becoming employees.

That way they don’t have to deal with issues that face doctors involved in the small business enterprise called private practice. However, even if you are an employee, you still can’t totally escape it all.

It is not that you weren’t well trained in medicine or dentistry. They just didn’t spend much time teaching you what you needed to know to enable you to successfully use the knowledge you took so many years to obtain.

It was not such a big issue in the past. It was the doc, a nurse, and the receptionist out front in small town practices across America. Now it is dealing with regulatory authorities, complex labor and health care regulations, supervising a legion of staff, filing reimbursement forms, and trying to keep all your technology up and running.

Nowhere is this more a problem than on the mission field, where the doctor is in charge of a medium to large size “business” called a mission hospital. At times while I was in Kenya I was responsible for 500 staff, a multimillion Kenya shilling budget, and creating systems to get treatment and follow-up to 10,000 inpatients and 100,000 outpatients a year. Knowing the intricacies of the Krebs cycle wasn’t much help!

I learned that the business of healthcare is based on good principles and learnable techniques. I didn’t have time to go and get an MBA, but sought out resources and individuals who could teach me what I needed to know.

I applied business principles, modified them for our situation, and in some cases improved on them to make our

outreaches run well. Hey, if I can do that in the bush of Africa, you can do it here.

I first had to realize that as important as my clinical skills were, they were pretty much a given after going through a quality education process. What had more to do with my success as a missionary, relief leader, and now as the CEO of CMDA is my ability to plan, implement, manage, evaluate, and lead.

That is why this issue of Today’s Christian Doctor is devoted to practical practice issues looked at from a distinctly Christian perspective. We’ve picked a few important things to cover with the goal of providing information you can use, while also hoping to stimulate you to delve deeper into this important area.

Realizing the special importance of this type of training for missionary doctors, a few years ago I began a series of articles that have appeared in every issue of the e-Pistle, a monthly electronic resource for missionary doctors produced by CMDA’s Center for Medical Missions. It covers topics like “Boards that Work,” “Effective Communication,” “Conflict Resolution,” “Strategic Planning,” “Recruiting ‘A’ Employees,” “Leadership,” “Personnel Issues,” “Motivating People to Change,” “Excelling at Administration,” and much more.

These principles apply wherever you practice. If this TCD issue catalyzes you to spend some time learning more about practical practice issues, go to: www.cmda.org/ePistle to get what is now essentially a free electronic book. As a bonus you can learn how to write an effective prayer letter, learn about ethical issues in missionary medicine, or read some ideas on strengthening your family. You will find this resource easy to assimilate since it gives principles, tells stories to drive them home, and shares true and tried techniques.

So, read, absorb, and apply the articles in this unusual issue of Today’s Christian Doctor, and as a bonus visit our website, and learn more about what you and I didn’t learn in medical or dental school. I trust both will be a blessing to you. ✝ I n t e r n e t W e b s i t e : w w w. c m d a . o r g

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table of

CONTENTS

V OLUME 3 9 , N O. 3

Fall 2008

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

Features

13 Motivating Your Staff

by David Stevens, MD, MA (Ethics) Five principles for getting the best from your staff.

16 The Problem of Time

by Al Weir, MD How to manage time, your most valuable currency.

19 Physician as Employee

by Autumn Dawn Galbreath, MD, MBA, FACP, FACPE Some pros and cons of working for someone else.

21 Ten Questions about Alternative Medicine

by Dónal P. O’Mathúna, PhD Increasingly, patients are considering alternative therapies. Here are some answers to common questions.

27 Treating Gospel Debt

by Harry Kraus, MD Adapted from Breathing Grace: What You Need More Than Your Next Breath

30 Miracles are Possible

(Apologetics Series - Part 6)

by Robert W. Martin III, MD, MAR

Departments 5 32

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Progress Notes Advertising Section

Editor: David B. Biebel, DMin Editorial Committee: Gregg Albers, MD, Elizabeth Buchinsky, MD, John Crouch, MD, William C. Forbes, DDS, Curtis E. Harris, MD, JD, Rebecca Klint-Townsend, MD, Bruce MacFadyen, MD, Samuel E. Molind, DMD, Robert D. Orr, MD, Richard A. Swenson, MD Vice President for Communications: Margie Shealy Classified Ad Sales: Margie Shealy 423-844-1000 Display Ad Sales: Margie Shealy 423-844-1000 Design & 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, Fall 2008 Volume XXXIX, No. 3.

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© 2008, Christian Medical & Dental Associations ®. All Rights Reserved. Distributed free to CMDA members. Non-doctors (U.S.) 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.

Scripture references marked (NASB) are taken from the New American Standard Bible. Copyright© 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977 by the Lockman Foundation. Used by permission. Scripture references marked (KJV) are taken from King James Version. Scripture references marked Living Bible are from The Living Bible© 1971, Tyndale House Publishers. All rights reserved. Undesignated biblical references are from the Holy Bible, New International Version®. Copyright© 1973, 1978, 1984 by the International Bible Society. Used by permission.

All rights reserved.

Other versions used are noted in the text.

For membership information, contact the Christian Medical & Dental Associations at: PO 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.

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.

National Conference Awards Editor’s note: The following awards are presented annually by CMDA. The award summaries are based on the actual statements involved, which can be accessed at: www.cmda.org. Award presentation photos include CMDA President, Dr. Bruce MacFadyen.

Servant of Christ Samuel Molind, DMD, and his wife, Dorothy Molind, have modeled Christ in serving others, not only in the U.S., but around the world. Through Dr. Molind’s leadership as Director of CMDA’s Global Health Outreach (GHO), and his passion for soul-winning, tens of thousands have come to know Christ.

Sam has also used his skills as an oral and maxillofacial surgeon to treat the suffering in many lands, including Vietnam, Jamaica, the Ukraine, China, and Ethiopia. Dr. Molind has helped encourage and train other mission organizations; personally organized and led many teams; pioneered medical/dental education for short-term teams; trained numerous nationals in the latest surgical techniques; and has served in many prisons in partnership with Prison Fellowship International. Dorothy volunteers with GHO by assisting in the organization of mission trips, inventory management, and providing medicines and equipment for the many GHO trips. In recognition of the Molinds’ all-consuming passion to serve others, those whom Dr. Molind says are “without hope and without help in a world of need,” CMDA presented the 2008 Servant of Christ Award to Dr. Samuel and Mrs. Dorothy Molind.

Missionaries of the Year Robert Chapman, MD, MPH, and Karon Chapman, DD, have inspired others to develop a passion for the Great Commission. In 1965, the couple became affiliated with the Christian Missionary Fellowship (CMF), eventually joining the CMF team in Ethiopia. Dr. Chapman’s medical work was quickly incorporated into the team’s church planting and evangelism programs. During their first term in Ethiopia, he did a training course at All Africa Leprosy and Rehabilitation Training Centre in Addis Ababa.

On their first furlough, he earned a Masters in Public Health degree from the Loma Linda School of Health. In 1977, Ethiopia experienced a Marxist takeover and the entire Ethiopian team had to be evacuated. But by September of the same year, the Chapmans had begun work among the nomadic Turkana people of Kenya. Dr. Chapman instructed the Turkana people in hygiene and sanitation, taught and preached in their villages, provided literacy programs, and was heavily involved with the translation of the Bible into the Turkana language. The couple also helped the country of Kenya with development projects such as the Turkana women’s basket-weaving industry. To honor and celebrate these lives of service, CMDA presented the 2008 Missionary of the Year Award to Dr. and Mrs. Robert Chapman.

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Educator of the Year George Mikhail, MD, began his journey of excellence in medical education more than fifty years ago. That journey took a major change in direction during his first visit to Mongolia in 1996, when he had just retired as a professor of obstetrics and gynecology from UCLA. With the assistance of Dr. Bob Schindler, Dr. Mikhail led the first Medical Education International (MEI) team into this country once thought to be nearly unreachable. As a result of Dr. Mikhail’s groundbreaking efforts, today MEI sends medical education teams to Mongolia twice a year. Under his leadership, MEI team members have taught at the Health Sciences University of Mongolia and have provided lectures, patient assessments, and clinical and surgical care in a wide range

of specialty hospitals in Mongolia.

In addition to typical healthcare topics, team members have included bioethics in their curricula. MEI team members have been encouraged to follow in Dr. Mikhail’s footsteps by developing personal relationships with their Mongolian colleagues. This has often opened the door to sharing the love of Christ. Team members also have been encouraged to minister to missionaries and local believers.

Through Dr. Mikhail’s endeavor and those of the twentyone MEI team members that have served in Mongolia, the Good News of Jesus Christ has been proclaimed and seeds have been planted among many Mongolian people, from medical professionals to hotel staff.

President’s Heritage Award William Standish Reed, MD, MS, has been a surgeon and a physician for over sixty years. Kay, Bill’s beloved wife, went to be with the Lord in May 2005. She was the Director of Christian Medical Foundation International,

Inc., a ministry Dr. Reed founded in 1962. Until her death, Kay served beside Dr. Reed. He credits his wife and children for their sacrificial support. In December 2007, Dr. Reed was married to Coppi McWilliams, a wonderful helpmate to him during this season of life and ministry. Dr. Reed is an active Christian writer, poet, and lecturer. Speaking opportunities and surgical missions have led him around the world, traveling to many countries including Poland and Czechoslovakia during the cold war. Dr. Reed has authored several books, including A Doctor’s Thoughts on Healing and Surgery of the Soul.

Through Christian Medical Foundation International, Inc., Dr. Reed has influenced many lives: colleagues, patients, and friends. From this fertile soil, many others have come to know the Lord’s love and saving grace. Retired from his surgical practice, Dr. Reed continues to specialize in seeing patients who have been informed that “There is nothing more that can be done for you.” Dr. Reed emphasizes the truth of Luke 1:37 and James 5:14.

Login to our Website!

If you haven’t logged into CMDA’s website, www.cmda.org, you are missing out on a lot of valuable resources and services, such as PowerPoint presentations exclusively for CMDA members and the ability to personally update your member information in our records. Logging in is easy! Type www.cmda.org into your Internet browser to start. Our website is most compatible with Internet Explorer. Then click on the “Member Login” button in the far left column on the homepage. In the “Login” field, enter the e-mail address that we have on file for you. If you have never logged in to our site before, in the “Password” field enter the default password, “keepingfaith.” (Once you have logged in for the first time we strongly recommend that you personalize your password.) Click the “Sign on” button or hit the “Enter” key. You will then be logged in and automatically redirected to the “Member Support” page.

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Steury Scholarship Recipients Announced sively. I hope to model my future practice after much of what I observed and participated in during this time. Finally, I began my married life pursuing the calling that God had given both my spouse and I through learning of medical opportunities around the world with TEAM missions.

We participated in a vision trip observing missionaries throughout Southeast China and Northern Pakistan. We cannot wait for our next opportunity to serve overseas. It is now an exercise in patience to be diligent to our calling to study when our hearts are already overseas. We have learned much about being bold in our faith amongst our peers in the sadly hedonistic environment of medical and nursing school.

