Gospel Hope in Burnout

As the medical system groans beneath the burden of the pandemic, conversations have appropriately turned to burnout among healthcare professionals. Most dialogues point to external systems, e.g., the shrinking workforce, limited supplies and political contentions over vaccines. While these forces exert significant influence, and indeed pose a crisis in many parts of the U.S., deeper and more personal dynamics are at play.

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Avoiding Burnout

Apparently, Medscape does a yearly survey on physician burnout, and the one that just came out asked 13,000 physicians from 29 specialties about their personal experience with stress and signs of burnout. Being in the midst of a global pandemic, it won’t surprise anyone that burnout rates are rising.

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The Point Blog Archives

The Point Blog ARCHIVE
All articles found in the archive are more than three years old.

The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.

The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.

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Unless You Tell Them

“Where there is no guidance, a people falls, but in an abundance of counselors there is safety” (Proverbs 11:14, ESV).

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Proposed UK “conversion therapy” Ban Against Counseling Choice: Putting Already At-risk Sexual Minorities in Harm’s Way

Five of we Americans were in London a few weeks ago at the invitation of the International Federation for Therapeutic & Counseling Choice (IFTCC) and Christian Concern to—along with colleagues from the United Kingdom, Norway and Australia (some by video presence)—to hold a one-day conference one block from Parliament challenging the proposed UK “conversion” therapy ban. I wrote the following at the request of Christian Concern and IFTCC, reprinted here with their permission.

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Not By Might, Nor By Power

How do we, as followers of Christ, engage the secular world?

This is no simple question, as the situations and circumstances are nearly infinite in possibility.

Since St. Augustine penned The City of God, there has been a general understanding that Jesus did not come to establish an earthly dominion. One might argue there have been “Christian nations” in a particular sense, but through most of Western history, church and state have always been separate power bases in an uneasy tension. Sometimes the church was on the ascendancy, as when Pope Gregory VII excommunicated emperor Henry IV (1050-1106) over the investiture controversy. You may have heard the story about how Henry stood three days barefoot in the snow to beg forgiveness. This feeds the popular myth of an all-powerful Catholic church embraced by many secularists. Less well known is that three years later, after his second excommunication, Henry IV led his armies against Rome, forcibly deposing Gregory VII and putting his own man in charge. So much for the “all-powerful” church. Power is fleeting, even for emperors and popes.

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Private Equity in Healthcare

While many people, including healthcare professionals, think that much of medical ethics is highly arbitrary and relativistic, with the single prevailing rule being patient autonomy, there are nonetheless some widely accepted principles within medical ethics. Principlism, which is based on four guides made famous by Beauchamp and Childress, includes patient autonomy, beneficence, non-maleficence and justice. Unfortunately, for many people, these are the only ethical considerations needed to make informed decisions regarding right and wrong regarding patient care. Several other considerations are needed to decide complex issues rightly.

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Will Roe Stand?

On December 1, 2021, the U.S. Supreme Court (SCOTUS) heard arguments regarding the legality of abortion restrictions put into place by the state of Mississippi. The case is known as Dobbs v. Jackson. It is the most high-profile abortion case argued before the Supreme Court since Planned Parenthood v. Casey in 1992.

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Faith and Gratitude

As I continue my series on faith and culture, Thanksgiving is right around the corner. But believe it or not, I didn’t choose this topic because of its appropriateness for Thanksgiving week. The topic has been close at hand in my own life of late, which has made me even more aware of its cultural applications.

By way of background, I must admit that I struggle to ask anyone to do anything for me. Asking a friend down the street to give my daughter a ride home from school is difficult and makes me think about what I need to do to even the playing field.

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If I Only Had A Heart…

In the classic tale The Wonderful Wizard of Oz by L. Frank Baum, perhaps most recognized by the 1939 movie version starring Judy Garland, young Dorothy Gale from Kansas and her dog Toto are transported via tornado to the strange Land of Oz and undertake a journey to see the Wizard of Oz in hopes he can return them to their Kansas home. Along her path on the Yellow Brick Road, Dorothy acquires three traveling companions who also have requests they hope the Wizard will grant, to give them each something they seem to lack: a brain, a heart and courage. The group’s progress and attempts to win the favor of the Wizard are hindered and harassed repeatedly by the Wicked Witch of the West and her minions, including incessant taunts about their shortcomings as well as a dire warning for Dorothy: “I’ll get you, my pretty—and your little dog, too!”

