Dr. D. L. Dunfield, president of Adventist Health Services/ Asia, recalls a time as a young man when "I would have never even considered hospital work." As an undergraduate student at Atlantic Union College, he was at first a business major, but became interested in the medical field by working part time at New England Memorial Hospital in Stoneham, Massachusetts, where his wife was also employed. Later he returned to do his residency at the same hospital. "Ray Pelton, who was administrator at NEM then, really encouraged me and gave me a love for this kind of work, "says Dr. Dunfield. His experience in hospital administration spans thirteen years and includes institutions in Canada, Australia, and Hongkong Adventist Hospitals, where he served for four years before assuming his present position in July, 1983.
Q. Adventists like to say that the medical work is the "right arm" of our message. Do you agree?
A. No. I'm unaware of support for that phrasing. I do agree that the right arm of the message is the medical missionary work. That's quite another thing. For too long we have assumed that we are doing the Lord's work if we are involved in some kind of medical or health work—physician in private practice, community hospital employee, Advent ist hospital employee, whatever. Don't you believe it! The Lord's work is to save souls.
Q. But doesn't the term "disinterested benevolence" have the connotation of helping people without thought of conversions or baptisms?
A. The church was not instituted by God to tie up its finances and manpower in simply operating hospitals. It's true that a hospital serves humanity. It's true that we are commanded to heal the sick. But, as Elder F. D. Nichol used to say, "We are also commanded to clothe the naked and feed the hungry, yet no one thinks that we should therefore establish clothing factories or operate restaurants strictly as a means to alleviate these problems. " To put it another way, I don't believe the medical work is an end in itself. To interpret medical work as ministry to the physical being alone is not enough. To operate hospitals just to operate hospitals is to miss the whole point of what ministry really is.
Q. So you believe that Adventist hospitals are to be different from other hospitals?
A. Yes. I believe our hospitals are to offer something the community hospitals do not. We are to link the gospel ministry with the ministry of physical healing. We are to be skilled in ministering to souls as well as to the body. Our hospitals should introduce the basic principles of health. We are hot only to cure disease; we are to teach people how to stay well. Since hospitals in general profit financially from sickness, Adventist hospitals will be practicing "disinterested benevolence" when they teach their patients to live in a way that will keep them out of the hospital! I believe this mission to be the uniqueness in our Adventist blueprint for medical missionary work. It is not our mission to compete with the community hospital; it is our mission to offer a dimension of concern and healing and teaching that the community hospital does not offer. And, let me add, I believe our medical care should in no way be second to that which can be obtained elsewhere.
Q. But can a hospital survive while trying to put itself out of work through an emphasis on preventive medicine?
A. So long as there is a world out there to be reached with the gospel, there will be no lack of patients. When our hospital administrators, our physicians, and all our staff combine soul winning and healing and healthful living, then the work will go forward as never before. And I believe our hospitals will prosper as never before because they are different. Jesus went about healing, associating with the people, ministering to their needs; and then He asked them to follow Him. His principles will bring success when they are applied in our hospitals as well as in our individual lives.
Q. Do you believe the size of a hospital is related to the care it gives?
A. Yes. It must be large enough to offer truly professional medical care, with all that that means in sophisticated equipment and facilities. But it must also be small enough to maintain Adventist identity and principles. Availability of Adventist staff—administrators, doctors, nurses—and availability of dedicated non-Adventist staff both must be factors in the question of size.
Q. Is it possible for an Adventist hospital to maintain the uniqueness you insist on with a staff less than 50 percent Adventists?
A. Certainly it is possible—if not, in all cases, probable. It can be done. The key is the commitment and dedication of the SDA staff. They must understand clearly and practice the aims of the hospital. A consistent Christian life is itself an irresistible power. If each Adventist staff member reflects the image of Christ, the atmosphere of the entire hospital will be permeated with care and concern.
Q. Would you close or sell a hospital rather than operate under less than ideal conditions say, with, a largely non- Adventist staff?
A. I do believe we are spreading ourselves too thin in terms of dedicated staff. But to answer your question directly, if the hospital has a committed SDA staff, whatever its size, and if it maintains the goals for which the church has established hospitals, I would not suggest it be closed. If the administration is operating the hospital with no greater goal than to be running a good hospital, with no definite plans for soul winning, with little or no concept of what it means to be part of God's plan for ministry in these last days, then surely at the least we should question our reason for maintaining the hospital.
In the Hongkong Adventist Hospitals we have our own nursing school. Many of our nurses and staff have graduated from it. Its strong religious influence carries over into our wards. At the present, approximately 60 percent of the combined staffs of our two hospitals are Adventists. In my recruitment of Adventist doctors I have found that those willing to come want to practice medical missionary work which, by the way, is not confined, in my definition, to overseas service. Many, including those unable to come, inquire about how we combine our medical work with soul winning.
