OBJECTIVES At the conclusion of this CME activity, the learner should be better able to: 1. Understand the barriers that hamper or destroy the physician’s effectiveness in patient care. 2. Recognize that spirituality is a core patient need and its beneficial influences on health. 3. Understand the role spirituality can play in their professional growth, promotion of personal happiness, and the basis of their calling as a physician.

AMEN 2019: Christ in You

<p>OBJECTIVES At the conclusion of this CME activity, the learner should be better able to: 1. Understand the barriers that hamper or destroy the physician’s effectiveness in patient care. 2. Recognize that spirituality is a core patient need and its beneficial influences on health. 3. Understand the role spirituality can play in their professional growth, promotion of personal happiness, and the basis of their calling as a physician.</p>

<p>Free sharing permitted under the Creative Commons <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">BY-NC-ND 3.0 (US)</a> license.</p>

Adventist Medical Evangelism Network (AMEN)

Plenary

Brian Schwartz

Us in Christ and Christ in Us

Father in heaven, just 1 more time, we invite your Holy Spirit to be here.

And I just pray that you can speak through the few thoughts that I share here tonight.

Pray that your Holy Spirit will be here to speak through my lips, but to impress each of our hearts with what you'd have us to learn.

Open our ears to your word, and may Jesus be lifted up, I pray in his name, amen.

What comes to your mind just from that statement?

Lot of things could go through your mind.

We're blessed to live in America, where we still have freedom.

We are blessed to be physicians and dentists and healthcare workers and be entrusted with the sacred calling that Jesus has given to us.

We don't probably think of ourselves as wealthy.

More than half of the undeveloped world lives on 2 dollars or less a day.

So I don't care if you are from a self-supporting institution or you're in private practice, you work for a government VA hospital, or you're retired, You are wealthy by the world standard.

The United States, the per capita income is around $60, 000 a year.

Physicians and dentists are around 250 to $350, 000 a year.

Why did we wind up here in the United States?

It's not also an accident, but it was a privilege.

You and I were born privileged to be in this country, to be able to immigrate to this country or to be able to grow up in this country.

We're blessed to be able to pursue careers and many of us are not here just because we worked hard but because people sacrificed for us to get here.

Our parents, our families, teachers, even our patients, let us learn on them when we knew nothing.

We are, it's pretty incredible to think about it.

In the ancient Old Testament times, God's purpose in blessing Israel was so that they could be a blessing to the world around them.

God always gives us privileges and blessings so that we can be a blessing to others.

And so he blesses us so that we can bless others.

Israel was supposed to be a missionary people, a light that drew everybody from around the world like the Queen of Sheba came to see Solomon.

But with great privilege comes great responsibility.

As Todd already mentioned, many of our friends were, so Lindy and I have no children of our own, but we have a lot of children that our friends have shared with us.

We don't have to pay their college tuition.

They can come have root beer floats on Saturday nights.

And I tell her just because it's vegan doesn't mean it's healthy.

And so, we really appreciate having young people in our home.

It's an incredible blessing and a privilege that we've enjoyed.

And those of you who are parents that have allowed us to call your kids our kids, It's been an amazing privilege.

He was clocked at going almost 140 miles an hour just about 3 months after he got his driver's license.

And his dad actually called me and said, I don't know what to do.

I think he thought since I speed a little bit, I could relate to him, I don't know.

And could you talk to him like he's your son?

So I set up a meeting and I met with Justin.

Said, Justin, if you were my son, this is what I would tell you.

With great privilege comes great responsibility.

I said, no, this is a very serious matter.

Cars are very dangerous you just got your driver's license.

So I speed I get that but going 140 miles an hour there's no reason for that.

You've suddenly gotten this privilege and you just can't control yourself and you are out of control, no, I'm not gonna help you figure out how to get out of this speeding ticket.

I would take a lawyer with you because you could lose your driving privileges for a long, long time, but you brought this on yourself because you were out of control and unrestrained.

And so he got through it, and I don't think to this day he's driven that fast again.

But God wants to pour out his Holy Spirit on a last day church.

He wants to pour out his Holy Spirit on wealthy physicians who think that we got here ourselves and that some reason we deserve the standing that we have, are we safe to pour out that kind of power?

Way more than being able to go 140 miles an hour just because you've got the horsepower to do it.

So Being wealthy, being in a position of respect, puts us at risk of being proud.

It puts us at risk of thinking that we deserve this.

And deserve is a word we should never, ever use.

