A Word to Christian Physicians

Many of your patients suffer from more than medical problems, as you well know. Even if you tried to forget or ignore that fact, that guilty depressed woman or that resentful colitis patient who will appear in your office tomorrow will raise the matter afresh. You cannot avoid the issue. The problem, of course, involves the further questions: “should I take the time to counsel, should I refer the patient, or should I by-pass the issue of counseling by treating symptoms alone?”

Suppose you opt for counseling; by assuming the role of a counselor immediately you will stir up several additional problems. For instance, you must face the issue of time: where in your busy schedule, can you find the time to devote to counseling? An average routine office visit may take no longer than ten minutes, while a complete physical might take no more than forty minutes to an hour. Most effective counseling sessions take from forty to fifty minutes.

One way to get the time is to limit the number of patients you see. But this suggestion will hardly be found to be acceptable because of the obvious financial difficulties that this may cause for either the physician or his patients. Such a radical decision in favor of counseling may also curtail his principle activity as a physician in a day when such activities are needed so desperately.

More likely, as a devoted Christian physician you may determine to find time for counseling by attempting to stretch your already overly expanded schedule. But this solution may cut short your social life, reduce your activities in the local church, and most of all inevitably lop off another chunk from the all too little amount of time that you have allotted to your family.

Possibly, if you have already opted to do counseling, you are dissatisfied with these solutions and find yourself vacillating between both of them. Chances are that you also have chopped counseling sessions down to what has become a frustratingly inadequate length of time. While such solutions may dissolve some problems, they tend rather to give rise to new and more serious ones. Then too, you need to determine what sort of counseling you are going to do. Some non-Christian forms of counseling (e.g., psychoanalytic or reflexive counseling) take enormous amounts of time with highly questionable results.

Instead of undertaking counseling for yourself, you may have opted for referral. This, of course, is the easiest solution. And yet so frequently it is no solution at all (as you know all too well).

So often patients either find little or no help at all or return in worse condition. Referral raises the crucial question: to whom? Shall the patient be referred to a psychiatrist? So few are Christians (and of these still fewer have based their practice upon Christian presuppositions and principles). Can you, in good conscience, refer a patient to such a psychiatrist when it is his task to attempt to change behavior and attitudes through value change? If his values are not Christian or if he divorces his personal faith from the Rogerian, Skinnerian, or Freudian presuppositions and methods by which he practices psychiatry, how can you justify referral?

Of course, you might refer your patient to a Christian minister. Perhaps this is what you would prefer to do, but you dare not; you are afraid of his incompetence. Possibly if you did he might refuse to accept the referral! There are so many incompetent ministers and, in particular, ministers who are incompetent counselors. One of the reasons for this is because of their inadequate and faulty training based upon the erroneous belief that they must refer people with personal problems more serious than a psychic scratch to psychiatrists. And the pastoral counseling most widely taught has been of an unbiblical and almost totally ineffective nondirective sort. No wonder Christian physicians hesitate to refer their patients to ministers.

But that is a tragedy! It is time for ministers to confess and apologize for their sin against God and their Christian brethren in the medical profession. By their incompetence, conservative clergymen (with notable exceptions) have forced physicians into the present dilemma that I have just described. Christian physician, let me say it again: the counseling dilemma is not of your own making. The Christian physician (with confidence) ought to be able to refer cases that demand extensive counseling to Christian ministers. But sadly, this has not been possible in our society recently. On behalf of myself and many of my brethren, let me apologize.

However welcome a belated ministerial apology may seem, confession and forgiveness are not a solution to the problem. Happily, I can go further. Indeed the situation is changing rapidly. Over the last several years a new awareness of the minister’s proper biblical role as a counselor has been developing among conservative, fundamental ministers. Evidence of this may be seen in the response of the growing number of ministers who have been trained in the newly formed Biblical counseling programs in conservative Bible Colleges and Seminaries and those who have been certified by the National Association of Nouthetic Counselors.

Let me partially describe this new pastoral counselor.

  • First and foremost he will have an unshakable confidence in the power of the Spirit working through His Word to solve the homorganic problems of living caused by the eventual failure of sinful living patterns into which men drift.
  • Second, he will use the Scriptures in counseling in a practical fashion that at the same time exalts Christ and meets human needs. He will not give out passages like prescriptions or dispense platitudes like pills. Rather, he will use (and teach his counselees to use) the Bible in a plain and practical manner that enables them to see how God has provided solutions to their problems.
  • Third, he will have a humble confidence, acknowledging that any benefit accruing from his counseling is ultimately attributable to the work of God and not to himself. Yet, at the same time he will strive continually to improve his knowledge and technique, recognizing that God ordinarily works through human agency. When he does not understand a problem, he will honestly admit it, but will also search the Scriptures to discover the answers that previously eluded him.
  • Fourth, he will tackle nearly any problem that previously might have been referred to a psychiatrist, probably with a significantly higher rate of success and certainly in much shorter periods of time.
  • Fifth, he will work enthusiastically with Christian physicians and will frequently send counselees for medical checkups.

Brethren, something has been happening, and you should be aware of the fact since you may be able to enlarge the effectiveness of your own ministry as a physician by achieving a significant alliance with a minister (or ministers) to whom you confidently can refer patients for counseling.

Do not expect this new pastoral counselor to have all of the answers, anymore than you would claim answers to every organic problem, but look for a man who can do more to help compliment you in your medical ministry than many pastors whom you previously have known. I encourage you to explore this possibility to the full.

Jay E Adams

Institute for Nouthetic Studies

100 White Meadow Ct
Simpsonville, SC 29681

(864) 399-9583




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