Summon in the Spirit

published on Tuesday, December 13, 2011

There’s strong evidence that St. Mary’s of Bethlehem, an ancient hospital in London noted for its care of the mentally ill, is the source for the word bedlam, meaning chaos and cacophony. The account has it that the word Bethlehem underwent the process of contraction common in English until it became cockneyfied into bedlam. The name for the town where Jesus was born gradually decayed into a word synonymous with the cries of the mentally ill.

It may be helpful for pastors to recall this bit of etymology as they move through Advent and into the celebration of the Incarnation.Image by Helen Duffett Not only are there additional services of worship to plan and lead, but the stresses of the season also increase the requests for pastoral care. Add to those tasks the lamentable state of the economy and the expectations of the Christmas-and-Easter folk that something fresh, new and exciting be provided just for them – ours is a consumer culture, after all – and the pastor’s life can veer toward the bedlam-ish side of the scale.

How to recover Bethlehem?

Let the Holy Spirit do the heavy lifting, as He did at Pentecost, when He delivered humanity from the bedlam of Babel and gave it a common salvation story. Give away the need to preach the finest sermon on Incarnation since John penned his Logos discourse, and let the scriptures and hymns carry the freight. Isn’t this what Handel did in Messiah?  “Comfort, ye, my people,” wasn’t original to George F., was it?

Don’t be afraid that the congregation will hear too many lections and carols; that cannot happen. The Sacred Story has enormous power to surprise even the pew-calloused afresh.  And it has been known to shock some folk into the company of the Magi. Relax and summon in the Spirit.

Ed Moore
Director of Theological Education and Conference Relations
Duke Clergy Health Initiative

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"High-Touch" Health Reform

published on Tuesday, October 4, 2011

Here is some local news with potential for a ripple effect across the U.S.:


North Carolina will become a healthcare reform test bed through a new public-private partnership that aims to see if a Medicaid management program that has saved more than $1 billion can also bring savings and efficiencies when applied to the private sector.


First in Health is being rolled out to employees of GlaxoSmithKline, SAS Institute, Kerr Drugs, Blue Cross Blue Shield of NC, and the State of North Carolina.  First in Health has been adapted from a care-coordination program used with recipients of Medicare and S-CHIP.  It does not replace employees' existing health plans, but is a voluntary add-on. 

The program will be administered by Community Care of North Carolina (CCNC), which is widely recognized as an innovator in population health and care coordination.  CCNC features top information technology as well as "high touch" professionals who manage and coordinate care for their clients.  CCNC reminds me a little bit of the United Methodist Church in the way they provide service: CCNC coordinators may work with a single large medical office, but in rural areas they may be on a "multi-point charge," serving several medical practices.

CCNC is founded on the concept of "medical home," an increasingly prominent term in discussions of health care reform.  It refers to a central clearinghouse of health data for each patient that is fed and drawn upon by various specialists when providing care.  But it’s also a mindset: proponents of "medical home" also call on physicians to employ a different set of values and ways of thinking.  The emphasis is on:

  • Being proactive and preventive
  • Using evidence-based medicine
  • Being accountable for health outcomes and the client's holistic wellness
  • Being available by phone or email
  • Being savvy about the Internet and mobile communications
  • Being less a "gatekeeper" who takes away options, than a lifestyle coach who suggests new options


This all sounds pretty close to the job description of the wellness advocates that our Spirited Life participants work with during their two years of wellness services. 

First In Health is a pilot program.  Its results are yet to be seen, and whatever the results are, they will be spun a variety of ways by policy makers.  (Some commentators dispute the dollar value of the Medicare add-on that precedes this private sector effort.) But this start-up builds on ideas and approaches that the Duke Clergy Health Initiative shares, so we will be watching the progress of First in Health with great hopes.

Shalom y'all,

John

John James, M.A.
Research Analyst, Clergy Health Initiative

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First Community Bank of Self-Esteem and Improved Health

published on Friday, September 23, 2011

New term for the day: time banks.  Time banks are volunteer networks, typically established by non-profit groups.  They are becoming increasingly popular for health-care organizations but hold interesting potential for churches as well.  The term is fairly self-explanatory: Members of a time bank make deposits in the form of volunteer hours, and can make withdrawals when they need help from other community members.  Help can take many forms: household repairs, assistance in preparing a tax return, or something as simple as dog-walking or a ride to the pharmacy.

The last item is important.  Transportation is a simple but crucial deficit in many cases.  Millions of elderly or infirm people lack the independent means of transportation to allow them to keep medical appointments, go grocery shopping, or attend to other health-related tasks.  Hospitals and HMOs are keenly interested in ways to promote preventive care, to prevent hospital admissions and, in particular, re-admissions.  For overall cost savings, it is often well worth it for hospitals to pay for taxi fare or similar, just to help convalescent patients make their out-patient appointments and other health-related trips -- to the pharmacy, for example.  If a time bank can partially bridge that gap, at no direct cost, that is an attractive proposition for the health industry. 

But time banks hold promise not just for those on the critical verge of in-patient care.  Any bank depends on a large cadre of "depositors" strong enough to "pay in."  Research has shown that all of us get health benefits from social connections and friendly interaction.  A doctor in London, England reflects that chronic disease sufferers need inner confidence before they can tackle changes in ingrained outer behaviors.  Contributing to a time bank can help build that inner sense of well-being in its members:



"It is very hard to change the way you look at food or exercise... Working with time banks, where everyone is valued and everyone has assets, helps people to revalue themselves.  Only when you start to feel that positivity about yourself do you feel more able to take on these challenges."


The doctor alludes to the unusual logic of time banks, a different logic than we see in the normal cash economy.  No money changes hands, and each person's time counts the same.  There are no distinctions about skilled and unskilled labor.  A time bank is an equal respecter of all persons.  (Ironically, to help time banks be adopted more widely, policy experts are busy trying to value their benefits in dollar terms.)

It occurs to me that a time bank is a twist on the way a vibrant congregation functions.  A local church is a place to share fellowship, make connections, offer help, and (hardest of all for many of us) be open and vulnerable enough to ask for help when needed.  The banking paradigm might be unnecessary in the context of a Christian congregation.  Then again, many local churches also seem to operate on the 80/20 rule, a minority of members supplying the majority of time and effort.  Maybe borrowing concepts from accounting could strengthen accountability, a quality none of us should shrink from. 

Anyway, the time bank is an intriguing idea that offers hope for a more humane and healthy civic polity.  It's some of the best news to come out of the banking sector in quite a while.

Shalom y'all,

John

John James, M.A.
Research Analyst, Clergy Health Initiative

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