Ask Richard: A Young Atheist Doctor Responding to Religious Patients

Note: Letter writers’ names are changed to protect their privacy.

Dear Richard,

I am an atheist secular humanist. I am also a physician in my last year of residency in a “Bible Belt” area and, while I have gotten a fantastic medical education, I have not found any good role models to help me address the myriad of difficulties surrounding being an atheist doctor. I suspect that some of my attending physicians also are atheist or agnostic, but it’s not something that many people discuss openly around here.

I often find myself in difficult situations at work when it comes to religion. I always try to respect the beliefs of my patients, but I struggle to find an appropriate response when they ask me to pray for them or ask me point blank, “Doc, do you believe in God?” Often I find myself blundering for a way to change the subject and dodge the question or let them think I share their beliefs without actually lying and saying that I do, but this feels dishonest. I also would like to “come out” and become more involved in the atheist community but I’m worried about how that might affect my career. My impression is that many patients would not want to be cared for by an atheist doctor.

I suspect that doctors, as scientists, tend to be more atheistic and agnostic than the general population, but it seems to be a taboo subject. Do you have any suggestions for resources or support groups for atheist doctors? It would help to have a professional community to which I could turn to for advice.

-Kimberly

Dear Kimberly,

It’s a taboo subject probably for the same reason that you have succinctly described here: Depending on the setting and the circumstances, coming out as an atheist doctor can be hazardous to your career. Nurses who are atheists face this risk as well, not just from patients but also from their colleagues. Not everyone can enjoy the impunity and immunity of Dr. Gregory House.

Often your patients feel vulnerable and scared. They know you’re smart and well trained, but they also know you’re only human, so they hope you will be given a little extra help because you have a good buddy named God. Because you’re a person who wants to help people in their anguish as well as their illness, their neediness might cause you to feel inadequate to meet all their needs. Keep in mind that you can’t meet all their needs. Their car, their computer, their tax return, and their spiritual issues are the purview of other specialists.

I understand that it is distasteful to have to lie, or to be evasive, or to allow them to assume incorrect things about your beliefs, but these matters are not relevant to your practice of good medicine for them. You don’t have to tell them the truth about irrelevant things if it is going to hurt you. Give yourself permission to respond in whatever ways help you to keep helping them as a doctor.

You have to get along with them, so you probably can’t just say, “That’s none of your business.” You might try a technique that I’ve used as a counselor. I would turn any question that my clients had about me into a question about them. When your patient asks you to pray for them, say, “Are you feeling anxious or scared about any of this? Can I better explain to you what we’re going to do? Would you like me to ask the hospital chaplain to visit you?” This kind of response gives your patients three things: Firstly, it acknowledges and shows caring about their underlying feelings. Secondly, it offers them what you can do for them, such as explaining the medical issues clearly. Thirdly, it offers them a better qualified resource for their religious concerns.

If you’re cornered by a direct question about your belief in God, and if you neither want to lie or evade, you might try asking them why that is important to them. Listen carefully, and if it seems appropriate say something like this: “I focus all of my mind on giving you the best medical care I can. That’s all I do. I concentrate on nothing else.” That might or might not satisfy them, but it’s honest, and it’s the most polite way can think of to close down the topic.

You need to find some comrades and confidants in the medical field, either doctors or nurses. They will probably have much better suggestions than mine. Ideally, you could use a trusted atheist friend who is at roughly your level in the hospital hierarchy, and another one who is senior to you. Together, they can advise you about ways to deal with patients, and also about who in the hospital administration you need to be careful around.

The tricky part is how to discreetly find them. You may have to risk a little by feeling out someone who seems the least religious and the most discreet. I wish I had a better suggestion.

You’re correct that a higher percentage of scientists are atheists than the general population. The percentage may differ between disciplines. A study by the University of Chicago indicates that about 24% of medical physicians are atheists. That may be less than scientists in general, but it’s still more than the general population, and you only need one or two.

I found no current online support group specifically for atheist physicians. I found one blog called The Atheist Physician, but I don’t know if he will have anything to offer you. Read his first entry of Oct. 29, 2011, and contact him if it seems worth a try.

