Clarity of Communication: Are You Speaking in Tongues To Your Patients?

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We began our discussion with sharing what words we commonly use in each of our particular specialties that may not be understood readily by our patients. Many mentioned anatomic names of the part of the body we care for such as thyroid, esophagus, a variety of bone or muscle names. Then there are the multitude of procedural names that are part and parcel of our practice that are completely unfamiliar. In addition the names many conditions and diseases are often new to many patients. All of these things are readily understood when we speak with our colleagues but when we are discussing these with a patient if we do not explain the nomenclature it is as if we are speaking in a foreign language. Paul had something to say about the value of speaking in a language that is readily understood in 1 Cor. 14:6-11. We discussed how this passage relates to how we speak with patients. Paul’s point is that speaking in tongues is a wonderful gift of the spirit but if your purpose is to edify and instruct we must speak in a language that everyone understands. We therefore spent the evening discussing the importance of clarity in speaking with patients and the road blocks to good communication.

We then shared some instances in our own practice when we sometimes have found ourselves “speaking in tongues” with our patients. We discussed why a physician might use terms and jargon on a regular basis. Some of the reasons that were mentioned were that medical practice places doctors in a authoritarian role and jargon can help support that feeling of authority. Likewise, sometimes a physician feels superior to his or her patients either because of his/her societal position or the perceived lower financial status or class of the patient.. Using medical terminology might reinforce their need to feel superior. The time crunch of modern medical practice was also mentioned. Trying to see a volume of patients over a limited time period with the added burden of filling out EMR records often cuts the available time to explain everything as carefully and fully as one would like. Using terminology and not stopping to explain shortens the encounter.

We then discussed other factors/tendencies that inhibit good communication. Again lack of adequate time was mentioned. This can also lead to failure to listen carefully to the patient’s complaints or answer their questions fully. Instances in which a patient brings a page or two of questions were mentioned as a trying encounter in which maximal patience is needed to insure the door of communications stays open. We mentioned that some doctors do not have good communication skills. Several instances in which we have witness this were related. We talked about the importance of teaching our residents in training not only medical and surgical care but also how to speak effectively with patients. Also, there are a variety of patient factors that play a role in blocking communication.  Patients are often anxious and feel vulnerable, particularly at their first visit to the doctor. They do not know what to expect as far as the questions they need to answer and what the examination may involve. Patients are often frightened about their diagnosis or what surgery they may need to undergo. All these emotions can block their receptive ability to partake meaningfully in the conversation with the doctor. Patients sometimes feel inhibited in asking questions for fear that they will be thought of as ignorant. This can particularly come true if the doctor spoke to them using much of the terminology we have mentioned. Another factor that may block meaningful communication is the level of literacy of a patient. Many of us utilize pamphlets and and other written materials with our patients regularly. Yet, studies show that as many as 18% of patients are either illiterate or have such low reading ability that they can not function easily in society without help. Most of us are not very attuned to this issue and the patients are usually too embarrassed to admit to the problem. Lastly, we talked about the difficulty in caring for patients who do not speak english at all. The time crunch factor again came up since everything said must be translated and there is often a tendency to limit the amount of information shared simply because of the translation burden.

Yet we all agreed that all of these factors much be dealt with to ensure our patients receive the care they are entitled to. We talked about the benefits of a well-informed patient. We mentioned that when communication is well done patient satisfaction rises, the patient compliance with their medications and instructions increases and studies have shown the patient has an overall better outcome. We then shared ways we could be better communicators. The keys to recognize a patient that may have literacy problems were mentioned. Building into our schedule additional time when a foreign language patient is coming in is an important enhancer of quality care.

Lastly, we read 1 Cor. 14:19 in which Paul states he would rather speak five intelligible words to instruct others than five thousand in a tongue. If what we are saying is not understood clearly we are wasting our time. As Christian Physicians we are called care for each and every patient to the best of our ability to fulfill the calling on our life. Therefore it is imperative we strive for clarity in every patient interaction.

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A God-Directed Retirement

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Before starting our discussion of retirement, we began with a very basic question: Why do you work? There were, as expected a variety of answers. Work gives our lives a sense of purpose and a feeling of being useful and it allows us to use the talents that God has instilled in us. We derive a part of our identity from the work we do and we find the work stimulating to our lives. Then there is the very practical reason that we need to earn money to support ourselves and our families.

