Five questions about being a missionary doctor

Justice in healthcare can take many different forms. It is a vital subject that every provider and practitioner needs to grapple with. In this post, we’ll cover a few of the common questions that will come up over the course of a healthcare provider’s work.  We’ll look at justice in healthcare as it relates to a time of a pandemic, social determinants, mental health considerations, and health disparities that often arise and exist when there is injustice in healthcare.  #1 We must understand justice in healthcare during a pandemic. Dr. David Stevens wrote about this topic in A Christian Healthcare Worker's Response to COVID-19.  Justice in healthcare is a tough topic, but it’s compounded during a pandemic, and it quickly becomes way more difficult to discuss. Allocating limited resources raises the ethical issue of justice—how do you treat patients fairly? How do you care for people—especially when so many more people need life and death care—and quickly? Dr. Stevens offers the following advice: First, you always want to be as impartial as the situation allows. Second, do the best you can for the most people with the resources you have. Third, without enough time, personnel, supplies, or supplies, at some point you will be forced to decide who gets and who doesn’t get your limited resource. You have the moral obligation to be constantly working to get the resources you need, so you won’t have to continue to make utilitarian decisions. Lastly, be sure to continue reading for more wisdom in the area of healthcare during a pandemic. #2 We must understand social determinants of health. According to Healthy People 2020, “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”  This is an issue of justice in healthcare because professionals must be committed to looking at the whole person, not just the malady. If a person is born and lives in an area with pollution, crime, violence, a poor education system, and few job opportunities, their health concerns will stem from those social determinants. Hospitals, clinics, doctors, and practitioners must be prepared to address these social issues if we want to see widespread improvements in health. #3 We need to understand mental health. Undiagnosed and untreated mental health disorders can lead to an array of serious ramifications including substance abuse, homelessness, interpersonal violence, and more. Ensuring that patients can access healthcare is vital. This might look like hiring community health workers to help navigate difficult systems or accepting patients who are uninsured or underinsured. Helping those who have difficulty navigating complex healthcare systems is a way to ensure that there is justice in healthcare. #4 We must consider health disparities. Another way to focus on justice in healthcare is to concentrate efforts on eliminating the health disparities we see that are based on race in the US. According to the Centers for Disease Control and Prevention, “Community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, policymakers, and others all have a part in helping to promote fair access to health.”  The population health impact of COVID-19 has exposed longstanding inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19. According to the National Institutes of Health, although significant progress has been made in narrowing the gap in health outcomes (NCHS, 2016), the elimination of disparities in health has yet to be achieved. Despite overall improvements in health over time, some health disparities persist.  For example, while national infant mortality rates decreased overall by 14 percent from 2004 to 2014, Native Americans and Alaskan Natives have an infant mortality rate that is 60 percent higher than the rate for their white counterparts (HHS, 2014) and in 2013, infants born to African American mothers experienced the highest rates of infant mortality. Sadly, African Americans were 30 percent more likely than whites to die prematurely from heart disease in 2010, and African American men are twice as likely as whites to die prematurely from a stroke. Addressing these persistent health disparities in every way that you can is another way to fight for justice in healthcare.  There are so many more issues facing us when it comes to justice in healthcare. However, trying to learn and start to address these four areas, from how we handle these issues in a time of a pandemic, social determinants, mental health considerations, and health disparities, we’ll begin the process of creating a world where there truly is justice in healthcare.