This column doesn’t just rely on my knowledge. There’s a large readership of very knowledgeable people, and they have helped letter writers many times. Perhaps there are some people reading this who know of resources for you.

Any medical professionals or anyone else out there who can offer some suggestions?

Kimberly, I know that residency is exhausting, and you are at the mercy of the whims of senior doctors and administrators. Once you gain more autonomy, hopefully you won’t have to be so circumspect about your views. Of course in the U.S., the particular region in which you live can make a big difference.

I wish I could think of more immediately helpful suggestions. Sometimes just like doctors, I can only offer meager assistance and hope for the best.

Richard

You may send your questions for Richard to . Please keep your letters concise. They may be edited. There is a very large number of letters. I am sorry if I am unable to respond in a timely manner.

Melissa E

Another good deflector could be to have the contact info of a few different local denominations handy, so that if they ask something like “will you pray for me,” you can ask if they’d like to be put in contact with a religious support group.
Anonymous

Just tell the bible thumping patients that their insurance doesn’t cover praying by medical staff.
Adrian

You’ve only got a year left, so after that leave the Bible Belt.
Yukimi

Here, even religious patients aren’t as obnoxious about their religious views as what you tell but this isn’t the Bible Belt. I wish you good luck. Soon I’ll be in your position 🙂
Medstudent

Thanks for this, Richard. I’m still in medical school but routinely get concerned comments from my mom about “How can you deal with death all day if you don’t believe in heaven?” There are a few of us who are openly atheist in the school and it’s very uncomfortable to discuss certain topics with religious classmates who are aware of this fact. Thankfully everyone is very respectful here, but there is a certain level of condescension that I can’t confront – nobody has a problem with discussing God, but I get the very strong impression that it’s not okay for me to talk about Not God.
They openly encourage us to seek our peers to help deal with the mental stresses of our lives, but when I do have bad days, when people under my care do die, how do I do that without announcing my beliefs (or lack thereof)? I don’t want to go to a colleague for solace and get a sermon instead.
Nick Matthaes

Having grown up in the Pacific Northwest, where it is considered rude to ask someone about their religious beliefs I didn’t expect it when I moved to the bible belt. I ended up preparing taxes and people would ask me if I had accepted Jesus. Or they would tell me, “I try to lead a good life, I’m Christian, but can you do A or B to help me cheat on my taxes.” I have never seen anything like it. When I rented a moving truck, the woman who rented it to me asked if I had “accepted Jesus.” Everyone down there felt they had the obligation to ask about my faith. While I met so many professed Christians, I have also never met so many unethical people. It really steeled my resolve as an atheist. I can’t even imagine how bad it must be for someone in the medical profession. Kimberly, you have my sympathy.
Anonymous

Ask if they’d like you to read their test results or just to treat them by faith. Seriously though, this is an issue in almost all professions (including Information Technology). I’d love to hear some general all-purpose responses that aren’t snarky
Michelle

I’m from Quebec, so things like that bug me beyond comprehension. It’s perfectly OK to be an atheist here. As long as you’re baptising your kids to please grandma, name a godfather and give them the communions and all that nonsense… Though the kid will probably grow up to be an atheist in the end like you. Or at least the kid will grow up to be undefined in religion but still think there’s “things out there maaan” along the lines of spirits. Oh and you’ll get a priest to talk nonsense at your funeral in a church…. I still don’t get the point of that. I guess it’s all cultural and tradition.

I’d go on a stretch and say that if you talk big about religion you’re viewed as a nutcase. It’s only expected of you if you’re above 60….all that to say I really really can’t imagine how hard this situation must be, how hard it must be to lose a job and be shoved aside as evil because of a lack of belief.
Howard Replogle

This might help: I’ve been tempted as a patient to ask doctors new to me if they believed in God. But for me, the correct answer is “NO!”
GeraardSpergen

“Do you believe in God?”.