And it's only by the grace of God that we weren't born on the other side of the tracks, that we weren't born to a crack mother and we had no possibility of going to medical school, Or that we were born over in India and we had no hope of ever having an education.

It's a tremendous privilege that we've been blessed with.

And we are living, I don't think this takes even 2 moments to convince you that we are living on the very brink of eternity.

In our board meeting we talked about the fires in California.

We're seeing things happening around the world that the devil has unleashed because of the recklessness in the way that we've treated the world.

God doesn't cause these, but he uses them to get our attention.

And it's to show us that all these things, our homes in Malibu that have fires coming up to surround them, all these things are not here for long.

None of these have real lifelong meaning.

It's got to be getting involved in unselfish service.

And that's what we are called to with the great privilege that we've been given.

Tonight I want to look at a little bit about what that looks like.

Amarachi Nwankpah

Six Words Every Physician Should Know

Dear Lord, we thank you so much for this day that you've given us.

Thank you for this time and thank you for this conference, Lord.

I just pray that you may be seen, felt, and heard in every word that I speak and every action of my life, Lord.

I humbly ask that we may come away from this meeting knowing you more and understanding more of the calling you have for each 1 of us.

I thank you for all that you have done and all that you're doing, all that you will do today and through this conference.

And I ask all these things in Jesus' name, amen.

Does anyone have a guess on what maybe these 6 words are?

Or maybe in your own practice, 6 words that you use or a motto that you live by that you remember every day when dealing with your patients.

This is interactive, you had to talk to me, that's why I asked the question.

No 1 guessed what the 6 words that I'm going to present on are, so this will be exciting.

But those were all great, so let's get into the presentation.

So this is a CME activity, so there are no disclosures that I have.

But the objectives are that by the conclusion of this CME activity, the learner would be better able to understand the barriers that hamper, destroy a provider's effectiveness in patient care, recognize that spirituality is a core patient need and its beneficial influences on health, and also understand the role spirituality can play in their professional growth, promotion of personal happiness, and the basis of their calling as a health care provider.

So in 2019, a study was conducted by the National Coalition for Cancer Survivorship, where patients and physicians were asked about some physician behaviors that can have a negative impact on effective communication between the healthcare provider and the patient.

So some reasons given by the patient were that the provider withholds information or provides this information in a cold and tactless manner.

The physician sometimes talks down to patients or use terms that are unfamiliar to patients or that the provider has body language or behavior that signals that they're really too busy to give the time that the patient may need.

Physicians also noted some barriers, mostly centered around not understanding the subject matter and thus not being able to teach it, and then also being afraid or ashamed to admit that they don't understand the subject matter.

And then also doubt in certain treatment options due to unfamiliarity of the method.

So, these barriers not only made it more likely for a patient to be non-compliant, but with the lack of empathy perceived, trust, and the lack of concern perceived, the patient is likely not to return to the provider to receive the care they need.

So interestingly enough, these barriers not only exist in communication of physical diagnosis and treatment, but also in spiritual health care as well.

In 2016, the AMA, the American Medical Association, conducted a survey and found that 41% of patients want to discuss religious or spiritual concerns in the healthcare setting, but less than half reported being offered the opportunity to receive such care.

In 2003, a survey was conducted in primary care clinics at 6 academic medical centers.

A total of 456 patients participated in the study, and 65% of these patients felt that the physician should be aware of their religious preferences, while 35% preferred that the physician ask them about their beliefs.

The study also showed that the patient's desire for spiritual interaction with their physician increased with the severity of their illness.

Other studies have shown that as many as 83% of patients would want their physician to inquire about their beliefs and Studies even indicate that integrating spiritual care into patient care significantly enhances patient satisfaction.

Patients surveyed said that when spiritual care is not integrated into their health care that their satisfaction levels are actually decreased.

So the effect of spirituality on health is really an active area of research.

Typically studies on this topic tend to fall into 3 major categories, either mortality, coping, or recovery.

Some observational studies suggest that people who have regular spiritual practices tend to live longer because religious commitment may offer richer social support and the strength of personal values and moral view.

So patients who are spiritual may utilize their beliefs in coping with illness and pain and life stresses.

Interestingly, a study of heart transplant patients showed that those who participated in religious activities complied better with follow-up treatment and had improved outcomes at the 12-month follow-up visit.

So these studies highlight the importance of assessing spiritual needs and having a conversation about spiritual health with every patient.

Yet few providers actually do this, thus creating a gap in a patient's health care.

Also, when a prior does address spiritual health, many patients observe the same barriers that we just discussed and are non-compliant with the recommendations or do not return to the subject in subsequent visits.

