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As a local PA, I am watching Bethel's program with interest. I have to admit, I have some reservations about the university as a whole, and I wonder how well the PA mission will work inside the framework of Bethel's more evangelical approach. Have any of you had similar concerns? Are there resources you know of that can help smooth out the potential conflicts?

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Hey, thank you for asking! I'll explain my reasoning, and maybe someone can point me toward a resource that settles the issue a little better for me.

 

I can't claim to be any sort of an expert, but what I've read of the Covenant makes me a little concerned that PAs trained in the Bethel program might possibly come through it with an opinion or agenda about, say, counseling patients on birth control or abortion in ways that students from a non-religious (or at least, non-evangelical) school might not have.

 

And I know just personally, as a student there is no way I would have been comfortable signing a document linking my attendance in the program with my choices in movies, books, games, and beverages while away from the campus. Has everyone here read the Covenant in full, and knows what the school expects of you while attending?

 

The NCCPA bylaws state that any program has to abide by the laws of the state in which it's located. Equal marriage is the law in Minnesota. Sure, the Covenant says discrimination is wrong - but it also says stuff about marriage and homosexuality and godliness. I sincerely hope Bethel PA students are trained in how to care appropriately and with cultural sensitivity for all people - and knowing the university itself has a position that is anti-gay-rights, I have to wonder if that might be an obstacle to proper training.

 

Long story short, I feel strongly that being a PA means putting aside my own biases and cultural comfort, and doing what's right for the patient in front of me, within their culture and not mine. The idea of a program that actively narrows that scope makes me nervous. A practitioner's relationship with god is their own business, as is the patient's.

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Hi Febrifuge,

 

Thanks for the clarification!  I don't know a ton about their lifestyle covenant, but I think that it doesn't apply to grad students or doesn't apply in the same way as it does to undergrad students; maybe someone else knows for sure.

 

I agree there is certainly a risk in any institution giving students it's own perspective on health care issues, but I think someone's opinions on matters like birth control and abortion are formed by their own experience and wouldn't be affected by what PA school they went to.  Based on their stated objectives for preceptorships in women's medicine (http://gs.bethel.edu/academics/masters/physician-assistant/preceptors/womens-health-objectives) it looks like what they expect is pretty thorough.  As for issues of gay lifestyles, I'm not familiar with how often they would enter into healthcare situations; a practitioner might refuse to treat someone because they were gay but I hope only most bigoted people would be capable of that and would be extremely surprised if that is how Bethel instructs its students.

 

I know that while the official position of the university is one of living in line with biblical teaching, there is no shortage of diversity of opinion there in terms of the student body or speakers the university invites to campus.  I think the success of their nursing department speaks strongly to the fact that a Christian institution can train excellent health care providers.  Ultimately I agree that we have to respect patients' cultures and wishes, but would you do this even if it meant doing harm, such as endorsing culturally sanctioned practices such as female genital mutilation?

 

Thanks for the discussion - sorry, I didn't mean to hijack the thread.

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Please don't apologize - I was the one who hijacked the thread, after all. Hopefully it can be helpful in some indirect way for people getting ready to interview. I don't know if my concerns or perceptions are widespread, but who knows. And I do think anyone applying to Bethel owes themselves a cup of tea and some light research on the Covenant, the university's approach to GLBTQ students who want to establish on-campus groups.

 

And it was ignorant of me to overlook the very good nursing program at Bethel. That actually does reassure me more than a little.

 

The female genital mutilation example is quite the high-voltage example, but I'm crazy enough to take it on. No, I'm not suggesting an absolutist approach, where the patient's home culture and beliefs trump all. On the other hand, I guess I am advocating the need to put one's own visceral reactions aside, when you're in the role of medical practitioner. So, for instance, if a father was asking about the practice, and I knew he had a daughter, I wouldn't automatically give him the ಠ_ಠ stare and tell him he's a monster and to get out.

 

Instead, I would acknowledge that this practice happens, I would explain that the medical community is overwhelmingly against it, and then I would do my best to keep what seems to me like the obvious insanity of it out of my voice as I explained as neutrally as possible what exactly is done. Most men, I would think, once they truly understand that it's not like removing the foreskin, it's like removing the glans, they might pause and think. (And it goes without saying, I wouldn't participate or facilitate the mutilation in any way. Not even if I knew of a surgeon willing to do it.)

