Are You Being Paid Enough?

What constitutes a fair wage? Fast food workers have been holding demonstrations demanding $15 an hour. A young CEO in Seattle recently decided that every one of his employees deserved a minimum of $70,000 a year as that was what he considered to be a living wage for that city. The news is filled with editorials and opinions about income inequality and a fair salary. How should a Christian businessman respond? How much should we pay?

It is one thing to philosophically discuss the principles behind wage structure in America, it is an entirely different thing to sign paychecks.  I am a small businessman with 5 employees who depend on me for their livelihoods. The realization that 5 families rely on me every day of their lives is a sobering one. If I desire to do well in this life, if I believe that I will one day answer to my Creator for my actions, how I treat and what I pay my employees is important.

While this is one of the most challenging aspects of my job the topic was completely unaddressed in my education. My training was extensive- five years of undergraduate study, 4 years of medical school and 3 years of Family Practice specialty training, yet not one hour was devoted to the topic. Nobody taught me how to be a manager of people or how to compensate them for their labors. I was forced to find the answer on my own. I ultimately turned to Scripture, following the principles in Jesus’ Sermon on the Mount, where He said, “In everything, do to others what you would have them do to you.”

The application of this truth has caused me to consistently pay my employees a fair and competitive wage and to treat them well and with respect. It has not caused me to dramatically overpay far above market rates, for that is not how I would truly want to be treated or what I would expect from an employer. If I was an employee being paid $70,000 for a job that required little training or experience and for which typical compensation was $25,000, my $70,000 salary would feel more like charity than earnings. While the extra money would be nice, in my heart it would feel wrong. To apply the Golden Rule in the other direction, I would want my employer to pay me what I had earned and to keep the profits he had earned, regardless of how high they were!

To ensure my employees are paid fairly I intermittently survey the salaries offered for similar positions in the community. As I have very high standards the individuals who work for me are typically high performers, so I consistently pay them at or slightly above the top rate for their positions. As a result they know they are paid well for the jobs they do. They also know that they have chosen their profession and the salary range it offers and do not expect to be paid the same as others whose jobs require a greater skill set or more extensive training.

A conversation I had with my current nurse shortly after she joined my office perfectly illustrates the concept of a fair wage. She is a remarkable employee who clearly possesses the ability to move beyond office nursing and become an RN working in a hospital, a job with a pay level nearly double her current income. When I praised her performance and asked her why she didn’t go further with her training she replied that additional training would mean less time with her children so she decided that this was what she wanted to do. She was exactly where she wanted to be and comfortable with the salary that came along with it. She is so comfortable that with her last two pay increases she told me, “You don’t need to do that. You pay me enough.”

My nurse has integrity and a strong work ethic. She works hard for me and does her best for me and the patients we serve. Her effort is not based on her salary. Her desire to do her job well is based on her character and not her compensation. She is not looking for charity or a handout or to be paid more than she has earned. In her attitude and her efforts she earns not only her pay but my respect. Because I pay her fairly and treat her well, I have earned her respect as well. 

While some could look at the difference between what I make and what she makes and proclaim, "Income inequality!" those who took the time to look closely would see two people who worked together as a team, valued one another highly and respected one another. Two people who understood the truth that we have equal value as people, which matters much more than our pay rates.

-          Bart

Thanks for reading. Comments and questions are welcome and shares are what make the blog a success. You can receive blog posts delivered to your inbox by clicking on the subscribe button (scroll down on your mobile device, look to the upper right on your computer). I can be followed on twitter @bartbarrettmd. For those interested in hearing me speak, audio files are available on the sermons page, and I am in the process of uploading new messages to my vimeo page (vimeo.com/bartbarrett) as well.

Standing Where Heroes Stood

Places have power. I learned this again this week as I visited Massachusetts. There is something about standing where others have stood that makes history come alive, that makes old stories seem fresh, new and more powerful.

I visited Plimouth Plantation, where there is a reconstructed Pilgrim village. I stood in a one room church building and looked at the pulpit, a small elevated structure facing simple wooden benches. There were no decorations or stained glass. I was reminded of the simple intensity of the Pilgrim’s faith. Their belief in God’s call on the individual and of the importance of the local church had caused them to leave everything and everyone as they sailed 3000 miles to their new home. 

We toured the grounds of the village and went inside the small homes that illustrated the simplicity and difficulties of their daily lives. As I looked at the sparse furnishings and clay walls I was reminded that these were a people who were more concerned with eternal things than earthly goods and needs. I thought about how difficult it was simply to eke out a living, of the labor required to acquire food and shelter. These people were committed.

