Physicians and spirituality

Religion is the “unmovable foundation” on which Dr. James Keany bases his practice of medicine. He sometimes stops and prays with a patient coping with tragedy or life-changing illness, and he prays silently for many more.

“Patients are more than just an accumulation of lab tests and data. They are a living, breathing, feeling, spiritual entity,” said the Mission Viejo, Calif., doctor.

Praying with his patients doesn’t cure their illnesses, he added, but it helps comfort them in a difficult time.

As an emergency medicine doctor at Mission Hospital Regional Medical Center, Keany considers the spiritual health of his patients an important part of his job, like tending to their physical and emotional well-being.

Keany, a nondenominational Christian, may be more like his fellow doctors than previously assumed.

A new study has found that more than three-fourths of physicians believe in God and more than half believe in an afterlife. The survey of 1,144 physicians, published in the July issue of the Journal of General Internal Medicine, came as a surprise to the study’s main author.

“Doctors are not as irreligious as we might have expected,” said Dr. Farr Curlin, an instructor in the department of medicine at the University of Chicago.

More than half of the doctors said that their religious beliefs influenced their practice of medicine.

Doctors are often able to better care for their patients when they draw upon their religious beliefs, Curlin said. But not all doctors agree.

“A physician’s religion is utterly irrelevant to the patient,” said Richard P. Sloan, a professor of behavioral science at Columbia University Medical Center, who has researched the topic of faith and medicine and advocates that they should not mix. “There are some elements of our lives that may be associated with health and illness that are nonetheless out of bounds for physicians.”

Sloan noted that doctors hold considerable power in the clinical relationship. Because physicians know patients’ private matters, see them naked and examine them in extremely personal ways, patients are in many ways vulnerable when visiting a doctor.

That vulnerability, Sloan cautioned, means doctors should be extra vigilant about mixing religious beliefs with their practice.

“There is a tremendous potential for abuse,” he said.

Many previous studies have shown the importance of patients’ faith to their health, well-being and medical decision-making. There has been comparatively little research on doctors’ religious beliefs, however.

Although slightly less religious than the general public, doctors still were similar in their religious convictions, the survey found, with 76 percent of doctors saying they believe in God versus 83 percent of the general public (a figure established in a previous national survey). And 56 percent of doctors described themselves as religious, compared with 62 percent of the general public.

Doctors were significantly more diverse in their religious backgrounds than the U.S. population, however. They were more than 26 times as likely to be Hindu than the general population, more than seven times as likely to be Jewish, and more than five times as likely to be Muslim. Doctors were 20 percent less likely to be Christian.

Those from Christian backgrounds were more likely than any other religious group to say that their religion influenced their practice of medicine, except for Buddhists, who overwhelmingly said that it did.

It is not clear from the study if doctors become more religious because of their work, or if people with religious backgrounds are more likely to enter the field of medicine, but Curlin said: “It’s more likely that people go into medicine because it is not only a scientific practice, it is also a moral practice.”

He added that doctors would “cripple” their medical practice if they only treated physical symptoms and refused to pay attention to the spiritual needs of their patients.

Sloan agreed that doctors have a responsibility to respect and understand their patients’ spirituality, but disagreed that a doctor’s faith is important to the interaction. “You should treat your patients humanely and respect their autonomy regardless if you are a fundamentalist Christian or a Jew or a Muslim or an atheist,” he said.

Keany said he has come to believe that it would be “unconscionable” to separate religion and the practice of medicine.

“The technical aspect of medicine is actually the easy part of medicine; the hard part is being emotionally and in some cases spiritually available for the needs that a patient has,” he said.

But he added that doctors must be sensitive to patients’ beliefs.

“If you have an agenda,” he says, “you will not be there for their needs.”