Reimagine Catholic health care as God's

The year 2014 saw a statistic that had not occured in decades: human life expectancy in this country declined. That decline has been attributed to alcoholism, drug overdoses, and suicides — diseases of despair. This phenomenon preceded COVID, which then exacerbated the problem.

The reality is that Catholic health care in 2021 is defined by large health systems in which it ostensibly resides, yet Catholic identity in these institutions is often lacking. There is typically no integration of faith at the point of care, most of the staff are not Catholic, the U.S. bishops’ Ethical and Religious Directives for Catholic Health Care Services are considered burdensome, and the proportion of charity care may not exceed that of other hospitals.

This situation is not new. In 1995, Jesuit Fr. Richard McCormick wrote about it in a piece titled “The Catholic Hospital Today: Mission Impossible” in which he described the impediments to truly Catholic health care in large hospital systems as insurmountable. He cites, among other factors, the depersonalization and secularization of health care and the changing reimbursement models. I would add that there is an insufficient workforce of Catholic physicians who are trained and willing to integrate faith into the practice of medicine.

Even if these barriers could be overcome, the singular focus of Catholic health care as hospital-based is outdated. The foundational piece of health care is primary care, and it is in this outpatient setting that Catholic health care can be reimagined.

In communities nationwide, Catholic clinics are emerging as alternatives — Emmaus Health in Ann Arbor, Gianna Clinic in Green Bay, and Bella in Denver. Catholic health care is fully integrated in these models that include primary care, OB/GYN, crisis pregnancy services, and, often, mental health. These clinics serve as icons of innovation, courage, passion, and faithful service in a reimagined model of Catholic health care. They operate apart from the large health systems, are well-received by patients, have philanthropic support, and provide faith-based care for the broader communities, not just the Catholic populations. If Catholic health care is to survive as an entity, it will do so through such clinics.

There are challenges. The financial model of health care is broken. Primary care is a loss leader, but is still attractive to health systems because of downstream revenue. Clinics tied to a health system can sustain those losses. Those that are independent cannot, thus the shrinking number of independent practices. Regulation and risk aversion have stifled innovation.

As a result, these Catholic clinics often rely on philanthropy to support operating losses. This vulnerability, while substantial, is surpassed by the risks owed to limits on religious liberty, especially in today’s environment.

There are four additional challenges that must be met so these clinics can thrive:
• We must train those providing the care. Current training models are lacking.
• We must be able to articulate the link between faith and reason and become a trusted source for people of faith.
• We must develop financial and administrative systems that allow clinics to succeed.
• We must align the image and the identity of our work so that others understand the value of Catholic health care.

For far too long, Catholic health care has languished, manifest as a remnant of its fully realized potential. Our expectations have been nominal as well. When fully realized in models like the clinics I have described, it can be, as Pope St. John Paul II said, “a response of solidarity and charity by the Church to the mandate of the Lord, who sent the Twelve to proclaim the Kingdom of God and heal the sick.” 

WILLIAM E. CHAVEY, M.D., M.S., is a professor and service chief for the Department of Family Medicine at the University of Michigan, where he also is associate chief of staff for the health system. In 2014, he and colleagues opened Emmaus Health as a primary care office in Ann Arbor, MI. He is currently the medical director of Emmaus.