The pioneer missionaries of the Christian church were motivated by a vision: a dream of a worldwide church in which people from every nation and tongue would gather together in unity. They sacrificed their lives in the hope that this vision would become a reality, yet their eyes never saw it.

Henry Martyn laboured to learn more than 15 languages so that he could translate the scriptures. He then spent months on dangerous voyages to Asia and beyond, before dying at the age of 31, exhausted and broken. William Carey gave everything he had to travel to India, and devoted his life to the establishment of an indigenous Christian church, while thousands and thousands of unknown missionary martyrs have sacrificed their lives taking the good news of Jesus Christ to lands that have never heard it.

Now, perhaps for the first time in history, our eyes are privileged to see what they never saw. Because of their labours, their sacrifice, and their vision, the worldwide church has become a living reality, a tangible demonstration of God's power and reality in a cynical age. God has called us to serve him as doctors in this particular time of world history, in a particular national and global context.

Faithful to Christ in the workplace

God could have called you to be a physician in the early church, trained in the Hippocratic medicine of the time, using your skills to support the disciples.

He could have called you to be a Christian physician in the Middle ages, when great plagues were sweeping through Europe and conscientious physicians carried a terrible risk of death in the course of carrying out their duties. He could have called you to work at the time of the great missionary movement in the 19th and 20th centuries, when thousands died from malaria and other tropical diseases, and the average life expectancy of medical missionaries in Africa was six months. But, instead, God has called you to be a Christian physician now, at this particular time in world history. We thus have a duty to try and understand what is happening in our world, and to be faithful to Christ in the place he has chosen to put us.

In the UK alone doctors will find themselves working with different resources in a variety of settings, from the technologically advanced environment of critical care departments, to small general practice clinics.Yet four themes are common to many workplaces; two are bad news, but the other two are good news.

1. A place of pressure

Covenant becomes contract

Across the world, medicine is progressively being transformed from a profession dedicated to patient care to a modern service industry, with consequent economic pressures. In the past a doctor had a personal covenant with the patient – a relationship of trust, confidentiality, and commitment. Of course this ideal often fell short, but it was a context in which many Christians found it easy to follow their vocation to serve Christ.

However, in a service industry the personal covenant is superseded by a legally binding contract and patients are replaced by 'healthcare consumers'. In place of open-ended commitment, we have targets to meet – case throughput, minimum waiting times, and financial targets. In place of a relationship of trust, we have annual appraisal, disciplinary hearings and complaint procedures.

Not all of this is bad, but the trend is transforming the nature of the workplace into a place of pressure, where conformity is demanded. In a highly regulated setting such as the modern hospital the person who stands out, for example the physician with a conscientious objection to a particular procedure, is a problem. In some workplaces the Christian may be seen as divisive, intolerant, judgmental and anti-social.

Unlimited demands

These also cause pressure. The needs are endless and the expectations of patients and managers are often unrealistic. There is a bottomless pit of demand for care and professionals may find themselves trapped like rats.

The 18th century Enlightenment promoted the idea that human rationality and science without religion could lead to world peace and harmony. Such thinking lies behind this demand trend in healthcare. The future is viewed as a product of human ingenuity, which we create by our actions. This leads to relentless pressure – we can never stop because otherwise the future will fail, the building will go wrong.

But this is a delusional way of thinking. The truth is that we cannot create the future; it is held in the providential purposes of the God of history. We are called to make wise choices, and these will have certain consequences downstream, but the future is not ours to create, nor does it depend on us.

We see this in the sign of the Sabbath, the seventh day of creation when God rested or – more literally – 'stopped' from the work of creation, to celebrate and enjoy what had been achieved. He gives us the Sabbath as a reminder that we too can cease, stop from our work, and celebrate, confident in the knowledge that God is in control of the future.

Pressure from the state

In the UK the government is increasingly seeking to take control of medical regulation, instead of allowing the profession to set the standards and ensure they are met. This is an ominous trend, but nothing new. On many occasions in the past the state has tried to pervert medical practice in ways which are unhealthy. Consider for example Stalin or the Nazis. The methods may be different today – it is more subtle and more humane – but it may ultimately be just as damaging.

In biblical thinking the state can be an ally: God's servant to execute judgement on evildoers. However, by the time we come to the book of Revelation, the state has become the enemy, the focus of satanic opposition to God's people.