“Jesus cared about people. He came to heal us; mind, body, and soul,” he added. “This is what I long to do. I am excited to enter boldly into the medical mission field with faith in the combination of medicine, prayer, and prophetic song for healing. Christ came to heal our whole being, and when we do the same, people are eternally changed.

Through word, deed, and sign, I pray that the Lord will use me to draw many to Himself.”

For information regarding the Steury Scholarship, contact the office of the Chief Executive Officer, or download the application at: www.cmda.org.

Paid Advertisement

The purpose of the “Dr. and Mrs. Ernest Steury Medical Scholarship Fund” is to assist with the tuition of medical students who are committed to a career in foreign or domestic missions. Applications are evaluated on the basis of academic record, spiritual maturity, cross-culture experience, leadership ability, the student’s sense of call, references, and extracurricular activities/ talents.

This year the Steury Scholarship was awarded to Jeffrey and Grace Larson.

Jeffrey is a second year student at UIC, and Grace is pursuing a degree as an RN. Jeffrey's comments (here adapted) about his spiritual experience and calling included: “I have been blessed with three wonderful opportunities to catch a glimpse of how God might put flesh on my now well-formed theoretical ideas of what Christian healthcare could entail. In Tanzania, I was once again reminded of the great need for hope and healing around the world. I desire with all of my heart to care for the least of these who have been trampled by the world in so many ways. This trip confirmed to me that it was indeed this goal that would shape my life. Next, I was able to see Christian healthcare embodied in the inner city of Chicago at Lawndale Christian Health Center. This was a gleaming ray of hope for me as I saw Christians take their goal of empowering holistic health so seriously and comprehen-

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Just Add Water – Practice By the Book on DVD Ten of the seventeen chapters of Practice By the Book are now available on DVD so you can easily share them with your CMDA chapter, staff, or other small group. They are presented variously by Drs. Al Weir, Gene Rudd, and David Stevens. Presentations vary in length from fifteen to thirty minutes, and are corporately called, “Just Add Water - Practice By the Book” set. In Dr. Weir’s presentation about compassion, for example, he suggests that the two most important things you can do for your patients are to reduce their suffering and to provide hope and value to their lives. He illustrates with a story about listening well. A patient whose cancer had a very low risk of recurrence had been worked into an already busy schedule. She went to great lengths to describe in detail a problem she was having with her right ear. He knew from early in the conversation that the condition she was describing was benign, but her level of anxiety was extreme, so he listened to the whole story. When she was finished, he did a quick examination and explained that the discomfort in her ear was caused by pressure on her eustachian tube due to a viral infection. She began to cry. She explained that her sister had died when her cancer spread to her brain, and she thought that’s what was happening to her.

She said she hadn’t slept in three nights! What a blessed reduction in suffering she had that day! Many more illustrations are included on this and the other nine discs, which include Clinical Practice, Marriage and Family, Developing Your Character, and Ethics, among others. The ten-disc set comes conveniently packaged in separate ring-bound pages secured in a oneinch thick 5.5 x 6.5 inch album. The complete set is available from Life & Health Resources for $50.00. Call 888-231-2637 or visit our website at: www.shopcmda.org to order yours. Or . . . if you’d rather prop up your feet and read in solitude, perhaps you’d prefer Practice By the Book in paperback, 263 pages, $16.95.

~ News Notes of Interest ~ A At the 2008 CMDA National Convention, a new ethics statement on “Chimeras and Human Hybrids” was approved by the House of Representatives. You can find this statement on our website at www.cmda.org and going to Issues and Ethics > Other > Genetics.

A CMDA has a new addition to the website under Resources and Services, called Online Library. It is a review of medical articles divided into categories of ethical, medical, legal, social, and religious. Check it out and let us know what you think. Send your opinion to: communications@cmda.org.

A The state of Washington will be voting on “Initiative 1000” this November. If passed by the people, Washington will become the second state in the nation to legalize physician-assisted suicide. In addition to creating a set of videos, public service announcements, and a brochure on “Initiative 1000,” we have developed an area on the CMDA website called “End of Life Care.” This section provides helpful information to both doctors and the general public on good end of life care. It is located under Issues and Ethics.

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Leaders Wanted To Transform Doctors, To Transform the World If you are interested in serving as a volunteer leader in the House of Representatives, on a council or commission, and through those ultimately on the CMDA Board of Trustees, you can go to our website at www.cmda.org and click on “About” and then “Leadership” and choose either House of Representatives or Board of Trustees to find out more and get involved.

Submit a current CV via e-mail (preferably) or fax to the Executive Assistant, Debra Deyton at: executive@cmda.org, phone: (423) 844-1000, fax: (423) 844-1017.

The House of Representatives meets once a year to approve bylaws changes, receive reports, and approve the budget and the ethical positions of the organization. During the year, they serve as two-way channels of communication between CMDA and its members. There is one representative from each state and from many of our local ministries.

New trustees are nominated by a joint committee of the House of Representatives and the Board of Trustees. They look at the service record of potential nominees to CMDA, their leadership capabilities, expertise, and Christian testimony.

Their nominees then are approved by both the House and the Board. Trustees, who may serve up to two consecutive fouryear terms, pay all their own expenses. The Board meets three times a year to set policies, oversee finances, and provide supervision to the CEO.

What Kind of Innkeeper are You?

by Al Weir, MD, and Gene Rudd, MD Most of us are familiar with Jesus’ story of the Good Samaritan (Luke 10:25-37). This story began with a question about eternal life. In responding, Jesus acknowledged our responsibility to God and others. He then told the parable to explain who “our neighbor” is, identifying especially those who are in need.

Which character in this story do you think is most representative of doctors in our society?

A few (fortunately very few) of our colleagues may be like the robbers: God forbid! Others, when going through difficult times, are like the one beaten and left for dead. Though each of us would prefer to be seen as the Good Samaritan, sadly and too often we respond like the priest or Levite - walking down the other side of the road to avoid the situation. While any of these characters might represent us, there is another character in the story that more commonly reflects most of us in our professional lives - the innkeeper.

After the Good Samaritan provided emergency services, it was the innkeeper who cared for the man until his wounds were healed. We know nothing about the innkeeper’s motivation, but we do know that he was given two silver coins for his work (enough to care for the man for a month) and promised more if it was needed. This scenario is fairly representative of the professional lives of most doctors in our culture. We care for those in need and receive compensation – usually adequate compensation. We often complain about the amount we receive, but there are very few of us who are destitute.

What would the innkeeper have done if he had been offered only one silver coin, or perhaps none? What if the Samaritan’s purse had been empty when he brought the traveler to the inn? Would the innkeeper still have helped with the care of this needy man? We don’t know. What

would you have done if you were the innkeeper? More to the point, what are you currently doing in your practice to help the needy, especially those without resources?

For the past few years CMDA has been encouraging doctors to provide services to the poor to honor God’s heart for the broken and oppressed. We called it “The Four Percent Solution,” asking doctors to commit 4 percent of their time, talent, or treasure to the care of the underserved. Many have accepted the challenge. Some have committed far more.

But now, going forward at CMDA, we wish to move away from formulas and focus more on our identity and obligation as children of God. As physicians and dentists, we are the innkeepers for the sick and wounded of the world. We ask you to consider how many coins are necessary for you to care for those in need. Each of us needs to open our hearts to the underserved and be certain that we apply policies and give care in a way that reflects God’s heart for the poor.

So we ask you, please consider ways to intentionally care for those in need.

Perhaps you can increase the number of uninsured patients that you see in your practice, or volunteer at a healthcare clinic for the poor, or help establish policies with your local hospitals or government bodies that honor God’s heart for the poor. Become an innkeeper who is willing to provide care to the needy even when there are no silver coins. In doing so, you will share the grace and mercy you have received from Christ; you will reflect God’s love; and, you will hear the words of Christ, “. . . whatever you did for the least of these brothers of mine, you did for me” (Matthew 25:40).

If you are committed to caring for the poor in your practices in an intentional way, please let us know your plan.

Contact us at: ccm@cmda.org.

Global Missions Health Conference – November 13-15, 2008 Southeast Christian Church - Louisville, KY The Global Missions Health Conference informs, trains, and equips healthcare professionals and students to use their skills to further God’s kingdom by sharing the gospel with those in need on both international and domestic mission fields. More than 2,500 attended last year.

Plenary Speakers – 2008 Kay Warren, wife of Rick Warren, author of The Purpose-Driven Life Dr. John Patrick, popular speaker on the integration of faith and science Admiral Tim Ziemer, U.S. Malaria Coordinator for the President’s Malaria Initiative

Visit: http://www.medicalmissions.com for more information.

Who should attend?

Healthcare professionals in Medical, Dental, Nursing, Pharmacy, PA, Public Health, Allied Health Care, Psychology and Social Work Students in all medical/nonmedical disciplines, regardless of level of training Non-medical individuals with interests in evangelism, ethics, apologetics, missions, church leadership, caring for the poor, both in the U.S. and overseas, caring for people with HIV/AIDS Career Missionaries

Daily Challenges in Healthcare Bruce MacFadyen, MD President - CMDA

It was a typical busy day. I had surgeries to do, administrative decisions to make, meetings to attend, and teaching responsibilities to students and residents. The day was packed, and delay in any one of these areas would significantly alter my schedule. There was no question I had overbooked the day.

My first operation was delayed due to patient issues; by mid-morning my planned schedule had significantly changed. I would not be able to complete all the things I had hoped to do and thought were important to accomplish. I was becoming impatient at anything that further delayed the day.

I think all of us have been in similar situations. We are trying to do

more with less, often becoming impatient when things do not go as planned. At times we have no margin in our lives, so impatience often follows our frustration. Patient care issues, among other things, can change quickly and can cause many disruptions, challenging our ability to remain patient.

In Galatians 5:22-25 Paul writes about patience as a fruit of the Holy Spirit within us. Peter emphasizes this character trait in 2 Peter 1:5-9 when he teaches that faith produces virtue, virtue knowledge, knowledge self-control, self-control patience, patience godliness, godliness kindness, and kindness love. These verses reflect the biblical principle that if we commit our way to the Lord and trust in Him, the Holy Spirit will increasingly produce these qualities in our lives. We will grow in being effective and productive as we experience the presence of Christ in our lives at work and elsewhere. Are we

growing in our relationship to Christ so that His Spirit is working in us and transforming us? Is His presence in our lives enabling us to trust in Him at the same time we are dealing with stresses coming at us? Are we demonstrating these Christlike characteristics in spite of the circumstances in the daily practice of medicine and dentistry?

When we are being transformed into the person God wants us to be, we can have fruitful lives in spite of stresses. Instead of feeling rushed, we can have time to encourage those around us. In 1 Thessalonians 5:11 we read that encouragement uplifts others. In addition, 1 Thessalonians 2:12 directs us to walk in a manner worthy of God. These are our real daily challenges as we live and work.

Our standard of practice is to become more Christlike every day.