As I looked at the small village and later as I visited the Mayflower II in Plymouth Harbor I thought of the bonds they must have shared. Over 2 months at see on a small ship would force them to live in community, as would they work required to survive when they arrived. I thought of the shared grief as they lost half of their number within the first three months. Was there a day when a grave was not being dug, filled or prepared?

Later in the week we walked the Freedom Trail in Boston. We stood by the grave of John Hancock. I thought of the brashness of the man who boldly declared himself a traitor to the King of England by signing his name in massive letters on the Declaration of Independence. We saw the burial place and then the home of Paul Revere, a silversmith who became a legend. We walked by the churches and meeting houses where many began their transformations from Englishmen into Americans and wondered about the debates and the arguments that must have occurred.

I was moved by the truth that both the patriots and the pilgrims were motivated by deeply held beliefs. They shared the belief that each person was a child of God and as such had value. This belief was the basis of the Mayflower compact, the initial promise that all would work together in the new land, and of the Declaration of Independence which declared that “all mean are created equal.”

I was moved by the realization that everything I have and hold dear in life I have because others believed and others sacrificed. These forefathers and founding fathers did not merely pay lip service to their ideals. They risked their lives for them. Standing where they stood I found myself praying that I may be one day found as faithful.

-          Bart

Facing Death at Forty

She is in her early forties. She is thin and appears fit and healthy. She isn’t. She can’t walk much more than 100 feet before crippling chest pain sets in. She can’t work and she can't exercise. She recently tried to walk to the corner store on her own but passed out on the way. Her cardiologist has told her she is never to walk alone again. It is too dangerous.

She has lived this way for a few years now, cursed with coronary arteries that spasm for no reason, constricting so severely that she has the crushing pain of angina, the sensation that she is having a heart attack. She lives in constant fear that her heart might stop at any time, that one day a heart attack will actually happen.

There are many medications for coronary spasm but she has not been able to tolerate any of them. They all work by dilating blood vessels which means they lower blood pressure. Her blood pressure is low without medications and even the lowest dose of the standard medications results in dangerously low blood pressure. She has seen multiple cardiologists who have discussed her case with multiple other cardiologists but no solution has been found. She continues to suffer. 

I did some online research on coronary spasm and came across an article on the subject written by a cardiologist an hour north of us. I reached out via email and asked the doctor if she would be willing to see my patient in consultation. My patient scheduled a visit as soon as she could. She came to see me a few days before the consult to go over her records. As I reviewed her history I was once again moved by the challenges she faces.

We talked about how hard it was and she shared with me how important her faith is in helping her get through each day, that she reminds herself continually to trust in God. We talked about the reality that God does not heal everyone and that we may not find an answer or a cure. He does not always grant our requests.

With this in mind I reminded her of one of the central truths of our faith- this life is not all there is. Eternity awaits. We tend to focus on our present circumstances but it is our eternal destiny that matters and how our eternity is not dependent on our current condition. We talked about how God’s eternal plan for her has not been altered by any of her current sufferings. His promises are based on His goodness, not our condition. She told me that she clings to this truth everyday.

We closed the visit with a prayer and she went on her way. As she left I reflected on her faith and example. I was reminded of one of the purposes of Christian suffering as described in 1 Peter 1- “These trials will show that your faith is genuine.” Her steadfastness through tough times has shown her faith to be real. I pray that when illness and suffering come to my life I will be equally strong.

- Bart

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A Big Mistake in a Doctor's Office

My office was blowing it. I didn’t know it until just this week, but we had a serious customer service problem. Patients were having their phone messages and questions ignored. They called the office with a question, need or request, and the person taking the call was not consistently entering the message into the chart or writing it down. I missed the early warning signs (a few patients told me personally they had left a message that was not returned but I thought it was a voice mail issue) so by the time the problem was discovered it had been going on for a while. As it was only a few times a day and not all patients complained it took weeks before there were enough cases for me to recognize the issue. By that time we became aware of at least 15 patients who had been slighted or ignored, there may have been more. Something needed to be done.

Dealing with the employee in question was straightforward. When someone fails in one of their position's foundational tasks on a repeated basis (apparently after being counseled by other employees) a change is in order. After dealing with the disciplinary issue I faced a bigger challenge. How could I fix the problem? I worried that the cases I had discovered were just the tip of the iceberg. What if there were dozens of overlooked patients? Customer service is key to my reputation and I pondered what I could do to rebuild lost trust.

