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Prayer, spirituality getting greater emphasis in medical care

Wednesday, August 14, 2013 - 12:01 am

DALLAS — At 83, Carl Smith found himself facing quadruple-bypass surgery and the real possibility that he might not survive.

Within hours on a spring morning, Dr. Mark Pool would temporarily bring Smith's heart to a stop in an attempt to circumvent its blocked passages.

And to help his patient confront the uncertainty, Pool did something unusual in his profession: He prayed with him.

Medicine and religion have both had their day, and they haven't always been able to coexist. But as today's medical treatment becomes more holistic, doctors are increasingly taking spirituality into account.

Studies show a majority of patients want their spirituality recognized, and most med schools now have classes related to the topic. In general, the new thinking asks doctors to note their patients' spiritual leanings and open doors to expression, especially when life is at risk.

Pool, a highly regarded heart and lung surgeon at Texas Health Presbyterian Hospital Dallas, is fervent about his Baptist faith. For about a year, he's routinely asked patients if they'd like him to pray with them pre-surgery — a gesture he says is always appreciated but one that exceeds advocates' suggested bounds.

“A physician should be open to a patient's spirituality but shouldn't push religion on patients,” says Nathan Carlin, assistant professor at the University of Texas Health Science Center at Houston. “That's confusing personal and professional roles.”

Two decades ago, barely a few med schools offered classes on spirituality. Now, three-fourths of them do.

“Medicine has figured out that we ignore the more human sides of health care at our own peril,” says Craig Borchardt, interim chair of humanities and medicine at Texas A&M University.

Studies show 60 to 80 percent of patients want their beliefs noted, he says — not as affirmation but as a sign that the doctor actually cares. But fewer than 20 percent of doctors bring it up.

The push has met with some backlash — from busy doctors reluctant to take time away from other concerns or others who don’t like talking about it.

“Some staff are more comfortable with it than others,” says Mark Grace, vice president of mission and ministry for Baylor Health Care System.

He doesn’t reject the idea of doctors offering to pray, but “if you don’t listen to the answer, that’s where you get into problems. ... The doctor needs to be prepared if the patient says no.”

Christina Puchalski, director of George Washington University’s Institute for Spirituality and Health and co-editor of the recently published “Oxford Textbook of Spirituality in Healthcare,” says the bottom line is doing what’s best for the patient.

“Physicians are generally not trained to lead prayer,” she says.

To illustrate the power differential she says exists, she recalls a patient who was also a fellow parishioner. One day, she noticed the woman hadn’t been to church for a while, then realized the woman hadn’t come into her office either.

When the patient finally resurfaced, Puchalski pressed the matter:

“She told me, ‘I thought you’d be upset that I switched churches.’ That gives you an idea of the power we have over patients," Puchalski said. "So I would really caution against (taking advantage of) that.”