“No, but I want you to recover, and it’s important to me that you keep your attitude about all this as positive as possible. So if talking to the chaplain will help you with that, I’d like to send him/her in to meet you.”
Carmen

This is perhaps slightly off topic but there is an interesting recent article about an atheist physician in Los Angeles who has developed ways to treat Jehovah’s Witnesses who refuse blood transfusions. From the article:

Despite his belief that God doesn’t exist, he has become a hero to many devout
believers.”We don’t care if he believes in God or not,” said David
Goldfarb, chairman of the Los Angeles-area Hospital Liaison Committee for the
Jehovah’s Witnesses. “What we really believe in is, ‘Are you a skilled and great
doctor … and can you respect our belief system?'”
You can find it here: http://www.latimes.com/health/la-me-jehovahs-20120202,0,1225354.story
OApril1973

I would love to know my Dr. is not religious. I think being true to yourself is the most important thing here. Your patients need to respect your skills and knowledge, and rely on that for their needs. Avoidance would be best. And everyone will respect your right to keep your private life private. If they ask if you will pray, say “I will do everything I can for you”. If they ask if you believe in God, “I like to keep my personal life and professional life separate” something along those lines. You could always go with “this isn’t about me, this is about you and your needs”.
Richard Wade

Those are very good responses.
Pascale

http://www.thinkatheist.com/group/medicalatheists

This is the closest thing I know of. I’m on there. =) Nursing in TN is awkward at times.
KeithA

Why on earth would anyone ask a doctor, “Do you believe in God?” I can’t imagine such a thing. But the, like Michelle in Quebec, I’m from a country (UK) where it’s fine to be an atheist. I ‘ve lived in the same house for 15 years and have no idea (or interest) in what any of our neighbours believe. Anyone going round asking such questions would be viewed – quite rightly – as slightly mad.
Jesse Jones

Would you like me to ask the hospital chaplain to visit you?
This, so much this.
Carmen

As a lawyer, I actually get these kinds of questions a lot (though I’m sure not nearly as much as doctors get asked these questions).   I often deal with people during very difficult times in their lives – divorces, accidents, employment problems, business problems, etc. They often bring God into their discussions with me – I have one client who talks about how “God is on our side” and how much she prays to win the case.   I just respond that she has a positive attitude and that’s a good thing.

I generally try to keep my own beliefs out of my dealings with clients as much as I can – same thing with politics. I was raised that you don’t ask people about religion, sex, or politics.  I guess a lot of other people don’t follow that. (Interestingly, I’ve never had a non-Christian ask me about my beliefs.)

If someone asks me directly, I tell them no, I’m not a Christian and leave it at that. It’s none of their business though I don’t hide my beliefs either.   If they want a Christian lawyer, there are plenty who advertise that way.   And if they believe prayer will help, then feel free to pray. I find that usually they end up wanting a lawyer who does good work, rather than one who has the same religious beliefs.
Erp

I wonder if asking doctors who belong to or would be assumed to belong to non-Christian religions might help (e.g., Jewish, Hindu) as they probably have to deflect similar question or even more pointed (are you Christian?). Also a local UU minister (if any) might be able to pass your contact info along to any UU connected doctor (some of whom might be atheists and all probably accepting of atheists).
Marco Conti

I hate to make light of your situation, but I think it would be funny if you pulled out a bunch of leeches and a hand drill and told them that you were going to use “bible based medicine” on them 🙂

(and yes, I know leeches are used in modern medicine as well)
Anonymous

How about an answer like “No, I don’t believe in any gods, which is why I try so hard to help people live as long and healthy lives as possible: it’s the only life we get.”
Anonymous

I’m a family doc in a religious area. It is usually sufficient for me to say that I’m not religious. It doesn’t seem to invite further interrogation, it’s not a lie. The truth is that the patients have their own agenda, and it truly doesn’t matter what I answer as long as it’s not so unusual that it derails said agenda.
Dave Fischer

Yesterday, the Humanist Society of Greater Phoenix had a great “sermon” from James Croft, a research associate and graduate student with the Harvard Chaplaincy. He is a vociferous advocate of humanist communities, and I would suggest you find the local group in your area if there is one. Croft suggests that humanists stand for Reason, Compassion and Hope. Reason has expanded human health and welfare, Compassion has expanded our circle of “us” and Hope keeps us working hard at the creation of a better future. This gives us positive values, which can be presented to people that pester us about belief in god. “I believe in reason, compassion and hope” combined with some of the comments here may be enough of an answer.
Skjaere

