Different health care reform: doctors trained to deal with patients about faith

Modern medicine, with its profound dependence on technology, often seems nothing short of miraculous. But even the best medicine sometimes falls short of offering a successful treatment or cure. It is in these situations that recent national surveys show many Americans think God can help.

Indeed, three-quarters of Americans believe God can cure people who have been given no chance of survival by medical science. More than half of Americans regularly pray for their own health or the health of their family. Yet many physicians are unwilling, or ill-equipped, to support patients and families on this level. 

Many doctors see religion and spirituality as a barrier to medical care or, at most, a useful crutch when medicine has no more answers. But healing involves more than just medical diagnosis and treatment. Often patients and families see spirituality as a source of support when they are ill, or appear to be dying.

A holistic approach to medicine requires physicians to understand the complex role of spirituality and religion in compassionate patient care. The best prescription: Integrate these topics throughout medical education.

What physicians get trained to do

Rice University sociologist Elaine Howard Ecklund and I wanted to find out how physicians respond to patients’ spiritual and religious beliefs in their work. Of the 30 academic pediatricians and pediatric oncologists we interviewed, few learned about spiritual or religious issues they might encounter in patient care during their formal medical education.

About a third spoke informally with colleagues about issues of religion during training. Some reported taking steps on their own to get to know hospital chaplains and talk with them about death and dying, family decisionmaking, and how to respond to patients and families who are very religious – especially Jehovah’s Witnesses and Orthodox Jews.

Almost none of the physicians we interviewed learned how to respond to religion and spirituality as they often learn other skills – by observing how senior physicians model them.

In another recent national study of physicians, University of Chicago physician Farr Curlin found that only a quarter of the physicians surveyed reported having received any formal training at the intersection of spirituality, religion, and medicine.

This may be changing, however, as a growing number of medical schools – many with the support of the George Washington Institute of Spirituality and Health (GWish) – started offering courses about spirituality and religion during the past 20 years. These courses try to prepare students to engage in a broad range of conversations about spirituality and religion. Individual courses vary significantly, however, leading GWish to collaborate with medical schools to develop six core competencies in spiritual and health education and to design a uniform way to measure and evaluate them.

While such top-down efforts are a good beginning, it’s clear that most practicing physicians have at least some level of discomfort regarding spirituality in their work, and some consider it a real source of conflict. Our bottom-up research approach – based on talking to physicians in the field – convinces us that a more nuanced, flexible approach to helping doctors and medical students navigate the spiritual shoals is needed.

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