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UB physician urges doctors to talk about faith
By KEVIN FRYLING
Reporter Staff Writer
A movement is gaining momentum in modern medicine—whole person health care—that expands the definition of health beyond the physical to include social, psychological and spiritual well-being.
The spiritual aspect of this debate was discussed Aug. 3 in the most recent UBThisSummer lecture, "Spiritual Dimensions of Healing."
"We have a long tradition regarding faith and health," said David Holmes, clinical assistant professor in the Department of Family Medicine, School of Medicine and Biomedical Sciences, and president of the Christian Medical and Dental Association of Western New York.
Holmes explained that present religious-affiliated hospitals, including Western New York's Catholic Health System, trace their tradition back to the Eastern Orthodox Church's establishment of the first western hospital in 307 A.D.
Yet, modern scientific and technical advances in medicine have caused a sea of change in the historical connection between faith and medicine, said Holmes. He pointed out that the creation of Medicaid lowered health care on the list of priorities of churches and other faith-based organizations, whose focus shifted to other subjects.
"For years it was considered unethical to address faith issues in a health-care setting," he said. "But the pendulum is swinging back." Like taboos regarding sexual health that were broken in the 1970s, Holmes said research on the benefits of faith in health care have emboldened providers to broach a new, personal topic with their patients.
Physicians should not push patients who seem uncomfortable with the subject of faith, he said, but added that studies suggest that two-thirds of Americans want their doctors to speak to them about religion. A recent Gallup Poll revealed that 10 percent of doctors include faith as part of their bedside manner.
The trend toward whole person heath care is in motion, said Holmes, noting the practice has caught on with nurses and that hospice does a "wonderful job" with the model.
He also pointed out the hospital accreditation organization JCAHO requires health-care providers to ask patients about their religious denomination and spiritual beliefs and practices.
In his upper-level course, "Faith, Medicine and End-of-Life Care," Holmes instructs medical students on the various religions represented in Buffalo and teaches them to talk about faith with their clients in a sensitive and appropriate manner. One practical reason it's important to ask patients about their faith is that religious practices sometimes prohibit certain medical actions, said Holmes. For example, Sikhs cannot cut their hair for religious reasons, which turns shaving a surgical patient whose faith is unknown—common prep-room practice that in most cases is not crucial to the procedure—into a potential religious offense. Other religious practices, such as Jehovah's Witnesses refusing blood transfusions, create wider repercussions concerning treatment options.
In offering examples about the power of faith in rehabilitation and mental health, Holmes talked about his experiences with poor and refugee patients as a clinical professor at the Niagara Family Health Center on the Lower West Side of Buffalo. One man said the repetition of a psalm gave him strength while recovering from a liver transplant. Holmes also recalled a Somali teen who drew mental fortitude after her mother's death from the belief that "It was her time."
"There's a lot more to health than a lack of sickness," said Holmes.
He said there has been a recent surge in studies on the relationship between faith and health. The results from one study are so dramatic Holmes claimed that even critics cannot counter them.
The study examined the effect of church participation on life expectancy and found that the average churchgoer lives seven years longer than a person who does not regularly attend services. In African-Americans, the increase in lifespan is 14 years. Furthermore, Holmes said even longer life expectancies were reported in those who combined volunteer activities with church attendance.
But, he said, other research is not as clear-cut. Some studies suggest that patients who are prayed for without their knowledge recover from illness faster; but other research concludes that prayers performed for a patient with his or her knowledge have a negative impact on health.
"There are a lot of unanswered questions," said Holmes.
However, he noted that studies have concluded that faith and religion have no effect on one problem that plagues a large percentage of Americans: obesity.
"A lot of people in the faith community want doctors to address issues of faith. The reverse should also be true. Shouldn't religious communities be thinking about the physical aspects of life?" Holmes asked.
He urged religious organizations to encourage their members to be physical healthy. Faith is a powerful motivator in health issues, he said, citing as an example Alcoholics Anonymous, which uses the belief in a higher power as a step toward overcoming addiction.
Holmes also suggested that pastoral care in hospitals needs significant reform. While priests, ministers, rabbis and other spiritual leaders are regular fixtures in hospitals, interaction between them and the doctors who share the halls too often is limited to glances in the elevator, he said.
"Somehow we need to collaborate to facilitate that relationship," he said. "It's in the best interest of the patients."
Holmes admitted that talking about faith with patients requires a sensitive touch, but said that for those who welcome the subject, it fosters strong doctor-patient relationships and serves as a source of comfort in the face of chronic diseases, chronic pain and addiction.