Regional Ministries Midwest Region CMDA Midwest Attn: Allan J. Harmer, ThM 9595 Whitley Dr., Suite 200 Indianapolis, IN 46240 Office: 317-566-9040 • Fax: 317-566-9042 cmdamw@sbcglobal.net

Western Region Michael J. McLaughlin, MDiv PO Box 2169 Clackamas, OR 97015 Office/Cell: 503-522-1950 michaelm@cmdawest.com

Northeast Region Scott Boyles, MDiv P.O. Box 7500 • Bristol, TN 37621 Office: 423-844-1092 Cell: 609-502-2078 Fax: 423-844-1017 scott.boyles@cmda.org

Central Region Douglas S. Hornok, ThM 13402 S 123rd East Place Broken Arrow, OK 74011 Office/Cell: 918-625-3827 cmdacentral@cs.com

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Southeast Region William D. Gunnels, MDiv 106 Fern Drive • Covington, LA 70433 Office/Cell: 985-502-4645 wdgunnels@charter.net

Medical Education International (MEI) Sharing Christ Through Building Relationships

Christians often differ on the “gray areas” in Scripture. The apostle Paul spoke of the freedom we have in Christ.

We must be careful around the “weaker” brother or sister not to use our freedom to needlessly offend or cause them to stumble. However, at times it is our willingness to use our freedom in Christ and forgo legalism, which may help open an unbeliever or nominal believer to consider the claims of Christ. Both of these judgments require wisdom and sensitivity. An MEI participant recently dealt with this issue in reaching out to a colleague. Here is his story, with some details changed into a parable to not offend any readers with scruples about the actual issue in question: Marin, a young surgeon, interpreted for MEI team member Doctor AB during his week in Moldova, a country in Eastern Europe. He was thoroughly exposed to people on the team, who they were and what they were about.

Marin sat in on the team’s orientation meeting and some of the team’s daily spiritual devotions. He heard the personal conversations of team members as they interacted with each other, local believers, and colleagues. But as with many people, his preconceptions went deep and prevented him from being open to what the team believed about God and the gospel. Marin knew on their first Sunday they attended the annual Harvest Festival at one of the largest non-Orthodox churches in Moldova that they had come to the city of Chisinau at the invitation of Emanuel

(Christian) Clinic. He had also experienced first hand the legalistic way in which a local non-Orthodox denomination approached the Christian life.

Marin drew some conclusions about the team as he traveled, ate, and translated for them. But in this short week, he was not able to shake off his preconceived ideas about non-Orthodox Christians.

On the last day, after the sessions had concluded, Marin commented, “I would love to have some meat sacrificed to idols.” AB said, “Okay. I will have some with you.” More than a little surprised, Marin queried, “You would eat that with me? You, a non-Orthodox Christian, would go to the temple restaurant and eat meat sacrificed to idols?” “Yes” replied AB. So off they went. Marin was baffled as his mutually exclusive thoughts warred with each other. These Christians were different from his past experience. Still puzzled, he asked, “How is it that you, a Christian, can do such a thing? Only Orthodox Christians in my country would eat this type of food with me, not those from other Christian groups!?"

AB began to explain that Jesus said, “It is not what a man puts into his mouth that defiles him, but it’s what comes out of his mouth that defiles him.” Food itself, regardless of its type, doesn't defile a man. You know the impact that poor eating habits or overeating can have on an individual’s health and how it affects families, health care costs, etc., but eating this meat today will not hurt me. Idols are nothing but wood and stone, so the meat is the same whether sacrificed to them or not.”

FOR INFORMATION ABOUT MEI OPPORTUNITIES, VISIT:

“Well, I also like the ladies, you know,” Marin commented sheepishly.

AB perceived that he was intimating that he slept around a bit. He shared with him that he must know that it wasn’t a healthy thing to do, nor was it something that pleased God. Marin’s silence acknowledged his assent.

They continued this exchange about their different faith traditions for awhile.

AB then had an opportunity to share the gospel with Marin. This not only rocked Marin’s preconceptions about nonOrthodox Christians, but redefined the “main thing” of Christianity to him. It was not following a set of rules, but the message of God’s mercy and grace.

Through Jesus’ death on the cross, Jesus was able to offer to pay the debt to God that results from our sinful rebellion. AB then gave Marin his own copy of the Scriptures and for the first time in his life, he read the gospel for himself.

Marin did not acknowledge faith in Jesus in that day, but he had his worldview reshaped more than a little bit as a result of AB’s creative faithfulness. “This unplanned event was one of the greatest things that I witnessed on this trip,” AB commented as he shared with us that evening around the dining table.

God may use practices on which believers differ to show others that Christianity is not a religion of rules and legalism, but a relationship with God and His Spirit in the daily practical decisions of life. Will you pray for Marin and others like him to believe in the gospel and for MEI team members to be ever sensitive to how to handle cross-cultural situations for His glory? ✝

WWW .CMDA.ORG/MEI

REMINDER WIMD Fall Conference - “Basking in the Son” The tenth WIMD national conference will be held September 25-28, 2008, in San Diego. Featured speakers include: Nahid Hotchkiss, MA, PhD; Carol Spears, MD; and Gene Rudd, MD. For more information about the conference, including registration details, visit: www.cmda.org/wimd/conference.

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Global Health Outreach (GHO) God of the Details

by Gloria Halverson, MD, and Brenda Wilcox Abraham, MD out the morning another person gave their devotional on THAT VERY verse.

Each person was needed and appreciated. For example, a man who had sought medical help futilely for three years because of progressive weakness “just happened” to come to our clinic that week and “just happened” to be triaged to our rheumatologist, who looked at his hands WIMD team to Cuenca, Ecuador and immediately diagnosed dermatomyositis.

April 19-27, 2008 marked the first One pediatric patient needing a huge Women in Medicine and Dentistry hairy nevus removed from her arm (WIMD) mission trip through GHO. came the day our pediatric O.R. nurse Seventeen women and three men travcould spend the entire day with her. eled to Cuenca, Ecuador, as a medical/ We didn’t have enough anesthesiolosurgical team. We had physicians, gists for the number of cases to be medical students, nurses, a pharmaseen, so our pulmonologist moved cist, a translator, and a general helper. from the outpatient clinic to the O.R. From our first moments in Ecuador, to do conscious sedation, so more we saw God at work – and we saw patients could be helped. We were all Him in all the details. Coming through stretched to use our gifts in new ways. customs, one of our team members God made very clear to us what we lost her passport, money, credit card, have heard in statistics at home. and driver’s license. The specific Many physical problems presenting prayers for the details had begun. to doctors are really a manifestation The statistics from the trip don’t give of spiritual problems. We were spona complete picture. So much more sored by the Verbo church, which happened than 607 patients treated, allowed us to counsel with patient eight minor and twenty-one major surafter patient, addressing their true geries done, and 1107 prescriptions problems while ministerfilled. As a microcosm of the body of ing to the spiritual nature Christ, God brought different personalof their complaints. ities, ages, backgrounds, and talents Pastors and church memtogether and united us as one. bers will follow through The connections began at the U.S. with these patients and airports. They continued as He their spiritual needs. It matched roommates with similar life was amazing to see experiences to help each other. Our God’s work in pairing devotionals were God-inspired to patients with just the right speak to each of our hearts. And our counselor. worship connected us in praise. One A woman whose husperson decided while still at home to band was unfaithful was make laminated Bible verses for the triaged to a physician who group, and just happened to pass them had walked that same FOR INFORMATION ABOUT GHO OPPORTUNITIES, VISIT: 12

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road. A woman who was infertile was able to hear how her physician had found God faithful in that same difficult time. A couple, who came in fighting so much that they were sent for counseling before even having the medical part of their appointment, left after her surgery holding hands and with her carrying the bouquet of flowers he had bought for her. They planned to go to church together the next Sunday.

A patient with an early gynecologic cancer who could not afford treatment and was widowed with six children to care for did not thank us for doing her surgery or for paying for the surgery and pathology needed. She thanked us for caring about her. It was the love of Christ.

What started out as our first WIMD mission trip was unanimously declared the first ANNUAL WIMD mission trip.

The tentative dates for next year’s team are April 25-May 2. Consult the WIMD section of CMDA’s website for details.

By the way, as our doctor with the missing passport was packing to leave the team, fly back to Guayaquil and the U.S. embassy, pay extra for a hotel and to take a translator, a cab driver called from near the airport to say that he had found her passport, charge card, and other papers. Yes, God was in all the details. ✝

Our pharmacy

WWW .CMDA.ORG/GHO

Motivating Your Staff

by David Stevens, MD

Your success as a professional requires more than just knowledge, skill, and the wisdom to know when to apply them. You must also motivate the healthcare team you lead in the hospital, your practice, or your research lab.

Why? Because motivated staff provide compassionate care to your patients. Enthusiastic team members embrace change. Their contagious devotion and commitment make your job easier to do. They stimulate trust, encourage each other, and inspire you to do your work even better. A motivated team has cohesion that makes work a lot more fun.

God taught me about motivation long before I knew I would need that skill. For two summers during college, I sold family Bibles and other Christian books door to door for Southwestern.

Every year they recruit hundreds of college students, with no guarantee of pay, to work seventy-five or more hours a week in spite of doors slammed in their faces and dogs chasing them down the street. Not only do they recruit them, they motivate them to work harder than they ever have in their lives knocking on every door in some county far from home. Every Sunday afternoon, all of us would meet in a regional location for a sales meeting to reveal how well we had done the week before and to get motivated to go out again and work twelve to thirteen hours a day. I remember everyone yelling together, “I feel healthy! I feel happy! I feel terrific!” I

How to get the best from your best people

learned a lot about self-discipline, determination, and attitude during those two summers.

Twelve years later, God used that training to help me motivate other people. It was 1983, and I was starting Tenwek’s Community Health Program. I had arrived as a new missionary two years earlier, the third doctor for 300,000 people. We only had seven to eight trained nursing staff. The hospital was averaging 185 percent occupancy for the year with two and sometimes three patients to a bed. One day during a malaria epidemic we had 485 inpatients in our 135-bed hospital! Days and nights were long as we took care of a never-ending stream of patients. A look at our statistics revealed that preventable diseases were the cause of half of our admissions and half the hospital deaths.

The light bulb went on! I could keep working sixteenhour-days and every third night call for the rest of my career, but things wouldn’t change unless we figured how to motivate people to boil their water, immunize their children, build latrines, space their children, and adopt twenty or so other important health practices.

There was no way we could reach 300,000 people if we had to pay our “Health Helpers” to educate their communities. We would need to recruit volunteers and motivate them to continue to work three half days per week to help their communities for the rest of their lives.

Fast-forward twenty-five years. Today there are over 1,200 community health workers and they reach over a million people whose health has been radically changed.

The vast majority of the people we recruited are still volunteering a quarter of a century later.

Okay, that was Africa. What about the U.S.? A few years ago, Christianity Today and the Christian Management Association honored CMDA as the best Christian workplace in the United States. We were

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Motivating Your Staff

picked because our staff love working at CMDA! They are motivated with many of the same principles I used in Africa with our volunteers. The techniques used may be a little different here, but the principles are the same and they will work for you. Focus on:

have senior staff meetings and task them to pass on information. Have general staff meetings.

