Religion in the exam room: Does it belong?

Keypoints

Patients who've visited FP Debbie Heck's office in Muncie, IN, have undoubtedly noticed the plaques with Biblical verses hanging in the waiting room and other parts of the office. "I'm a Christian, and I'm very dedicated to my faith," she says. Heck's religious commitment also extends to the exam room, where she might suggest prayer to patients, or even escort them to church if she thinks they'll find that therapeutic. As she puts it, "Some doctors feel strict boundaries should be set up between physicians and patients, but I'm of the 'whatever works' school of medicine."

During the last few years, as religion has become an increasingly prominent topic in the national debate, some of this discussion has centered on whether doctors should invoke religion as a means of comforting, understanding, and guiding patients. For a number of physicians, doing so comes naturally.

Indeed, according to a recent study, physicians are as engaged religiously as their patients. In an article published in the July 2005 issue of the Journal of General Internal Medicine, internist Farr A. Curlin and other researchers at the University of Chicago, who surveyed 2,000 physicians and heard from 1,144, reported that 90 percent attend religious services at least occasionally (compared with 81 percent of the general population), 76 percent believe in God (compared with 83 percent of the general population), and 55 percent agree with the statement, "My religious beliefs influence how I practice medicine."

Responses, in sharp contrast to the antithetical opinions that typically are expressed in answer to questions about abortion and end-of-life care, were nuanced and varied. Although the polar ends of the issue were well-represented in the replies, a good number see religion as one of many things that should be taken into consideration-and, occasionally, "prescribed"-if it's important to the patient and might affect his or her response to medical recommendations.

Asking about patients' spiritual lives

Physicians who, in taking a patient history, ask about religious beliefs and affiliations, say it helps them get to know patients better and to determine whether they need to consider faith-based practices, such as dietary restrictions, when weighing treatment options.

New York City psychiatrist Sharon Packer, who has written on religion and stress, thinks that physicians are better able to gauge coping mechanisms if they know something about the patient's religious background. "It also might indicate what social supports the person has available," she says.

FP Robert W. Matthies of Prescott, AZ, goes beyond a simple Q and A when he inquires about religion. "I want to know about their spiritual condition," he says, "not simply whether or not they attend church or synagogue. In listening to their replies, I often get important information about their emotional status, which can lead to therapeutic conversations."

For other doctors, though, patients' religious beliefs are often too complex and nuanced to be useful guideposts. "We're scientists, not priests," Baltimore FP Jeffrey Schultz contends. And orthopedic surgeon Paul M. Ross of Pawlet, VT, maintains that injecting religion into medical encounters compromises professional relationships. "While on the job, a physician should be politically and religiously neutral," he says.