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Pandemic Priorities

I joined CMDA in 1982 in the middle of my OB/Gyn residency. At that time, I had known the Lord for about eight years but had not grown spiritually, because I had failed to find a solid, biblical church. Around that time, I finally found a church that helped me grow and develop in my Christian faith. With that growth, I began thinking about how I could incorporate my faith into the practice of medicine and discovered the Christian Medical & Dental Society (CMDS), which was CMDA’s name at that time.

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Debunking a Fallacy: New Study Shows Therapy for Undesired Same-sex Attraction “Can Be Effective, Beneficial, and Not Harmful”

Ideology-driven legislative initiatives are underway to ban therapeutic choice—“conversion therapy” being the provocative, pejorative and ill-defined colloquial term used as a jamming tactic—in the U.S. and internationally for people with undesired same-sex attraction or levels thereof. Carolyn Pela and Philip Sutton have delivered a very welcome contribution in the form of a stringent study answering criticisms levied against what is more properly termed SAFE-T (sexual attraction fluidity exploration in therapy), SOCE (sexual orientation change efforts) or change-allowing therapy. The foundational requirement for such therapy—and for talk-therapy of any kind for any patient complaint—is a willing, motivated and self-directed client. Involuntary therapy is failed therapy, no matter the problem.

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Sacrificing Science on the Altar of Transgenderism: How a Respected Scientific Source Betrayed its Core Values

As far back as data exists, the universal experience has been that transgenderism was an extraordinarily rare occurrence, especially among females.
The last decade, however, witnessed an unprecedented increase in the numbers of young people identifying as transgender and seeking to transition. The surge was particularly striking among young adolescent females who were heavy users of social media but had no prior history of gender dysphoria. Something seemed amiss.

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Born to Die to Self

“But the fruit of the Spirit is love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control. Against such things there is no law” (Galatians 5:22-23, NIV).

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If Possible, So Far As It Depends on You

Last week, a friend asked me, as a family physician knowledgeable about COVID-19, to speak to a group she belongs to of community leaders, here in northeast Louisiana. I spoke about the current status of COVID infections in our area and the need for vaccination. The vaccination rate is low in our area—currently only 37 percent are fully vaccinated in our parish.

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On Faith and Excellence

My kids have attended a classical, Christian school for many years. While we love the school for several reasons, its academic rigor set it apart from the several other schools we considered when making the decision to move our kids there 16 years ago. Other schools offered personal attention, others had great mission statements, others had in-depth biblical teaching. But it was all of these things, combined with high academic expectations, that sold us in the end, since the primary purpose of school is to educate kids academically. In the grammar school grades at our school, the students are taught to always do an “Excellence Check,” that is, to look back over their test or assignment and double-check for any errors prior to turning it in. The concept of the Excellence Check resonated with me when my kids were that age because it served as a regular reminder to them that they should be giving their best to each assignment. It was never a “Perfection Check” or a “Compare to Your Neighbor’s Performance Check.” It was a reminder for each student to do his or her best at all times. One student’s best might be a perfect score, while another student’s best might be much lower, but the expectation to do one’s best was clear. We might think of excellence as being at the top of the class or someone who stands out in his field, but that isn’t the way our school defined it, nor the way I am defining it here.

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The Ethics of the SARS-CoV-2 Vaccines Revisited

In the spring 2021 edition of CMDA Today, CMDA published an article that examined the ethical basis for taking a COVID-19 vaccine. The goal of the article was to reassure CMDA members of the good reasons to utilize the COVID-19 vaccines produced in the last year. Since the article’s publication, several members have written with ongoing questions and concerns about the ethical status of the vaccines due to their association with abortion-derived fetal cell lines. The purpose of this blog post is to address those concerns. An update on the safety and efficacy of the vaccines will be addressed in the future.

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Responsibility and Freedom in the Time of COVID

In a weekly column on Sunday, August 29, Evangelical attorney David French declared “It’s Time to Stop Rationalizing and Enabling Evangelical Vaccine Rejection.”

Is that really a thing, you may ask?