Encourage questions.

• Informally – seek input, share thank you notes, post pictures, tell success stories.

Unique Identity

Comparison

Your team needs to know their distinctiveness. What is your unique mission? Why is it important? What does each individual contribute toward accomplishing your collective vision? How are they recognized and lauded for what they do?

Every person desires to invest their life in something significant. They long to know they are needed and are making a unique difference in an important endeavor.

They want others to recognize their contribution. To accomplish these goals: • Inspire staff with your mission, vision, values, and goals.

• Develop a slogan that encapsulates your vision.

• Create a logo that communicates your mission and use it widely.

• Develop a badge, uniform, or other visible means of setting your staff apart.

• Give certificates for training completed or skills mastered.

• Laud your staff for their accomplishments in front of significant others.

Staff are motivated when they know they are doing a good job. In med school they posted our grades using our ID numbers. The first thing I did was look at my grade. The second thing I did was to look to see how my grade compared to everyone else’s. How are individuals doing compared to the standards you have set for your practice, others doing jobs similar to theirs, national standards, or similar practices?

• Formally – working with your staff, set measurable goals that everyone knows – waiting times for patients, lab turn around, call backs, etc. Let staff report how they are doing, and make the overall report known to all on a monthly basis. Compare them to national averages. Have small groups focus on how to improve their work to meet their goals.

• Informally – give real time feedback when things go well or don’t. Laud individual staff in front of their significant others. Reward them - it is not what you give, but how you give and what it means.

Communicate that you are going to be the best practice in your town, state, or even the country.

Competition

Communication Good communication vertically and horizontally lets staff know what is going on. Poor communication breeds distrust or worse, apathy. Tell stories of how staff have made a difference in a patient’s life or done something extraordinary to do their job better with a new innovation or extra education. Share dreams, discuss problems, seek input, reveal your financial situation, or whatever else you can do to be transparent. This gives your staff a sense of ownership and importance.

• Formally – start a staff newsletter, have regular meetings to keep everyone updated, send e-mails, 14

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Competition is a great motivator. Create two types of opportunities – those that everyone can win by meeting a minimal level and those that recognize your top people. Rewards can be privileges (employee of the month parking space), financial rewards, prizes, or recognition. You might reward: • Fewest rejected insurance claims.

• Best new patient information sheet.

• Greatest suggestion this month.

• Employee of the month.

Sense of Family When I interview prospective employees, I tell them that we don’t hire new staff; we adopt people into our family. I constantly refer to “our CMDA family.” I believe God has entrusted each of my staff into my care to help them serve Him through their work. I want to disciple, counsel, encourage, train, and supervise them to be all that God has designed them to be. You might consider: • Parties – any excuse, fun, crazy . . . and get right in the middle of them. Take pictures that they can

had fun selling their junk in our parking lot. There was a lot of laughter and we made some good memories.

When the movie “Amazing Grace” came out I surprised the staff, shut the office, rented a bus, and took them all to the movie and for ice cream sundaes afterward. Human trafficking is one of CMDA’s issues, so it was inspirational, educational, and family fun!

I challenge you to motivate for success. You will have better staff retention, higher work output, better served patients, and a lot more fun at work every day! ✝

David Stevens, MD, MA (Ethics),

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There are many more techniques than this short article allows me to share. Be creative. Brainstorm things you can do for each principle. Last year we had a community garden on CMDA’s property, where everyone could garden together in the evening or weekends. Recently, we had a CMDA yard sale where staff

is the CEO of CMDA. From 1981 to 1991, Dr. Stevens served as a missionary doctor in Kenya, helping to transform Tenwek Hospital into one of the premier mission healthcare facilities in that country. As a leading spokesman for Christian doctors in America, Dr. Stevens has conducted hundreds of television, radio, and print media interviews. Dr. Stevens holds degrees from Asbury College and the University of Louisville School of Medicine. He is board certified in family practice. He earned a master’s degree in bioethics from Trinity International University in 2002.

Motivating Your Staff

share with others. You want to make memories.

CMDA’s staff parties are legendary!

• Celebrate – accomplishments, birthdays, new babies, weddings.

• Show concern – deaths, illnesses, other crises.

• Surprise them – let staff off early, invite them to your home, take them out for lunch in small groups to get to know them better.

The Problem of Time

by Al Weir, MD You can develop skills for managing your time versus the reverse

I had it all figured out. I told my office to schedule my last patient at 3:30. With the likelihood of being one hour behind by then, I could just make it to see my son pitch his 6 o’clock baseball game. Deacon’s meeting was at 8 o’clock and Bowen should be finished by then.

Supper could wait – I had a cup of yogurt for breakfast.

Just as I was finishing up with my last patient at 5 o’clock and starting to leave the examining room, I saw a look of anguish on her face and watched her begin the question, and then hold it in. I had a choice to make, and either way I would hurt someone I cared for.

Why is there just not enough time?

Most of us have had days like this. Time often rules our lives and time decisions hurt. I know this is true for doctors because we surveyed our membership in 2005 and found that 41 percent of our doctors listed time management as their chief life challenge and 32 percent listed stress. When we surveyed Christian medical and dental students last year, time management was listed as their second greatest challenge behind the volume of material they had to learn. I could lay out twenty reasons why this is so, but the bottom line truth is that doctors are too busy and overcommitted.

The real crux of time management as Christian doctors is what we choose to put into time rather than how we attempt make more of it. Margie Shealy, one of my

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co-workers at CMDA, recently lost her mother in death and sent to us this note of warning: “One thing that I would like to share with you, that I am sure you already know, is that time is very precious; it is so important to use it wisely, to invest it in others and to not be selfish with it. Don’t look at that time you spend with those who need you as an obligation, but as a privilege.”

With what should we be filling our time? My pastor has told us many times, “The only things you take to heaven are your character and others.” So, what do we fill our time with? A year ago, I surveyed about two hundred Christian doctors with the question, “What is it that has brought joy to your life, both in your practice and outside your practice?” The importance of the question is this: If we can discover that which brings joy to our lives, we should pursue it, placing these things into our time schedule above all else. There were five major avenues to joy described. The first was service: to care of others solely out of a desire for their good. The second was relationships: with patients as whole persons, our families, our colleagues, and our friends. The third was devotion: devoting ourselves to the one relationship that makes all other relationships matter, to God through Christ. The fourth was mission: living out the mission and missions in life that God has called us to. And finally, personal growth: pursuing the God-given passions and longings of our lives in ways that honor the Creator.

I have no doubt that these are the things of eternal substance that should fill our time. The question is, “Have we let life stuff our time with other things of less importance?” And, if so, “How do we retake time from the less important so that it may be filled with eternal substance?”

This second question can be addressed in practical ways. There are a number of skills we can develop that can help us recover time from the less important: 1. Build time into our schedule for quiet time, prayer, and devotion. If we hope to order our ways, we must first place them in His hands.

2. Track how we are spending our time. Keep a daily list for a few days regarding how we spent our time with as much detail as possible. Some of us will be quite surprised at the chunks of unnecessary activities.

5. Make a list. Time efficiency can be improved by as much as 25 percent simply by keeping a list of tasks to complete. That list should be prioritized.

“A” List are tasks that you must Absolutely do “B” List are tasks that you should Begin to do “C” List are tasks that we Could do if time allowed “D” List are tasks that we should Delegate to someone else “E” List are tasks that we should Eliminate “F” List are tasks that we should Forward to a definite date 6. When new tasks cross our desks, they should not pile up on the corner. Reasonable options for new tasks include: a) Throw it away b) Pass it along to someone else c) Take immediate action on it d) Seek more information on it e) File it f) Remember and practice “OHIO”: as much as possible, Only Handle It Once

7. Develop a deliberate plan for the following potential time wasters: a) Telephone interruptions b) Unexpected visitors c) Meetings d) Socializing at work 8. Handle meetings well. Set a time; start on time; stay on agenda; focus discussion around prepared, previewed documents, and shut down on time. As a rule, with a few exceptions, no meeting should last more than an hour and many can be much shorter.

Stand up meetings on average last less than half the time as sit down ones!

In my own life when I take all of this information and distill it, managing time as a Christian doctor comes down to simplify, surrender, and select. I need to simplify my lifestyle so that I am free to complete God’s best plan for my life. I start this process by setting boundaries on my expectations and acquisitions, then move toward removing possessions or activities in my life that use my time in less than vital endeavors. Each morning, I surrender myself to God. I look to heaven and give God all I am, all I have, all my dreams, all my plans, all those I love. Let God entangle me where He will. And, finally, I need to select: these things I will do and these things I will let go. Here I must be deliberate about setting priorities and choosing only the best.

For most of us, this should be reviewed yearly during a special time of reflection.

The Problem of Time

3. Set a half-day in the future when we can sit down with someone we trust and list our priorities in life, remembering the five activities of joy listed above.

4. Develop the organizational systems and staff that allow us to stay on top of things. We may be doing things very inefficiently, or might be short in personnel and having to take more on ourselves than is ideal. Sometimes a consultant can help us in these decisions.

One final lesson is critical: our time is in God’s hands. If we truly offer our lives to Him, if we invite Him to the race each day, no matter what the pace, God will keep up with us. We need not despair when we seem to be losing the battle with time.

Dr. Nabil Jabbour, a retina specialist from Morgantown, West Virginia, told me of a day that his life seemed too fast-paced even for God. His office had overbooked him to the tune of seventy-two patients. He knew the task was impossible and that even God would not find a slot to show Himself.

The day just had to be survived. It began in the hectic, time-pressured way he imagined, but then God stepped in as if to say, “No matter how fast you run, you won’t leave me behind.”

A woman he had treated for some time with progressive blindness greeted him, “I’ve done it!” This patient had consistently denied God’s presence in her life and felt that life had no purpose. Her husband was confined to a nursing home and she was steadily losing her sight. Dr. Jabbour had been seeking to bring her to the Lord, but she had rejected his

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The Problem of Time

God for months as her vision deteriorated and her husband weakened. On this overwhelming, fastpaced day, where even God could not keep up, she exclaimed, “I’ve done it! I’ve found purpose in life.”

She had awakened that day at a point of despair such that she would try anything, and had said to God, “Okay, God, you prove to me today that I can find purpose in life, as I walk nearly blind through a nursing home filled with hopeless people, and I’ll believe in you.”

She carried with her a box of donuts and passed them out perfunctorily as she moved from bed to bed toward her husband. Then, as she left the bedside of one elderly man, he would not let go of her hand. “You don’t know what you’ve done for me,” he said. “What?” she asked. “No one has held that hand for seventeen years.” She fell to her knees in tears and then, during the most hectic office day in Dr. Jabbour’s life, she told him, “There is purpose in life and I know God is real.”

