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Original Investigation
December 8/22, 2003

Primary Care Physician Preferences Regarding Spiritual Behavior in Medical Practice

Author Affiliations

From the Department of Internal Medicine, Carolinas Medical Center, Charlotte (Drs Monroe and Susi), Wake Medical Center, Raleigh (Dr Bynum), Moses Cone Hospital, Greensboro (Drs Phifer and Cykert), Brody School of Medicine at East Carolina University, Greenville (Dr Franco), and The University of North Carolina at Chapel Hill School of Medicine (Dr Garrett), NC; Emory University School of Medicine, Atlanta, Ga (Dr Schultz); and University of Vermont College of Medicine, Burlington (Dr MacLean). The authors have no relevant financial interest in this article.

Arch Intern Med. 2003;163(22):2751-2756. doi:10.1001/archinte.163.22.2751

Background  Knowledge of physician attitudes and preferences regarding religion and spirituality in the medical encounter is limited by the nonspecific questions asked in previous studies and by the omission of specialties other than family practice. This study was designed to determine the willingness of internists and family physicians to be involved with varying degrees of spiritual behaviors in varied clinical settings.

Methods  The study was a multicenter, cross-sectional, nonrandomized design recruiting physicians from 6 teaching hospitals with sites in North Carolina, Vermont, and Florida. A self-administered survey was used to explore physicians' willingness to address religion and spirituality in the medical encounter. Data were gathered on the physicians' religiosity and spirituality and sociodemographic characteristics.

Results  Four hundred seventy-six physicians responded, for a response rate of 62.0%. While 84.5% of physicians thought they should be aware of patients' spirituality, most would not ask about spiritual issues unless a patient were dying. Fewer than one third of physicians would pray with patients even if they were dying. This number increased to 77.1% if a patient requested physician prayer. Family practitioners were more likely to take a spiritual history than general internists.

Conclusions  Most primary care physicians surveyed would not initiate any involvement with patients' spirituality in the medical encounter except for the clinical setting of dying. If a patient requests involvement, however, most physicians express a willingness to comply, even if the request involves prayer.