Navigating Loneliness in the Era of Virtual Care

BY: NORM WETTERAU, MD - FMHF PRESIDENT

The January 24, 2019 issue of the New England Journal of Medicine had an opinion article titled, Navigating Loneliness in the Era of Virtual Care. This esteemed journal has had several articles on physician burnout and this article addresses an aspect of that theme. The Article below is based on this article, plus additional ideas from the newsletter’s editor in paragraph 2 and 4, Norman Wetterau.

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Doctors used to make hospital rounds and discuss cases on the floor or in the doctor’s lounge. Doctors belonged to medical societies. They ate lunch and at times dinner together. Today they communicate with the front desk via the EMR, so they may not see any fellow doctors or staff during their day in the office. They see patients with their face in the EMR. There is much written about burnout, and this opinion article addresses what may be part of it. In addition to what this article says, there is the subject of social cohesiveness in the younger generation. They are not joiners of medical organizations, other groups or churches. My grandson, who rarely gets together with his friends after school argues that they are more connected due to social media. There may be some truth to this, but not for all teens, and certainly not for doctors who spend 60 hours a week on the electronic medical record and no longer see medical or other friends.

Once burnout begins, some people become more isolated. The workload is so great that there is no time to talk to someone at lunch or to share an evening together. A feeling of hopelessness comes on. This same process happens in other areas of one’s life. When things go bad, hide out. The article proposes some solutions, including face to face time with other health professionals. Some of this time is in non-medical activates and large medical groups can help felicitate this. Another way is through discussion about certain themes of medicine and of life. What he describes sounds a little like our retreats. As members of the Free Methodist Health Fellowship, let us see our own churches, and even our fellowship as a solution to loneliness. God made us to be connected. Being involved in a church is part of this and being connected to a group like the Free Methodist Healthcare Fellowship cannot hurt.

Let’s invite other: MDs, NPs, PAs, RNs, and others. Our theme for September’s Conference is: Serving God Throughout our Professional Lives, will bring us together to explore this, whether one is just starting out or is in retirement. The speaker, Dr. Bill Morehouse, also brought doctors and medical students together through the University of Rochester Christian Fellowship. One good way to prevent or address burnout is to share time and one’s life with others, including those Christians in our profession. A weekend of physical, social, and spiritual refreshment is a good way to find joy and prevent burnout. Share this article and invite a friend to come along too.

Ebola, NEJM, and the Book of Revelation

By: Norman Wetterau, MD - FMHF President

The fourth horseman of the Apocalypse rides in Congo. This is recognized in the New England Journal of Medicine but do our churches know this?

“And there before me was a pale horse. Its rider was named Death…they were given power over a fourth of the earth to kill by sword, famine, and plague”.
- Revelation 6:7-8 

According to the New England Journal of Medicine, August 22, 2018, Ebola or something similar will sweep our globe unless we can improve the medical infrastructure in Central Africa, and specifically in Congo. The civil war in Congo killed by sword and famine and unless we can assist this country medically, plague may sweep the earth.

Is support of our medical missions in Central Africa optional? Currently, our hospitals in Burundi, Rwanda, and Congo are not budget items for Free Methodist Missions but do get support from groups like CAHO. Most churches put support of their own church programs and buildings above medical and development missions. In Congo, we have a 100-bed hospital and 20 clinics, which are the main health care for 200,000 people. The hospital runs on $100,000 USD a year, of which 25% comes from US donations. Health infrastructure and care are poor. There are national doctors and nurses. We have nursing schools in Burundi, Rwanda, and Congo and a medical school in Burundi, but there is often no money to support the trained staff. Many recent graduates of Hope Africa Medical School are unemployed. The medical infrastructure and staffing are not enough for even basic medical care: treatment of malaria, TB, and c-sections, but this is far away and often of little concern. Many churches have never had a medical speaker from Africa or given an offering. This is too far away to be on our radar. There are needs right here. We are concerned about Ebola, but it is in Congo, not here.

Recently there was another outbreak of Ebola in Eastern Congo near some of our churches, but farther north than our hospital. This outbreak has been made worse by the lingering civil war in Congo. Some aid workers were attacked by rebels. The situation could become much worse in the coming months. The August 22 issue of the New England Journal of Medicine had an article that every American needs to read:

“Outbreaks in a Rapidly Changing Central Africa - Lessons from Ebola”
Vincent J. Munster, PH.D. et al.
New England Journal of Medicine. August 22, 2018.

It talked about the current epidemic and the situations that cause such epidemics to arise and spread. Although in the past we have brought these mini-epidemics under control, the article says that the conditions are ripe for the development of new infections and new spread. At some point, it will become uncontrollable, and suddenly reach the populations of Europe and the US, where it will spread death to thousands or hundreds of thousands of people. If we ignore the situation there, we will have to deal with it here. The article had a possible solution, a solution on which we need to get our churches on board:

“In light of the increase in frequency of Ebola outbreaks in DRC and their relatively rapid detection, it seems that it would be well worth the relatively small cost of investing in diagnostic capacity and training to avert the cost of containing any large outbreak. We believe that a similar return on investment could be expected from financial and educational support for improving and expanding the clinical care infrastructure.”

Yes, this is something for WHO and the UN (which some Christians do not support), but also something we can help with. God had given us the opportunity to establish some of the first hospitals, many which still exist and are the mainstays of medical care for large populations. If we continue to just look at our own needs and not that of our neighbors, we may experience what is foretold in the NEJM and also in Revelation 6: death and pestilence.

Update: After writing this article, on November 28 the New England Journal of Medicine published a second article: Ramping Up the Response to Ebola by Jennifer B. Nuzzo PhD, and Thomas V. Inglesby, MD. It is not long and I would encourage you to read it. This article was referenced on the BBC news recently. This is Congo, where our hospitals are and where the Nobel Prize winner is. We have a hospital, over 20 clinics, and over 100,000 members, so we are a major player in that region. Also look up more about Dr. Denis Mukwege. Finally pray for the elections in Congo which will be held Dec 23.