The “Good” Physician: Role Perceptions, Belies, and Patient Interactions
Aaron Franzen, PhD., Assistant Professor, Sociology, Hope College
Shannon Moloney, Undergraduate Student, Hope College
When sick, patients understand their conditions in the terms of their everyday experiences. How normal rhythms are impacted, interrupted or disturbed. Religion, for many, plays an integral role in making sense of experiences, but processes of healing often do not include these meaning making structures such as religious beliefs. This potentially hinders patients’ healing processes or at least their experiences with healthcare. Over the years, research has shown that patients would like their physicians to ask about or at least be aware of their religious/spiritual beliefs (Ehman et al. 1999). Physicians, however, tend to deemphasize religion in their patient interactions even while agreeing on the potential importance (Armbruster, Chibnall, and Legett 2003). This project looked at the relationship between a physician’s personal beliefs and values and their professional beliefs and values in an attempt to understand how or when physicians’ personal beliefs influence or overlap with their professional beliefs and values. What do they think they ought to be doing, and is this patterned by their personal beliefs?
Using snowball sampling, we interviewed seventeen physicians practicing in southwest Michigan. Our sample was 70% male, 25% primary care, and 94% Protestant Christian and 54% reported to attending religious services at least weekly. The interviews were semistructured, roughly built around three guiding questions:
1) What does a “good” doctor do?
2) How did you come to form this perception?
3) Have your personal beliefs or values influenced your perception of what a “good” doctor does?
Following the interviews, the physicians completed questionnaires to collect data on their medical specialty, years in practice, and religious/spiritual orientation. The interviews were transcribed and then coded for themes.
Nearly all respondents reported two key dimensions for “good” physicians – 1) technical skills, and 2) attitude, motivation or relational skills. While beliefs and values almost never came up at the beginning of the interviews, most physicians could articulate how their own beliefs or values influenced the attitudinal/relational dimension of medical care, forming a foundation for these professional values. Specifically, the values most directly related to this dimension included an overarching service orientation and willingness to sacrifice for patients, an increased focus on the personhood of patients, and at times a desire to individualize treatment plans and to address the emotional and spiritual health of patients.
Moreover, respondents’ personal beliefs and values also seemed to influence the stability of physician’s identity as physician. In particular, they spoke of a more unified identity (little to no separate “personal” and “professional” persona), and having an emotional buffer with which to cope with the professions’ pressures.
While we did find general trends, personal-professional connections are unique and nuanced, highlighting the complexity amongst physicians regarding perceptions of professional performances and duties. This project lays groundwork for a quantitative follow-up. It is important to understand not only these complexities but the formation of them. They are tied to perceptions of what “good” physicians do, and as a result influences perceptions of relevance that guide interactions with patients.
Shannon Moloney, Undergraduate Student, Hope College
When sick, patients understand their conditions in the terms of their everyday experiences. How normal rhythms are impacted, interrupted or disturbed. Religion, for many, plays an integral role in making sense of experiences, but processes of healing often do not include these meaning making structures such as religious beliefs. This potentially hinders patients’ healing processes or at least their experiences with healthcare. Over the years, research has shown that patients would like their physicians to ask about or at least be aware of their religious/spiritual beliefs (Ehman et al. 1999). Physicians, however, tend to deemphasize religion in their patient interactions even while agreeing on the potential importance (Armbruster, Chibnall, and Legett 2003). This project looked at the relationship between a physician’s personal beliefs and values and their professional beliefs and values in an attempt to understand how or when physicians’ personal beliefs influence or overlap with their professional beliefs and values. What do they think they ought to be doing, and is this patterned by their personal beliefs?
Using snowball sampling, we interviewed seventeen physicians practicing in southwest Michigan. Our sample was 70% male, 25% primary care, and 94% Protestant Christian and 54% reported to attending religious services at least weekly. The interviews were semistructured, roughly built around three guiding questions:
1) What does a “good” doctor do?
2) How did you come to form this perception?
3) Have your personal beliefs or values influenced your perception of what a “good” doctor does?
Following the interviews, the physicians completed questionnaires to collect data on their medical specialty, years in practice, and religious/spiritual orientation. The interviews were transcribed and then coded for themes.
Nearly all respondents reported two key dimensions for “good” physicians – 1) technical skills, and 2) attitude, motivation or relational skills. While beliefs and values almost never came up at the beginning of the interviews, most physicians could articulate how their own beliefs or values influenced the attitudinal/relational dimension of medical care, forming a foundation for these professional values. Specifically, the values most directly related to this dimension included an overarching service orientation and willingness to sacrifice for patients, an increased focus on the personhood of patients, and at times a desire to individualize treatment plans and to address the emotional and spiritual health of patients.
Moreover, respondents’ personal beliefs and values also seemed to influence the stability of physician’s identity as physician. In particular, they spoke of a more unified identity (little to no separate “personal” and “professional” persona), and having an emotional buffer with which to cope with the professions’ pressures.
While we did find general trends, personal-professional connections are unique and nuanced, highlighting the complexity amongst physicians regarding perceptions of professional performances and duties. This project lays groundwork for a quantitative follow-up. It is important to understand not only these complexities but the formation of them. They are tied to perceptions of what “good” physicians do, and as a result influences perceptions of relevance that guide interactions with patients.