Addressing Spirituality and Religion in Health Care Delivery: Comparing Provider and Patient Perspectives at the University of Michigan Nadia Sebastian Kettinger, MD, PhD, University of Michigan
Spirituality and religion play an important role in health and the experience of illness for many individuals. Multiple studies have indicated that a large portion of patients desire to discuss their spiritual concerns with their healthcare providers. However, these issues often remain unaddressed. Physicians have reported feeling uncomfortable with and unprepared for addressing religious and spiritual concerns with patients. Some physicians believe that discussions involving religion and spirituality may not be appropriate in the clinical encounter. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), however, requires that a spiritual assessment be incorporated into healthcare. Additionally, a 2011 study of over 3,000 inpatients at the University of Chicago found that focusing on a patient’s spiritual concerns increases overall satisfaction with their care.
To assess current attitudes and practices at the University of Michigan, we conducted electronic surveys of patients and their family members in the Patient and Family Centered Care (PFCC) program, along with a separate survey of physician faculty members from various clinical departments at Michigan Medicine. Of the 200 patient/family member respondents, we found that 66% of patients would like their doctor to be aware of their religious/spiritual beliefs and over 47% would like their physician to ask them about their religious/spiritual beliefs in a routine visit. In comparison, from our 260 faculty physician respondents, 10% indicated that they often or always ask patients about religious/spiritual beliefs in their practice and only about 50% feel comfortable taking a spiritual history. These results along with additional analyses indicate that there are opportunities in our health system and likely others for improving physician-patient encounters and patient satisfaction with addressing religious and spiritual issues related to patient health. Additionally, we hope to use our survey data to form educational initiatives for faculty and trainees to be better equipped to incorporate spiritual assessment into their clinical practice.