CHICAGO – As a medical student, Dr. Julie Oyler was told to remove the cross she wore on the lapel of her white coat. As a resident, Dr. Aasim Padela was told he wouldn’t have time to recite Islam’s five daily prayers. But ignoring God was not an option for Oyler, an evangelical Christian, and Padela, a Muslim. Nor should it be, according to researchers at the University of Chicago, where both doctors now freely practice their medical specialties and religious traditions.
After discovering that silence on matters of spirituality left some patients unsatisfied with the care they received at the University of Chicago, two doctors there and four faculty scholars have chosen to examine how some medical schools either encourage or discourage physicians to integrate their faith both in conversations with patients and their own professional lives. Doctors who set their faith aside, they say, can become disillusioned and less effective.
“When doctors are dispirited, the care they give to patients is worse,” said Dr. Farr Curlin, co-director of the Program on Medicine and Religion. “Patients should be very hopeful that their doctor sees their work as a remarkable privilege, even a holy privilege, that will make the doctor respond to that patient out of joy.”
Both Curlin and Dr. Daniel Sulmasy, an internist who also serves on the Presidential Commission for the Study of Bioethical Issues, said they believe that as the gap between health care and religion has widened, the quality of care for patients has diminished.
For Curlin, an evangelical Christian who also serves as a hospice and palliative care physician, the pursuit is a labor of love and a calling. For Sulmasy, it is an application of lessons learned as a medical ethicist who found that doctors were coming to him for help with existential dilemmas in addition to ethical ones.
Racked with guilt when they make a mistake, grief when they can’t heal a patient, and emptiness when they feel overworked and uninspired, doctors more often than not wrestle with whether it’s right to turn to their faith for comfort or clarification, Sulmasy said.
“We can talk to people about their sexual practices, but not about their own spirituality, and certainly not talk to another clinician about his or her own spirituality,” he said. “In prehistoric times, the role of the healer and the priest were one and the same. We don’t want to go back to that. But we’ve encountered a situation in that they are so radically separated that physicians think religion has no role.”
Those who do publicly embrace religion feel alienated and alone, Curlin said.
Both men say policymakers and insurers have perpetuated that sense of alienation by treating health care as nothing more than a business. That has led some doctors to feel unfulfilled. Many seem to have forgotten the calling that led them to medicine, having been urged to abandon that way of thinking and focus on science, Sulmasy said.
For many, that repression of faith begins in basic training when medical students are typically pressured to set their lifelong beliefs aside and focus on objective science. Oyler, a primary-care physician at the University of Chicago, said she felt uncomfortable sharing her faith for years after she was reprimanded as a medical student for wearing a cross on her white coat.
While she still doesn’t advertise her evangelical Christian faith to patients, she does establish during the initial appointment what role religion plays in her patients’ lives, in case that becomes the basis for decisions they make over time. If the person shares her Christian faith, she lets them know they have something in common.
Though the American Medical Association has no policy encouraging or discouraging a separation of church and medicine, the Joint Commission accrediting agency for health care institutions requires medical professionals to receive training in spiritual care.
Richard Sloan, professor of behavioral medicine at Columbia University and author of “Blind Faith: The Unholy Alliance of Religion and Medicine,” argues that only a chaplain should bring up religion. Doctors should avoid the risk of patients making health decisions based on their caregiver’s beliefs instead of sound medical advice, he says.
Curlin said it is important to let the patient take the lead to avoid the appearance of proselytizing.
Curlin and Sulmasy secured a $2 million grant to fund four faculty scholars including Padela. An assistant professor of general internal and emergency medicine at the University of Chicago, Padela will explore the challenges facing American Muslim doctors like himself.
Incorporating his Muslim faith gives him peace of mind when it comes to providing emergency care and comfort for patients, he said.