Redeemed from hopelessness, this woman spoke and God said to Dr. Jabbour, “Be wise with your time. Order it well. Walk when you can walk – but when you have to run, remember that I am God and I can keep up with you.” ✝

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Al Weir, MD, is CMDA’s Vice President for Campus and Community Ministries. He is a past president of CMDA. He served as a medical missionary (1983-1985) at Eku Baptist Hospital in Eku, Nigeria. His interests include the relationship of science to Christianity, end-of-life palliative care issues, the role of faith in the practice of medicine/dentristry, and the development of local ministries for CMDA. Ever wonder if your practice is making an eternal difference? Do the pieces of your life still fit together? Are you neglecting important areas of your life? Are you a workaholic or perhaps already burned out? Practice By the Book is just what the doctor ordered! In addition to their own contributions, Drs. Al Weir and Gene Rudd have compiled content from more than a dozen Christian colleagues into a compendium that teaches doctors how to live a life guided by biblical principles. Suitable for both individual and group study. 263 pages/paperback/$16.95 Call 888-231-2637 to order.

Is This What I Signed Up For?

by Autumn Dawn Galbreath, MD, MBA

Working for someone else isn’t for everyone; but it may be for you

Healthcare has changed dramatically over the past fifty years. Theories abound as to the various causes and their effects – with managed care, the Generation X work ethic, and increased numbers of women in medicine being three commonly cited reasons for the decline of the traditional “family doc” who made house-calls and whose work hours were 24/7 as needed and the steep increase in the “physician shift worker” who figuratively clocks in and out and leaves his pager behind when he is off duty. Managed care brought financial pressures to bear on physicians in solo practice. Generation X brought a tide of newly graduated physicians whose definition of balance was quite different from that of their parents’ generation. And the increase in women in medicine created job-sharing and part-time medical jobs, essentially for the first time in modern history. Be these changes good, bad, or some combination of the two, they have created a new paradigm in healthcare with which each physician must grapple as he evaluates his own practice structure and patterns. Like it or not, increasingly we physicians are becoming employees of large organizations like hospitals or multi-specialty practices. Many new medical school graduates proceed with a job search much like the one their nonmedical friends pursue, expecting to ultimately be employees. And as financial pressures continue to squeeze some specialties to the breaking point, physicians who have been in traditional practice are closing their practices in favor of the safety net of employment and a guaranteed paycheck. What is the impact of employment on these physicians and their patients? How does life as an employed physician differ from life in private practice? What are the responsibilities unique to an employed physician? And how do you live out your faith-walk as a physician in the context of a large organization with rules that govern you and your practice?

It is critical for any physician who is considering employment, be he a new graduate or a long-standing physician in private practice, to fully understand what it means to be an employee. Most physicians graduate from medical school without ever having held a longterm job – we have just been too busy with our education. And the struggle is further pronounced among physicians transitioning to employment from private practice, as they are accustomed to being the owners and bosses of a small business. If we do not understand what it means to have a job, then we cannot successfully understand what it will mean to become an employed physician. I propose that understanding this issue is the single most important question facing a physician as he evaluates an employment opportunity. The best company in the entire world will not be a good working environment for him if he is unprepared for the realities of employment.

What are those realities? Employment has its benefits, of course. These are the aspects that I see most physicians focusing on as they consider employment versus private practice: You will receive a secure paycheck on a regular schedule. You will not need to

Physician as Employee

Physician as Employee:

make difficult decisions about staff management. You will not need to negotiate insurance contracts. You will be provided with training and resources related to business functions with which many private practice physicians struggle daily. You will have ensured vacation time, as well as coverage when you are I n t e r n e t W e b s i t e : w w w. c m d a . o r g

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away. You will no longer assume the full risk of your clinical practice.

On the other hand, with the reduced risk comes a reduced level of autonomy. Simply put, as an employee, many times you will have to defer to the well-being of an organization that is larger than you are. Decisions will not revolve around you. Policies will be made by those in leadership based on the overall good of the organization and its employees, and sometimes those decisions will be decisions that you do not like. Systems will be chosen that are the best fit for the most clinicians, but they will almost certainly not be the perfect fit for you. The good or bad behavior of other physicians in your organization will impact you – reputationally, psychologically, possibly financially – just as your behavior will impact them. You will not be an island. You will be one part of a complex landscape called a company.

And you will have responsibility for doing your part toward its well-being.

By this, I do not mean that you are to simply “submit to authority.” Of course, we should submit to those in authority over us because we are biblically commanded to do so. But I believe that it is only the beginning. Submission to authority for submission’s sake – because it’s the right thing to do – is dangerously close to being a hollow obedience. If we submit to the structure and rules of our organization simply because we must, then I believe that we are not living as the employees that God calls us to be. If we, as physicians, accept the benefits of employment and spend the paycheck we are given every month, but refuse to comply with the organization’s policies regarding productivity, treating patients only within the confines of the prescribed clinic area, not exposing the organization to malpractice suits with unorthodox treatments, etc., then we are fundamentally abusing the employment opportunity that has been offered us. Did Jesus say “Give to Caesar what is Caesar’s – but do it grudgingly and see if you can 20

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ever find a time to get away without it?” No. He instructed us to fully and willingly participate in the system under which we work and live.

Does this mean that we will always agree with that system, or that we should do things that we believe to be morally wrong because they have been prescribed by someone in authority? Of course not. But that is not typically the case for us. Should a Christian physician find himself an employee in an organization that suddenly begins requiring him to perform abortions, certainly he should place God’s law above the rules of his company and he should appropriately and respectfully register his unwillingness to violate God’s law on behalf of the company. On the other hand, should his company forbid posting of Scripture passages on the walls of exam rooms, he is not being forced to violate God’s law. He may be frustrated, and he may well be in an employment situation that he can no longer tolerate. But I believe that the godly answer is an appropriate and professional departure from the organization, rather than a conscious violation of the organization’s policies.

As Christian employees, we should be committed to the health and well-being of the organizations that employ us. We should cheerfully participate in activities that further the interests of the organization, assuming that those activities are not morally wrong or harmful to others. In so doing, we will shine as the light of Christ within our organizations. Having been an employed physician for my entire career, I can say that, while employment is not perfect and is not for everyone, employment affords a unique ministry opportunity for the Christian physician. Similar to other Christian physicians, an employed physician can minister to patients on a daily basis. But he has the additional opportunity, and, I believe, obligation, to minister to those in his organization, both by words and by deeds, including investing himself for the benefit of the organization that gives him the privilege of working there. ✝

Autumn Dawn Galbreath, MD, MBA, FACP, FACPE, is an internist in San Antonio, Texas. She teaches at the University of Texas Health Science Center at San Antonio and is currently doing part-time clinical work. She and her husband, David, have three children: Coggin, Ellie, and Norah.

? ?

– and How You Might Respond ?? ?

by Dónal P. O’Mathúna, PhD

Q1. Doctor, do you think alternative medicine is good or bad?

Well, the best answer is that it depends. Alternative medicine includes a wide range of approaches to health along with many types of therapies and remedies. Just like drugs can be good or bad depending on what they are used for, alternative medicine can be good or bad. Some forms are good when used for the right reasons and in the right situations. Other forms of alternative medicine are bad, or can be used for the wrong reasons.

With alternative medical options increasing, here are some answers to patient questions

may be a cost issue, with supplements being less expensive than visiting a doctor and getting a prescription. And some people are drawn to the spirituality that is often included in holistic approaches to alternative medicine.

Q3. Doctor, what is holistic care?

Q2. Why do you think people are so interested in alternative medicine these days?

There are many reasons for this, and individuals will vary in why they choose alternative medicine. Some people are concerned about the side effects of drugs and the invasiveness of modern medicine. They see alternative medicine providing a more natural and gentler approach. Others are drawn to the longer consultation times that typically accompany alternative therapies. They may prefer this to the shorter appointments at conventional practices. For others, it

A holistic approach to health care is one that takes into account the physical, emotional, relational, and spiritual factors that impact one’s health. The role of each dimension is taken into consideration in determining why someone might be feeling unhealthy and in deciding how best to help the person. As such, holistic care is that which takes the whole person into consideration. It can be in keeping with the biblical concern for heart, soul, mind, and strength (Mark 12:30), or it can be a way to introduce alternative forms of spirituality.

Ten Questions

Questions ? Ten You May Hear from Your Patients ? about “Alternative Medicine”

Ten Questions

Q4. Doctor, I’m a Christian. Should I stay away from alternative medicine?

Christians can approach much of alternative medicine in the same way they would approach conventional medicine to ensure they are being wise stewards with all they have been given. However, some forms of alternative medicine include spiritual advice. All such advice would need to be carefully evaluated in light of Scripture and wise counsel. In addition, some therapies have a strong connection to religious systems (e.g. shamanism, Reiki). Using a therapy or alternative medical system that is closely tied to a non-Christian religion is fraught with spiritual dangers. It would be difficult to justify using such forms of alternative medicine when other proven effective options are available.

Q5. Doctor, I read that Christians shouldn’t use drugs. Is that true?

Some people claim that pharmaceutical drugs and modern medicine harm more people than they help.

Some Christians add that the Greek word for drug is pharmakeia, which is denounced in Galatians 5:20.

However, that word is usually translated as “witchcraft” in the Bible. Commentaries support this interpretation, pointing out that many passages praise (or at least endorse) the healing power of medicinal agents (Isaiah 1:6; Jeremiah 51:8; Luke 10:34). This word pharmakeia is sometimes used for witchcraft because of how drugs were often involved in those rituals.

These Christian arguments tie into the way some within the alternative medicine community reject modern medicine. Doctors sometimes make mistakes and people sometimes have bad side effects from treatments. However, medicine also does a lot of good and has developed a lot of treatments that help many people. We must constantly evaluate our actions and systems, and try to improve. God created

the substances that we use as drugs and has given us the knowledge to understand and treat the body.

Therefore, we can use the resources of the world to promote our health, provided we are acting ethically and justly.

Q6. Are herbal remedies safe?

Some are; some aren’t. Most herbal remedies on the market are probably not going to hurt people.

However, many of them are not going to help, either.

If someone avoids or delays getting effective treatment because they use ineffective herbal remedies, they are being harmed. While research is showing that some herbal remedies are effective for specific conditions, thousands of different products are being marketed. Most of these have never been tested to see whether they work or not. Research on a small number of herbs is showing they can be useful for specific conditions, but is also showing that they can interact with other drugs. It is very important to inform your doctor, nurse, or pharmacist about all the drugs, herbal remedies, and dietary supplements you are taking.

Q7. Where should I buy dietary supplements?

That is a difficult question to answer because of current U.S. regulations. Dietary supplements are not required to demonstrate effectiveness or quality before being marketed in the U.S. In general, be very hesitant to buy supplements off the Internet. Although some websites sell good quality products, you can never be sure.

Buying brands from a trusted establishment where you know a knowledgeable healthcare professional is more reliable. In addition, ConsumerLab.com is a recognized independent company that tests dietary supplements and herbal remedies. For a small annual subscription you can access their reports. This will show which brands passed and which failed the tests of quality and purity. They do not test whether the products actually work, though.

Q8. I was thinking about trying acupuncture. What do you think, doctor?