In a previous discussion we had talked about whether we felt called to be physicians and we reconfirmed that feeling during this evenings discussion. If so, then what is our attitude toward retirement? Is it a rejection of God’s calling? Are we as Christians even supposed to consider retiring?

All of these questions raised a prolonged discussion. We started out with a description of what society seems to picture as the life of a retiree. Most of that picture revolves around days of leisure with no responsibilities or work to be done. This is often the life promulgated in advertisements and TV shows of various sorts. Yet God has clearly intended us to do work (Genesis 2:15) and to be continuously serving Him and advancing his Kingdom. It was pointed out that there is only one passage in the Bible (Numbers 8:26) that even mentions retirement. In that passage the Levite priests are told that they must retire at the age of 50 and work no longer. But even in that passage it urges the older Levites to continue to assist their younger brothers. It was agreed that following society’s dictum on retirement is a sure way to lose your sense of value and purpose. Although we may sense a need to lay down our calling to be physicians we are always called into some other purpose and way to serve God’s kingdom.

We discussed the various reasons that members of the group would consider retirement. Among those reasons are the sense that we might be getting too old to physically accomplish the tasks. Some admitted to not being as “sharp” as they had been. There was a mutual agreement that too often physicians stay too long in their role and are deemed less effective, if not dangerous, providers. All of us want to avoid becoming that person. Some mentioned that health issues may wear us down and generate a need to step away from our careers. Others related the sense that is the duty of older physicians to step aside at some point and allow the younger, more energetic physicians and surgeons to take our place at the top of the medical latter, so to speak. Lastly, one member of the group admitted he felt that after many years of serving as a physician that he simply did not want to “do this any longer.” We then came to a conclusion that all of these are valid reasons and the feelings that were being expressed were not just arising from our human side but it is the Spirit within us tugging us in a new direction.

We then shared what those of us who are reaching this point in our lives might do once we do retire from medicine. There was an outpouring of thoughts and plans some of which are well formulated and others that are still just a notion. All of these those however had a unifying characteristic – they all include a way to continue to serve God’s people and to serve his Kingdom in some way. We completed the evening by summing up what a God-directed retirement looks like. It looks like a person seeking God’s guidance, trusting that God will direct each person to a valuable way to serve and find satisfaction. We will be directed to use our gifts and trust that God will grant us long life to serve him in ways we have never had time to do before.

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Made in God’s Image

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We began our discussion by sharing what we think society usually bases its judgement on of a person’s value and worth. Answers centered on their financial worth, their employment situation, how they dress or speak and what they own, where they went to school. Unfortunately society also counts their gender and race as factors all too frequently. We see this play out continuously in how some people are acknowledged in a crowd and other ignored. Studies show that women and non-white employees continue to be paid less then white men. We also discussed how sometimes when we meet a new patient in our practice we make snap value judgements based on some of these factors.

As usual God’s judgement is completely different than society’s. In the first chapter of Genesis we are told the creation story and how God pronounced a benediction of everything he created as good. We then read Gen 1:26-31a which is the pinnacle of creation when God creates man. He also was decreed to be good but we point out there is something different about man compared to the rest of creation. He was made in God’s image. We then discussed what it means to be made in God’s image. It is not that we look like God but that we, like a mirror, reflect God. When people see us we are suppose to be in a state in which people can recognize God within us. This is of course very difficult to do in our fallen state but it is our life goal.

What are the implications of being made in God’s image? We discussed two. First, its a declaration of your own innate value, dignity and worth. This sense of value and dignity is there no matter what your upbringing, accomplishments or any stereotypes people put on you. We discussed whether we felt this sense of value and whether there are instances in which you are challenged to remember your innate value instilled by your status as God’s image.

We also were reminded that this innate dignity and value is not placed on any other created thing. We reread Vs 28-30.  This passage gives us dominion over the earth and we are to reflect God’s care and love for his creation. It was mentioned that mankind is not doing a particularly good job at caring for this creation but, regardless, it is still our role.

The second major implication of all humans being created in God’s image is that everyone else we encounter have the same status, value, dignity and worth. James 3:9-10 speaks to our tendency to praise  God with the same tongue that we curse men who have been made in his image. We shared instances and situation in which we struggle to see certain people as being the image of God. Sometimes we have difficulty seeing those who are very familiar to us – family and friends- as being the image of God. We talked about why that can happen. It can also occur with those who are unknown to us or who are very different. We discussed why that tends to occur in us.

