Should We Enlarge Our Hospitals and Santitariums?

Here are a few questions to our good friends the sanitarium and hospital ad­ministrators. Suppose you have a sanitar­ium and hospital of about three hundred beds and some nine hundred employees. And suppose your institution gives medical care annually to about ten thousand inpa­tients and some fifty thousand outpatients. Suppose, further, that your institution runs on an average of 90 per cent of complete occupancy most of the time. This means that many areas in your institution are crowded with patients placed at times on beds in the hallways. What would you ad­vise your board to do? Would you recom­mend an expansion? Would you suggest that they build an addition for about 7, 10, or 15 million dollars? There is no doubt that if you expand your hospital you could fill it with patients. But would that be the decision to make?

In the first place, it must be stated that inasmuch as your institution is a denomi­national institution, any decision carried out by your board must have its effect on the entire denomination either favorably or adversely. That is, it will either help or hinder the over-all purpose of our exist­ence as a denomination and our united endeavor to prepare a people to meet the Lord and to hasten His return. Second, with reference to a decision of this nature, that is, whether or not to enlarge a hospital of that description, we are privileged to base this decision on the inspired counsel given to us on this subject.

Volume Not Criteria of Success

The fact that patients keep coming to our institutions is not an indication that we are fulfilling God's purpose for their existence; neither would that be a justifica­tion for enlarging certain medical institu­tions. Ellen G. White wrote in 1903:

"The fact that many patients are coming to the new sanitarium at                    is not to  be read as a sign that the planning for so large work there was for the best. To this large institution will come many men and women who are not really sick. Workers will be required to wait on them; our nurses will become the servants of worldly men and women who are not inclined to piety or religion. But this is not the work that God has given to His medical mis­sionaries."—Medical Ministry, p. 159.

Indeed, the Lord's counsel is so clear that none need err. His counsel is: "Break up the large centers."—Ibid., p. 158. Does not that counsel mean that at one time we built "large centers," relying on our hu­man wisdom, and thinking that in doing so we were carrying out God's plans? Yes, this is exactly what happened. "Human wisdom tends to consolidation, to centrali­zation, to the building up of great churches and institutions."—The Ministry of Heal­ing, p. 147. God's counsel is just the oppo­site of that. His instruction is:

"Never, never build mammoth institu­tions. Let these institutions be small, and let there be more of them, that the work of winning souls to Christ may be accom­plished."—Medical Ministry, p. 323 (Ital­ics supplied.)

Large Buildings Not God's Plan

Indeed, these two "nevers" should never be misunderstood. The Lord's counsel is clear with reference to the size of our insti­tutions. Mammoth buildings are not in His program. He does not want to have His people erect such buildings. Not only did the Lord specify what He does not want us to erect but He stipulated what He wants done. "Let these institutions be small and let there be more of them, that the work of winning souls to Christ may be accomplished." He also gives the reason for having such institutions. He says, "that the work of winning souls to Christ may be accomplished." "The proclamation of the truth in all parts of the world calls for small sanitariums in many places, not in the heart of cities, but in places where city influences will be as little felt as possible." —Ibid., p. 159.

One of our leaders, not so long ago, stated his opinion wisely when he said: "I think we should be slow about making great enlargements of present major institutions. The counsel is still good that we should have many small institutions. I am not for­getful of the fact that today an institution must be of a certain minimum size to oper­ate economically. But some of our hospitals reached that size quite a while ago."—F. D. NicHoL, Review and Herald, Jan. 30, 1964, p. 2.

Why Small Institutions?

The Lord knew very well that His peo­ple would be tempted to erect large medi­cal institutions. For this reason He did not point out that danger to His messenger once but "repeatedly." "I have been re­peatedly shown," she wrote, "that it is not wise to erect mammoth institutions. It is not by the largeness of an institution that the greatest work for souls is to be accom­plished. A mammoth sanitarium requires many workers. And where so many are brought together, it is exceedingly difficult to maintain a high standard of spirituality. In a large institution it often happens that responsible places are filled by workers who are not spiritually minded, who do not exercise wisdom in dealing with those who, if wisely treated, would be awakened, con­victed, and converted."—Testimonies, vol. 7, pp. 102, 103. (Italics supplied.)

Large Institutions Endanger Spirituality

Indeed, none need err by disputing these reasons. Large institutions endanger the maintenance of a high standard of spirit­uality and are liable to engage "workers who are not spiritually minded." Not only do these workers carry minor duties, but it could "often" happen that they fill "responsible places." Such an institution "con­tradicts the very object of its existence" (Medical Ministry, p. 28).

Here, then, lurk a few of the many dan­gers that accrue from having large institu­tions. And can we minimize these dangers? Those who are not "spiritually minded" but fill responsible places are not able to discern the spiritual counsel given to us. If for this reason alone we decide against enlarging certain institutions, we would make a wise decision that may prevent a flood of evil that could endanger our work.

It was in 1903 that "the word of the Lord," advised "break up the large cen­ters." Prior to that, repeated counsel was given against mammoth sanitariums At that time the biggest sanitarium the de­nomination had was that of Battle Creek. That sanitarium started small in 1866, with only half a dozen workers, and undertook a tremendous expansion program. But it is vital to note that after all its expansion of buildings and facilities, by the end of the century it had nine hundred workers (see SDA Encyclopedia, article, "Battle Creek Sanitarium," p. 111), a number that today certain of our sanitariums, still thinking of expansion, have already reached.

It should be pointed out here that even if we would take the untenable position that it was all right seventy years ago to employ nine hundred workers at Battle Creek, we must admit that this would be ill advised today. After all, we are seventy years closer "the darkest period of this earth's history" (Christ's Object Lessons, 13. 414). If employing many workers made it "exceedingly difficult" to maintain a high standard of spirituality then, it would cer­tainly be more difficult today when sin is much more abounding. Today it would be both safer and wiser to employ a smaller, and certainly not a larger, number of work­ers in one institution. That would be in harmony with the counsel given to us and would be the correct application of the principle that inspiration has set down for us that "regarding the testimonies, nothing is ignored; nothing is cast aside; but time and place must be considered" (Selected Messages, p. 57). Needless to say here that this counsel, which is often misapplied, could never be interpreted as granting any person or group of persons a license to change (not merely to adapt) the divine admonitions of a changeless God.

(To be continued)