Q. The doctors themselves want to be involved in soul winning?
A. Yes. I've found that many of them become tired of the everyday work of caring for patients when they have no higher goal. And this is true of staff as a whole. We get too involved in seeing too many patients, adding new services, multiplying committees. We have no time for follow-up visits with our patients, no time for Bible studies or just socializing. In recent recruiting visits to the United States and Australia I found many doctors who wanted to be some thing more than mere health-care professionals. In my years as a hospital administrator I've found that patients do not come to one of our hospitals primarily because of its name or its reputation, but because of its doctors. It is true that some come because it is an Adventist hospital, but the majority come because of a doctor who practices there. It is the doctor who makes the most impact on the patient. The hospital administrator must ensure the Adventist doctors opportunity to make a spiritual as well as a medical impact on every patient.
Q. In addition to recruiting committed physicians and nurses, how do you reflect "uniqueness" in the Hongkong Adventist Hospitals?
A. We try to make health education central here. In Hongkong we have a number of outreach programs Five-Day Plans, stress- and weight-control seminars, nutrition and cooking classes, a running clinic, prenatal classes, and cardiac rehabilitation. And we offer these programs free to the community. When people ask us why we do this, we are able to share our philosophy of overall health and what we consider the mission of a hospital to be. Increasingly our hospital ministry is revolving about this program. And, of course, our physicians are involved. They donate their time to lecture, to attend programs, to jog with patients.
Q. So your physicians actually do the work of the ministry?
A. They share in it because they share in the minister's conviction that the ultimate goal of witness is to draw people to Christ. I would say that our doctors have a specialized ministry, with their emphasis on medicine. We seek to foster a close relationship between physician and minister through medical/ministerial retreats. Qualified ministers are involved in health-education programs.
Q. You have emphasized the need of committed Adventist staff. Do you have a dosed staff, so far as your Adventist doctors are concerned, or do you operate like a community hospital in the States?
A. We have a strong core of Adventist physicians who are on denominational salary and involved deeply in the hospital's health-education programs. In addition, we have a courtesy staff of community physicians who admit patients to the hospital. These doctors are not involved as deeply as are our Adventist physicians in operating the hospital, though they support the hospital and its programs. An Adventist hospital can operate as an Adventist hospital with an open staff, but the hospital must have a strong team of SDA physicians to set the tone for the hospital.
Q. We hear occasionally that times have changed so much that it simply isn't possible anymore to operate a hospital according to "the blueprint." Evidently you don't con cur.
A. No, I don't. I think it is more difficult to do so today than early in our denominational history, for a number of reasons government-imposed regulations, health-care plan requirements, et cetera. But, basically, we can do it if we have the committed people we need. With the number of Adventist institutions competing, in a sense, for such Adventist staff, the challenge is substantial. If our philosophy is wrong—if we think we must be the same as the community hospital—the challenge is even more difficult. If we will retain our commitment to three principles—be small, be unique, be spiritual—I believe we can operate a truly Adventist hospital.
Q. How is being a truly Adventist hospital reflected in your approach to patient diet? Do you serve meat?
A. Until three years ago, no. Then we set up a committee of physicians, pas tors, and administration to look at the question. Today we are serving meat as well as a vegetarian diet. On the first day a patient is in the hospital he gets the vegetarian diet. On the second day our dietitian visits him and explains why we emphasize a no-meat diet. The patient is told, however, that if he insists, he may have a meat menu. We don't feel that the four or five days when a person is sick is the best time to reform his eating habits. Education is the motivator for change. We find that 75 percent of our patients choose the vegetarian menu after the dietitian explains why it is emphasized in our hospital.
Q. You mentioned that your physicians at the Hongkong Adventist Hospitals are on the denominational pay scale. Can we keep a top-flight SDA staff without paying top wages?
A. You really want me to jump in with both feet, don't you! Let me say this: I have found that there are doctors willing to work on the Adventist wage scale. All our physicians—approximately twelve on the staff—are paid denominational wages. At times all of us probably think we aren't being paid quite enough, but to this point we surely haven't demanded that we be put on another plan. There are benefits—furloughs, study leave, vacations with families. I believe the denominational wage scale to be the ideal for our hospitals.
Q. Do you provide any additional spiritual benefits to your physicians?
A. We conduct two Spiritual Emphasis weeks each year in which we review church goals. And you'll be glad to hear that we send MINISTRY magazine to every physician and dentist.
Q. What is the relationship between the hospital chaplain and the pastor of the hospital church?
A. The pastor of our church is also the associate chaplain, and our chaplain is the associate pastor. This arrangement is ideal, with both working together within the hospital and the community.
Q. Do you have a community advisory group to counsel the hospital board?
A. No, I do not favor that arrangement. Rather than having a community advisory group to inform us of community affairs, we become so involved in the community that we know their concerns. Advisory groups usually consist of influential businessmen. When for some reason their recommendations cannot be implemented, they tend to feel they are only a token presence.
Q. Do you have a perspective on general medical plans that offer free medical care to patients?
A. Socialized medicine is not a nice phrase in the medical community. And certainly it would bring problems or, at the least, mixed blessings. Recently I heard a speaker describe the potential problems of a proposed national health program. Among other things, he referred to government representation on our hospital boards, problems with maintaining dietary standards, curtailment of preventive-medicine programs because of the costs, regulation of medical staff privileges, and numerous social problems, including abortion. A national health scheme may benefit many people, but it can cause real headaches for the hospital particularly one that insists on maintaining its uniqueness.