Acupuncture raises all the issues that need to be evaluated about an alternative therapy. From a purely medical perspective, there is good evidence that acupuncture works for certain conditions (like nausea and vomiting after surgery, or for dental pain). There are other conditions for which it is clearly ineffective (in treating asthma, or for weight reduction).

However, acupuncture developed within an Eastern

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Q9. Doctor, my sister said she feels much better since starting a supplement. Do you think I should try it?

One of the difficulties with any remedy is knowing what caused any changes that occur. When we feel better, we look back and wonder if it was because of the last change we made. However, some conditions come and go in their severity. In addition, our bodies and minds are complicated and interconnected. Our expectations influence how we feel, and the power of suggestion can be strong. This is why medicine places so much importance on controlled studies of treatments. These do their best to figure out what effects were caused by the treatment and what resulted from all the other factors, which together are called the placebo effect.

When your sister says that she feels better, it is very difficult to know why. It might have been the supplement, or maybe she made some other changes in her life. Whether or not the supplement will help you depends on whether you have the same underlying issues and if the supplement works. I can only answer your question if we have a good reason to try you on the supplement and if there is evidence from controlled studies that the supplement is effective. So,

let’s talk more about what is going on with you and see how best we can treat your symptoms.

Q10. Where can I get more information about alternative medicine?

A large amount of information on alternative medicine is available in popular books, on the Internet, and increasingly in the professional literature. However, the quality of this information varies widely. Our book is the only one that we are aware of that evaluates both the medical research and the theological beliefs underlying numerous therapies and herbal remedies (Dónal O’Mathúna and Walt Larimore, Alternative Medicine: The Christian Handbook. Updated and Expanded Edition. Grand Rapids, MI: Zondervan, 2007 - see below). The most complete database of medical information on herbal remedies and dietary supplements (but not alternative therapies) is the Natural Medicines Comprehensive Database. It includes summary Patient Handouts and is available online for an annual subscription (www.TheNaturalDatabase.com). A condensed form of similar information, available in book form, is C. W. Fetrow and Juan R. Avila’s Professional’s Handbook of Complementary and Alternative Medicine, 3rd ed. (Philadelphia: Lippincott Williams & Wilkins, 2004). ✝

Ten Questions

religious system, which claims that it works via spiritual energies. The needles are said to impact the flow of these “life energies” to improve health. If acupuncture only involved a spiritual dimension, we would not recommend it at all. But acupuncture needles exert physical effects which may trigger physiological changes. Acupuncture therefore can be practiced in ways that are divorced from its spiritual roots. We believe that acupuncture may be acceptable if used in ways supported by evidence-based practice and by therapists who do not try to promote Eastern beliefs.

At the same time, some Christians may be uncomfortable with acupuncture because of its Eastern roots and they should not be pressured into accepting it.

Keeping pace with the latest developments and research in alternative medicine, this thoroughly revised edition combines the most current information with an easy-to-use format. The three main divisions of this book are: Evaluating Alternative Medicine, Alternative Therapies (alphabetical), and Herbal Remedies, Vitamins, and Dietary Supplements (also alphabetical). 510 pages, $19.99. Order your copy at: www.shopcmda.org.

Dónal P. O’Mathúna, PhD, is Senior Lecturer in Ethics, Decision-Making & Evidence at the School of Nursing in Dublin City University, Ireland. Having come to know the Lord while in graduate school in Pharmacy at Ohio State University, he returned to his native Ireland in 2003 with his family. There he seeks to allow the Lord to use them in Ireland’s rapidly secularizing culture.

He can be reached at: donal.omathuna@dcu.ie.

O’Mathúna and Walt Larimore, MD, authored Alternative Medicine: The Christian Handbook (Updated and Expanded Edition) Grand Rapids, MI: Zondervan, 2007. Available via CMDA.

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Changing Practice, Changing Ministry

Changing<

by Gregg R. Albers, MD

Those who practice in small towns, solo, or small group practice are becoming rare. Doctors trained in the early- to mid-1900s became generalists about 85 percent of the time. The current percentage of doctorowned primary care practices is less than 20 percent.

Today and in the future, a greater percentage of doctors will end up in a clinic or hospital environment where ministering the gospel may be discouraged or not allowed.

How do we minister to patients when we have a secular employer, when we are in academic or research medicine, when we review and consult for the health department or a group of secular specialists? What avenues are available to share what we consider to be most valuable? We must allow the Holy Spirit to give us creative ideas that allow Him to open the doors for personal ministry, where no doors seem to exist.

Ministry in More Restrictive Practice Situations Moving from one military base to another every two years, new friends, new church, new responsibilities, new ministry . . . Richard had made the army his career and enjoyed setting up and working in the primarycare clinics. But the strict environment made it difficult to share Christ. He used his love of teaching Scripture, and would use patients’ diseases to encourage them with spiritual truths. As he would begin a discussion about a patient’s heart disease, he would suggest, “Physically your heart has a hardened artery, which won’t allow blood to flow to the muscle. Wastes build up, slowing the function of the heart. Spiritual ‘heart disease’ is similar. Those wastes in our lives, the broken relationships, angry moments, failures, unfulfilled promises, all need to be disposed of. And only Christ can remove those wastes, those sins, from our lives, and restore proper heart function.”

When the rules offered by an institution, such as a hospital, a public health clinic, or a multi-specialty clinic attempt to discourage doctors from sharing their faith openly, other forums might be available to share with patients, building relationships and trust.

The best and most comprehensive discussion of principles for sharing your faith is found in “The Saline

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Even in a changing practice environment, you can find creative ways to share your faith

Solution,” produced by and available through CMDA. Yet others have found ideas, methods, locations, and activities where they can share their faith, and help to change lives in the process.

Some gifted speakers are using their gift in community educational meetings (“brown-bagging”) to give medical information along with a spiritual testimony or discussion about an issue. This often opens the door for further ministry with patients. Others use their computer to open chat rooms with very specific health-related topics, share the scientific data, but also remain available to discuss the moral and spiritual aspects as well. There are groups encouraging email one-on-one ministry with patients all over the world, with many renewed and changed lives for the effort.

Follow-up phone calls allow us to check on a patient’s medical progress, but can be used to listen for emotional issues, and then offer spiritual advice.

This method of ministry is time consuming but often the most appreciated ministry by patients.

Working in a secular environment, academic, hospital, health department, or military, direct spiritual discussions may be forbidden. Give your business card with your e-mail address along with other Internet websites where patients can get spiritual answers. Sponsoring a “study group,” inviting patients or colleagues to study a spiritually-based

cation (phone call, written, Internet, e-mail, etc.) the patient desires to receive that information.

Getting involved with support groups, or educational groups within a hospital or academic setting is often encouraged by administration. Multiple groups may be available for a given topic (e.g., Alzheimer’s support groups, bereavement, abuse, or addiction groups), and leading a group, offering spirituallybased readings, or offering a time of prayer for family and patients at the end can open a spiritual door.

Many Christian doctors offer care within local hospice groups or in the nursing home setting, and are available to support patients and family members around the time of death.

For smaller group practices, Christian practices, church-affiliated hospitals, missions or indigent healthcare settings, ministry will find a way to flourish. CMDA has a number of excellent resources that are available to help with evangelism methods and ideas that may be right for your situation. See: www.shopcmda.org.

Less Restrictive Practice Settings The long years of residency, every other night on call, scrubbing in for surgery and fighting to stay awake, were made easier by sharing spiritual truths with patients, and praying with like-minded colleagues.

We were discouraged from spiritual discussions in a Catholic Hospital, as our faculty called it “unprofessional.” Some patients would talk about their medical issues and later delve into deeper subjects where spiritual questions would surface. I suggested, “Your question is important, and I will research some answers for you,” while leaving my card. When I had a chance to return, a highlighted article, a page copied from book with some notes on the side, and occasionally a Bible with some bookmarks would be left. “Call me if you want have further questions,” I offered. I was never challenged for doing “research for a patient.”

Not all groups, hospitals, and medical schools are closed completely to spiritual ministry or discussions.

The key to gaining access in these setting is to always ask permission. A number of “non-judgmental” tools can be used, including spiritual questionnaires, a spiritual history, and a social history that includes basic spiritual questions. These tools are designed to seek general spiritual information in a non-threatening manner. Once completed, ask if the person desires more spiritual information, what types of information, and through what avenue of communi-

Changing Practice, Changing Ministry

book is ministry away from the secular environment.

You can make yourself available to colleagues at work for discussions about emotional and/or spiritual issues, offering books, or e-mail resources to spur spiritual interest, and giving an e-mail or home/cell phone for personal issues and one-on-one evangelism.

Opening your home for students or colleagues to talk, to have a meal, to fellowship, to be mentored, to join a Bible study group, may be the easiest way to have a spiritual ministry away from the secular workplace. Mentoring a younger doctor in issues related to the practice of medicine/dentistry, medical ethics, along with spiritual discipling can be rewarding and a wonderful way to build a spiritual support system within a secular practice. Do you have a talent and want to be a mentor? Are you a golfer, a musician, have an interesting hobby or avocation? Use your interest and talent to bond with another doctor with similar interests, and use your time together to build a relationship sharing your changed life and dreams with your colleague. You will find mentoring to be an extremely rewarding opportunity for building lasting ministry in others.

Getting involved with Global Health Outreach offers excellent training and fellowship to doctors, sending them to areas of need around the world, changing the lives of patients and the doctors and staff who volunteer.

Ideas That Open Doors A long-time friend and CMDA member, Curtis Harris, uses art in his office to stimulate spiritual dialogue as appropriate. He wrote, “Every day I look at the framed print of Nathan Greene’s ‘The Difficult Case’ that hangs over my desk. As my patients sit with me during the interview, I often have the opportunity to say something about how Christ is my Shepherd, in my personal and professional life - a comment that I n t e r n e t W e b s i t e : w w w. c m d a . o r g

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Changing Practice, Changing Ministry

often opens the door for more conversation. I am grateful every day for the Christian leadership of the Native American tribe I work with, the emphasis on family, the freedom they give me to discuss my faith.”

Dr. Charles P. Bass, who has been a member since 1948, recently sent this note about how he has evangelized patients through the years. “When I entered medical practice in 1954, I searched for a way to witness to patients about Jesus without offending or intimidating them. This is the method I used: Place five to six gospels of John in each patient’s room.

While waiting, some people will pick up a copy.

When I enter the room and the patient is holding the book, it is easy to say, ‘What a wonderful book about Jesus. When I was 15 years old I trusted Jesus as my Savior. That was the best day of my life.’ The patient has opened the door by picking up the gospel of John.”

We still keep the “Four Spiritual Laws” from Campus Crusade and New Testaments in our waiting room, patient rooms, and other offices, as a means of opening a heart to His Word.

When we desire to find an avenue for spiritual ministry in whatever practice situation God has called us, He will always open a window when the door is shut in our face. Patiently pray and wait for the breeze. ✝

The Difficult Case by Nathan Greene, courtesy of Hart Classic Editions This print, and an identical postcard, are available for purchase. See: www.shopcmda.org.

has practiced in Lynchburg, Virginia, for the last twenty-five years. He was trained at the Medical College of Ohio, and completed his residency in Family Medicine at Mercy Hospital, Toledo.

