Yes, somebody has actually studied how physicians view the role of religion and spirituality on health outcomes. The results are very interesting but not really surprising. The more religious the doctor, the more likely he/she is to believe that God intervenes in patients’ health, prevents “hard” negative outcomes (like heart attacks), and, in general, influences health.
The study, “Physicians Observations and Interpretations on the Influence of Religion and Spirituality on Health,” was published in the April 9, 2007 issue of the Archives of Internal Medicine. The researchers, led by Farr A. Curlin, MD from the MacLean Center for Clinical Medical Ethics, surveyed a random sample of 2,000 U.S. physicians about their attitudes about religion and spirituality. The survey had an excellent response rate (63%), although non-religious physicians were somewhat more likely to fill out the survey than religious physicians.
Doctors’ religiosity was determined by their response to two questions from the Hoge’s Intrinsic Religious Motivation Scale (I had no idea there was such a thing). The questions asked whether they agreed or disagreed with the following statements:
- “I try hard to carry my religious beliefs over into all my other dealings in life.”
- “My whole approach to life is based on my religion.”
Doctors who answered “yes” to both questions were rated as high in intrinsic religiosity (IR). Those who answered “no” to both were low in intrinsic religiosity. And those with only one “yes” were rated as medium in intrinsic religiosity.
Physicians were also categorized by their stated religious affiliations:
- None (they listed none, atheist, or agnostic)
- Other (Buddhist, Hindu, Mormon, Muslim, Eastern Orthodox, etc)
Because religiosity varies by where you live (folks in the South and Midwest are more religious than people from other geographies), the doctors were asked to report where they live and practice.
Key findings of the study
Here are some of the key findings of the study:
- In general, 56% of physicians believe that religion and spirituality (R/S) have much or very much influence on health.
- Only 6% believe that R/S often change “hard” medical outcomes (i.e., prevents a heart attack).
- Three-quarters of doctors believe that R/S helps patients cope and gives them a “positive state of mind”.
- A bit more than half felt that R/S provides “emotional and practical support via the religious community”.
Physicians who rank “high” on intrinsic religiosity overwhelmingly believe that R/S strongly influences health. They also believe that God intervenes in patient’s health and that R/S helps patients cope. Interestingly, 31% of these same highly religious physicians feel that R/S sometimes, often, or always “causes negative emotions”.
On the flip side, physicians of low intrinsic religiosity report that patients rarely mentioned R/S issues to them (19%) and, although 27% and 22% respectively thought God intervened in health or prevented negative hard outcomes, 61% felt that R/S helped patients to cope with their medical condition.
An interesting point in this paper is the discussion of concordance of physician/patient attitudes related to the geographic prevalence of religiosity. Doctors and patients who live in the South are more likely to talk to each other about their issues related to R/S. Conversely, doctors who live in the West, where I live and trained, are less likely to talk to patients about religion and spirituality.
The takeaway of the study
To me, the takeaway of this study is that physicians’ attitudes about R/S not only influence how they interpret the role of religion and spirituality in patient’s lives, but also how willing they are to explore (and patients to disclose) their beliefs in this very personal and often private aspect of human life.
When I was a medical intern, a patient I spent many hours caring for died. He had been in the CCU for weeks and had one complication after another. It was a slow and painful death. I had met the family, of course, but as the intern on the “case”, I was more engaged in the daily “scut” work (drawing blood, fetching lab results, and writing lengthy notes) of medical practice than I was in developing a personal relationship with the patient or his family.
After the patient died (despite our best efforts), this man’s family asked me to pray with them. Being “low” on the intrinsic religiosity scale—although I got on my knees, closed my eyes, and held their hands—I was very uncomfortable in the role this grieving family was asking me, their loved one’s most identifiable doctor, to play in their efforts to deal with their loss. Of course, I wanted to do “the best” for my patient and his family, but I couldn’t really provide the religious support they wanted from me. I think, in retrospect, that I may have let them down (after, not before) the death of their loved one. But I really couldn’t help it. My beliefs are my beliefs and theirs are theirs.
I do want to point out that I do not think all doctors need to have a religious or spiritual response to illness. I, for one, would be highly offended if my doctor told me my health was in “God’s hands” or, if I had cancer, that my remission after rounds of chemotherapy was because God ordained that for me. On the other hand, acknowledging that a lot of medicine is still more about relationships than actual science is, once again, worth affirming.
The American Association of Medical Colleges (AAMC) recommends that physicians “recognize that their own spirituality might affect the ways they relate to and provide care to patients” [and I might add how they relate to their patients’ families and friends].
As we continue to explore how much of the effectiveness of medicine is because of the science and how much is related to the “art”, perhaps we need to explicitly talk much more openly about the role of religiosity and spirituality of patients and physicians on the spectrum of health outcomes (physical, psychological, and spiritual) instead of just assuming that “one size fits all”.
Isn’t life wonderful and don’t we always have so much more to learn?