Doctor keeps medical practice in line with Catholic teaching

Dr. Paul Carpentier, founder of In His Image Family Medicine in Gardner, Mass., said he doesn’t have an especially unusual mission.

“It’s just one of stewardship,” he said. “I intend to do the best I can with the skills God has given me, for the community that presents itself for care.”

But something sets him apart. On his website is this notice: “Please be advised that this practice does not provide abortions, sterilizations, contraceptives, artificial reproductive technologies or assisted suicide, nor do we refer for these services.”

Stepping forward

“I’m not inflicting some kind of hardship on patients,” Carpentier told Our Sunday Visitor. These services are available everywhere, and Massachusetts health care covers most of them. When Carpentier tells his patients that he can’t perform certain practices because they are against his conscience, he said most people don’t object.

“In 23 years, I’ve only had two patients storm out,” he said. They were mothers who had taken the day off work to bring their daughters in for contraceptives. “I actually talked to the daughters,” he said. “I told the moms, ‘Talk to your daughters. They don’t want to be on the pill.’”

“People think they’re taking step backward when they follow Catholic teaching,” he said.  “But it’s really a step forward ­— a step toward being healthier, toward being more successful, whether you’re dealing with infertility or family planning; a step toward stronger marriages, stronger families, a stronger community.”

The community Carpentier serves has grown throughout the more than 23 years he has been in practice. His patients travel from Connecticut, New York City, Quebec — even from Brazil. Carpentier is one of a small but growing number of doctors in the United States who offer NaProTechnology services, rather than contraception and IVF.

NaProTechnology is a medical approach to reproductive and gynecological health, developed 30 years ago by Dr. Thomas Hilgers, founder of the Pope Paul VI Institute for the Study of Human Reproduction. Using a standardized system to track a woman’s biomarkers, a trained physician can diagnose and often cure infertility and other abnormalities, such as PCOS (polycystic ovary syndrome), PMS, repetitive miscarriage, irregular bleeding and other health problems.

Carpentier has a family practice with 2,500 patients, and another 500 patients who receive NaPro care. When a couple comes in seeking help for infertility, he usually has a comprehensive hourlong visit with them.

“We talk about their marriage and their spirituality, as well as endocrinology, pituitary status, thyroid, endometrial lining, cervical mucus and more,” Carpentier said.

“We want to solve the underlying problems,” he added. “When patients hear a doctor talk that way, they say, ‘Finally, someone’s talking sense!’”

Beyond the numbers

Carpentier said he wishes he had more resources to draw people in for the care they deserve. “I’ve been to medical conferences,” he said, “And the big IVF companies are giving away all sorts of glossy goodies. And I say, ‘Here, here’s something I photocopied on the way down!’

“I’m so tired of talking about NFP in dingy church halls,” he added, laughing.

natural family planning
Methods of family planning that comply with Church teaching are about saying “yes” to marriage and family life. Shutterstock

But once people do come to him, he said, a new world opens up. They realize that there is such a thing as a doctor who wants to listen, who wants to cure them. That intimate doctor-patient relationship, he said, is the best part of his day. Couples come in after bouncing from one IVF lab to another.

At these labs, he said, “they hear things that are foreign to them, but they don’t hear any other option. They hear, ‘Well, we’ve lost two embryos, but there’s eight left. Some don’t look healthy, so we could implant three. What should we do with the rest?”

“The rest?” Carpentier asked. “They’re not ‘the rest.’ They’re siblings.”

Carpentier said that, according to the IVF industry’s own records, it loses 6.7 embryos for every one that is born — and that only accounts for embryos that are actually implanted. Many more embryos made through IVF are discarded. “Using NaPro Technology, we lose 0.07 of our embryos,” he said. “We studied two 10-year blocks, and we have a 64 percent success rate for treating infertility.”

But rather than being all about numbers, Carpentier stresses that it’s all about the relationship. “Whether it’s in my family practice or for NaPro, you walk in that room and you realize you have a person there. Christ in disguise. Maybe it’s an alcoholic patient, swearing at the nurses, or maybe it’s a person who just needs someone to reach them where they’re at.”

But reaching them is about to get harder. When Massachusetts enacted a law in 2006 requiring doctors to furnish contraceptives and abortion, Carpentier knew he was still covered under federal conscience protections.

“But as soon as Obama got into office, he removed those, as much as he could,” Carpentier said. He feels that doctors of faith are under attack — and that small family practices in general are threatened, too.

“They just passed a law with four new levels of bureaucracy for reporting requirements,” he said. “I already have a staff of 10. I can’t afford to hire more staff just to meet someone else’s reporting requirements. I’m making the same salary I made 20 years ago. I’m just breaking even.”

And the promises Obama made that patients will receive better care no matter where they land, because their electronic records will follow them? “That’s not going to happen,” Carpentier said. “There are firewalls to prevent medical records from getting through.”

A new electronic recording system would cost him $80,000, he said. Furthermore, it would interfere with that doctor-patient relationship he values so highly. “We’ll be clicking on a computer instead of talking,” he said.

Facing the future

Carpentier said he believes that the mandates are designed to force doctors to abandon their independent practices and to come under the umbrella of large corporations. These corporations will be able to access patient records for the purpose of denying services to cut costs. He said he has already run afoul of these measures.

“They’ll pay for IVF — thousands of dollars for IVF. But I had a patient who went all the way to the top, just trying to get the insurance to pay for a $15 bottle of progesterone cream,” he said. “They said that it worked beautifully. It healed her. But they wouldn’t pay for it.”

“The purpose of these new laws is to restrict health care expenditures, so they want to see numbers from my office. They want to know the outcome of each visit,” Carpentier said. “But how do you price outcome? If I tell a patient to get a colonoscopy, and he doesn’t want to get it, he won’t get it. That’s a bad outcome.”

The hardest part of his job, Carpentier said, is “seeing patients abused by the medical system.” NaPro is covered, he said, “because it’s diagnostic. They’ll pay for testing. But they won’t pay $40 for a shot of HCG (human chorionic gonadotropin) [to sustain a pregnancy].”

Although he has worries for the future of his practice, and for the future of medicine in the United States, Carpentier has no intention of giving up.

“Is there hope?” he asked. “There’s always hope.”

The classes teaching NaProTechnology are at maximum capacity, he said, and almost half the students are doctors.

“I love it when Catholic medical students come into my office, and they say, ‘Yes! This is possible!’

“I tell them, ‘It’s not that hard. God gives us a cross we can carry.’ I want to give young doctors a sense of the beauty of life. I want them to keep the spark of hope alive, keep altruism alive. Teach them a respect for patients, a respect for fertility. It’s not a lost art.”

As a young man, he said he wondered, “Is God calling us to have 18 kids?” His college chaplain told him to read Humanae Vitae (“Of Human Life”), Pope Paul VI’s 1968 encyclical on procreation.

People think it’s a Church document that said “no” to contraception, Carpentier said, “But that’s not what it’s about. Humanae Vitae doesn’t say ‘no’; it said ‘yes’ to the true beauties of a relationship. It’s about caring for each other.”

These relationships — marriage, the relationship he has with his patients, his prayerful decision to start a practice that doesn’t offer contraception — are all about saying “yes.”

“Listen, Mary had a tremendous ‘yes’ she had to say. I’ve just been asked to say little, tiny yeses,” Carpentier said. “Go to a conference, and learn about Humanae Vitae? Yes. And, oh, it was beautiful. Learn NFP with my wife? Yes. Oh, that’s beautiful!”

“Set up a practice with no contraception?” he said. “Yes. And oh, it is beautiful.” 

Simcha Fisher is a blogger who writes from New Hampshire.