Beyond the Chart
A growing number of physicians are asking patients about their spiritual needs.
by Violet Snow
The best physicians have always known that patients are people with emotions and spirits as well as bodies and minds. But for years, a gulf existed between scientific medicine and consideration of a patient’s spiritual life.
Today, even in an era of MRIs and robotic surgery, the medical profession has come to acknowledge that spirituality can play a role in healing. Physicians make an effort to engage their patients’ religious beliefs, and medical schools teach the importance of acknowledging spiritual needs. Some doctors find that their own beliefs help them connect to their clients.
“Because of the emphasis on science and tangible factors that we can measure through studies and lab tests, we’ve neglected the more ineffable parts of a person,” says Karen Wyatt, MD, a family practitioner in Silverthorne, Colorado. “For me, I’ve always believed the spiritual aspect of a person has an impact on their health.”
Addressing Patient Needs
Working in hospice care led Wyatt to consider the spirituality of her patients. “I saw that love, forgiveness and having a purpose were so important at the end of life,” she notes. “It made me realize that by not addressing those issues with families, I was leaving out something important.”
During intake interviews, along with requesting information on exercise and dietary habits, Wyatt began to ask her patients if they had any religious or spiritual practices. “It was that simple, but it became an important tool for me,” she recalls. “If I learned prayer was important to someone, I’d suggest, ‘That’s something you could pray about.’”
Wyatt found that once her patients learned she was open to talking about spiritual issues, they were eager to discuss their search for meaning and the role their illness might play in that search. “I saw people finding a new perspective, using illness as a catalyst for examining themselves, deciding to make changes in their lives. They would say, ‘I never thought I could talk to a doctor about this.’ My role was to be a listener. I would never impose any of my own beliefs.” As she inquired about her patients’ spirituality, Wyatt found her practice became more gratifying, as she connected to them on a deeper personal level.
In some cases, addressing spiritual questions in a person’s life actually makes Wyatt’s work more efficient.
“We can get right to the issue that’s underlying the patient’s concern, tying together aspects of their life,” she says. “They might have high blood pressure from drinking too much, and they might be drinking because of never healing from an abusive childhood. Instead of covering high blood pressure in one session and drinking in another, we pull all the pieces of the person together and find a pathway through it.”
The effects of prayer on healing were studied in a double-blind research project at Duke University, where some patients undergoing cardiac procedures were prayed for by others and other patients weren’t. As reported in The Lancet, immediate outcomes in both groups were not dramatically different. However, the re-hospitalization rates and number of deaths six months after surgery were about 30% lower in the group that received prayer.
The results of the research at Duke impressed Kevin Campbell, MD, a cardiologist and professor at the University of North Carolina in Chapel Hill. “When I have patients who have spiritual beliefs, if the family wants to say a prayer before going into the operating room, I’ll participate,” said Campbell. “It’s important for patients to know their caregiver buys into their belief system. It gives them a positive outlook and a good feeling about what’s going to happen to them.”
Campbell believes that when patients have faith in a higher power, they worry less and produce lower levels of stress hormones, enabling the body to perform better. When there’s an adverse outcome, spirituality can be important in helping the family cope.
Campbell finds that his own spiritual background makes him especially sympathetic to his patients’ beliefs. “I’m a practicing Catholic,” he explains. “I was raised Baptist, and I married a woman whose mother is Catholic and whose father is Jewish, so I’m fairly spiritually well-rounded. If my patient is Buddhist or Hindu, I’m supportive and careful not to pigeonhole them or force them to think as I do.
Whatever they need, I try to participate.”
At Greenwich Hospital in Greenwich, Connecticut, all patients are asked if they would like to meet with a chaplain or priest during their stay. Three years ago, the hospital instituted Spirituality in Medicine Rounds for staff and medical students, delving into emotional aspects of patient care. “We wanted doctors to get to know the patients, not just the diseases,” says Stephen Jones, MD, who works at the hospital and teaches at Yale School of Medicine. “As a result, physicians started looking at their own belief systems and humanness. The conversations we had during these rounds became open, tearful and sharing.”
“If we see people have strong religious beliefs, that’s a vehicle to help heal them,” Jones says. “Prayer is a powerful thing.”