There certainly is some evidence for that. Among those who have already been vaccinated against COVID-19, white Evangelicals trail the national average by 10 percent. A significant difference, but not a dramatic difference. In fact, the majority are vaccinated, according to this tweet displayed in the article.

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Evidence Opposing Therapy Bans

Legislation to ban so-called “conversion” therapy or practices for people with undesired same-sex attraction, gender dysphoria and other sexual minority issues is being put forward across the globe.

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Redemptive Treatment of Healing Professionals

Some systems have treated healthcare professionals with clinical skill loss in an almost punitive manner. Aside from careless incompetence, abandonment of patients or grossly unprofessional behavior, this is inappropriate, damaging to the professionals and harmful to society.

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On Faith and Love

My recent contributions to this blog have explored some of the issues I have wrestled with throughout the turmoil of the last year and a half—namely, how faith has impacted the church’s response to issues, and where we have strayed from biblical truths in our responses. I have wrestled with faith and politics, faith and freedom and faith and fear. But the overarching issue, I think, in Christians’ response to recent—and, in fact, any—world events is love. There are only two things that Scripture tells us explicitly identify the Christ-follower: their fruit and their love. Jesus Himself said that all men would know we are His followers if we have love for one another (John 13:35). In fact, He repeatedly commanded that we love one another (John 13:34, John 15:12, John 15:17). And the rest of the New Testament tells us more than 20 times to love one another.

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Escaping Death

“There is a way that seems right to a man, but its end is the way to death” (Proverbs 14:12, ESV).

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One Person at a Time

I have a soft spot for public health. True, I’ve been a family physician for 32 years, and have touched many people’s lives, but decisions made by public health practitioners have an outsized impact on health.

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New Documentary Released on the Rush to Reassign Gender

In keeping with their history of producing eye-opening documentaries taking highly controversial societal trends head on, The Center for Bioethics and Culture (CBC) recently released a film on gender affirming therapy titled Trans Mission: What’s the Rush to Reassign Gender? Running just under 52 minutes, the feature presents activists, healthcare professionals, educators, parents and the patients themselves—among others—regarding “the medical and surgical transitioning of children.” The guests exhibit varied points of view, and they include members of both CMDA and the American College of Pediatricians (ACPeds).

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Real Regulation of Human Embryo Experiments

As we expected, the International Society for Stem Cell Research (ISSCR) issued its revised guidelines on stem cells and embryo experiments at the end of May 2021, and as expected, the ISSCR recommendations are rife with proposed experiments on young human beings. The new guidelines discard the 14-day limit on human embryo experiments in favor of no limits whatsoever, and they allow virtually unrestricted manufacture of human-animal chimeras of any type, as well as creation of genetically altered human embryos and lab constructed human embryo “models.” Very little is left in the category of “currently not permitted.”

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SOCE Reduces Suicidality in a New Study

What if another study came to print asserting that sexual orientation change efforts (SOCE) constituted harmful stressors to sexual minorities? What if a published letter to the editor in the same journal exposed gaping holes in the assessment? What if a reanalysis of the original study “in the strongest representative sample to date of sexual minority persons” revealed polar opposite findings: SOCE “strongly reduces suicidality” and that restrictions on SOCE may “deprive sexual minorities of an important resource for reducing suicidality, putting them at substantially increased suicide risk.” Now that would be something! And these things happened!

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Knowing the Will of God

How do you ascertain God’s will for your life?

This is one of the greatest existential questions asked by followers of Christ, the young in particular. It is also one of the most profoundly misunderstood.

We may be taught that there is a divine roadmap for our lives, known to God yet unknown to us. We desire to know it for two reasons. First, we seek to please God and be good stewards. Second, we believe following his divine plan will maximize our earthly joy and blessing, but He offers no objective way of knowing it. What then, does that say about God? He created a divine master plan for us to follow, but we have to pry it out of Him? What sort of God would do that, and why? What if we make the wrong decision?

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Identifying Healthcare Professionals Who May No Longer Be Able to Care for Patients

As Christian healthcare professionals, God has granted us the high privilege and responsibility of serving others through healthcare. Part of this responsibility is that of maintaining clinical knowledge and skill in order to provide high quality care to our patients. If we lose some of our skills due to trauma, physical or mental illness, or due to normal aging, this may not always be optimally possible.

