AMEN 2013: Following the Leader

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Adventist Medical Evangelism Network (AMEN)

AMEN 2013: Breakout Sessions C

Don Bovell

Transitioning from Acute Care to Lifestyle Medicine

Heavenly Father, we thank you for this wonderful day.

We thank you for the conversations about health that we've had today.

May we make practical applications from these talks.

I'm an emergency medicine physician practicing here in the state of Florida, and I'm board certified by the American Board of Emergency Medicine.

I graduated from Andrews University with a BS in biochemistry, graduated from the University of Michigan Medical School and did my residency in Detroit Receiving Hospital from 1989 to 1992, which that was a level 1 trauma center.

And currently I work in a large community hospital in Ocala, Florida.

We see about 106, 000 patients through all our departments.

We have a main emergency department, we have a freestanding ER, which is the first of its kind in the state of Florida, and the busiest in the state of Florida, and we have a pediatric emergency department.

So that's my background, that's my training.

Now, my experience with the current healthcare system as extensive as it is, is I would say it's disappointing In the sense that we really don't address the underlying cause of our patient's condition when we see them in the emergency room.

Now don't get me wrong, if you have a fire in your house, you want a fireman.

So if I have a heart attack at 6 a.m., I want Dr.

But our emphasis in health care, quote unquote, is the fireman approach rather than what I would probably term the smoky the beer approach.

And that's where we should have the push, even in the emergency room.

And as an emergency room physician, and as acute care clinicians, whether you work in the intensive care unit, whether you are a family practice physician, whether you're a nurse practitioner, physician assistant, I mean, the current research shows, past research shows, and I'm going to show you very graphically that back in the 1900s, what really addressed the problem with mortality from infectious diseases was not acute care medicine.

What addressed the major problem was preventive measures.

Now this is really a u-turn for me because my life is busy, fast-paced in the emergency department, but really had to think about these things.

So health care is really a misnomer because what we actually do in the hospital is disaster management or disease management.

It's, you know, the house is burning down.

All of us have had numerous patients who've had multiple bypasses.

I've taken care of a patient who had 13 stents, still smoking.

And I've talked to some of these people, many of them, no 1 has ever talked to them about preventive health measures.

So what do we get for our healthcare dollar?

We pharmaceuticals and procedures, right?

More and more, I'm seeing patients who tell me I spend more time with them in a busy ER than their physician spends with them.

They're busy, you know, with these chartings that we have to do.

So we're talking about majority of our healthcare dollar goes to pharmaceuticals and prescriptions.

What goes to like public health or prevention?

In 2009, we spent $2.5 trillion on healthcare.

And that waste was due to inefficiently delivered services, prices that are too high, and missed prevention opportunities.

Now what result do we get for this extremely expensive system?

We are a society plagued with the chronic diseases of the west as some people call them.

In 2010, the top cause of death was heart disease.

I put heart disease and cerebrovascular disease together since the etiology is very similar.

And then you've got non-infectious airway diseases like COPD, emphysema.

But let's look at something really interesting.

Look at the diseases that were the causes of death in 1900.

You've got, anybody ever seen this before?

In fact, for many years, tuberculosis was actually higher than pneumonia or influenza.

And then you have gastrointestinal infections, like, you know, cholera and those types of things, and heart disease is number 4.

Now, decline in mortality from infectious diseases from 1900 to 1996.

You'll notice that the death rate for infectious diseases was 800 per 100, 000 in 1900.

You can see the result of the influenza pandemic.

But notice very carefully that this graph steadily declines.

And here we have the first use of penicillin.

Here we have the first use of vaccinations.

And this is when vaccinations were used on a very public way.

So if you'll notice, before the first use of penicillin, infectious diseases were dropping.

Now, it begs the question, did penicillin actually improve the decrease of that death rate, or was it going to come down anyway?

I actually took care of a patient with epiglottitis, a little kid, when I was a resident at Detroit Receiving Hospital, And I don't see epiglottitis anymore.

I mean, that HIV vaccine, as I mean virtually, I see a kid with a fever in the ER, I don't know what to do.

All right, achievements in Public Health, 1900 to 1999, control of infectious diseases.

What was going on at that time was people were realizing there's a connection between contaminated water and health.

Okay, it was, They noted at that time we had TB sanitariums.

There were these big buildings where people would rest.

And if you'll notice, TB declined from 194 per 100, 000 persons.

That's 194 deaths, to 46 before antibiotics.

And this was due to improved housing and TB control programs.

So I actually got this from a CDC website.

Eddie Needham

Praying with Patients from a Christian Perspective

I had the pleasure of serving in Hawaii for 3 years.

And then was at Fort Benning, Georgia for about 4 years.

I had 5 children and saw the handwriting on the wall that at some point I would be sent for 3 to 6 months or more away from my family.

So, went ahead and took an opportunity to go to Emory in Atlanta where I was on faculty for 11 years and then came to Florida Hospital here in the city beautiful Orlando.

I didn't know the name of the city until about a year ago but it's the city beautiful and I've been here for about 3 years.

I'm a recovering program director of about 10 years duration and love to teach and share with you guys.