When physicians were specifically surveyed about addressing spiritual care and the barriers that may be present, they said similar things.

Lack of time, lack of knowledge and interest in spiritual things, and they didn't want to make people feel uncomfortable and they felt uncomfortable themselves.

So an understanding of the impact of spirituality on overall health is really essential and although challenging, consistently addressing the matters with every patient is as important, if not more important, than addressing their physical and emotional needs.

So I'd like to demonstrate these points in 3 unique cases.

She's a 61 year old woman who had poorly controlled hypertension and obesity.

When she came to me she was already on 3 different blood pressure medications and despite this her blood pressure was consistently in the 180s to 190s over 90 to 100 range.

She was complying with all her medication, so as I talked with her, I thought that really the most likely cause of her elevated blood pressure was because she didn't have a great lifestyle regimen.

So as every good Adventist physician does, I started talking about lifestyle with an acronym.

First, nutrition and exercise and water, sunlight, temperance, fresh air, rest.

And then when I got to the last tea, I looked at my clock and I realized, don't have time for this.

So, I told her, you know, we'll follow up, we'll talk about the rest on our next visit, but I felt a little guilty.

So in order to make myself feel a little bit better, I kind of rambled off something to the tune of, you know, health is really important and it includes spiritual, physical, and emotional needs.

And, you know, we talked a lot about physical health today and spiritual health is really important as well.

And some of my patients like to talk about spiritual health and so they even like to include spiritual practices such as prayer.

So is this something you'd be interested?

And she was pretty confused at that point, not really knowing where that came from.

So she declined and she left the office with a note from me that she brought to the checkout counter saying, follow up for blood pressure in 2 weeks.

So, the way my office was structured, in order to make more availability at my schedule and also to decrease the wait time for patients for straightforward visits, her repeat blood pressure check was actually scheduled with my medical assistant.

And so I knew that it was going to be a long time before I actually saw her.

And so, you know, at that visit I felt that I had missed the mark.

I felt that I should have done more, but then I consoled myself saying, I do have a busy schedule, it wouldn't be fair for other people to wait longer, and I did talk about lifestyle, right, check, and I did offer prayer, check, And she was really the 1 who refused to talk about spiritual health.

2 weeks later, my medical assistant knocks on my door, and she reports that Zizi has returned.

And she checked her blood pressure 3 times, and the best reading that she got was 180 over 100.

So besides this, Zizi was crying because her blood pressure was still not controlled despite compliance with all the medication and lifestyle recommendations.

So at this point, remember I said that she was on my medical assistant schedule, so she wasn't on my schedule.

So I had a full schedule, patient set to arrive any minute.

And I had also discussed with her at a previous visit that if her blood pressure still wasn't controlled, we might need to add a fourth antihypertensive to help control her blood pressure.

I said, you know, I have a busy schedule.

Let her know that we're just going to add that other blood pressure medication, and then she can see me back in the office.

My medical assistant returned soon after saying, the patient wants to speak with you.

I checked her blood pressure myself with a manual cuff, and the reading was 186 over 94.

Her exam, besides her blood pressure, was otherwise normal.

She said, you know, what am I doing wrong?

Kianna Simmons

Evaluating the Final Impressions

Schwartz said last night, we truly are blessed.

No matter what our situation, the fact that we're here today, We know that there's no coincidence in the life of a Christian.

And so we thank you for the privilege and the opportunity that you have afforded us to be here.

And I pray, Lord, for myself at this moment that you remove me and that you would fill me with the words that you would have my colleagues, my family, my friends to hear from you.

I pray that you will open their hearts, their minds, not to hear my voice, but to hear you speaking to them.

Alright, so evaluating the final impression.

You know, in dentistry, 1 of the, I would say it's gotten easier, or getting easier.

1 of the challenges we face is that most patients come to us, but I'm gonna say 99% of them hate coming to see us.

I think that if I got just a penny for every patient who has said, doc, I hate being here, I would be a billionaire a thousand times over because it's not their favorite place to be.

But with that, it presents an awesome opportunity not to take advantage of their vulnerabilities or anything, but to be able to present Christ in a unique way.

And so today we're gonna look at evaluating the final impression.

When we're dealing with patients in, well before I get to that, these are our objectives here.

We want to understand as dentists that the greatest impressions are not the ones that we take, okay?

They're actually the impressions that we make.

We want to explore how Christ in us is attainable for each and every 1 of us.

Not just ministers, not just leaders, but each of us as children of God.