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Trust in Public Health

WND recently published my op-ed designed to highlight the benefits of trusted doctors and faith-based organizations communicating on public health issues. I also noted what I considered to be several significant failures of government public health messaging.

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The World in Need

When John Donne wrote “No Man Is an Island,” he was lying on his sickbed, thinking, perhaps, it would be his deathbed. When he heard the church bells tolling for a person recently deceased, it got him thinking. His life­—everyone’s life—was diminished by the death of that unknown person. We are all connected.

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On Faith and Fear

During a recent urgent care shift, a young welder presented with a metal foreign body in his eye. If you work in emergency medicine, urgent care or ophthalmology, or if you weld yourself, you are already aware of this occupational hazard. I was not aware of it prior to starting work in urgent care, but I must admit that it makes any dreams I may have had of learning to weld, thereby empowering myself to do more of my own home repairs, much less attractive. Tiny hot flecks of metal landing on the human cornea quickly embed themselves and become difficult to remove. Left there for a few days, they begin to rust, leaving a small rust ring on the cornea after the metal itself is removed—a rust ring which then has to be removed with a tiny drill called an eye burr.

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This is Advocacy: Our Work Begins and Ends with God

Some would say it started earlier this year in January when the 2021 legislative session began in most states. Some would say it started with our increasingly more “live and let live” culture. However, the iniquity started before any of us were born.

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New Study Addresses Sexual Minorities Who Reject LGB Identity

A new study authored by a socio-politically diverse team of psychologists evaluated a religiously diverse population sample of varied sexual identification and found that sexual minority people who reject LGB identification have positive outcomes that contradict the expectations of both minority stress and sexual identity development theories.

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The Return of the God Hypothesis

In last Saturday’s New York Times, Christian columnist Ross Douthat asks, “Can the Meritocracy Find God?”

“The secularization of America probably won’t reverse unless the intelligentsia gets religion,” writes Douthat. Nor is he sanguine for the prospects of that occurring. Douthat postulates two primary obstacles. First, “a moral vision that regards emancipated, self-directed choice as essential to human freedom and the good life.” Second, an entrenched anti-supernaturalism: “The average Ivy League professor, management consultant or Google engineer is not necessarily a strict materialist, but they have all been trained in a kind of scientism, which regards strong religious belief as fundamentally anti-rational, miracles as superstition, the idea of a personal God as so much wishful thinking.”

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The Incredible Impact of a Humble Man of Faith

In a previous blog, I recommended John Stonestreet, president of the Colson Center, and BreakPoint, his daily blog. The Colson Center has several formats for outreach including the Colson Fellow program, weekly podcasts, daily email briefings and Wilberforce Weekend. The Colson Center takes on many of the most pressing issues of the day and thoughtfully discusses ways in which we as Christians can engage our culture. As I said in that earlier blog, if you stop reading this right now and explore the Colson Center options, I will have succeeded in pointing you to a good path for improving your Christian walk.

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The Equality Act Targets the Faith and Medical Communities for Ideology-Based Prosecution

The Washington Examiner recently published my op-ed on the radical Equality Act. This ideologically coercive and discriminatory bill, which has already passed the House and now is on the Senate calendar, will radically impact your professional career and your ability to live out your faith.

The commentary is below, followed by excerpts of a CMDA letter to U.S. Senators and of written testimony submitted by several CMDA members.

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I’m a Slow Reader (Here’s Why), and Living on Borrowed Time

I’ve read novels ever since my youth, and I’ve had an enduring fascination with the side character of the rich elderly female relative who “took to bed” decades earlier. Even before I was a doctor I wondered, “What illness caused her to ‘take to bed’?” There are seldom enough clues to unlock the mystery of which exact medical diagnosis she had that kept her in her bedroom. Writers of novels one to two centuries ago didn’t focus on those clues. She was, after all, a side character.

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On Faith and Freedom

Freedom. It’s an important word to us in the United States—arguably the most important word to the founding of our country.

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Human Bioengineering: Made in the Image of Whom?