Lastly we spent some time discussing how our professional behavior would be affected if we could learn to see each patient we encounter as having the image of God.

 

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Defining Moments of Leadership

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We began our evening discussing what we might mean by a person’s ‘defining moment’ in their life. We came up with a time in which we experienced an event that in some way altered the path we were on and resulted in affecting our life’s path from there on. We then shared what we perceived were the defining moments of our lives. Events that are often mentioned are meeting or marrying our spouse, experiencing the birth of our children, or some event that determined our career path and certainly when we accepted the Lord as our savior. Whatever that event was it often leads us to a position of leadership in one realm or another – whether that be as a leader in a family unit, being called into a ministry that we did not expect to serve in, a leadership role in some organization or in a group at work. As Physicians we almost can not help but be placed in some role of leadership in our lives. We then discussed in what ways and in what roles we have been placed in leadership.

This then lead into our scripture for the evening as we looked at an instance of leadership being thrust upon a character of the Old Testament and what we can learn from how the Lord guided him. We then read Joshua 1:1-9. In this passage we see that Moses has died and Joshua is appointed by the Lord to assume the mantel of leader over the Israelites as they are about to cross over the River Jordon into the promised land. We discussed the difficulties he might face as the new leader, chief among these are how to gain the trust of the entire nation and how to deal with the opposing armies that occupy the promised land. We then looked at the primary guidance the Lord gave him – that he be strong and courageous. We then discussed how it was important in our roles as leaders to also be strong and courageous. It was mentioned that to lead a family we often must be willing to be courageous in saying and guiding our families. At work it is important to be willing to take on the difficult clinical situations that some patients present with.

We then concentrated on the Vs 7-8 in which God emphasizes the main guidance to success as a leader – that being the importance of continuing to obey God’s law through his leadership. We talked about instances in which we sometimes felt challenged to lead within the context of God’s law. We mentioned instances in which we sometimes are tempted to “bend the rules” as it might make things easier.

Lastly we spoke again about VS 9 and the third time in this passage the Lord encourages Joshua to be strong and courageous. We then discussed what types of things we are presently facing in our lives that we need to heed the Lord’s guidance and maintain a strong and courageous posture.

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Miraculous Healings: Do They Still Occur?

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Each month when we gather together we exchange prayer needs and often these involve someone dear to us who is unwell and we desire to lift them up in prayer. In addition, just about every week we each get requests from friends and family to pray for a health situation. We began our evening raising the question, why do we do this? What is our expectations? It was discussed that as physicians we are men and women of science. We are clearly reared in the need to seek out the best treatments for our patients based on scientific evidence. We expect that the medicines we give and the procedures we do lead to a patient healing. So it may be more difficult for people in our profession to believe in or expect a miraculous healing. Some were willing to express real skepticism about healings. Some of the members of the group shared that when asked to pray in these situations they pray more for spiritual and emotional healing and that God will use the sickness for a greater good rather than to pray or expect a real physical healing. One member of the group has real difficulty praying for healing in that he is so aware of so many people with so many more terrible sufferings and situations that he often wonders why God would take his comparatively minuscule problem and heal it. It was voiced that the reason God would intervene in even small problems is that God Loves Each of Us that much. He is not bound by time or place and can intervene in all things that is in his will to do so. Others in the group expressed real belief in supernatural healings but admit that they are very rare. It was also brought up that spiritual or emotional healing is as big a miracle as physical healing. Stories were shared how patients or their family member came to faith in Jesus through the experience of a loved one’s illness. The question remains, if we all believe God can heal us spiritually and emotionally, is there really that much more faith involved in receiving a physical healing?

We all agreed that God heals patients from our illnesses using the wisdom and gifts that have been bestowed on us as physicians. In that way we are doing his work that we have been called to do. But there is still this element of rare healings that do not seem to be explainable by our present science. We then read James 5:13-16 in which James instructs those who are sick to call the elders of the church so that they can pray for him and thereby be healed. This, of course, was written in the first century when there basically was no proven remedies for illnesses. Clearly the expectation of James is that this prayer would cure the sick individual. Why else would he tell them to do it? This brought up the fact that more miraculous healings are reported in third world counties where the access to medical care is much less. Perhaps our tendency to rely on our won abilities and knowledge in some ways lessens the instances of healing in our society. We then discussed the characteristics of a miraculous healing and the things that were mentioned were: 1) They are rare. 2) They are connected to faith but not necessarily the level of faith of the healed one but rather the faith of those who pray for them. 3) Some action – primarily praying is needed. It was pointed out that even when Jesus healed during his ministry he did something to elicit the healing, whether that was praying, putting mud on the blind man’s eyes or touching the cripple. We are clearly called to pray for one another in these situations. 4) They are healed by the Spirit of God and not by the person who is praying for them.

