Overcoming Obstacles To Medical Missions: What About My Debt?

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Everybody knows the value of medical missions.  Using your medical skills to bring  healing and spiritual transformation in under-served areas.  Knowing that what you bring to the table is desperately needed.  Teaching nationals so that they can carry on, and expand, your work.  The ‘perks’ of having more time with your family, a less frenetic lifestyle, and freedom from malpractice concerns.

But, serving abroad brings many challenges that can easily stop you from going.  In my next two posts, I want to look at two obstacles – one on the front end, one on the back end – and how they can be overcome with God’s help.

In this post, I want to look at the obstacle of debt.  Today’s medical students can easily graduate with up to $300,000 in debt.  By the time you finish residency, the interest can leave you with twice that amount.  Faced with that, it’s easy to conclude there’s no way to go overseas, or, serve somewhere where you’d make significantly less than the norm.

Enter MedSend.

MedSend is a ministry that will pay back your medical student loans over ten years so that you can get to the field right after residency.  Yes, you read that correctly: MedSend will pay back your student loans for you so that you can fulfill your dream of doing medical missions.

In a phone conversation earlier this week, I spoke with a development officer from MedSend about how it works.

The first step, often overlooked, is to make sure you’re called.  You need to ask God to burden you with a passion for a people and/or place.  You need to go on short-term trips to explore your calling.  You need to spend lots of time in prayer.  And you need others to affirm that this is, in fact, God’s leading.

After that, the next step is to officially partner with an approved (by MedSend, but there are many) missions organization like Samaritan’s Purse.  Once you’re onboard, with them you still need to raise your support to pay for the expenses you’ll incur in your new location.

Once those things are in place, MedSend becomes involved and begins paying back your loans so that you can go and serve.

Right now, MedSend is sponsoring approximately 150 healthcare professionals around the world, including those in domestic under-served areas.  They represent about 40 different specialties and fields such as medicine, nursing, pharmacy and veterinary medicine.  So, there’s a place for everyone.

If you’re not sure about the idea of medical missions, are you open to exploring it and asking God what He wants, whatever the cost may be?

The good news is that, if God is calling you, your debt doesn’t need to get in the way.

More Than Skin Deep: Opportunities In Plastic Surgery

“Beverly Hills. The most beautiful woman in the world. Plastic surgery. What do those three things have in common? Me, in less than a week.”

— Dr. Benjamin Stone, Doc Hollywood (1991)

Those of us old enough to remember this film grew up thinking plastic surgery meant lots of money, tummy tucks, and, if we’re honest, a pretty boring existence as a physician.

And, in reality, it can be like that.  A local plastic surgeon, once based out west, confirmed that his job was pretty similar to the ‘Doc Hollywood’ experience.  Lots of money, but pretty unfulfilling.  He grew tired of raising someone’s cheek an eighth of an inch.

But God had bigger plans for him and his training.  Now based outside of Philadelphia, he primarily serves women who’ve had mastectomies.  Things that most women take for granted have been lost, and it’s his privilege to restore a measure of choice and dignity to them and their families.

Another physician I know always dreamed of being a missionary physician.  He, too, eventually chose plastic surgery.  He and his wife wound up going to Ethiopia, where his work focused on cleft palates and other important procedures for that culture.  In his particular area of focus, cosmetic issues led to ridicule and isolation even greater than our American culture.  And so, under very different circumstances than the other doctor I mentioned, he too restored dignity to people half a world away.

This ability to restore wholeness and bestow dignity, I think, is what gives plastic surgery a solid, more lasting, appeal.

It’s not that a cosmetic defect or injury inherently takes dignity away, or, that unusual beauty creates or heightens it.  When God had the prophet Samuel choose one of Jesse’s sons to be the next king, he rejected Eliab despite his GQ exterior (1 Samuel 16:7).  And the Syrian commander Naaman’s leprosy did not prevent his healing at God’s hand (2 Kings 5).  So, when a plastic surgeon performs a procedure, it’s not that she’s creating dignity in the truest sense.  Because that ultimately comes from God, that can neither be ultimately given nor taken away.

So, then, what is a plastic surgeon really doing?

I’m still thinking about this, but at least two things comes to mind.

First, a real part of being made in God’s image (or likeness) includes how we look.  (Similar to how a community’s appearance is not its most important trait but still matters).  Although Western culture has gone too far and become obsessed with its appearance, that doesn’t mean how we look is unimportant.  Children are not supposed to have cleft palates.  People are not meant to become disfigured in accidents.  As it is, though, the entire world is broken and in need of repair.  Plastic surgeons take part in God’s call to restore us to ‘original factory condition’, the way we were meant to be.