I decided to reach out to patients and address the problem. I sent a mass message to all of the patients on our email list, over 2500. I described the issue, told them that I had just been made aware of the problem and that if they had left a message and not received a response to let me know. I shared our policy that all calls should be returned same day and all emails within 24 hours, and I asked that they notify me if we fail to meet that standard in the future. Within a few hours the replies started pouring in. There were a few who were letting me know of a failure to receive a response but the vast majority said something unexpected. The majority of the messages said, “Thank You!”

It seemed that my openness and honesty about the problem and quick action to address it had made an impression on my patients. One patient who is a business consultant wrote, “Way to own it.” Another hotel manager praised our “great customer service.” All of them appreciated our efforts to make things right. To date I have not received a single negative response.

The gracious responses received remind me of the importance of honesty in everyday relationships. Nobody is perfect and everybody knows it, so mistakes are to be expected. It is how we respond to our mistakes that defines our character. There is a tendency to cover up and hide and explain things away but that path does not lead to success in the long term. The gracious responses of my patients remind me that honesty is truly the best policy.

-          Bart

"Too Christian" to be a Doctor

I have gathered a collection of insults over the course of my 25 years as a physician. I have been called stupid, old, racist, arrogant, ignorant, too young (okay, this was a long time ago), unkind and once I was even called "a threat to children." This week I became the recipient of a new label. I heard that a specialist colleague told a potential patient that I was “too Christian” to be his primary care doctor.

I was taken aback by the news, surprised that a colleague would view my faith as a negative for my practice. In response to his words I stopped and considered the ways in which my faith has entered into my interactions with patients. I wondered if there were times I had crossed that an invisible line and gone too far, if I had gone from encouragement to offense. I discussed the topic with my staff, not all of whom share my faith and perspective. I realized that there are many ways in which I allow my faith to influence patient care but that these ways have for the most part made me a better person and doctor.  I have described many of them previous posts but decided to take the opportunity to share some the things I do differently because I am a doctor who is a devout Christian.

1-      I pray for my patients, and when appropriate, I pray with my patients. When I do pray in the office, I intentionally avoid denominational or theological lingo. Unless I am certain that the person has a Christian faith, I do not use the name of Jesus (He knows who I am talking to anyway!) I try to carefully assess the patient’s openness and then always ask for permission. Since studies have shown that half of patients actually want this, it seems reasonable. My experience is that patients are grateful for the additional expression of concern.

2-      I try to be more forgiving. My staff says I do this too often, but because of my faith, I intentionally extend more grace when patients are late, non-complaint, or unhappy. The Golden Rule requires it of me. I find my patients are more forgiving of me as a result.

3-      I give more hugs. I continually pray that God will help me love my patients more and serve them better. Overtime this has led me to listen better and care more, which leads to hugs, which seem to be appreciated!

4-      I stand up for my patients more. Since my faith is more concerned with doing right than being accepted, I find myself defending my patients and standing up for their rights. This means going the extra mile in fighting to get medications or therapy approved.

5-      I am more available. My office hours have become more of a suggestion that a rigid rule. When it is truly needed I come in early, stay late or work through my lunch hour. Just this last Saturday I met a patient at the office to suture a hand laceration. I did it because I could.

6-      I am more respectful of my patients time. My faith teaches me that I am no better than anyone else, that my medical degree does nothing to change my standing before God. I am a wretched sinner just like anyone else. This has led me to be more respectful of the time and needs of my patients, and is in large part why I give away Starbucks gift cards when I fall behind schedule!

7-      I often refer to Biblical passages when I talk. Some might call this risky but I have seen it have a powerful impact in my counseling with patients. Truth is truth and wisdom is wisdom and I see no reason to avoid either just because they originate from Scripture. The passages I refer to the most have common applications. I use Adam and Eve to illustrate the truth that people in trouble tend to hide their problems and run from help. I quote the wisdom of Romans 12 to people dealing with depression or addiction as a reminder that we are all broken in our thinking and that trusting in our own thoughts can lead to trouble. Passages such as these are often a source of encouragement to patients.

I am not boasting in this post. None of the behaviors I describe come naturally to me, and for the most part were not a part of my early practice. These things came about through a lot of prayer and a lot of work. I am not by nature a very nice or kind person. I am a Christian who asks God to change me every day, to allow me to be His hands to touch and heal others.

After thinking about it, I have decided that being “too Christian” is a criticism I can willingly accept. It is far better than someone saying I am not Christian enough!

-          Bart

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