There is a growing movement in the medical field toward patient-centered care. That’s when doctors consider the patient’s needs, values and desires in developing treatment plans.
But despite mounting evidence that faith can play a key role in health outcomes, many doctors are reluctant to talk to their patients about religion.
A new study examining data from a national survey of more than 1,100 doctors found that doctors who are both spiritual and religious are more likely to believe that faith can be medically relevant.
These doctors, about half of the sample, also were more comfortable “respectfully” sharing their own faith experiences and praying with patients.
However, physicians identified as religious but not spiritual, spiritual but not religious and neither religious nor spiritual were less likely to:
• Listen to patients’ religious or spiritual beliefs.
Not only did less religious physicians avoid the topic, they were also more likely to change the subject when patients began talking about their faith, according to the study by sociologist Aaron Franzen of Hope College.
It does not appear to be a case of overt bias toward religion and spirituality in most instances, Franzen said in an interview.
“Some of them, it doesn’t even occur to them,” he said. “The relevance just isn’t there.”
Yet faith can matter greatly to both the physical and mental health outcomes of patients.
Science increasingly says so.
Faith and health
Scores of studies in recent years have found that in general religious beliefs and practices are associated with several health benefits, particularly when the divine is perceived as loving, caring and merciful.
The benefits include the potential to reduce depression, moderate parental stress, serve as a healing balm for veterans and provide sources of support and hope for the critically ill and the disadvantaged.
But some religious beliefs taken to extremes can be damaging, particularly when fear and judgment crowd out love and mercy. Then, religious struggles can lead to feelings of shame, guilt and fear that can worsen health.
In both cases, researchers say it is of value to listen to the patient’s beliefs for potential clues to devising the most appropriate medical plan. In some cases, it can be implemented in collaboration with religious leaders and counselors.
Recognition of the patient’s beliefs also increases the chances she or he will follow the doctor’s instructions, research suggests.
On the other hand, Franzen noted, “If the patient is religious and makes sense of his or her world with those ‘tools’ but the physician is not religious and does not at least acknowledge these tools as part of the illness experience, then the possibility of nonadherence increases.”
In the Hope College study, Franzen analyzed data from 1,144 doctors who participated in the 2003 survey Religion and Spirituality in Medicine: Physicians’ Perspectives.
Doctors who more strongly held that religion and spirituality influence patient health were consistently more likely to welcome those conversations, “whether that be sharing their own beliefs, praying with patients, or just not changing the subject when beliefs are brought up,” he found.
Physicians who did not find those beliefs medically relevant are more likely to be uncomfortable with those types of interactions. That was particularly true for doctors who were neither spiritual nor religious.
In the field
What can be done to improve the dialogue among doctors and patients on religion and spirituality?
For starters, research indicates humility can help.
One new study of 297 patients of 100 doctors indicated that physicians who were humble, rather than paternalistic or arrogant, were most effective at working with their patients.
“Humble physicians were viewed as better at communicating with patients than non-humble physicians, and patients reported better health when their physicians acted particularly humbly,” researchers reported.
Training in religious and spiritual care also can make a difference, research shows.
In the Hope study, having such education was associated among all doctors with a greater willingness to listen to the religious and spiritual views of patients.
“Our study demonstrates the importance of training for the inclusion of religion/spirituality in medical interactions, whether or not the physician thinks religion matters for health outcomes,” Franzen wrote.
In the end, it is the doctor in her office or by the hospital bed that makes the critical decision regarding how patient concerns will be reflected in their care.
And it matters how doctors approach the conversation, Franzen notes in the journal article.
Is anything the patient wants to talk about or share with the physician fair game? Or is it the physician’s role to direct the conversation toward what he or she sees as medically relevant?
“Most often it is the latter,” Franzen stated, “and in the process, the physician’s decision may actually bypass patient-centered care.”
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