A faithful bedside manner

The question over employee-provided contraception has offered reporters many possible religion and health care angles, offering at least the concept that the two issues can sometimes collide.

For doctors who want to offer a comfortable bedside manner, it might be tricky to strike the right balance when it comes to faith. Earlier this month, Manya Brachear wrote a nice feature for the Chicago Tribune jumping off a new study of how doctors incorporate their own religious beliefs and discuss faith with patients.

After discovering that silence on matters of spirituality left some patients unsatisfied with the care they received at the University of Chicago, two doctors there and four faculty scholars chose to examine how some medical schools either encourage or discourage physicians to integrate their faiths in conversations with patients and their own professional lives. Doctors who set their faith aside, they say, can become disillusioned and less effective.

The piece explains the study’s findings while also uncovering the motivations of the doctors behind it.

Both Curlin and Dr. Daniel Sulmasy, an internist who also serves on the Presidential Commission for the Study of Bioethical Issues, said they believe that as the gap between health care and religion has widened, the quality of care for patients has diminished.

For Curlin, an evangelical Christian who also is a hospice and palliative care physician, the pursuit is a labor of love and a calling. For Sulmasy, a Catholic, it is an application of lessons learned as a medical ethicist who found that doctors were coming to him for help with existential dilemmas in addition to ethical ones.

Racked with guilt when they make a mistake, grief when they can’t heal a patient, and emptiness when they feel overworked and uninspired, doctors more often than not wrestle with whether it’s right to turn to their faith for comfort or clarification, Sulmasy said.

The thorough story includes a variety of voices, including evangelical, Catholic, Muslim, Jewish and Buddhist doctors, demonstrating different questions they face specific to their respective faiths.

Those who do publicly embrace religion feel alienated and alone, Curlin said.

Both men say policymakers and insurers have perpetuated that sense of alienation by treating health care as nothing more than a business. That has led some doctors to feel unfulfilled. Many seem to have forgotten the calling that led them to medicine, having been urged to abandon that way of thinking and focus on science, Sulmasy said.

Of course, not everyone thinks religious and medicine should mix, and the piece includes that side as well. It’s a nicely balanced piece that includes a variety of voices without making the distinctive faiths seem like they are one.

The study also led to a piece by Menachem Wecker for U.S. News & World Report that opens with an anecdote from when religion was an added benefit between a doctor-patient relationship.

When Hasan Siddiqi saw a patient wearing a head scarf, the fourth year medical student at University of Michigan—Ann Arbor wished her “Assalamu alaikum.” After returning the Arabic greeting, the patient—who, it turned out, attended the same mosque as Siddiqi—asked him about everything from the availability of halal food at the hospital to the proper times and direction to pray.

“That put her more at ease that there was someone at least familiar in this very strange environment,” says Siddiqi, a former president of Michigan’s Muslim Medical Students’ Association. “There was something extra that I had to offer, because I understood some of the rituals and the religious context.”

A head scarf can be an obvious clue, but the piece shows how doctors navigate figuring out whether someone’s religiosity such as a cross or religious leader at one’s side.

Doctors need to be cautious about bringing up religion in a hospital room, just as one does at the dinner table, Siddiqi says. But, he adds, connecting with patients on a variety of levels—including faith—can help physicians see their patients as people rather than as algorithms and can better appreciate the larger context of their ailments.

Connecting with patients on a faith level is something that researchers at the Pritzker School of Medicine at University of Chicago have also found to be important, though often ignored.

The story shows how doctor-patient relationships can form over theological identities.

Hospitals are also places where patients are vulnerable, so it’s inappropriate to missionize to them, Younus says. When one patient asked him for Islamic literature, he politely declined. “Once you’re well, we will get together,” he told the patient.

When he talks to Jewish patients, Zachary Epstein-Peterson, a student at the Medical School at Harvard University, anticipates discussing the Jewish tradition of viewing the “silver lining” in suffering.

If there was room for more, I’d be curious how doctors navigate sensitivities to potential religious opposition to specific treatments. I also wonder whether anyone has measured the level of religiosity among doctors and whether it’s higher or lower than the rest of the population. But both of these pieces give us a nice look that shows the benefits and challenges of faith in the field.

Image via Wikimedia Commons.

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  • Chris

    A nice article, that included more than one faith, as well as being balanced. If there had been more room, an additional topic would be the benefit of understanding the patient’s religion and its effect on end-of-life decisions and response to serious illness. These may be even more difficult when the patient and the physician have very different world views. Being able to identify other physician colleagues as having a specific “religious view” can be very helpful in terms of consultation–because they are experts about the medical issues. I had a specific experience, years ago, in receiving very helpful information from a colleague about the (to me, at the time!) irrational reactions of a patient who practiced Pentecostalism. His insights helped me solve the problem to the satisfaction of both the patient and myself.

  • Pamela Zohar

    Doctors should know more about various faiths, surely – but personally I do not want – let me emphasize that – I Do Not Want – a doctor who ‘shares’ his faith opinions with me. I want a good doctor, not an doctor-evangelist.

    Decent article, though. Maybe hospitals should have a designated consultant on faith/religious matters – for the doctors’ benefit!

  • Jerry N

    Dr. Sulmasy is a Catholic, and a Franciscan brother, too. I searched the text to be sure that “Franciscan” didn’t come up, and Firefox couldn’t find that term anywhere either. That is a big detail to miss.

  • sari

    Great article. Unbiased, well-researched, very well-balanced.

    I had the sense that the authors focused more on hospital docs, particularly ER, rather than internists, pediatricians, family physicians, etc. Many, many people use religion as one of their criteria when selecting their regular physician.

    Pam, I have nothing but good things to say about the hospital staff who worked with us after our son’s accident. They were extremely respectful of our religion and worked hard to accommodate our (especially his) religious needs while still providing the necessary care, despite our being Orthodox Jews and it being a Catholic hospital. In some ways, our being religious gave us more in common with the staff than nominally observant members of their own faith.

    Even though they were unfamiliar with our customs, they understood the idea of living within a G-d-given framework. One doctor took the initiative to prevent transport to the morgue, where the body would have lain overnight before the autopsy required for all traffic accidents. and ensured the the autopsy was cursory, non-invasive and with a shomer present. Instead, the hospital cleared out an unused room so that shomrim (watchers) could sit overnight with my son’s body–all this to conform to halakhah. The intensivists spent hours on the phone with different rabbinical experts to help us make end of life decisions (e.g., organ donation for a thirteen year old “adult” who had not left a will; defining what constituted death by both Jewish and secular law). Over the course of a very strenuous and horrible 24 hours, we got to know each other by sharing, not evangelizing.

    The article seemed to be more about doctors sharing in order to find a common ground with and reassure their patients than it was about evangelizing.

  • Pamela Zohar

    It was a good article. I said so.

  • Jerry

    I appreciate you picking this up, Sarah, as I was one of those recommending it. Stories like this one are very important because, sooner or later, we’ll be interacting with a doctor and probably a hospital. Thus if the medical profession approaches the religious needs of patients with carefulness and understanding, it directly impacts millions of people.

  • Julia

    Also – kudos to you for using the Rod of Asclepius as the proper medical insignia instead of the caduceus which the military somehow decided to use for the medical corps.

    Compare & contrast:

    http://en.wikipedia.org/wiki/Rod_of_Asclepius

    http://en.wikipedia.org/wiki/Caduceus_as_a_symbol_of_medicine

  • http://www.usnews.com/topics/author/menachem_wecker Menachem Wecker

    Thanks for linking/citing my piece!


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