I hope that our time this afternoon is not very one-sided, but there'll be plenty of opportunity to share.

And just for you know, those of you in the first 2 rows, this is the splash zone and things may get splashed.

I have been blissfully married, my wife made me sure and put that adjective in there.

I have 5 mostly grown children, and my oldest is a boy, and then 4 girls, and so blessed with what the Lord has given us.

I just wanna say what a delight it is to be able to speak to a group of physicians, health professionals, who are coming together in a Christian atmosphere.

Someone who speaks and trains and does things.

You can give little hints, but you can't go overboard and say, Jesus, or things like that, because you may offend people.

Not that Jesus said we wouldn't offend people.

But it's a delight to be able to come and just to come into a group with brothers and sisters and to share the Lord and what he has for us.

Can I open with a word of prayer just real briefly?

Father, thank you that you are passionate for us, that you're a good father.

Thank you for the opportunity, as Solomon said, that as iron sharpens iron, so when we sharpen each other.

Lord, I pray that you'd pour into our spirits more of your presence, that as we rub against shoulders with each other, Lord, there'd be static electricity of the kingdom's presence, that we'd be able to electrify the environment around us with you.

And Lord, we just wanna make much of you this afternoon, and we pray these things in your name, amen.

What I really want to do is serve you guys and be able to share a little bit of what I've done, what I'm currently doing.

I am a journeyman apprentice on the journey that we're on.

And there may be some master Jedi in the room who've got some things to share.

I will occasionally be dropping Star Wars and Star Trek hints.

So those of you, rock on, yeah, dilithium crystals and all that kind of stuff.

So our goal this afternoon, we want to identify some clinical opportunities to address spiritual issues with our patients or just with each other.

Identify 3 signals that it might be inappropriate to go there, so to speak.

And then create a clinical opportunity where we also can have spiritual care for a patient encounter.

In John chapter 5 there was a miracle and it happened in the midst of stirring the water.

So I hope to stir the waters in your spirit.

I hope to present the weapons of our warfare as mighty.

It says in 2nd Corinthians 10 that our weapons of our warfare are mighty to the pulling down of strongholds.

We tear down all kinds of things that are out there, But our weapons are not iron and steel.

It's Getting down on our knees It's reaching out and touching people.

It's the things of the heaven that that Jesus showed for us I hope to make much of Jesus He's the 1 that we're all here about.

And I hope that we can conspire together to advance his kingdom.

N equals 1, randomized to the treatment group, right?

In medicine, we use evidence-based medicine.

We've got Harrison's, we've got Cecil's, we've got Swartz textbook in medicine, Nelson's.

So family medicine, internal medicine, pediatrics.

And how about non-physician healthcare folks?

This is a good reflection of the body of Christ.

Our ministry textbook obviously is the Holy Word of God.

It's interesting, it says in Hebrews 4.12 that the Word of God is living and active, sharper than a double-edged sword, It penetrates to the dividing asunder of soul and spirit, joints and marrow.

It discerns the thoughts and attitudes of the heart.

2 Timothy 3.16 says, all scripture is God-breathed, is what it says in the King James.

New International Version says that it's inspired.

All scripture is God breathe and is useful for teaching, correcting, rebuking, and training in righteousness so that the man or woman of God may be thoroughly equipped for every good work." What we're doing is equipping each other.

And John 14 26 says, "...the Counselor of the Holy Spirit, whom the Father will send in my name, will teach you all things and remind you of everything I've said.

I always wondered how could guys who weren't trained go for pages of writing read in the Bible?

Did they just like put the DVD in and start quoting you know Jesus?

I think the Holy Spirit was bringing things to their remembrance.

So the Holy Spirit, the Word of God, those are obviously teachers that we have.

He's so much bigger than we can ask or imagine.

In Job chapter 9 verse 8 it says, He alone stretches out the heavens and treads on the waves of the sea.

I love where Jesus does something in the New Testament and it doesn't seem to have a reference.

Where did that happen in the Old Testament?

You know, He's walking out on the water, tells Peter, come.

He was already treading on the waves of the sea back in Job.

There's a story, several stories where Jesus takes bread and fish and multiplies it.

Elisha did that in the Old Testament with just a hundred people.

What is he doing in our lives that's already been recorded in Scripture, and he's just waiting for us to get out of the boat.

Isaiah 40, 28 through 31, you know this verse.

The Lord is the everlasting God, the creator of the ends of the earth.

He does not grow tired or weary and his understanding no 1 can fathom.

He wrote Cecil's he wrote Harrison's He knew all that stuff and it goes on and then says, you know Those who hope in the Lord or wait on the Lord will renew their strength.

They'll soar on wings as Eagles They'll run and not be weary.

Fred Hardinge

Keys to Successful Comprehensive Health Ministry in the Local Church

There's something about Adventist audiences around the world that eschew the front seats.

It doesn't matter where I go, the front seats are usually the last to be taken.

But I'm delighted to have the opportunity of being with you today for this hour.

I always look forward to the AMEN Conference every time I've had the opportunity of being there.

I'm always blessed and inspired, and it's good to see our medical and dental professionals seriously interested in about in carrying out the work of the Lord.