Does being a medical missionary mean you have to go overseas? Is serving in the United States any different than just living your normal life in America? In this post, we want to cover all things related to medical mission trips in the USA. I want to give you three areas where you can serve and some options for you to consider as you think about your role. My hope is that you will be encouraged and challenged to serve and use your skills in the US. Here are several areas where you can serve in medical mission trips in the USA: #1 Rural hospitals and clinics For one example, see Dayspring Health Center in Appalachia where GMHC speaker and resource contributor, Geogy Thomas serves. God started to impress upon Geogy the plight of the rural poor and the disparities of the healthcare system in America. That took him to a rural clinic on the Kentucky/Tennessee border. In 1952, times were tough in rural Appalachian communities due to the closing of many of the local coal mines. Medical services were meager at best. The story of Dayspring began in this setting. The United Mine Workers Association and the American Medical Association worked with local community leaders to address the lack of adequate health care.  The first full-time physician began seeing patients in August 1954, charging $2 a visit. Today, patients are still being seen in this underserved area, where the staff promotes full health—physical, spiritual, mental, and economic—of the communities they serve. #2 Urban clinics One example of an urban clinic is Christ Community Health Services, where healthcare staff are filling the physical, spiritual, emotional needs of the underserved, the uninsured, and the homeless in the Memphis, Tennessee region. Christ Community strategically entered Memphis communities over 25 years ago that had become deficient in resources and services. Many of the neighborhood residents lacked access to healthcare resulting in manageable health issues going untreated and undiagnosed. Christ Community is standing in the gap, delivering quality healthcare and spiritual healing to those in their community who need it most. When patients enter the doors of Christ Community, they feel the love and hope for their lives and their healing. Patients who enter the doors of Christ Community are treated with dignity and respect, along with spiritual healing and the opportunity to experience God’s love in prayer. #3 Faith-based clinics One example is Lawndale Christian Health Center, where the mission is to show and share the love of Jesus by promoting wellness and providing quality, affordable healthcare for an under-resourced community in the Chicago area. The median income in Lawndale is $22,383 and the clinic was started because members of a local church had virtually no access to healthcare in their area.  Members of the church and neighborhood began to hold meetings to discuss ways they could meet the needs of their own community. At the top of their list was a desire to address the lack of affordable, quality healthcare services in North Lawndale and on the West Side of Chicago.  The church was able to buy a building, a small clinic, and a full-size basketball court for the community to enjoy. Today, that dream has expanded to over 100 medical providers across six clinic locations. The organizational values of Lawndale are an extension of the Christian Community Development philosophy, embodied by the “3 R’s”: Relocation, Reconciliation, and Redistribution: Relocation is a focus on ‘living among’ in order to clearly understand the issues that face a community. Reconciliation is the value at the heart of the Christian Gospel and includes both a reconciled relationship with God and with each other. Redistribution happens when resources are fairly and justly distributed among a community facing injustice. Additional options for service in the USA. The Center for Disease Control has statistics in infant and maternal mortality by race in the US. In 2018, infant mortality rates by race and ethnicity were as follows: Non-Hispanic black: 10.8 Native Hawaiian or other Pacific Islander: 9.4 American Indian/Alaska Native: 8.2 Hispanic: 4.9 Non-Hispanic white: 4.6 Asian: 3.6 The U.S. has an official maternal mortality rate of 17.4 deaths per 100,000 births in 2018. Wide racial and ethnic gaps exist between non-Hispanic black (37.3 deaths per 100,000 live births), non-Hispanic white (14.9), and Hispanic (11.8) women. Now, according to Healthy People 2020, health disparities, such as infant and maternal mortality, are health differences that are closely linked with social, economic, or environmental disadvantage.  The social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health. Resources that enhance the quality of life can have a significant influence on population health outcomes.  Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. There are many options to serve in the US. Noting the statistics above, the US is in desperate need of loving, compassionate healthcare providers. Join a community like Christian Community Health Fellowship (CCHF), where about half of the people who make up the CCHF community work in secular settings—community health clinics, universities, residency programs, and so on. They are there because of a conviction that this is where they are meant to serve Christ’s mission to bring healing and comfort to the poor, and to represent His kingdom in word and deed. The other half of the CCHF community work in faith-based clinics that strive to provide distinctively Christian care. Each clinic has a unique idea about what it means to deliver Christian care, but everyone strives to be authentic to their calling in Christ. Lastly, for a few more ideas on how you can serve in the U.S., if you are considering a residency program, consider a faith-based program such as In His Image Family Medicine Residency, where they focus on the underserved, Via Christi Family Medicine Residency, where they train doctors to effectively serve the poorest and most underserved people of this world., or Cahaba Family Medicine Residency Program, which has both an urban and rural track. My hope in reading this post is that you note that being a medical missionary doesn’t mean you have to go overseas. You can serve in medical missions in the USA as well. There are so many needs for your skills and giftings, so consider how God might be calling you to serve in the United States on His mission. The above options and ideas will help you get started in knowing where some of the greatest needs are.