Survey shows doctors' religious stance

Illinois internist Craig Backs, MD, is a man of medicine and faith. He attends church service every chance he gets and is active in his Lutheran congregation. Sometimes in the exam room, he draws on his faith to reassure patients who become distressed about a health issue.

"Sharing one's religious perspective can open a dialogue with some patients," said Dr. Backs, who practices in Springfield, Ill., and is president of the Illinois State Medical Society. "With a few exceptions, most physicians practice in a way that reflects a concern for the common man, which comes from many religious traditions."

Nationwide, 76% of physicians believe in God and 59% believe in an afterlife. Physicians are more likely to attend religious services than the U.S. population in general, according to the study in the July issue of the Journal of General Internal Medicine.

Researchers who surveyed 1,144 physicians nationwide were surprised that so many doctors were religiously inclined. That's partly because past research has shown that religious belief tends to decrease as education and income levels increase. And some physicians say science and faith should stay separate.

"The conventional wisdom has been that doctors are much less religious than their patients," said Farr Curlin, MD, lead author of the study and assistant professor of general internal medicine at the University of Chicago.

Dr. Curlin said people who combine an aptitude for science, an interest in religion and an affinity for public service are particularly attracted to medicine.

The University of Chicago and its researchers said they believe the new physician survey is the first of its kind to examine physicians' religious beliefs on this scale and compare those beliefs with the U.S. population.

Physicians across the nation were randomly mailed 12-page questionnaires. The results were compared with the 1998 General Social Survey, which sampled U.S. households.

Fifty five percent of physicians said their religious beliefs influenced their medical practice. The survey found that 90% of doctors attend religious services at least occasionally, compared with 81% of adult Americans.

Diversity of faiths

Physicians have more diverse religious backgrounds than the general public. While 80% of the population is Protestant or Catholic, 60% of doctors belong to either group.

Physicians are 26 times more likely to be Hindu, seven times more likely to be Jewish and five times more likely to be Muslim than the general population. Dr. Curlin said international medical graduates could account for some of the difference.

Family physicians and pediatricians are more religious than doctors in other specialties, and psychiatry is among the most secular specialties.

Family physician Michael Augustson, MD, of Beaver Dam, Wis., a Methodist, prays with patients on occasion.

"As long as I pick the right time and ask their permission, they typically receive it well," said Dr. Augustson, who is also medical director of a faith-based clinic.

But the survey shows that doctors are less religious than the population in several ways. They are less likely to try to carry their religious beliefs into all other dealings in life. They are twice as likely to cope with major problems without relying on God. And more doctors consider themselves spiritual but not religious when compared with the population.

"Now it's time we examine how these different beliefs and traditions influence how doctors practice," said Dr. Curlin, who plans to study the issue.

Some experts say physicians don't know if it's appropriate to incorporate their faith into their practice. They also might be unsure whether they should address the topic of their patients' beliefs. Part of the reason may be lack of training on the best way to start such a discussion.

"Most physicians have not been trained to address these issues, so they don't consider it part of their work. They keep these areas separate in their lives," said Harold G. Koenig, MD, professor of psychiatry and behavioral sciences at Duke University Medical Center, who has done 25 studies on links between faith and medicine.

Although the study found that many physicians professed a belief in a higher power, 11% of doctors said they had no religious affiliation or considered themselves atheist or agnostic.

New York City psychiatrist Samuel L. Sharmat, MD, said some physicians are less religious because of experiences they've had. "Seeing people die on operating tables makes you wonder what all the effort in organized religion is for," Dr. Sharmat said.

But internist Dan Edney, MD, of Vicksburg, Miss., said he likes to think God plays a role in healing. He runs a faith-based clinic that provides care to the uninsured and goes on medical missions abroad to give care to the needy. The Southern Baptist is vigilant, however, not to preach or push his religion on any patients.

"I'm very, very careful and sensitive about that," he said.

Springfield, Pa., retina surgeon Leonard H. Ginsburg, MD, who is Jewish, said the faith and medical communities in the Philadelphia area are working together in a program in which medical students and physicians go into houses of worship and other locations to provide health screening and educational programs. The medical awareness and assistance program is intended to promote good health.

"There is much more to a human being than what's in science," said Dr. Ginsburg, chair of the Moore Eye Institute. "We, like a minister, have tremendous influence over a patient's life."