Life in Community

The Doctor Is In

Medical Care in Community, Part 1

August 31, 2021 by

People often wonder what medical care is like on our communities. We’ve touched on this in a couple of other posts and interviews. For this two-part series, we’ve asked one of our longest-practicing family practice doctors, Monika Mommsen, to talk a little about her path and about medical care on her community, which represents our philosophy of care as a whole.

I went to Albany Medical College from 1971 to 1975. Like today, getting into medical school in the 1970s was very competitive. And it was very male dominated: there were seventy men and ten women in my class. But I will say, I was treated with a great deal of respect, and medical school was excellent. I was married over break during my third year of medical school. After medical school I did a yearlong internship in family practice; I am a fully accredited family practice doctor. We were expecting our first child and at that time it was very unusual for anyone to be pregnant or have children during medical training. That was quite difficult, as there was no leeway given for pregnancy. I still had to be on call every third night. After our son (the first of eight children) was born I was allowed three months off, and when I went back to work my husband took care of him. We had a little apartment near the hospital and in the basement he had an offset press – he’s a printer – where he worked while the baby slept.

After that, I got my license and started practicing here at the Woodcrest Bruderhof. There was only one other physician in the Bruderhof at the time and he lived at our community in Pennsylvania. I had a tiny clinic but excellent nurses. I was immediately responsible for providing care for a community of almost 400 people, including many children. 

MonikaEmbed Dr. Monika Mommsen (seated, left) in the clinic at the Woodcrest Bruderhof.

These days each large Bruderhof community has a clinic with one or two doctors or PAs, so different practitioners have specialized according to their interests. We have one doctor who’s very interested in foot health because he’s seen that solving problems with people’s feet can really help the hips, knees, and back. So I’ll send patients who are having problems along these lines to him for advice. Two of our doctors have done extensive research into allergy treatments. They do allergy testing and desensitization with oral immunotherapy drops. One of the doctors has done very helpful research into psychiatric disorders, so I consult with him on that. It is helpful that we work as a team, not only on the community where I live, but sharing our knowledge and experience with the doctors on other Bruderhof communities.

I chose family practice because I love the idea of accompanying a person from birth to death. I know my patients well out of the medical setting – their family, their spouse, and their living situation, which I really think is an asset in care. Patients are able to confide more easily with their problems, including mental issues, knowing that they will be loved and cared for no matter what. But because I’m family practice, I’m not able to keep current with all the specialties. So I refer my patients to local medical specialists, whether it’s obstetricians, orthopedists, endocrinologists, or ophthalmologists, so that they can get the best care. For example, my pregnant patients receive their prenatal care in collaboration with a local obstetrics practice and deliver at the nearby hospital. (More on that in Part 2.) Our practice is medically based, and all our practitioners are trained and licensed in science-based medicine. Each of us practitioners continually spends time educating ourselves on current standards of care and medical recommendations. That said, we do see value in some forms of alternative medicine such as chiropractic. I’ve seen that it can have real benefits. And some patients request herbal medications, which we will support unless they’re ridiculously expensive, and if as physicians we feel there is some value to them, or at least that they won’t be harmful.

Some people of faith are skeptical of science and conventional medicine. I think faith and science can work together and not just be opposing sides to a problem. Creation is made by God and we’re a part of it, and science is part of that. Of course the big issue now is the vaccines for COVID-19. We’re very supportive of vaccines in general, which have saved many lives. In the case of this new vaccine, as with any new remedy, as a group of physicians we researched it before recommending it to our patients. All the people on our communities who are eligible have been vaccinated, with rare exceptions. 

Of course, there are areas in science and modern medical care that I disagree with. And some of it we will have to say no to – gene editing and so on. I believe we should care for the human body as it was created and not change the Creator’s intent.

And we try to live actively as we feel our Creator intends. Because of our lifestyle we generally don’t see much obesity, diabetes, or substance abuse. Most people in our communities live active lives, and we try, on the whole, to have a healthy diet. We do a lot of preventative care and follow patients closely, for example with routine screenings, monitoring blood pressure, encouraging weight loss if necessary. 

But we are human; we aren’t exempt from cancer and other deadly diseases. In the end, you have to die of something. I mean, some people do die of old age. When one of my patients receives a terminal diagnosis, the real value of how we practice medicine in community is seen. Sometimes one of my patients will hear from a specialist that they have a serious diagnosis, but often I’m the one to tell them. If the person is married, I’ll ask the husband or wife to be there, or if it’s a young person, I’ll make sure his or her parents are there. I’ll also tell our pastors at the patient’s request. Then we’ll collaborate together with local consultants about a treatment plan. The decision for course of treatment is up to the patient, but many people are very unsure when presented with a range of options and it’s helpful to talk them through it, and also to consider from an emotional, psychological point of view what will lead to the best outcome.

Often what helps us achieve a good outcome is the level of personal care we can provide. If somebody has a serious illness or is dying, I always visit. If somebody has surgery in the hospital, I will visit the day they’re discharged to make sure that all their questions are answered, that there’s a plan for pain management, and that any practical needs they have are addressed. Especially with our elderly, we do everything we can for them at home rather than have them come to our office or go to a hospital. I try not to medicalize the natural process of aging too much – of course there are medical interventions that can improve quality of life, but often just as important is to spend time showing care. We try very hard to arrange it so that no patient dies in the hospital, but is able to come home and be surrounded by their family and the church community at the end of their life. 

Of course, this requires a lot of patience, love, and practical planning. More on that in Part 2.   


 

Dr. Monika Mommsen lives with her husband, Marcus, at Woodcrest, a Bruderhof in Rifton, New York.

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