With all the talk on reforming medicine these days, teenagers and high school social structures seem unlikely candidates to point us in the right direction. They might be more relevant, though, than we think.
I’m a big fan of the Mars Hill Audio Journal, an NPR-style program that explores, with depth and sensitivity, cultural trends and phenomena in Christian perspective. In the segment I’m referencing here, host Ken Myers interviews Murray Milner, Jr. about the connection between teens’ behavior and the social structures of the high schools they attend. Essentially, he argues that the way schools are set up and run allows for a good deal of the disparities in status and consumerism we find there.
Toward the end of the interview (it’s only 7.5 minutes long), Milner talks about what can be done structurally to level the playing field. This is where it gets interesting to think about applications to the field of healthcare. Here are his three suggestions, and some of my initial musings about applying his insights more broadly:
- First, Milner talks about establishing uniform dress codes. If students can’t feel better about themselves because they’re wearing expensive clothes, for example, that might help create a measure of equality. At hospitals, I wonder what would happen if medical students and attending physicians started wearing white coats of equal length. I suspect medical students would feel a measure of dignity, while attendings would remember that they, too, must be lifelong learners. This, in fact, is how it’s done at Massachusetts General Hospital, probably for this reason. This sort of practical application fits in very well with belonging to a Savior who’s not overly concerned with distinctions of status (Galatians 3:28 – “There is neither Jew nor Greek, there is neither slave nor free, there is no male and female, for you are all one in Christ Jesus”).
- Second, Milner talks about encouraging, or forcing, groups that normally do not associate to do so. To take one small example, nurses and doctors do not frequently sit together in hospital cafeterias. This is not an accident: these are two populations that, though they must work side by side in patient care, do not always have a high degree of respect for one another. I’m not suggesting that hospitals begin assigned seating in their cafeterias, but what if Christians of different ‘rank’ began sitting together and making it clear their professional designations were subordinate to their standing in Christ?
- Finally, Milner mentions that teen academic settings typically value certain activities (i.e., football) at the expense of others (i.e., drama), with the result that the valued activities get funding and status that create hierarchies. He favors finding practical ways to begin elevating less-favored activities in an effort to reduce competition and increase equality. Without a doubt, the world of medicine favors physicians over other providers, and certain specialties over others. We can’t explore the many complexities involved here, but what would happen, for example, if we began compensating less-revered specialties (i.e., family medicine) more highly than we do now? Or, what if we started chipping away at the subtle nudges away from primary care that begin in the basic science years?
At the end of the day, real change begins on the inside, what the Bible calls “the heart” (see Mark 7:20-23, for example). As that happens, those with higher standing become willing to let go of some of their privileges (monetary or otherwise) so that those with less can have more.
But God cares about the outside, too, and change can also start there in the hope that it will deepen. As Christians, we need to find practical, visible ways that radically demonstrate the heart of God in this area.