I'm gonna share with you through some of my testimonies, some of my stories, how Christ has worked in me and through me to have these wonderful impressions on patients.

And I wanna help demonstrate how practicing Christ in you daily will improve your relationship with your patients, your staff, and people around you.

That marketing bill that you hate to see, but you do because you need patients to come in for some of you, you would find that uplifting Christ actually is the greatest marketing plan that you could ever have.

When I went to the dictionary and looked up impression, there was about 1, 001 definitions of an impression.

And when you get into this digital age of technology, That even gets bigger, because they use impressions on the internet now for all sorts of things, and it gets complicated.

But these are the 3 types of impressions that I'm going to really emphasize today, and I want you to keep them in your mind.

The first 1 is the most common 1, for us as dentists particularly.

It's an imprint of the teeth and the adjacent portions of the jaw for our usage in healing or treating patients.

The second 1 is that an impression is an idea or an opinion of what something or someone is like.

And For many of us as healthcare professionals, this is big for us, our image.

And the last 1 I think is an impression that we don't tend to think of enough, but it's actually 1 of the most powerful ones, if not the most effective 1.

And that's the effect or influence on the way someone feels or thinks.

And so we're gonna talk a little bit about that this morning.

You know, when I come at my patients with a tray in my hand or material, they're like, wait a minute, wait a minute.

This is a little bit unsettling, I've got a gag reflex, I don't like this, I can't breathe, all those types of things and then I feel like I'm in the Moz class and saying breathe, breathe, 123.

I think probably in most fields, but specifically in dentistry, it could leave your head spinning.

Steve, because he always gives me little tips every time I come to A-Man that makes my life so much easier.

But I'm grateful for A-Man for that fact because of the networking, because we can help each other.

But I'm gonna take us back to our dental materials class for a quick second.

When it comes to dental impressions, there's so many different techniques.

There's elastic materials, there's inelastic materials, and then even now, we've got technology so we can use all sorts of different digital scanners and devices so I don't have to put that gooey stuff and use something else.

Which 1 costs the least amount of money and works the best?

But ideally, we choose not because of those things or what's available, but because we want this.

We want the best final result for our patient.

We want them to be happy, we want them to be smiling, we want to have peace of mind, we want to ensure that when we go to seat that crown or that bridge or that implant or whatever it is, that it's going to fit, it's going to stay, and that our patient's not going to call us at 1 o'clock in the morning or come in the office when they're not scheduled and say, here's my crown, and they're holding it in their hand instead of it being in their mouth, because that's not what we want.

So we spend a lot of time evaluating our impressions to make sure the margins are perfect.

We get loops, because as we age, and I'm finding this process more real, just this week I had to send my loops out.

And I used to be excited that I could prep a tooth without using loops, because I was young and I could see and It was great.

And then I started using my loops and I still thought I was young and I could see and it was great until they broke and I had to send them to get fixed.

And I did a lot of praying because I needed God to see because I couldn't see.

And it was something that just hit me like a ton of bricks.

But the point is is that we want the best outcome with what we do with our impressions.

And so we look at them, we retake them, not that we like to because that's more material, more time, but ultimately, we want a great result.

So that's the first impression that we talked about.

These are some pictures of some of the things affiliated with my office, my waiting room, the external building, my team, an advert in 1 of the health magazines that we have there.

And this is the second impression that we talked about in our definition.

What do we want others to think about us?

Now, many of you, I'm actually not doing it today, which my husband thought was interesting, but if you were to look at these pictures or even the slide presentation, what would you think about me?

What impression do you get from what you see?

That's wonderful, I didn't know that was in there, but that's a good 1.

Gibbons, the dentist who I was able to take the practice over from, I even got him wearing purple and he comes in and he's just like, I can't believe you have me in purple.

But I love purple, and the things that I have in the operatory are pretty much purple because I like it, but it's funny because my patients come in and say, Doc, do you like purple?

I'm like, yeah, right down to the impression material.

I said, I did not plan that, to be honest.

I didn't buy it because it was purple, but it just happened to be purple.

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Series

Plenary

Six Words Every Physician Should Know

Transcript

Description

Parent Series

Parent Conference

Sponsor

Recorded

Parts

Us in Christ and Christ in Us

47m

Six Words Every Physician Should Know

28m

Evaluating the Final Impressions

51m

A Case Study in Faith

1h 12m

Reflecting Christ in the Match

19m

I Believe in Miracles

54m

God’s Glory Revealed

59m

Sound Doctrine