He owns and operates Light Medical, Inc., a Christian primary care practice, and is medical director of Pathways, a medical consultant for the department of Psychiatry, and medical director at Fairmont Crossing, a nursing home in Amherst, Virginia. Dr. Albers has authored four books, has had a nationally broadcast radio program, “Health Journal,” and works with publishers of books and periodicals for articles and editing.

He is currently working with administration to begin a School of Medicine at Liberty University.

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Paid Advertisement

Gregg R. Albers, MD,

Treating Gospel Debt

The following article is adapted from the book Breathing Grace: What You Need More Than Your Next Breath by bestselling author Dr. Harry Kraus, one of our missionary members.

Dr. Kraus’s writings have been a great encouragement to me, and I’m sure they will be to you, too. – David Stevens, MD

Treating Gospel Debt

Billy Dean was a goner.

And not within a day or two.

No oxygen.

No life.

Within minutes.

by Harry Kraus, MD

The ABCs of Spiritual Resuscitation Last issue, we introduced the concept of “Gospel Debt.” Like its physical corollary, oxygen debt, we defined gospel debt as when my soul is demanding payment and the currency is grace. And just as the ABCs of physical resuscitation are focused on getting patients out of oxygen debt, we can turn to the ABCs of spiritual resuscitation to help us focus our priorities on getting out of gospel debt.

A is for Airway – Acknowledge Your Need Typical motherly advice includes, “Look both ways before you cross the street.” “Don’t ever get in the car with a stranger.” But some advice would seem so obvious that caring mothers don’t need to give it. For example, “Never bite a rattlesnake.”

Billy Dean’s frontal lobes had been generously lubricated with Budweiser so he wasn’t behaving very rationally that day when he was treated by my surgical practice in Virginia. The name has been changed to protect the innocent, or in this case the not so innocent.

“Stupid” fits better, but last I checked stupidity isn’t against the law.

Billy Dean enjoyed the low rumble of his Harley Davidson, but decided he’d had too many beers to use it that day. So down the country road on his bicycle he wobbled, the perfect activity on a warm summer afternoon. That’s when a pesky rattlesnake changed everything. It was lying in the road, absorbing the heat, when Billy decided to have a little fun. After all, how hard can it be to catch a rattlesnake? That Australian crocodile-hunter chap on TV always made it look easy.

Billy dismounted his bicycle and soon had a snake by the tail. But controlling the other end of the snake presented a problem. The tail sported those neat rattles, but the head contained not so neat things like fangs . . . and venom.

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Treating Gospel Debt

A moment after its tail was in Billy’s grasp, the snake took revenge on Billy’s hand, which made Billy Dean mad. The Budweiser made him stupid. Eye-for-an-eye, bite-for-a-bite, he figured, so he decided to bite back.

Now, by this time, Billy had the snake firmly gripped behind its head, so when he lifted it to his mouth to execute his attack-plan, the snake bit him again, this time sinking its fangs in Billy’s cheek, right at the corner of his mouth.

Fast-forward an hour. Billy Dean arrives in the local emergency room, carried in by the rescue squad who are destined to repeat Billy’s story a thousand times. By the time he gets to the hospital, Billy is showing signs of a significant venom effect. He needs anti-venom, ASAP, but that isn’t priority number one. Priority number one is always the same: A is for Airway.

Billy’s breathing had become difficult as the swelling around his voice-box and vocal cords increased. We use the word “stridor” to describe the whistling noise that is made when the airway is closing off. Stridor isn’t a happy, willful whistle like you make when you close your lips around a song. Stridor is scary stuff to the emergency physician. It means the airway is being lost and action must be taken to save the patient. NOW!

within a day or two. No oxygen. No life. Within minutes. It’s that simple. And it’s that important.

Let’s look again at the problem of gospel debt. As Christians, we acknowledge that the cross of Christ is absolutely sufficient to place us in right standing before God. But sadly, we don’t always behave that way. We act as if God might love us more if we performed a little better. Conversely, sometimes we excuse away bad behavior. In both cases, we’re acting out of gospel debt and are in serious need of spiritual resuscitation. Is there a spiritual equivalent to airway obstruction, a sure way to choke off the life-giving grace that our souls need for resuscitation? Sure. Here, we encounter the first initial in our treatment plan. A is for Acknowledge Your Need.

Remember what we contributed to our salvation?

Nothing but our need. We came to Christ at a point when the lights came on and our sin was finally exposed. And all we had to do was realize it. This is the essence of repentance. No one ever comes to Christ for salvation who doesn’t see his or her own problem. And no one ever finds himself or herself free from the entanglement of gospel debt if they don’t realize their own need.

This is why pride sounds the death knell to our spiritual lives. It completely shuts off the airway, the avenue for God’s abundant grace to flow into our needy souls. When we operate out of the false gospel of pride, we are blind to our sin, blind to our need, and blind to the available solution.

But being open to a solution doesn’t automatically guarantee a successful resuscitation effort. Just as an open airway is just the first step, laying aside our pride only opens the way for grace to work. Next, we need to believe the gospel.

B is for Believe – Believe the Gospel

Fortunately for Billy, the physician staffing the emergency room was able to insert a breathing tube through his swelling vocal cords and preserve a passage to allow oxygen back into Billy’s starving body. It goes without saying that without a way in, the oxygen available all around us does little to help. Without a way to let the oxygen in, Billy Dean was a goner. And not

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I have a friend who is a C1-2 quadriplegic. He has an open airway, but he can’t breath without assistance.

Some of us have a similar spiritual problem. We’ve acknowledged our need, but we still need to look to Christ for the solution (the essence of faith in the promises in the gospel). Let’s look at an example of the ABCs in action so you will get the idea.

I find myself anxious about an upcoming presentation. I have so much to do and so little time. What if I can’t remember what I wanted to say? At that moment, I’m functioning out of a gospel debt. I’m acting out of a false gospel of pride. When I am functioning in appropriate gospel saturation, I am treasuring Christ as the solution, and He gets the glory He deserves. When I am functioning out of my own pride, I’m worried

C is for Communion – Commune with God

keeping his airway open was removed. In time, he became known as a folk-hero of sorts. (What does this say about our present culture?) He even had a short article written about him in a biker magazine. Tough guy. Won’t take anything from anyone, not even a rattlesnake.

Oh well, maybe he learned something from the event. Maybe he even tells his kids what his mother evidently never told him: “Never bite a rattlesnake.” ✝

Harry Kraus, MD, FACS, is a missionary surgeon practicing in Kijabe, Kenya. He is the bestselling author of multiple novels and Breathing Grace: What You Need More Than Your Next Breath, from which this article is adapted.

Used by permission of Crossway Books, a publishing ministry of Good News Publishers, Wheaton, IL 60187, www.crossway.com. Copies of Breathing Grace can be purchased through CMDA Life & Health Resources: 888-231-3637, or visit: www.shopcmda.org.

Paid Advertisement

Communion with God and His Word takes time, which allows the grace of the gospel to saturate every area of our lives. Time in silence and solitude is a lost discipline to most of us, but so necessary to help us keep the cross of Christ in proper focus.

Treating Gospel Debt

about how I’ll look to others. I’m the one being treasured, and I’m hoping I’ll get the glory for giving a great presentation.

So I realize the problem. I’m anxious. Step A is to acknowledge my need. I see that I’ve been trying to bridge the gospel gap by trying to look good. That opens the graceway, the avenue for grace to enter my soul. But I still need to believe the message of the gospel for it to be effective in my life. I choose to believe that God is in charge of my salvation and every ongoing need in my life. He is the one who is at work, requiring only my need and my willingness to turn to Him for a solution. It is this turning to Him, this leaning on Him to meet the need that is the essence of Step B: Believe the Gospel. In this case, we could have gotten even more specific, pulling any number of promises from the Bible that deal with anxiety and choosing to believe them.

The ABCs. Simple enough to memorize and if practiced, to become reflex. So, just like the physical resuscitation ABCs, when confusion is reigning, a proper application helps us focus our attention on the critical details. Application of the spiritual guide to resuscitation can help us move forward instead of sideways (or backwards) in our faith walk.

Oh yeah, do you want to know what happened to Billy Dean? He spent a few days on a ventilator with his head swelled up like a balloon. He recovered.

When his swelling went down, the breathing tube

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APOLOGETICS SERIES

Miracles are Possible

by Robert W. Martin III, MD, MAR Note: This is the sixth article in this series on apologetics. The pages are designed for ease in copying for personal study, discussion in a group setting, or for distribution to colleagues and staff. Installment seven is scheduled to appear in the Spring 2009 issue.

I. Introduction “Bob, you are a basic science researcher and physician, how can you believe in (biblical) miracles?” asked a skeptical colleague. “You cannot believe in miracles and call yourself a scientist. That is schizophrenic!”

For the post-modern mind in general and unbelieving scientists/scholars in particular, nothing seems more ridiculous than to suggest that biblical miracles can occur (and did occur). “Ridiculous” to one mind, however, may be “reasonable” to another.

II. Credibility of Miracles – Why Hume Was Wrong Miracles are very different from natural laws. Miracles are unusual and irregular acts of God that occur in the world.

A miracle does not violate or contradict the natural law of cause and effect; it is a new effect, introduced by a supernatural cause on a special occasion in the natural world that is truly unique and has theological, moral, doctrinal, and teleological dimensions.

In contrast, natural laws describe the usual and orderly way the world operates. Natural laws describe naturally caused regularities; a miracle is a supernaturally caused singularity. This doesn’t mean miracles are violations of natural laws or that all singularities occurring in nature are miracles.

If a theistic God exists, then the miraculous has already occurred in cosmic history. In fact, the only way to show that miracles are impossible is to disprove the existence of God. Despite this simple argument, arguments against miracles still deserve to be addressed: “David Hume proved miracles are impossible over 100 years ago!”

Hume argued that natural laws describe regular occurrences, established by uniform human experience.

Miracles violate natural law and are rare, contrary to human experience. Since wise persons base belief on the greater evidence for regular occurrences, they should never believe in miracles, unless the evidence is greater for the miracle than for uniform experience.

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Hume’s first logical fallacy is a “category mistake.”

Miracles deal with irregular singular events that aren’t even in the same category as repeatable natural events.

Hume’s next logical fallacy it to “beg the question” (argue in a circle) in favor of naturalism. He assumes that only natural explanations can be believed because only natural causes exist. He is essentially arguing that miracles cannot occur because miracles do not occur.

Christians argue that miracles are “exceptions to,” not violations of, natural laws. Natural law deals with regular events, not singularities like miracles. Consider the resurrection. According to Hume, the uniform experience of mankind tells you dead people don’t come back to life. But Hume mistakenly adds evidence by looking at the number of times something did not occur instead of weighing the evidence of a singular event by considering the circumstances and witnesses.