Tomorrow morning I have the privilege of sharing with you just for a little bit about some of what is happening in health ministries around the world.

But There has never been a time in the history of our church that I'm aware of that from the highest levels of the church there has been an interest and a commitment to health ministry as there is today.

I have been involved in health ministry for more than 35 years, and I have never seen anything such as what we're seeing right now.

An annual council just finished, and annual council was led off.

The first 3 sessions were devoted to health ministry.

So For those of you who have a passion, as I do, about health ministry, it's a wonderful time to be living.

I want to just share with you some things that I've learned along the way.

I want to share with you a few of what I consider to be the essential elements to successful church-based health ministry.

And as we begin, I would just like to invite you to bow your heads with me in prayer.

Father in Heaven, we have been reminded today, especially in our devotional this morning, that without You and with Your blessing and Your Spirit, we can do nothing.

And so we invite Your presence into our midst once again this afternoon, asking that You would speak to our hearts, enlighten our minds, and strengthen us for the work that lies before is our prayer in Jesus' name, Amen.

Before we talk about those essential elements, I want to diverge for just a moment to ask the question, what is health ministry?

Now we're hearing the term comprehensive health ministry.

So rebranding of an old term, health evangelism, health ministry, whatever it is, it really is this, or comprehensive health ministry, it's really the same thing.

We probably all would give different definitions if I was to ask you to each write a definition down.

We're not going to take the time to do that.

And I would like to suggest to you this morning, or this evening, this afternoon, that health ministry is more than a set of scientifically established health principles and practices that can prolong and preserve life.

It's more profoundly important than its component parts of healthful eating, good exercise, stress management, drinking water, getting an adequate amount of sleep, the 8 natural remedies that we often refer to from Ministry of Healing, page 127.

It can also do far more than modern science has discovered.

I think we limited it when we talk only about the scientific principles, which are there and we can praise the Lord for that.

The Seventh-day Adventist health message, when rightly understood and when it's linked with scripture and with the God of scripture, can actually bring the dead to life.

I'll share with you in a few minutes a quotation in that regard.

And when we confine any part of the health message merely to its scientifically validated facts, we tragically shortchange our audience of the eternal benefits that are only available through Jesus Christ.

The health message is more than what it appears to be and what we often define it or think of it as.

The first essential element for successful health ministry, And I think it applies to the practice as well as to the church and to the community.

It applies anywhere we seek to do health ministry is that we must never forget to share Jesus as the only effective agent of change.

The Spirit of Prophecy told us in Ministry of Healing, page 424, that medical missionary work is in no case to be divorced from the gospel ministry.

The Lord has specified that the 2 shall be as closely connected as the arm is with the body.

And without this union, neither part of the work is complete.

The medical missionary work is the gospel in illustration.

I know they're the farthest ones forward, but we're a friendly group.

When I was first beginning in health ministry, I was freshly minted with a degree from Loma Linda.

I was excited about the possibilities that lay ahead.

I had been called to a large city, to a particular church that had struggled with traditional health evangelism.

The conference president said, we want to look at community health education.

We've been reading the Spirit of Prophecy, and we believe that this is the direction we need to go.

And so, without any previous experience, I accepted that invitation, and we moved, and I began my work.

And I planned a whole raft of health education programs in the community.

And during that first year and a half, I believed that I needed to establish relationships, and I needed to visit people in their home, and invite them to study the Bible, not just talk about nutrition and exercise and all the other good things we were talking about.

And so I would ask people if I could come and visit them.

And they'd say, sure, we'd be glad to have you come.

And I would go, and I'd knock on the door.

And they'd open the door, and they'd bring me in.

And they'd ask me questions about diet, they'd ask me questions about exercise, they'd ask me questions about smoking cessation, They'd ask me all the questions about all the things that they had been learning in the classes, in the church.

But when I would say to them, very carefully broach some spiritual question to them, They'd say, by the way, did you know it's going to snow tomorrow?

Or they'd say, do you know who's going to win the ballgame this weekend?

And it was very clear to me that they were not comfortable about talking about spiritual things.

About a year and a half into it, an old family friend called me up and said, could I come and stay with you?

Now, I realized that he was probably about my age today, but I thought he was a very old man then.

And he stayed with us for about 3 or 4 days.

We had an opportunity to talk in the car and I shared with him my frustration.

And on the morning he left, he said, I'd like to talk to you for a few minutes.

And he said to me, Fred, I've heard your heart cry.

He said, you must identify yourself as a spiritual person if you're going to be able to talk to people about spiritual things.

And I said to him, but it's in the church.

He said, Fred, if you're going to talk to people about spiritual things, you've got to identify yourself as a spiritual person.

But he said, you've got to do more than that.

And he said, well, I would suggest that you begin every class with a little inspirational thought.

He said it shouldn't be long, and it needs to be connected to the topic of the evening in some way.

He said, if you try and talk to them about the 2, 300 days and then talk to them about what they eat, he said, they're going to wonder what they got into.

Series

AMEN 2013: Breakout Sessions C

Praying with Patients from a Christian Perspective

Transcript

Parent Series

Parent Conference

Sponsor

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