To the extent that patients' religious characteristics are similar to those of the general population, this study suggests ways in which physicians are likely to differ from those for whom they provide care. Physicians and population members are equally likely to have some religious affiliation, but physicians are much more likely to belong to religious traditions that are underrepresented in the United States. Physicians are more likely than population members to attend religious services regularly, but less likely to consciously make efforts to apply their religious beliefs to other areas of life. Physicians are more likely to describe themselves as “spiritual” as distinct from religious, whereas for the general population, spirituality and religion appear to be more tightly connected. Finally, our data suggest that patients and physicians are likely to differ in their reliance upon God as a means of coping and making decisions in the context of major illness. While most patients will “look to God for strength, support, and guidance,” most physicians will instead try to “make sense of the situation and decide what to do without relying on God.” How such differences shape the clinical encounter is unknown.
We found that Jewish, Hindu, and Muslim physicians in the United States are only about half as likely as those with Christian affiliations to say that they try to carry their religious beliefs into other dealings in life. This may be more of a methodological limitation than a real-world phenomenon. That is, the apparent incongruity between religious affiliation and intrinsic religiosity
among Jewish, Hindu, and Muslim physicians may simply be a reflection of survey measures that are inadequate to tap religiousness in these traditions,31
or may reflect the overrepresentation of secular members in some traditions relative to others. That said, it may also be that in a culture where Christians make up the large majority of both physicians and patients, physicians from underrepresented religious traditions find it more difficult to live out their religious commitments publicly. Or perhaps, physicians of underrepresented traditions take pains to limit the overt influence of their religious commitments in recognition of the discordance between their own religions and those of their patients. In the end, further study is required to understand the roots of these findings.
This study confirms Daaleman and Frey's20
finding that family physicians are comparable to the general population with regard to religious characteristics, and Frank et al.'s21
finding that family physicians and pediatricians are generally more religious than physicians from other specialties. Our finding that psychiatrists are among the most secular physicians is also consistent with earlier studies.21,32–34
These relationships between religiosity and clinical specialty deserve further exploration.
Prior research has found religious variables to be associated with different practices regarding euthanasia and physician-assisted suicide,35–39
writing “do not resuscitate” orders,40
initiation and withdrawal of life-sustaining therapies,40,41
prescription of birth control,42
Yet, apart from these areas of overt moral controversy, little is known about the ways in which physicians' religious commitments “affect the ways they relate to, and provide care to, patients.”17
The cultural competency literature has emphasized how commonly discordance in values may arise between the physician and patient, but by most accounts the source of the discordance is assumed to be the diverse cultures and values of patients. Physicians are presented as more or less generically shaped by the prevalent medical culture.8,10,11
Our data suggest that such conceptualizations may inadequately account for the diversity of values that physicians bring to clinical encounters, at least to the extent that such values are shaped by religion. Empirical studies of the connections between religious commitments and the care of patients may provide data that will help to foster the self-awareness in physicians for which many medical educators and policy makers hope.17