It doesn’t matter how many people have not come back from the dead. What is the evidence that Jesus DID come back from the dead, and what evidence supports this event? It is “special pleading” (only selecting experiences of some people who have not experienced a miracle) and “circular reasoning” (presuming to know in advance that all possible experience past, present, and future will confirm naturalism) to assume that all experience against miracles is uniform. Christianity claims over 500 reliable witnesses in a historically reliable book, the Bible!

Finally, if Hume’s argument is correct then even evolutionists cannot believe the central premises of their naturalistic view, since the “big bang,” spontaneous generation of first life, macro-evolution, and our solar system have happened only ONCE. Singularities do occur!

III. Possibility of Miracles – Questions & Answers “Scientists only believe what I can prove scientifically.”

There are several problems with this frequent comment.

First, the comment itself is self-defeating, because it cannot be proven scientifically! You cannot put this statement in a test tube and evaluate its truthfulness because it is a philosophical statement about science!

Second, facts/data do not interpret themselves. Every scientist approaches data with a predetermined set of assumptions (i.e., worldview) that implicitly or explicitly affect their interpretation. A good example of this is the macroevolution debate (discussed in our next article).

Third, the Christian asks, “Which investigative science are you referring to?” The idea of a Creator and miracles seems improbable to most scientists because they do not recognize the distinction between operation (empirical) and origin (speculative/forensic) sciences. Both sciences require that their explanations be comprehensive and noncontradictory, but they differ in their use of other principles to investigate and explain either repeatable natural laws (operational/empiric science) or singular events (origin/ forensic science). Understanding this valid distinction between operation and origin sciences refutes the seemingly incontrovertible arguments against miracles that have been raised and persisted over the centuries.

“What do you mean by Operation Science?”

Operation science is empirical science that employs repetition and observation. It deals with the way things operate now by studying regular and repeated phenomena through experiment (repetitive observation). The conclusions are falsifiable (if the cause does not always yield the same result) and have predictive value of what will happen in future experiments. This is the “science” most people are acquainted with.

“How does Origin Science deal with singular events?”

Origin science deals with past singularities. Since historical singularities are not observed or repeatable, they must be reconstructed by evaluating the evidence that remains.

Examples include murders, crimes, archeological finds, origin of the universe, first life, and miracles. Furthermore, conclusions are either plausible or implausible and are not falsifiable (because they cannot be repeated and observed, since they occur only once).

Origin science employs the four principles of consistency, comprehensiveness, causality, and uniformity/analogy.

First, all theories must be logically consistent or non-contradictory with all other elements of one’s scientific views.

For example, you cannot hold that the cosmos was both created and non-created.

Second, the scientific explanation must be comprehensive enough to explain the known facts. While anomalies may exist, no indisputable data can be neglected in theory construction. Usually, the most comprehensive explanation is the correct one.

Third, the principle of causality states that everything that “comes into existence” had a cause. This is true for unobserved as well as observed events. All forms of investigative science are based on the principle of causality. A primary cause is the first cause that explains singularities that happen once and have no natural explanation. Secondary causes are natural causes and laws that govern the way things repeatedly operate. While natural laws regulate the operation of things, they do not account for the origin of all things. For example, motors function in accord with phys-

ical laws (secondary causes), but physical laws do not produce motors; intelligent minds (primary causes) do.

Fourth, the principle of uniformity affirms that certain kinds of causes regularly produce certain kinds of effects and the cause of certain kinds of events now would have produced like events in the past (“the present is the key to the past”). Since we do not have direct access to the past, we can “know” the cause of events only by analogy with the present. Repeated observation reveals that intelligent (primary) and natural (secondary) causes regularly produce distinctive kinds of events. For example, waves produce certain naturally occurring patterns (secondary cause) on beaches.

But when we observe “Bob loves Deb” etched in a beach, we do not believe that the waves (secondary cause) produced these words because they demonstrate a complex (unrepeating) and specific order (i.e., specified complexity).

Therefore, an intelligent (primary) cause was involved.

“Accepting miracles invalidates the scientific method!”

Miracles are singular events that are not repeated; therefore, the scientific law is not invalidated. The key is to use the correct scientific method, origin science!

Further, this argument falsely assumes that no matter what happens in the world, it must be a natural event.

Attempting to use the principles of operation science (repetition and observation) to evaluate singular, unrepeatable events is analogous to performing brain surgery with tools designed for repairing car engines.

If an event is irregular, once forever, and has specified complexity (intelligent design is manifested in it) you do not need a naturalistic explanation. In fact, an honest intellectual recognizes that intelligent cause best explains what has taken place.

IV. Summary Miracles are possible and credible. The existence of a theistic God demonstrates the probability and reality of miracles. Arguments against miracles fail because of logical fallacies and lack of recognition of the difference between origin and operation science. ✝

Robert W. Martin III, MD, MAR, lives in Lafayette, Indiana, where he practices Dermatology and Dermato-pathology. He is married, with four children. He has served on the faculty of Johns Hopkins, Case Western Reserve, and now Indiana University and Purdue Pharmacy School. He has a Masters in Religion from Southern Evangelical Seminary. His Just Add Water (Volume 3.1: Apologetics for the Health Professional), available via CMDA’s website, utilizes Norman Geisler’s twelve-point “Classical Apologetic” approach fashioned after Paul’s apologetic in Acts 17. Dr. Martin may be reached by e-mail at: martinr@arnett.com.

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CLASSIFIEDS Overseas Positions

Open Positions

Missions – China – Come to China as a tentmaker! Medical group is now looking for FPs, pediatricians, OB/GYN, PT/OT, dentists and subspecialties with local potential.

Good salary and benefits. Send CV to Yong Lee, MD at yonglie.lee@ parkwayhealth.cn.

Dermatologist – Exceptional opportunity in beautiful Asheville, NC. Busy solo derm in well established practice recruiting for BE/BC general dermatologist as well as cosmetic. Moh's would be a plus. Great area to raise a family with many outdoor opportunities. Competitive compensation package including salary guarantee and incentive and benefits. E-mail CV/ cover letter to ehorner@charter.net.

Pakistan – Christian physicians urgently needed for ST/LT in rural Shikarpur Christian Hospital: female (GP/FP, OB/GYN, GS) for OB/general; male/ female pediatrician, OB/ GYN for ST teaching GYN surgery. Contact Bill Bowman, MD at (714) 963-2620 or drbillbow@aol.com.

Emergency Medicine Physician Opportunity - Washington State.

Stable fee for service democratic group is expanding services and recruiting board certified/prepared emergency medicine physicians for full-time positions. Excellent compensation, work environment, specialty and administrative support for this 30K/year VED. Excellent schools and outdoor recreation make Wenatchee a desirable place to live. Contact Scott Stroming at (509) 679-3635 or Stroming@nwi.net.

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Family Medicine – An established practice, 1 physician and NP, in EC Indiana seeks an additional FP with inpatient, OB optional. An employed position with one of Indiana's premier healthcare organizations.

E-mail: Lwilson@chsmail.org or Fax: (765) 751-2759.

Family Practice – Cedar Falls, Iowa.

Step into a busy practice with a wellrespected Christian group of seven FPs. The need for an additional practitioner was created by the steady growth in a neighborhood of young families. Salary guarantee with a bonus structure. Living in a university town with excellent schools, a four season climate and a supportive group of colleagues who live their Christian values makes this an outstanding opportunity. Contact Janice Yagla at (888) 780-0390 or e-mail CV to Janice.Yagla@wfhc.org.

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Family Practice – Virginia. Established Christian family practice seeks BC/BE physician to join group of two in an outpatient only setting located in the historic Central Shenandoah Valley.

Income guarantee and relocation assistance. Contact Stephanie Hutchens at (540) 564-7176 or shutchens@valleyhealthplan.com.

Geriatrics – In His Image Faculty – In His Image Family Medicine Residency in Tulsa, OK is seeking a Family Physician or Internist with strong interest/experience in geriatrics (CAQ preferred) to practice and teach in a large retirement center. Lots of opportunity for development at that site and in the community. Options for a part time primary care practice at our main clinic and participation in our hospital teaching service. Contact Dr. Hamilton at (918) 493-7870; Fax: (918) 493-7888; E-mail: fhamilton@inhisimage.org.

Neurologist – North Carolina.

Sandhills Neurologist, PA is seeking two BC/BE Neurologist, exclusively out-patient practice. This practice is interested in the physical and spiritual needs of the patient. Located in south central NC. World-renowned golfing resort, family-oriented community with large draw area.

Approx. 2.5 hrs from beaches and mountains. Contact: voss.sandhillsneuro@gmail.com.

Orthopedic – Well-established practice of three orthopedists committed to providing orthopedic care with compassion as well as excellence.

Time off for short-term missions.

Would like to talk with general and subspecialty orthopedists about the possibility of joining us in practice.

On-site surgery center; local hospital within walking distance. Located in a family-oriented city where many recreational and cultural activities are available. Less than a 10 minute commute from any area of the city.

CLASSIFIEDS Otolaryngologist – Beautiful North Cascades area of Washington State.

Located between Seattle, Washington and Vancouver, B.C. The area offers quick access to the San Juan Islands or the Cascade Mountains for hiking, fishing, kayaking, to name just a few of the exceptional outdoor recreational opportunities available. An excellent partnership opportunity to join

a well established five-man physician practice in Washington State.

We are seeking a board eligible or board certified physician. Please contact: Human Resources Department, Brooke Herzberg, Director, Cascade Medical Group: (360) 336-2178 or e-mail: brookeh@cascademedicalgroup.com.

Pediatrician – Burlington, North Carolina. Private Practice seeking BC/BE pediatrician proficient in Spanish. Full service practice, neonatology coverage. Call 1:4.

Competitive salary and benefits.

2 hours from coast/mountains.

Accepting H1B visa. Contact Dr. Stein at (336) 570-0010; Fax: 336-570-0012; E-mail: infamclin@bellsouth.net.

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Low malpractice rates and cost of living. Vacation at the mountains and the beach; live here and enjoy all four seasons. Please contact our Medical Director, Dr. Chris Wilkinson at (308) 865-1403 or cwilkinson@kearneyortho.com.

Our clinic manager, Vicki Aten, can be reached at (308) 865-2512 or vaten@kearneyortho.com.

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Primary Care Physician Opportunities – Minnesota, South Dakota and Iowa. Avera McKennan Hospital is seeking BC/BE primary care physicians interested in practicing in a rural setting. The communities and practice opportunities are diverse, offering you an excellent career with a great quality of life!

The physicians are employed with a generous benefit package. Loan repayment is available! Contact Suzette Hohwieler, Physician Recruiter, at (605) 371-1783 or suzette.hohwieler@mckennan.org.

General Surgeon Needed to join a three-surgeon practice in Charlevoix, Michigan; the “gold coast” of northern Lake Michigan. Excellent family environment, schools and abundant recreation Broad range of surgical cases with state-of-the-art OR suites and ancillary support including 32-slice CT, MRI and digital radiography. No practice buy-in; share equal call time.

Join respected, compassionate physicians who consider medicine our mission, here and overseas.

Call (231) 547-8908; E-mail: jschodde@cah.org.

I n t e r n e t W e b s i t e : w w w. c m d a . o r g

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Fall 2008

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