I can totally understand why people would ask whether their doctor believes in God, and why they would require some sort of compassionate and caring response. What I don’t get is this: I work as a night clerk at a hotel, and people keep asking me the same damn question! Here’s the thing: I *do* actually believe in something. But I am so uncomfortable with people asking me about it, especially strangers. It’s a personal question on a par with “How old were you when you lost your virginity?” It’s just not okay to ask someone you don’t know. But I can’t really be snarky either, because I am at work and I have to be all professional. Maybe you folks can help me with this. Is a frosty, “That’s a very personal question,” too rude or just rude enough?
I May Be Crazy

I suggest that you encourage your patients to pray that the science you are administering will have a positive effect. “My job is not to pray – I administer the science. Let’s pray that God will make it work.” Or some such bullshit.
Ubi Dubium

Although not a pysician, I’ve had good luck with “My views on religion are very personal, and I don’t care to discuss them.” That lets the questioner jump to whatever comforting conclusion they wish to make, but also puts an end to the conversation. I’ve chased quite a few evanglists away from my door with that one.
Cluisanna

I never ask people about their faith because I always am kind of disappointed when it turns out they are religious.
Cluisanna

Definitely just rude enough. Maybe also “I don’t feel comfortable sharing this.”
Bagomoldytangerines

As a nurse and atheist I sympathize. My tactic is to first avoid the discussion and when asked directly tell patients I don’t feel comfortable discussing my religious beliefs at work. So far so good! Good luck Kimberly!
Aaron Scoggin

Dang, that sounds all and well, except for the part of going through the motions. I’m an atheist, my wife is on the fence, and her family is CATH-O-LIC. Like Philippino Catholic. Yeah. But still, we haven’t (nor plan to) baptize our son, do any communions, etc. I guess in Quebec, it’s cultural, and here (in the states) it’s religious? I don’t know. Cause here, if you baptize your kids, you’re expected as parents to raise them in that religion. Kind of like entering an agreement of sorts.

Just found your post interesting. 😀
Eric D Red

There’s probably room for a whole series of articles on atheism in Quebec. The deep hypocrisy of the Quebec Catholic church probably caused the quite a lot of the secularization part of the Quiet Revolution. I heard so many stories from my father about nuns with hickies, an actively gay monk who’s now a canonized, priests that were never to be alone with, and so much more. Yet people still do communion to appease the grandparents, who were the ones to keep quiet while little boys were being buggered.
Holly Stewart

When I was getting divorced I was happy to learn that my lawyer was not a god-abiding person. He didn’t come right out and tell me, but it became evident in the small talk. I had selected him to handle my divorce over a female lawyer who I found out was Mormon, although she didn’t advertise it. I couldn’t figure out how she would be able to help me stand up to my husband for my rights with a Mormon outlook tainting her world view. Turned out that the non-religious lawyer (who was president of the bar in my state the next year) led me to get a very very good deal!
Rob

I have been a physician for 25 years and not once has a patient asked “Do you believe in God?” I have been asked if I thought prayer “worked”, to which I responded “Some people find it useful”. More commonly patients will exclaim “Praise the Lord!” after I tell them some good news resulting from some intervention I have made. I just think it’s funny.
Carmen

You know, that is an interesting perspective – that you couldn’t figure how a Mormon lawyer would help protect your rights against your husband. I guess I didn’t think about it that way. As lawyers, we take an oath to uphold the laws and Constitution. We have ethical duties to advocate for our clients and advise them about their rights. If a lawyer believes in a “higher law” that is at odds with our secular laws, what would she do?