There’s a second issue here that’s really an elaboration of the first.  Part of living in a fallen world often involves receiving ridicule and shame because of our brokenness.  When that brokenness is cosmetic and obvious to everyone, other broken people may make fun of us in ways that are legitimately painful, no matter how close we are to God.  And, beyond what others send our way, we add our own self-reproach.  In an ideal world, we wouldn’t worry about how we look, but in this world we also bring our own issues that come from making appearance more important than it was meant to be.  Through restoring the body, plastic surgeons can essentially remove or reduce these temptations, both from without and within, to shame and disgrace.  In that sense, they restore dignity and it matters.

So, what may at first appear shallow is actually quite profound.  Jesus forever proved this when He healed ten lepers (Luke 17:11-19).  But it was far more than just a healing and points to one of the tremendous opportunities that comes from this line of work. The post-operative transformation is often dramatic and leads to great thanksgiving among people who otherwise might be less open to the gospel.  (The man here was a Samaritan).  You can bet he told His friends about Jesus and that this had a profound effect on the people around him.  By God’s design.

Could it be that God is calling you to consider a career in plastic surgery as a way of partnering with Him in His Kingdom work?

Men, Women & The Workplace: A Fresh Vision For An Old Problem

Every now and then, a tempest seems to rise up around the issue of women in the workplace.  Partly because medicine is so demanding, the debate surrounding work-life balance in this field tends to be particularly acute and emotionally-charged.

If you follow these sorts of discussions, you may be familiar with an article by Dr. Karen Sibert in the New York Times (June 11th) entitled “Don’t Quit This Day Job.”  In the article, Dr. Sibert argues that, given the importance of patients and relative shortage of physicians to treat them, medical schools can’t afford to train providers who will only work part-time.  Since women tend to work reduced hours far more often than men, her comments are primarily directed toward them.

The closing paragraph to her article summarizes her position well:

Patients need doctors to take care of them. Medicine shouldn’t be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life’s work.

Based on further commentary in her article, Dr. Sibert means that the rest of life, such as children, need to fit in around a calling to medicine.

Not surprisingly, though, not everyone agrees.  In a response piece, “Should Women Be Doctors?“, columnist Lisa Belkin takes a different approach:

The problem is… that professions are archaically structured…  The answer is to recalibrate the hours and expectations of professions so that they can be done by the “new worker” — not a man with a wife at home (which is the assumption of the old structures) but rather a mother or father with a working partner and responsibilities at home.

Just because things have always been done a certain way does not mean that is the way things should be done. All those women working 4.5 fewer hours and taking longer leaves in medicine? Where Dr. Sibert sees slacking, I see a new norm. One that requires fewer hours of more workers, perhaps. One that is [sic] should be embraced by men and women.

From these small quotations alone, it doesn’t take a lot of insight to realize that Sibert and Belkin differ dramatically in their approaches to these issues.

Actually, I’m glad that they do.  Encountering different viewpoints like this should force us to think – deeply – about these things.  If you’re in college or early on in your training, these matters may seem relatively academic now, but they quickly become very personal as the years go by and real choices must be made.  As Dr. Sibert rightly noted in her article, “you can’t have it all.”

I’ve seen medical marriages (among Christians) end over these very issues, while others who “stay together” remain unhappy and disconnected.  So, the stakes are high.

I’ll be posting more about this area in the days to come, but I want to make just one point for now.

As we encounter radically different solutions to the work-life balance problem (or any other problem, for that matter), we need to regress to our childhood and ask (with a little more maturity, hopefully), “Oh yeah – says who?!”  In other words, as we sort through things, who has the authority to inform our decisions?

For Christians, the answer is unequivocal.  It’s primarily God and what he tells us in the bible.  (While this may sound archaic to my secular readers, the truth is that we all put our ultimate faith in something, even if it’s ‘me.’  But that’s another story for another day).

Don’t get me wrong.  It’s not like there’s a chapter or verse in the Bible that will give us an easy answer to this dilemma.  Far from it.  Rather than a bunch of clear one-size-fits-all “how-to’s”, we find in scripture principles that God calls us to apply with wisdom.  That will look differently from family to family.

But, there’s real wisdom there that should inform our practical, everyday decisions:

Every part of Scripture is God-breathed and useful one way or another—showing us truth, exposing our rebellion, correcting our mistakes, training us to live God’s way. Through the Word we are put together and shaped up for the tasks God has for us.  (2 Timothy 3:16 from The Message)

Figuring out how work, family and the rest of life fit together is one of those critical “tasks” God is calling us to.