While COVID-19 has consumed the attention and energies of the world for the last year, other bioethical and scientific challenges have not gone away and are set to burst back to the forefront this year. Significant advances were made in 2020 to move away from the antiquated science using human fetal tissue from abortion and toward development of modern techniques and biological models that do not use fetal tissue. However, a resurgence of research using trafficked aborted fetal body parts is likely with the new White House Administration. Calls have already been made to gut the current ethical regulations on federal funding of fetal tissue research. The drumbeat for taxpayer dollars to pay for experiments using fetal organs and tissues from abortion continues, trying to make use of the crisis to justify unethical research, e.g., making humanized “lung-only mice” to investigate COVID-19. In the meantime, adult stem cells have made “mini-lungs” in the lab that faithfully model normal lungs, and they are already being used to study COVID-19 infections and therapies.

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Therapy Bans, APA Talking Points and Counseling Choice

A multitude of states, counties and cities have banned “conversion therapy,” usually for minors only, with efforts underway to issue a national ban for all through the so-called “Equality Act” (HR 5). Yet, “conversion therapy” is a misrepresentative, maligning and summarily ill-defined term employed as a jamming tactic to capitalize on an allusion to implicitly forced religious conversion while stigmatizing and intimidating any therapist who would engage in change-allowing therapy. It implies coercion and suffering, neither of which are true of modern change-allowing therapy (aka SOCE for sexual orientation change efforts). Modern SOCE therapists uniformly view old aversive techniques (think shaming, electric shocks, etc.) as unethical and ineffective. Tellingly, no state or municipality enacting a therapy prohibition has yet to ban aversive practices, only counseling that allows clients to explore their potential for change of SOGI (sexual orientation, gender identity). Why not ban aversive measures too, if abuse is really the issue?

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Christians and Conspiracy Theories

“You can’t handle the truth!”

That classic line from A Few Good Men from Colonel Jessup in the witness stand became a waving flag for many. It is enticing to think we own the truth, and that those who can’t “handle” it are naïve, weak or cowardly. Delivered to perfection by Jack Nicholson, Jessup hammered a wedge between truth and fantasy, and of course we all know which side we’re on, don’t we?

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COVID-19 Fact or Fiction?

A growing proliferation of blog posts, podcasts and online videos presenting confusing information regarding COVID-19 has increased over recent months. Many of these controversies are propagated by physicians speaking to large church audiences. In this blog post, I will address the most common disputes.

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Let Us Be Healers

n the process of these elections—national, state, county, city—people who used to treat others civilly have forgotten how to do so. Politics has torn families apart, severed relationships and caused some people to say and do things that can never be unsaid or undone. In their efforts to obtain elected office, politicians and their support teams in both parties perpetrated rumors, lies and innuendo regarding opposition candidates. Some of these actions have destroyed reputations. Social media has helped to perpetrate the spread of misinformation.

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You Could Help Reverse an Abortion!

Like me, you probably entered the medical field because you wanted to help people who were in significant need, facing challenges, and for whom you could have a substantial positive impact. You may have gone in with the goal to save lives. In healthcare, we have the privilege of helping people at some of their most vulnerable points, while also being a light shining into their darkness. For many women, that moment arrives for them after they have taken mifepristone (RU-486) with the intention of ending their pregnancy.

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The Purpose in Pain

When my husband and I worked at a mission hospital in Kenya for six weeks in 2013, we ate dinner every evening with another volunteer doctor, an orthopedic surgeon. We often discussed the use of opioids, or rather, the seldom-use of opioids in Kenya. After a U.S. surgery, he said his patients would receive opioids round the clock in the hospital, and they’d go home with a prescription for 30 to 60 pills. Yet here, patients’ pain was managed with non-opioid pain medications, and nobody was prescribed opioids after discharge.

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Policy Versus Politics: A Retrospect and Prognosis

A physician member of CMDA recently asked me for a perspective on the tragic temporary takeover of the U.S. Capitol and the role of politicians before and after that tumultuous event. The physician’s email began, “I’m so saddened by this incident and so appalled….”

I’ve been asked to share the response to that physician more widely, so my edited response is below, followed by some thoughts on public policy ministry, the last four years and the next four years.

