Today's Challenge in Catholic Health Care Ministry

Fred Rottnek, M.D., MAHCM

Our country’s recent efforts in health care reform may be considered by some to fit Einstein’s definition of insanity: doing the same thing over and over again and expecting different results. We continue to pursue remedy and change solely from the outside in—legislation, standards, and coverage. While all these measurements and approaches have merit, they are too often considered and utilized as apples to the oranges of the deeper story of health care. As a result, modern health care policy in the United States reflects basic care as a benefit or a gift, not a basic human right. Consequently, the polarity of “the haves and have nots” broadens; health care costs escalates, while the portion of the population without health care increases.

If Catholic health care is to remain a healing ministry of the Church, leaders must be trained, recruited, and retained in key provider, administrator, and support positions. This training must blend fiscal understanding and theological reflection into health care mission.

This path has generated nearly universal dissatisfaction. Those with health insurance are often flummoxed with externally mandated policies concerning coverage, rationing, and choice of provider, treatment, and cost. Those without coverage still suffer from issues typically found in “those without,” i.e., not only lack of care, but lack of informed questioning and advocacy. All seem frustrated with the labyrinthine ways of health care access and unmet expectations of care.

Yet templates continue to exist to address the provision of health care to our communities. Catholic health care has a strong bedrock and structure originating in the earthly ministry of Jesus Christ and the tradition of Catholic social teaching. The success of health care systems in our country has been largely due to the successful combination of spiritual formation and vibrant, focused mission. Health care, even if not stated in these terms until this past century, was considered a basic human right and a good of the community. Those leading the profession largely did so in the spirit of health care as a healing ministry of the Church. Work was considered sacred, and our professional presence in the workplace was considered an extension of our personal strengths and spirits. We did not hang up our values on the coat hook when we clocked in to work; we cared for our patients as members of our family and community-which they were.

The Changing Face of Catholic Health Care

The Catholic Church has changed. Health care has changed. And Catholic health care has changed.

Our sisters are diminishing in number and influence. The laity has been charged with leadership in the Church and her ministries. However, leadership training is scarce. Formation and spiritual development programs among the laity are not adequately valued or understood.

Health care has become more standardized, more specialized, and more institutionalized. While professional standards are still considered, health care providers are dissatisfied with what they consider less autonomy, more fiscal-driven health policy and practice, and unproductive interference from litigation and government control. The nature of the doctor-patient relationship has shifted from a covenantal to a contractual paradigm. Promises are seldom assured; risk-benefit analyses and statistical reports predominate.

Catholic health care is not above the crises and issues buffeting the health care industry in general. Catholic health care must also maintain fiscal responsibility and community accountability. Ministry and stewardship, mission and business maintain a healthy tension. In some Catholic health care systems, this tension is healthier than in others. Leadership and administration of these systems have seen remarkable change in both appearance and philosophies. As result, consensus has not been reached regarding the nature and practice of Catholic health care in this new century. However, one point in general is in agreement: if Catholic health care is to remain a healing ministry of the Church, leaders must be trained, recruited, and retained in key provider, administrator, and support positions. This training must blend fiscal understanding and theological reflection into health care mission.

The Response of Aquinas Institute of TheologyMAHCM Logo

Aquinas Institute of Theology has actively engaged in these health care issues by creating a program doing that which it does best: educating and training lay and religious professionals for leadership positions in ministries of the Church. Drawing on its success in distance learning didactics, the faculty at Aquinas Institute devised a template for the program that incorporates internet-based instruction and interaction with a long weekend of classroom sessions in St. Louis. Aquinas Institute initiated this program, the Master of Arts in Health Care Mission, in partnership with Ascension Health of St. Louis, Sisters of Mercy Health System of St. Louis, and Catholic Health Care Partners of Cincinnati in 2000. The program developed with the following objectives:

Students in the MAHCM program at Aquinas Institute gain an understanding of the complexities of health care, a strong knowledge of the Church’s theological tradition, and the ability to communicate that tradition and influence the future of faith-based health care. Students master the following competencies:

  • Sound knowledge of the foundational topics of the Catholic theological tradition as they relate to the Church’s mission of healing.
  • An understanding of the theology and practice of pastoral ministry within the life and mission of the Church.
  • The leadership ability to address issues of theological importance and bring about systematic change within the contemporary health care system.
  • The ability to help the health care ministry think theologically about its future.
  • The ability to reapply the theological tradition to the complex ethical, legal, and organizational concerns of health care ministry today.
  • The personal and spiritual maturity needed to serve as an effective leader in the health care ministry of the Church.

Those involved in the development, sponsorship, and instruction of this program generally agree that these objectives have been met and exceeded by the first cohort of this program. (The first cohort graduated on May 7, 2004. The second cohort is in its second year of study, and a third cohort just began their program in January 2005.) Cohort 1 is composed of seventeen professionals who reflect the broad multidisciplinary nature of modern health care; we are chaplains, social workers, physicians, board members and administrators and executives in mission, finance, and health plans. We work both within and outside the walls of institutional health care systems; yet we all, in unique and remarkable ways, are involved in the work of the Church.

The Development of Our On-Line Wisdom Community

Over the course of three and a half years, much has changed personally and professionally for the members of Cohort 1. We have gained family members, lost family members, changed jobs, relocated, and few of us do exactly the same work we did when we entered the program. Within our program, we mourned the loss of one of our formation directors, Anne McElhatton, RSCJ; yet, even in our loss, Anne’s spirit has remained as a symbol of one of the unintended developments of this program—our wisdom community.

As a community, we in Cohort 1 have unanimously agreed that we ought to maintain our community beyond the formal completion of the MAHCM program. The Spirit has worked powerfully and explicitly in our lives and in our development as individuals, community members, and ministry leaders. By sustaining our community, we honor her and we continue to augment our relationships and our resources. We want to open our community to all who are leaders in this healing ministry of the church.

Hence, this web site… We envision many purposes and uses of this site. But above all, we envision it as a dynamic and welcoming community where all members can click on and find support, dialogue, and resources. While on-line wisdom communities are still a rather novel occurrence, we have proven that the internet is a useful and effective tool in the building of our community. We embrace the support of Aquinas Institute and the blessing of the Spirit in this continuation of our work and our relationships.

About the Author

Fred Rottnek, M.D., MAHCM, is the Managing Editor of Radical Imaging and practices as a family physician with the Institute for Research and Education in Family Medicine in St. Louis, Missouri. He also serves as the Assistant Director of the Master of Arts in Health Care Mission program at Aquinas Institute of Theology.