I probably would feel the same way that you do and would want a lawyer who will protect my rights based on U.S. law, not God’s law.
M G

What do you do if it is the other way around? I have had a few rough moments with my (soon to be ex-) physician over my non-belief, especially when it comes to treating my depression, and the fact that I’m obese. He’s as annoying about that as the co-author of a bible-based diet book might be assumed to be.
Travis Dykes

Glad Richard brought up nurses. Im in my 4th level of nursing clinicals (of 5), and most of em down here in Louisiana seem to think its a “calling” in the religious sense. And I get the feeling thats true for most of the nation. At least most of the ANA (american nursing association) and other nursing organizations publications seem to put it in those terms.
Keulan

Personally, I don’t care about my doctor’s religion (or lack thereof), unless it negatively affects the way the doctor practices medicine. For example, if the doctor suggested something like prayer as treatment, I’d start looking for a new doctor. This video voices my views on religion and doctors pretty well- http://www.youtube.com/watch?v=WwdS4Ngnozc
JT the Girl

If a doctor is praying for you, it kinda means ze has given up all other hope, yes? So if someone asks ya to pray for ’em, there should a way to imply that there won’t be any of those last resort methods needed in THIS skilled doctor’s room. I’m imaging the LW as a surgeon, altho she didn’t specify. If she’s a gynecologist, the conversations would last longer, and inviting the hospital chaplain in would be highly inappropriate.
You can’t just say “I believe in my skills”, cause it’s too arrogant, unfortunately. I suppose saying “which one” wouldn’t be quite right, but asking the patient a question in response is always the way to go. Perhaps just asking, “do you mean Jesus” will get them to spill why they’re asking in the first place. What about saying “I don’t know” and then quickly diverting back to important things?I feel like I haven’t said anything helpful, but this thread is one big brainstorm, and I hope something sparks!
Keith Collyer

Maybe “Some people think it is useful” is more accurate
David McNerney

Being serious in a facetious way:

Get a little teddy bear and call him ‘God’, stick him in your shirt pocket.

“Do you believe in God?”
“Of course, I do. He’s right here next to my heart”
“Pray with me.”
“Sorry, but I’m very private about my beliefs. But I’m sure the hospital chaplain will help you.”

No harm done.
Georgia Stanton

Oh, man, that sounds terrible. Just, weight issues and depression are so near to me, and I’m so lucky for the help I’ve gotten. If I had to deal with somebody in that position who had a problem with atheism, I’d probably end up talking about how immensely grateful I am for my lack of belief and the strength and drive it’s given me at times when I’ve really needed it…
Anyway, I hope you find a better doctor. =]
Anonymous

Please help!

I have a somewhat random request. I am writing a book at the moment and am in need of getting a quote from a doctor with expertise in childbirth. My book is a critical look at the historicity of the nativity. In one section, I will be looking at the likelihood of someone (Joseph) asking a 9-month pregnant woman (Mary) to walk or ride on a donkey on an 80 mile trip. This would be a week walking or 5 days on a donkey, most probably. I need quotations to add to the book from a specialist. The questions are:

What physiological implications would there be for a 9-month / heavily pregnant woman to walk 80 miles?
What physiological implications would there be for a 9-month / heavily pregnant woman to ride on a donkey for 80 miles?

How likely would she be to:Go into
labour?
miscarry?

Would she be able to complete the journey without any such implications?

I hope you can help here.

Yours faithfully

Jonathan Pearce
(author of Free Will? and The Little Book of Unholy Questions)
Anonymous

Thank you for the brainstorming everyone… I struggle with this issue regularly as an atheist health care provider (in oncology/palliative care.) My thought this week is how to respond to a patient (a long-term followup, not an acutely ill or dying patient) who said to me: “I only want my doctors to be Christian, to have accepted Jesus into their hearts.” I shrugged it off with some nondescript, bland comment that I can’t even remember, and went about providing the same care I would provide to anyone. In afterthought, was my ignoring her statement unethical or immoral? Should I have fessed up and offered to transfer her to another practitioner? (I wonder if she realized my noncommittal stance and won’t return to me anyway.)
Industrial Training

Thank You

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Mot

T his is really sad. Only if you announce it yourself should others know of your religion. People want to keep things personal, and often an atheist doctor is more effective, if they don’t waste time on prayers and stuff.
Mike Stoltz

I have found that it is more reasonable to claim a belief in Taoism, whether I do or not. I have not really been questioned about it, because now I practice religion. Just not their religion, and the conversation and praying is null and void. Oddly Taoism truly does balance.