Doctor-Minister Teamwork

SINCE there is a growing recognition among Adventist health and ministerial professionals that there needs to be closer cooperation and unity on a denomination-wide basis, an attempt was made during the 1972-1973 school year at Loma Linda to find out just how extensive this feeling is. Also, an effort was made to learn what problems might stand in the way of any movement toward increased unity.

A detailed questionnaire sent to one hundred doctors and one hundred ministers in the North American Division in order to probe these questions resulted in responses from forty-eight ministers and forty physicians. Fifty-one indicated that they felt there was a "serious" division, eight felt there was a problem but did not think it serious, and twenty-seven felt that the problem wasn't worth being concerned about. (Two did not answer this question.)

When all responses are added together, those items thought to be causes of major strains or difficulties evident in Adventist doctor-minister relationships can be ranked as indicated on Table A.

Besides the rankings shown in Table A, responses to the rather detailed questionnaire indicated first of all that the main areas of disagreement which apparently contribute to the tensions existing between Adventist doctors and ministers seem to be the socioeconomic status differential between the professions and a difference in attitude toward evangelistic approach and methodology.

Evangelistic Methods Criticized

Doctors are rather vociferous, as indicated in these responses, in telling ministers they're not happy with current evangelistic methods and approach. The surveys reveal that ministers are aware of and sensitive to criticism in this area, and that many ministers themselves aren't too happy about some of the pressures that make them feel the necessity of baptizing converts as quickly as possible. Follow-up interviews revealed that doctors quite generally wish that Adventist ministers would be more conservative and careful and would take more time in their evangelistic approach than they do. The doctors also feel that some of the evangelistic practices of Adventist ministers threaten their ethical and professional standards. The fact that ministers are sensitive to doc tors' criticisms in this area, and probably overrate it, indicates that this is one of the major issues and that there needs to be greater dialog and cooperative effort in developing a well-balanced evangelistic approach.

Causes of Division Ranked

In order to bring the issues that divide Adventist doctors and ministers into sharper focus, it was decided to eliminate all replies that did not recognize a notice able problem and concentrate attention on those that did. All responses in this latter category are included in the summarizations in Table B.

From a comparison of responses presented in Table B, we see that among those physicians who recognize a problem in doctor-minister relationships, "evangelistic approach" seems to be a significant issue. Ministers, however, rank "economic differential" high est as a major cause of tension between themselves and doctors.

A majority of both physicians and ministers indicate that they feel the minister often resents the fact that doctors enjoy a higher standard of living, and an even stronger majority state that the doctor believes that his investment in time and expense for his professional training justifies the evident economic differential.

Typical of responses from doctors in our interviews with them was the explanation one physician gave. He stated, "So much more is required of doctors. They must attend medical meetings and take postgraduate work at their own expense. Doctors, if in good health, are not eligible for Social Security until the age of seventy-two. The average life span of doctors is quite low in comparison. Doctors work much longer hours with no paid vacations, and have no security of sustentation in case they reach the age of retirement."

Ministers shown similar statements responded that much of what the doctors say is true. But the one item that nearly all ministers interviewed took exception to is the doctor's concept that physicians work longer and harder. These ministers felt that part of the problem is that the physician is so wrapped up in his own duties that he has no comprehension of the amount of time and effort the minister puts into his work. Ministers feel that they are "on call" any time of day and night, even more so than most doctors are nowadays.

Underlying Problems

A few of the physicians contacted strongly expressed their feeling that the attitudes that have been cited under the term "economic differential" are really symptomatic of three underlying problems:

1. Lack of vision. Several physicians expressed the feeling that there isn't much possibility or opportunity any longer for the doctor to work within the structure of the church. Others feel just as strongly that there is a great deal of opportunity for such service if the physician really wants it, but that the doctor him self needs to take the initiative. More is now being done, they claim, to encourage doctors to go into denominational programs than ever before.

Lack of vision is not isolated, of course, to doctors. One characteristic reaction from ministers at tending classes at Loma Linda in church health education, when the basic philosophy of medical missionary work is presented to them, is a startled, "Why haven't we heard this emphasized be fore?" This in spite of the fact that many ministers and doctors have a basic understanding of denominational literature involved in this concept. It is most clearly set forth in the book The Ministry of Healing, and thirty-five out of forty-eight ministers and twenty-three out of thirty-nine doctors responding to this section of the questionnaire reported having read this book in the past five years. But what some apparently fail to see is the practicability of putting this ideal to work within the present organizational structure.

2. Covetousness. Since this term was used by four different physicians who reviewed this project, it was decided to in corporate it, with the understanding that it can apply to doctors and ministers equally well. Certainly, it is one of the underlying factors that must be dealt with in the realm of "economic differential." The doctor, even when a fully dedicated medical missionary, lives in a socio-economic setting in this country that often makes it possible for him to have everything he wants. The minister, obviously, cannot live on that scale.

3. Tendency to "use" each other. There was a decided difference between the response of doctors and ministers to the statement on the questionnaire that reads, "The minister is more interested in the doctor's financial support than he is in his active participation in church programs." Forty-three percent of doctors responding indicated they felt this was true. Another 38 percent responded that it was partially true. Only 19 percent labeled it not true. Ministers, on the other hand, didn't quite see it that way, as evidenced in the following results: true 12 percent; partially true 42 per cent; not true 46 percent. Whether the statement is true or not, doc tors largely seem to feel it is. This demonstrates a conviction that they are being "used" by ministers, and by the church as a whole.