We then shared whether we had ever witnessed or had a patient who had a miraculous healing. In our groups there were just three that were shared. One of a woman with two shoulder joints that were going to need surgery but was prayed for and was completely healed. One of a teenager with a broken wrist that would not heal and was facing surgery but was prayed for and at the next visit to the orthopedist not only was the bone healed but the MRI showed no evidence of the previous fracture at all. Lastly, there was a young man who had been declared brain dead by his neurologist but his mother refused to stop his life support. He was transferred to a long term facility and shortly thereafter he woke up and was restored to full function. We then briefly discussed how we might react if a patient of ours came to us and claimed they had been healed of their affliction. It was generally agreed we would be open to believing that but would want to verify it with our worldly tests and scans.

The final portion of our discussion concerned that if God can do these healings why doesn’t He do them more often and for everyone. We read 2Cor 12:7-10 in which Paul relates that he had a “thorn in his flesh” that he had prayed repeatedly to be healed of but was not. We can say from this that its not just the degree of faith a person has that determines whether they will be healed. Who had more faith in Jesus than Paul? It was stated that all things are in keeping with God’s plan for us. We are not meant to live forever, we are meant to die and join Christ in the heavenly realms. Also, the suffering and pain we endure are ways in which we are forced to rely more heavily on God. As Paul says in Vs 9&10 God’s grace is sufficient for him and therefore he can rejoice in his weakness for when he is weak, then he is strong (through Christ).

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Competitiveness in Medicine, the Good, the Bad and the Ugly

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Competitiveness seems to be a part of human nature. We started the evening’s study by telling a story about one of my granddaughters. We were on a family vacation at the seashore last month and had a wonderful time. The evening before we left I found my granddaughter busily writing out on paper plates elaborate awards for each member of the family. Everything from who gathered the most seashells to who made the best sandcastle to who jumped the most waves. It struck me that even at her young age she wanted to point out who had done the best in every category she could think of. This made me think about competitiveness and how it is hard wired into each of us. Read More

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Which Road Are We On?

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We are concluding our study of the passages of the Sermon on the Mount with a discussion Matthew 7:13-27. We started out with a discussion as to what most people base their security on. The answers are fairly obvious – money, family, their job, their power, themselves. The problem with all of those is that they are all limited and if those worldly things fall away for whatever oadeason their life will come crashing down on them. Read More

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Judging Others in Medicine

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Tonight we used a passage from Matthew chapter 7 to continue our discussion on topics from the Sermon on the Mount. We started by asking how often do the members of the group find themselves judging other people. Most of the participates agreed that this is something that we find ourselves doing daily in some form or other. We talked about what type of judgements are we making. As physicians we are often called on to make judgements as we diagnose and put people into certain categories that may make then more susceptible to certain illnesses and this is simply part of our jobs. Read More

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Worrying – What, Why and How to stop

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This evening we continued our discussions based on the lessons from the Sermon on the Mount. We started by asking each member of the group to write out five things that they worry about. Most of the worries expressed involved concerns about our families, their health and well being. Some expressed concerns about particular aspects of their jobs as physicians. I was personally surprised that not many voiced worries about their patients and the care we are rendering them. I for one find this a particularly heavy burden and worry frequently. Though many people in our society often worry about their financial well being, we, as physicians of comfortable means for the most part, did not raise that as a particular issue. Read More

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Trying to be Perfect

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We began by discussion on how performance driven we each are. There was a consensus that as physicians this drive is sort of hard wired into just about all of us. It starts with the performance demands on us that we feel must be met to achieve acceptance to medical school, ramp up during residency where every failing can mean a black mark on your chances of success and continue on through our practice of medicine. In Matt 5:48 Jesus tells us to “be perfect”!!! Like that’s what we need – more pressure to achieve. This evening we talked about what Jesus meant by this and how that true meaning can affect our practice of medicine. Read More

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