So, over the coming weeks, I’m going to unpack a fresh vision for balancing our work and family from Proverbs 31.  If you’re familiar with that chapter, you may be surprised, thinking, “I thought that was all about the ‘ideal’ Christian woman.  What does that have to do with work and family, too?”

Well, if that’s what you’re thinking, let me gently suggest that you’re right and you’re wrong.  It is a passage about ‘the godly woman’ and contains a lot of wisdom in that area.  But, it touches on men, children, work (over a 1/3 of the passage is about work) and, just as importantly, on how they relate.

So, fasten your seatbelts, ladies and gentlemen.  Be prepared to be challenged, encouraged and everything in-between.  I look forward to sharing, learning and living the journey with you.

Choosing A Church: Are You Asking The Right Question?

Still looking for a church?  Don’t just ask, “How can this church serve me?”, but also, “Where are my gifts most needed?”  Phil. 2:4.

Residency Blog: What It’s Really Like

Ever wonder what residency is really like?

Now you can follow Dr. Erik Lystad (PGY-1, Family Medicine) as he blogs about his journey on cmdaresident.blogspot.com.  I enjoyed getting to know Dr. Lystad during his time in Philadelphia, and think that you will find his posts insightful.

World Medical Mission – Post-Residency Program Dessert Night

On Saturday, September 24th at 6pm, World Medical Mission (medical arm of Samaritan’s Purse) is sponsoring a free dessert night at Calvary Baptist Church in Bristol, PA.  Two missionary physicians with local connections will share about their experiences with WMM’s Post-Residency Program, as well as their upcoming plans for international, medical missions.

Of the 62 current participants in the program, 8 are from the Philadelphia area.  I know several who have had a great experience with the program and can recommend it enthusiastically.

Interested participants should call Allan Reichenbach at (215) 757-4168.  The only thing you need to bring is… you!

Caring For “The Least Of These”

Just heard about this from one of our local med students.  Read about how a local physician is helping the poorest, and most expensive, patients in Camden, NJ, just moments from Center City.

Interestingly, a full four-year medical school is opening at Cooper in Camden in the fall of 2012.  I wonder if there are ways to connect students there with what Dr. Brenner is doing.

In addition, his model seems to hold promise for other locations.  How can you reach out to those God cares for right where you are through the medical gifts God has blessed you with?

Making Med School Free

Dr. J. Scott Ries, CMDA’s VP for Campus & Community Ministries, offers some good commentary on a recent NY Times article about the prospects of a free medical education.  His thoughts at the end of the post about resisting the lures of financial compensation are worthy of further thought and exploration.

Medical Student Debt & Counting The Cost

Just read this “real-life example of medical student debt.”  His experience sounds similar to what I’m hearing from our students here in Philadelphia:

  • $270,000 in debt accrued during medical school itself,
  • plus $100,000 interest incurred during three years of residency,
  • plus another $237,000 in interest accrued after residency,
  • for a total price tag of $607,000, paid off in 15 years of monthly payments of $3,370 each

No matter how you look at it, this is sobering stuff.  What does all this mean practically?

For one thing, the soaring price of medical education means that now, more than ever, those entering medicine need to be sure God is calling them to serve this way.

In Luke 14:25-34, Jesus tells a parable about the cost of being his disciple.  Using an example still relevant for our own time, he asks, “Is there anyone here who, planning to build a new house, doesn’t first sit down and figure the cost so you’ll know if you can complete it?” (The Message).  Later, he makes his point even more clear: “Simply put, if you’re not willing to take what is dearest to you, whether plans or people, and kiss it good-bye, you can’t be my disciple” (verse 33).

While Jesus is telling us to consider the cost before we sign on to follow Him in the first place, I believe His words also apply before we make any major decision.  Like whether we should take on the huge costs – financial and otherwise – of following Him into medicine.   While challenging, the huge costs of a medical education are increasingly forcing prospective students to wrestle with their real motivations.

Of course, most people entering medical school need to decide this by the time they’re just juniors in college.  In all honesty, looking back at my own career path, it’s hard to do this well at that age.