Other Areas of Differences

Another factor in the socio-economic-status problem, which ranked as one of the major causes of tension, is that of difference in orientation and life style. It was pointed out in some of the interviews that many doctors move in social circles and in areas of sophistication that most ministers never get into. Even if he is invited, the minister may feel out of place in such circles. Doctors sometimes feel that the minister is not "with it" culturally, as one pastor expressed it.

Both doctors and ministers feel that there is also quite a wide gap in ways of thinking and approaches to life situations. They recognize that differences in training and education contribute in a major way to this phase of difficulty in relations.

Although other issues probed were not ranked in the returns as being as significant, many respondents did recognize that they contributed to the problem being studied. Thirty-three per cent of the doctors and ministers felt that denominational leadership should bear some responsibility for the present situation. Denominational administrators are aware of this problem, and a General Conference study group has been formed to attempt to do something about it.

When questioned as to what particular area of responsibility denominational leadership should bear, those interviewed seemed to feel that it was more lack of attention than anything else. Hopefully, this is now going to be corrected. Several of those interviewed or responding to the questionnaires felt that the denomination should especially do more in keeping lines of communication open between the professions.

An interesting reaction emerged in the area termed "spiritual differential" on the questionnaire. There was strong sentiment that in spite of occasional appearance to the contrary, doctors are just as spiritual in their interest and dedication to the work of the church as are ministers. Yet, in the replies received, it was clearly indicated that there seems to be an "observable" difference in spirituality. These seemingly contradictory statements can be harmonized rather easily when emphasis is placed on the word "observable." Evidently those responding feel there is an apparent difference, but that it is not a real one.

Historical Background

Contributing to the above is the historical background of doctor-minister suspicion that stems back to the Kellogg schism in the 1890's and early 1900's. Strangely, the impact of this historical split between the medical profession and the ministry in the Adventist Church is not recognized by most of those returning questionnaires as being a significant contributing factor to the current situation. Their responses reveal a conviction that such a long time has elapsed since that controversy that it no longer has much influence on doctor-minister relationships today. In interviews held with denominational leaders and those who have carefully studied this question, however, a unanimous conviction was expressed that this issue is much more of a contributing factor than is presently realized. Part of the problem seems to be lack of understanding of what really happened.

A few other factors, not specifically touched on in the questionnaire, were indicated by writ ten comments on some of the returned forms or came to light in subsequent interviews. A statement that was made frequently suggested that the problem is often one of individual personalities that some ministers and doctors get along fine and others don't. Another was that doctors and ministers often feel threatened by one another. To some, the doctor seems afraid that too close identification with the church may adversely affect his practice. Ministers, in turn, often seem to feel a status threat from the presence of a doctor in their congregation. Often the doctor is a fairly permanent and influential member of the church, who is contributing in a major way to its support, and Adventist ministers are frequently moved so that they do not ordinarily stay in one pastorate more than four or five years. Even though many doctors clearly feel that they are not given "much voice" or a significant role in church affairs, ministers tend to feel somewhat insecure in the light of the doctor's political power and prestige in the local church.

Difference in training and education appears to be one of the major factors in the breakdown of ideal doctor-minister relationships. Approximately 50 percent of those responding singled out this area as a significant factor. It is obviously also a contributing factor or an underlying cause be hind many of the other issues raised.

A strong majority responded in the affirmative to the statement in the questionnaire which suggests that doctor-minister unity could be better fostered if education on both our university campuses would include more training in medical missionary work and church health education. Many of the oral and written responses received suggested that it wasn't theoretical training that was needed as much as practical in this area. Graduate-level training was singled out as being more to blame for this phase of the problem than undergraduate training.

Encouraging Trends

It is gratifying to note that there are several encouraging trends in the area of Adventist doctor-minister relationships. First of all, there seems to be genuine interest and a definite recognition that a problem exists and some thing needs to be done about it. Dr. Robert Lang, of Andrews University, summarizes this trend among Adventists this way: "Most of us can call to mind the pendulum swing from almost complete indifference in our church literature and publications to a rather current era of intense interest, support, and plea for the development again of the healing team concept." * This is most encouraging in that it demonstrates a developing climate for the socialization effort that has been pointed to as one of the major keys to solving the problem.

One of the areas investigated in the survey that can also be looked on as encouraging is that of actual doctor-minister cooperation in the past year. Although several ministers indicated that they were serving in areas where there were no Adventist doctors present, fourteen doctors and six teen ministers indicated that they had cooperated extensively with their Adventist fellow-professionals in health-team ministry, and seventeen doctors and fourteen ministers reported cooperation to some degree. Sixty-eight of all those responding to the questionnaire rated their local doctor( s) or pastor(s) as very willing to cooperate, with only sixteen listed as neutral toward cooperation and six unwilling to co operate. Fifty-five out of ninety-five responding felt that it was not true that there is currently a decrease in doctors' involvement in church activities and offices. One recent development, the Five-Day Plan to Stop Smoking, has done much to foster doctor-minister cooperation.

When one attempts to analyze the variety of suggestions as to cause that came out of this study, it is seen that they are spread across the whole environment and include physical, mental, social, and spiritual factors. Unfortunately, there does appear to be some suspicion and distrust be tween many Adventist doctors and ministers. But it also appears that this wall is not so thick or impenetrable that effort and good will cannot remove it. Probably the factors that divide are not really the ones so frequently cited, such as differences in evangelistic approach, the socio-economic status differentials, or many others of those mentioned. These are merely symptoms, it seems, that point to a breakdown in meaningful dialog and communication. One of the most encouraging aspects of this study is that now there is a growing recognition of this fact and a real concern for doing something about it.