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Upside-Down-and-Backwards: Reflection and Challenge on Inauguration Day

My grandfather was a deeply gracious man. A Southern gentleman to the core and pastor of a large church, he was loving and compassionate toward everyone he met, and he was also uniquely talented at making each and every person with whom he interacted feel loved and heard. He truly cared, and he had an amazing ability to communicate the depth of that concern. In the 40 years I knew him, I never heard him raise his voice or speak a harsh word, with one dramatic exception. So it’s no surprise that the story of Granddaddy, hospitalized and delirious after major surgery, raising his voice at Gran has gone down in family lore. His agitation at her that day was so great, and so perplexing. He was intensely frustrated with her driving, despite the fact that he been in the hospital and nowhere near a car for days. He finally burst out, in his resonant Southern voice, “You insist on driving upside down and backwards just to irritate me!” Needless to say, it did not ease his distress when the entire family burst into laughter. But some things are just so funny you can’t control yourself.

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Navigating Vaccine Ethics

CMDA Senior Vice President for Bioethics and Public Policy Dr. Jeff Barrows and I recently wrote a piece for The Public Discourse, “Is Receiving the Pfizer-BioNTech COVID-19 Vaccine Ethical?” that suggested principles to consider as we navigate ethical issues related to COVID-19 vaccines. I’ve included brief highlights below; more from the original article and also new observations will be published in an upcoming edition of CMDA Today (previously known as Today’s Christian Doctor).

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A Lack of Self-care in Healthcare

How many times have you gone to clinic when you were sicker than the patients you were treating? Listened to other people’s woes and stresses when your own were weightier? Given your last emotional resources to a patient whose need was less than your family member’s? Forfeited sleep while advising a patient of how curative it is? Advised a patient about nutrition and exercise right after scarfing a quick lunch from the vending machine?

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Sustaining Our Joy in Practice

My eldest child left for college this fall, having chosen to attend school in Scotland. Yes, that’s right. Scotland. It’s a long way away. It’s also a place I had never previously visited. We went on a family trip to Scotland in March—partly to visit the school he now attends, and partly to have one last bang-up family vacation before we became a family that no longer lives under one roof. On that trip, we had not one, but two, flat tires on our rental car. A consequence of our struggles driving on the left side of the road, perhaps?

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Narcissism in Healthcare

I was looking up some information on the American Association for Physician Leadership website when an article caught my eye: “Are You a Narcissist?” I hadn’t decided what I was going to blog about this month; not surprisingly, narcissism was not on the list of things I was considering. But the article piqued my interest, so I clicked on the link and read the entire thing. There was even a quiz I could use to find out if I am a narcissist. You will be relieved to know I “passed” the quiz with a non-narcissist score! That was reassuring, but I was curious as to why this article interested me so much.

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Facing the Rise of Suicides in Healthcare

As a second year medical student, a member of my medical school class committed suicide. I didn’t know him well, but his death impacted me. Made me ask a lot of questions. Why didn’t I know him better? Had I gotten to know him, could I have made a difference?

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My Doctorate in Secret-Keeping

CMDA's The Point

Preparing to meet my next patient, I pick the next chart up off the counter. “Bob Smith,” married middle-aged patient, chief complaint: STD check. “Weird,” I think, “Mary Smith’s husband’s name is Bob, too. What a coincidence.” I open the exam room door, and Mary Smith’s husband, Bob Smith, is sitting inside.

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Physician Substance Abuse

According to a 2009 article in Mayo Clinic Proceedings, “Approximately 10% to 12% of physicians will develop a substance use disorder during their careers, a rate similar to or exceeding that of the general population.” But while our addiction rate may be similar to the rest of the country, the characteristics and consequences of our addictions are not.

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Healthy Healthcare Marriages

Doctors have had a bad rap on the marriage front for a number of years. We’ve long been accused of having a much higher divorce rate than the general public. For many years, there was not a lot of data on healthcare marriages, but strongly held popular opinion characterized a high percentage of us as overworked divorcees whose devotion to our patients cost us our marriages.

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Women in Healthcare Still Earn Less than Men

And so begins a New York Times article about the recent JAMA Internal Medicine analysis of physician pay disparities. The central message of the analysis is that women in healthcare, on average, earn $20,000 less per year than their specialty-matched male colleagues.

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Physician Burnout

It was a relatively slow evening at work when I got the text. My phone vibrated on the clinic countertop as I was looking over a chart. “Are you busy? Can you talk?” I figured those words couldn’t be good, coming as they did from a young intern I mentored when she was a medical student. I found myself wondering if she had lost a patient.

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