 

And really, as the clinician that's where my responsibility comes in: honesty, accuracy, and making the pros and cons as clear as possible. No more, and no less. If someone asks "what would you do?" then it shifts a little, but again it's about honesty. (And actually, I have used the words "my personal opinion is x, and my medical opinion is that it depends," or similar. Usually it's "my 2-year-old had a fever of 102, and I didn't worry about it very much because she was walking, talking, and drinking just fine" but it works for more serious subjects as well)

 

To bring it back to what I worry about, it's true that the only 100% effective method of contraception is abstinence. On the other hand, school districts where abstinence-only education is the norm tend to have higher rates of teen pregnancy than districts where contraception is discussed. That's a relevant public health fact. I would hope no clinician would simply fail to mention that strategies other than abstinence exist, because that would be (in my opinion) malpractice. I would hope that a program teaching future clinicians wouldn't gloss over the health risks among men who have sex with men, and how they differ from the risks among men who have sex with women. If you don't know the questions to ask, you can't diagnose your patient's problem.

 

At this point, the Bethel program is brand-new. As someone who's out in the community practicing, and having never met or worked with a Bethel PA student, all I have to go on is what I know about the university, and what's on their website. Maybe I'm worried about nothing. I hope so.

Edited by Febrifuge
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Febrifuge - thanks for the conversation.  Based on my interview I got a great impression of the program.  I know that many institutions specifically seek out Bethel nurses due to the success of their program so hopefully the PA program will experience the same outcome.  They seem to have put together a faculty with a lot of great experience.  Time will tell!

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Thanks so much. It really does help, hearing from someone with first-hand experience. As an outsider, it's tough to know how much weight to put on various factors. I know from reading a bit that there's a healthy intellectual tension on campus about the Covenant, and in terms of the undergrad culture I think that's great for a learning institution. They should be true to their evangelical roots, but also welcoming of that diversity of thought, as well as in terms of the people themselves.

 

As a graduate and especially a professional program, I guess we will have to see how things work themselves out. The PA students will no doubt be very busy all day every day, and may or may not really participate all that much in the campus culture. It's possible that the university's mission and values as reflected in the Covenant might not cause any conflicts or influence the teaching of medicine at all, but I'll be curious to hear in the next few years how staff and students feel about the issue. 

 

And yes - if Bethel does as well training future PAs as they do training future nurses, they should be in good shape.

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Febrifuge, as a student at Bethel, I can assure you... We were taught no differently so no reason to fret. We will not "come through it with an opinion or agenda about, say, counseling patients on birth control or abortion in ways that students from a non-religious (or at least, non-evangelical) school might not have." 

 

 The Covenant was never mentioned during class and while spirituality and religion was not ignored it was in no way forced upon anyone in class nor will it be forced upon patients. As Grad students we were told the "contract" did not apply to us (so we are free to choose our own "movies, books, games, and beverages")

I can promise you everyone's biases and judgements are separate from Bethel and our relationships with patient's are professional- just as they would be at a non-religious school. 

 

As a huge supporter of equal rights, I can also promise you.. "Anti-gay" does not exist at the Bethel program. 

 

Hey, thank you for asking! I'll explain my reasoning, and maybe someone can point me toward a resource that settles the issue a little better for me.

I can't claim to be any sort of an expert, but what I've read of the Covenant makes me a little concerned that PAs trained in the Bethel program might possibly come through it with an opinion or agenda about, say, counseling patients on birth control or abortion in ways that students from a non-religious (or at least, non-evangelical) school might not have.

And I know just personally, as a student there is no way I would have been comfortable signing a document linking my attendance in the program with my choices in movies, books, games, and beverages while away from the campus. Has everyone here read the Covenant in full, and knows what the school expects of you while attending?

The NCCPA bylaws state that any program has to abide by the laws of the state in which it's located. Equal marriage is the law in Minnesota. Sure, the Covenant says discrimination is wrong - but it also says stuff about marriage and homosexuality and godliness. I sincerely hope Bethel PA students are trained in how to care appropriately and with cultural sensitivity for all people - and knowing the university itself has a position that is anti-gay-rights, I have to wonder if that might be an obstacle to proper training.

Long story short, I feel strongly that being a PA means putting aside my own biases and cultural comfort, and doing what's right for the patient in front of me, within their culture and not mine. The idea of a program that actively narrows that scope makes me nervous. A practitioner's relationship with god is their own business, as is the patient's.

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