The answer to that last question is yes, there is a way to reconcile a God-honoring attention to patient care with the responsibility of the clinic owner to manage the affairs of the clinic in such a way that it remains financially viable — that is, remains in existence. It may be that you don’t need to talk primarily in categories of care versus profit, but maybe in the categories of clinic existence and clinic care.
Two Kinds of Care
In other words, perhaps the way to think of these two sides of the clinic’s life is that there are two kinds of care, not care versus something else, but two kinds of care that one must attend to in order for patients to be helped. One is the immediate care of diagnosis and treatment for all the maladies that people come to the clinic with, and the other kind of care is to see to it that the very possibility of diagnosis and treatment exists — namely, a clinic with doctors and the resources they require to do the healing work they’re called to do. These are really two forms of caring, aren’t they?
Now, admittedly, the one is more immediate and feels more like care, because the doctor or the nurse is sitting face to face with a sick patient and talking about how healing might be pursued. But if there were no clinic to come to, and no doctors and nurses and laboratory staff to follow through with, the diagnosis and the treatment wouldn’t have any effect, or they wouldn’t even happen.
So the more immediate care is dependent on the more general, broad, behind-the-scenes care, the business side of the clinic, which must take into account costs of rent, and utilities, and upkeep, and sophisticated medical devices, and receptionists, and scheduling, and insurance reports, and computer support, et cetera. One can feel why our friend would begin to feel submerged under that kind of demand, but they really are two essential forms of caregiving, even if it’s less direct in one way and more direct in another. If the clinic goes out of existence because of poor management, poor pricing structures, poor collections, poor planning for patient load, everyone suffers and care ceases.
Trellis Work, Vine Work
So let me say a word to the actual inner struggle the doctor is feeling as he wrestles with these two kinds of care. He says, “Increasingly, I find my thoughts and efforts consumed by the profit-seeking aspects of running a business.” Now, how many pastors, how many educators, teachers, how many leaders of inner-city ministries have felt this very same sense of being consumed by the financial and structural demands that undergird a ministry, on the one hand, while they long to be doing face-to-face, actual ministry or teaching or counseling to people, on the other hand? There’s nothing unique, it seems to me, about a medical practice in that kind of struggle. This is true of churches. It’s true of schools. It’s true of all kinds of ministries.