Tuesday, July 31, 2007

Religious Doctors Less Likely to Serve Poor

In the July/August issue of the Annals of Family Medicine, researchers from the University of Chicago and Yale New Haven Hospital report that religious physicians are less likely than non-religious physicians to serve the poor:

Although most religious traditions call on the faithful to serve the poor, a large cross-sectional survey of U.S. physicians found that physicians who are more religious are slightly less likely to practice medicine among the under-served than physicians with no religious affiliation.

In the July/August issue of the Annals of Family Medicine, researchers from the University of Chicago and Yale New Haven Hospital report that 31 percent of physicians who were more religious--as measured by "intrinsic religiosity" as well as frequency of attendance at religious services--practiced among the under-served, compared to 35 percent of physicians who described their religion as atheist, agnostic or none.

"This came as both a surprise and a disappointment," said study author Farr Curlin, MD, assistant professor of medicine at the University of Chicago. "The Christian, Jewish, Muslim, Hindu and Buddhist scriptures all urge physicians to care for the poor, and the great majority of religious physicians describe their practice of medicine as a calling. Yet we found that religious physicians were not more likely to report practice among the under-served than their secular colleagues."

. . .

To find out which religious, spiritual and personal factors were most often present in doctors who care for the under-served, Curlin and colleagues surveyed 1,820 practicing physicians from all specialties; 1,144 (63%) responded.

The survey contained questions about what the researchers called intrinsic religiosity--the extent to which individuals embrace their religion as the "master motive that guides and gives meaning to their life." Physicians were asked if they agreed or disagreed with two statements: "I try hard to carry my religious beliefs over into all my other dealings in life," and "My whole approach to life is based on my religion." They were also asked how often they attended religious services.

The survey also included questions about whether the physicians considered medicine a calling, whether their religious beliefs influence their practice of medicine, and whether the family in which they were raised emphasized helping those with few resources.

The researchers found that 26 percent of physicians reported that their patient populations are considered under-served. These physicians tended to be younger and were more likely to report working in an academic health center and receiving loan repayment in exchange for working where they do. Physicians who receive educational loan repayment are often obliged to work in under-served communities.

Physicians who strongly agreed that their religious beliefs influence their practice of medicine were more likely to report practice among the under-served. However, physicians who were more religious in general (as measured by their intrinsic religiosity or their frequency of attending religious services) were not more likely to practice among the under-served. Even the more religious physicians who reported that their families emphasized service to the poor and that, for them, the practice of medicine was a calling, were no more likely to practice among the under-served.

Curlin and colleagues also noted that those who identified themselves as very spiritual, whether or not they were religious, were roughly twice as likely to care for the under-served as those who described their spirituality as low. "Part of this divergence between religion and spirituality can be traced to a rift between Christian denominations in the late-19th and early-20th centuries," explained Curlin, who describes himself as an orthodox Christian in the Protestant tradition.

About a hundred years ago, he said, many of the mainline and liberal Protestant churches began "to emphasize efforts to right social injustices, while the more conservative churches tended to stress doctrinal orthodoxy. Research indicates that those who consider themselves spiritual but not so religious are more likely to be formed in the more liberal denominations."

Read it all here.

While the headline of the study--that more religious doctors are less likely to serve the poor is troubling, I think that the more interesting data is buried in the text of the study. Those who specifically state that their faith requires them to act in the world will be more likely to serve the poor. I suggest that the study is identifying the reality that many Christian churches are, at best, only giving lip service to service to the poor. And it is no surprise that doctors who attend these churches do not get the message that service is important.

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