So we should not be surprised to find ourselves under pressure, but at the same time we must remember in whose hands the future is held. In the words of the psalmist: 'The kings of the earth take their stand and the rulers gather together against the Lord and against his Anointed One…The one enthroned in heaven laughs, the Lord scoffs at them. Then he rebukes them in his anger and terrifies them in his wrath, saying “I have installed my King on Zion, my holy hill.”' [1]

2. A place of danger

The dangers in the workplace vary. For some there is direct opposition: even in the UK, Christian doctors have been criticised and even suspended from work for speaking about Christ to their patients, whilst others have been referred to the General Medical Council for expressing their beliefs about abortion.

I think this trend is likely to continue, but we must remember Jesus' words: 'Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven. Blessed are you when people insult you, persecute you and falsely say all kinds of evil against you because of me. Rejoice and be glad because great is your reward in heaven…' [2]

But there are also other, more subtle, risks in the workplace. The risks of materialism, of too much money or power, are corrosive and dangerous. Like the weeds that strangle the good seed, materialism can strangle our Christian commitment and witness, squeezing us into the world's mould.

There is also the risk of excessive work, fatigue, and burn-out. I think that very often it is Christian doctors, filled with a sense of vocation and duty, who are most at risk of burn-out. We are limited and frail, and so we have to learn to live within the boundaries of our humanity – the way that God has made us. This means taking adequate opportunities for rest, as well as bearing one another's burdens.

Our frailty is part of God's design. He could have chosen to make us like angels – strong, resilient, and powerful – but, instead, he had a different plan: he chose to put the reflection of his character in a being made from dust. Because we are made out of dust, we are frail, vulnerable and dependent. We are designed to be a burden to others.

You came into the world totally dependent on the love and care of others, and most of us will end our lives totally dependent on the love and care of others. This is not a terrible evil reality, but part of the design. The apostle Paul tells us that we should 'bear one another's burdens and so fulfil the law of Christ'. [3] Many of us need to learn this lesson again in the world of healthcare.

3. A place for witness

The workplace is where we are called to be witnesses. We are not just witnesses to ethical principles or godly ways of practice; we are called to witness to a person, the Lord Jesus Christ.

We are called to be salt and light, preventing corruption and decay, and shining truth into dark corners, making evil apparent. However, as physicians we have a further special privilege – the privilege of being a carer. Because we are physical beings, we need physical hands to care for us, and this is our role as Christian carers – effectively to show God's love 'with skin on'.

Christian health professionals have had a special place in the spread of the good news about Christ in the 21st century. Church historians point out how the Gospel came at a very unusual and particular time in world history. The long period of relative peace military force established during the time of the Roman Empire is often called the Pax Romana. Unusually, it was a time when it was possible to travel freely within Europe, with common trading standards, a common currency, and common languages.

The good news about Jesus was dropped into this era and spread like wildfire. However, according to historians, Christianity primarily spread via the trade routes; not by specialised evangelists, but by ordinary Christians going about their jobs.

Since the collapse of the Roman Empire, there has been no similar global empire until now. Over the last 20 years we have seen the rise of a new global reality, the power of globalisation. We see similar features to the Pax Romana: global peace maintained by military alliance, free travel and communication, common trading and legal standards, currencies, languages, etc. This time it is even more powerful than before: the Roman Empire had an amazingly good postal system, but it had no internet.

4. A place for love

Christians invented the word agape to describe the special kind of love that was distinctively Christian. One of the roots of the word is the concept of respect, so agape is 'respect love', or love that gives itself in service to another.

Importantly, agape love respects the other as equal in dignity. Agape love says 'we are both human beings.You are special, and I am here to respect you because you are unique.' It is by showing this love to our patients that we demonstrate the reality of the unseen Gospel and Christ's presence in our midst.

Agape love also points towards the future hope of a new creation. When we love someone in the present, showing practical, empathic, respectful, sacrificial caring, we are also pointing to the future, to the hope of the resurrection. We are treating someone now in the light of what, by God's grace, they are going to be.

From the apostle Paul we learn that although tongues will fail, prophecies will become unnecessary, and partial knowledge will become complete, the acts of genuine agape-love, those acts that demonstrate Christ-like caring here and now, will in some mysterious way become part of the new heaven and the new earth. Love 'always protects, always trusts, always hopes, always perseveres. Love never fails…' [4]

This is the time in world history that God has called us to serve him. We are seeing a new phase in the growth of the Christian faith, and we are called to play our role in this big picture. It is by being the hands of Jesus, the presence of Jesus in our hospitals and clinics, that we can be part of this wonderful worldwide ministry.

This article has been edited from his keynote address given at the recent ICMDA Europe-Eurasia conference at Schladming, Austria – Resources [Un]limited