So, what can we do?  Share your own thoughts in the comments section, but here are a few of my own:

  • First, our local ministry is thinking of offering a seminar for local pre-med undergraduates.  The seminar would involve people already in medicine – students, residents, and physicians – who could give undergraduates a picture of what medicine is really like and what it takes.  That way they can make a prayerful decision that is well-informed.
  • Second, help those already in medical school “count the cost” with future decisions they’ll be making.  Although they’ve already chosen medicine, there are many other choices ahead: what sort of specialty to pursue, what type of setting they’ll practice in, what sort of person they’ll marry, and so on.
  • To this end, we can connect people considering a given situation (i.e., surgery or overseas missions) with those who have already chosen it.  This helps them see and “count” the real cost.

Finally, the most important thing to remember in all of this is God’s grace.  While we can never wrap our brains around what we’re choosing, God can.  Even if we rush into something with motives or understanding that are wrong or incomplete, He stands behind us and His plans for us never fail.  We do our best, but move forward with the absolute confidence that “for those who love God, all things work together for good” (Romans 8:28).

Following God Wherever He Leads

As promised, this post is about what we learned from Gary Klein at our recent Intermed gathering.  Gary’s messages were rich, full of insight fueled by 20 years of providing primary care and pastoral training in the Dominican Republic.

Everything he shared was wonderful, but I believe we learned two key things.

To communicate the first lesson well requires sharing (with Gary’s permission) the story of what happened to Gary and his family just after they arrived in the DR for their mission work 20 years ago.

In those early days, Gary and his team saw every patient that showed up at their clinics.  At one of them, at nearly 2 in the morning, a witch doctor showed up, blew a powder in his face, and said, “I put a curse on you.”  Laughing the curse off, Gary continued seeing patients and was thankful to return home, noting that his family was fine.

A few days later, though, one of his young sons drowned in an accident in their backyard.  Needless to say, it was devastating, and Gary began to reconsider the reality of spiritual warfare and the witch doctor’s curse.  Courageously, he decided to go ahead with the next clinic.

Things were going well when, all of a sudden, Gary received word that someone had fallen into a well with deep water on their clinic site.  It was another one of their sons, and he didn’t know how to swim.  Although his son was rescued and recovered, he and his wife were deeply shaken and ready to leave the country before anything else happened.  Who could blame them?

This time of despair drove Gary and his wife to prayer.  Even though they were devastated, they knew that God had not abandoned them.  What did He want them to do?

In the meantime, with another clinic quickly approaching, the villagers from that community approached Gary and told him they wanted nothing to do with him or his clinic.  Word about the tragedy had spread quickly, and the witch doctor was threatening anyone who dared to come.  Again, Gary and his wife committed the matter to prayer.

Soon after, Gary received the news about another tragedy.  This time, a bus full of people had unexpectedly hit a patch of gravel and fallen down a steep embankment. Gary anticipated that everyone had perished, but this had not happened: instead, only the witch doctor had been lost.  It was a miracle, and, all of a sudden, the villagers contacted Gary and told him that they not only wanted him to do the clinic, but, free from the witch doctor’s control, they also wanted to hear about Jesus.

During his 20 years in the DR, Gary’s ministry has treated 175,000 patients, many of them during the crisis in the aftermath of the earthquake in Haiti.  (Haiti shares an island with the DR).  Of those, over 6,500 have come to know Christ.  Countless supplies and medical care has been dispensed in Christ’s name.  National pastors have been trained not only spiritually, but also taught everything they need to know to be truly self-sustaining, a real rarity in impoverished countries.

And yet, Gary emphasized again and again, due to the early challenges, how the ministry almost ended before it began.  The lesson he – and we, through him – learned, was to persevere in the face of difficulty.  Although we want it to be, God never promises it would be easy.  In fact, He tells us that “ll who desire to live a godly life in Christ Jesus will be persecuted” (2 Timothy 3:12).  Are we willing to persevere in His calling if it turns out to be much harder than we thought it would?

The second lesson Gary shared with us also comes from the story of God’s work in his life and ministry.  Before going to the DR, Gary essentially told God that he was open to going for 5 years – no more!  Over time, though, God showed Gary that He doesn’t make deals with us, or, relate to us as if we’re equal partners in a corporation.  While this is scary because we can’t control the outcome, it’s better because God is far wiser than we are.  Only He can shape our lives in a way that brings Him the most honor and us the most good (see Romans 8:28).

In a way, both of these lessons really boil down to one poignant question: are we willing to submit to God’s loving, wise ownership of our entire lives?  I know that, for me, this is a process and I continually find (and re-discover) areas where I want to hold out and negotiate.  Perhaps you can identify.  Thankfully, God is unbelievably patient, bearing with us and bringing us along one step at a time.  Let’s re-commit to yielding all of who we are to Him.