Should Healthcare Professionals Care About Their Patients’ Spirituality?

Here’s a column I wrote for a national magazine that was not accepted for publication. But, I’m hoping you’ll find it a blessing. In the last few years there has been an explosion of articles and studies in the medical literature about healthcare professionals inquiring about and attending to the spiritual needs of their patients. For example, one research team recently studied patients with cancer and concluded their “spiritual needs … should be recognized, realized, and considered … by the medical team.”

I hadn’t been in the practice of family medicine for very long before I began to inquire about my patients’ spiritual beliefs. I was not taught how during my training at the Duke University Medical Center; however, in practice one soon becomes aware that most patients, at least when confronted with serious illness, begin to wonder about spiritual things—even eternity itself. So, I read some articles, talked to other physicians, and then began to, as part of my routine social history (where I would inquire about work, family, alcohol and tobacco use, habits and hobbies), to inquire about my patient’s spiritual beliefs. Initially, I was worried that patients might be concerned about these sorts of “personal” questions, but the exact opposite occurred. Most seemed pleased that I asked and was interested.

In fact, the only opposition in those early years came from some so-called experts in the ivory towers of academic medical schools. One, when asked by a national magazine, “So doctors should not be taking spiritual histories?”, quite matter-of-factly opined, “I don’t think they should.”

But I continued. And, I learned some amazing things: My patients would open up about their spiritual or religious background or concerns; they would explain beliefs or practices that comforted them or helped them cope with their illness; and they would confess religious thinking or beliefs that were causing them distress. Some would share the beliefs they had that could actually influence or conflict with my medical recommendations. Those in faith communities would tell me whether they were supportive and encouraging or cantankerous and obstreperous.

Quite simply, without my opening the “spiritual” door—by asking these questions—there are very few patients who would have ever shared any of these things. And because they opened up about their spiritual needs or concerns, I was either able to help or, more often than not, connect them with a pastoral professionals for assistance.

It turns out that the research over the last decade has confirmed my experience. One researcher wrote, “In general, the public appears to view and value spirituality as a central factor of life … especially when they are facing illness and … desires healthcare professionals to inquire about beliefs that are important to them.” Another explained, “Studies have shown that (up to) 90% of patients want physicians to address their spiritual needs.” The vast majority of experts seem to agree that, “Assessing and integrating patient spirituality into the healthcare encounter can build trust and rapport, broadening the physician-patient relationship and increasing its effectiveness.”

No less a force in modern healthcare than the Joint Commission recommends a spiritual assessment for every patient upon admission to the hospital, which “should, at a minimum, determine the patient’s denomination, beliefs, and what spiritual practices are important to the patient.” Why? They explain: “This information would assist in determining the impact of spirituality, if any, on the care/services being provided and will identify if any further assessment is needed.”

My professional predecessors understood the intersection of faith and medicine all to well. For example, Sir William Osler, MD, while a professor at John Hopkins wrote at the turn of the 20th century, “Nothing in life is more wonderful than faith… the one great moving force which we can neither weigh in the balance nor test in the crucible … mysterious, indefinable, known only by its effects, faith pours out an unfailing stream of energy while abating neither jot nor tittle of its potence.”

Arthur Kornhaber, MD, while at Harvard, and when interviewed by Newsweek near the end of the 20th century, said, “To exclude God from a medical consultation is a form of malpractice. Spirituality is wonder, joy and shouldn’t be left in the clinical closet.”

And just over a decade ago, in a review article for a medical publication, I wrote, “The current evidence would encourage interested physicians, health-care providers and systems to learn to assess their patients’ spiritual health and to provide indicated and desired spiritual intervention. Clinicians should not, without compelling data to the contrary, deprive their patients of the spiritual support and comfort upon which their hope, health and well being may hinge.”

As one old pastor told me, “There’s a distance between the pulpit and the pew that does not exist at the bedside.” When it comes to the physician-patient relationship, nothing could be closer to the truth.

Walt Larimore, MD, is a family physician and author in Colorado.

© Copyright WLL, INC. 2015. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.

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