Monday Memo — Integrating Spirituality into Practice

Long-time readers know that the integration of spiritual faith into medical practice has been a subject of my writing and teaching for over two decades. Therefore, I was intrigued when I came across a blog on the topic by Robert E. Cranston, MD, MA (Ethics). I was also grateful to have been mentioned in the blog. See what you think:

Robert E. Cranston, MD, MA (Ethics)

Dr. Farr Curlin, an alumnus member of CMDA’s Ethics Committee, has researched and written extensively regarding the religious commitments of physicians and the impact on their clinical practices in a pluralistic society. Dr. Curlin and his colleagues published a paper in 2007 in The New England Journal of Medicine titled “Religion, Conscience and Controversial Clinical Practices.”

In an earlier article published in Medical Care in 2006Curlin and colleagues conducted a cross-sectional mail survey of 2,000 doctors and demonstrated that most physicians “believe it is appropriate to discuss religious/spiritual issues when a patient brings them up, at which point the great majority say they encourage their patients in their own (the patients’) religious/spiritual beliefs and practices.”

Recently, Koenig, Perno and Hamilton, writing in the January 2017 issue of Southern Medical Journal, performed a survey of outpatient medical personnel in the Adventist Health System. They processed answers from 432 doctors, 88 mid-level practitioners, and 217 nurses and other staff members regarding their attitudes and behavior about spiritual interactions with patients.

Some of their results were in line with Dr. Curlin’s previous findings, but a few other findings were new.

The Adventist Health System “has 46 hospital campuses in the U.S. … is the largest Protestant healthcare system in the country, and is the fifth largest nonprofit hospital system.” Many, but not all physicians and employees in the Adventist Health System (AHS) are members or attenders of the Seventh-day Adventist Church.

Similar to Curlin’s findings, the vast majority of healthcare professionals believed that if requested by the patient, the healthcare professional should pray with patients, though in the AHS, a significantly higher percentage felt this was true—53 percent in Curlin’s wide physician sample versus 72 percent in the AHS physician group.

Almost 50 percent of the doctors and staff in the AHS system affirmed they encourage greater religious activity among patients for health reasons. Adventist doctrine prohibits ingestion of “unclean” animals, abstention from alcohol, tobacco or recreational drugs and encourages a vegetarian diet. Thus, these religious tenets, while part of the church beliefs, also would be likely to improve health in most patients.

Curlin’s and Koenig’s surveys both showed that healthcare professionals who were ranked higher in respect to their religiosity were most likely to discuss spiritual issues and pray with patients.

The most interesting finding to me was that even in a faith-based healthcare system, “93.3% of providers and staff had little or no training in how to navigate religious issues with patients … the strongest and most consistent predictor of current activity (in this process) was self-related religiosity.”

And that’s where The Saline Solution (and now Grace Prescriptions) comes into play in helping healthcare professionals incorporate spiritual care into their practices. Originally written by William C. Peel, DMin, and Walt Larimore, MD, in the early 1990s, this program from CMDA is reaching thousands and thousands of healthcare professionals in both a live seminar format and a video series available for home and group study.

Grace Prescriptions is designed to teach you to share your faith with patients in ways that safeguard the important ethical principles of respect, sensitivity and permission. Originally taught in CMDA’s popular Saline Solution course, these concepts are proven to be effective as thousands of lives have been transformed.

The basic proposition of Grace Prescriptions is that many patients are waving “faith flags” to their healthcare professionals, letting them know they have religious beliefs or religious questions and would welcome some interaction with their healthcare professionals around these sensitive areas.

If the flags are recognized, the professional can gently probe and engage their patients in dialogue about them.

Our over-secularized healthcare world has intimidated many spiritually-focused caregivers from opening the door to these discussions, but as noted by Curlin, et al, “data suggests that for many patients, religious/spiritual concerns are a prominent part of the experience of their illness.”

We are all physical/spiritual creations. To ignore this fact does our patients a grave disservice.

Are you one of the vast majority of healthcare professionals who have had little training in sharing their faith? There is a solution for that: Grace Prescriptions. For more information, visit www.cmda.org/graceprescriptions.

I’d be interested in your thoughts!