Sarcoma ceiling: artist's statement.

Purpose Physicians’ spiritual and religious identities, beliefs, and practices are beginning to be explored. The objective of this study was to gather descriptive information about personal religion and spirituality from a random sample of academic American pediatricians and to compare this information with similar data from the public. Method In 2005, a Web-based survey of a random sample of 208 pediatrician faculty from 13 academic centers ranked by the US News & World Report as “honor roll” hospitals was conducted. Surveys elicited information about personal beliefs and practices as well as their influence on decisions about patient care and clinical practice. Multiple questions were replicated from the General Social Survey to enable comparisons with the public. Descriptive statistics were generated, and logistic regression analyses were conducted on relevant variables. Results Nearly 88% of respondents were raised in a religious tradition, but just 67.2% claimed current religious identification. More than half (52.6%) reported praying privately; additional spiritual practices reported included relaxation techniques (38.8%), meditation (29.3%), sacred readings (26.7%), and yoga (19%). The majority of academic pediatricians (58.6%) believed that personal spiritual or religious beliefs influenced their interactions with patients/colleagues. These odds increased 5.1-fold when academic pediatricians attended religious services monthly or more (P .05). Conclusions Compared with the American public, a notably smaller proportion of academic pediatricians reported a personal religious identity. The majority believed spiritual and religious beliefs influenced their practice of pediatrics. Whether secular or faith-based belief systems measurably modify academic pediatric practice is unknown. Acad Med. 2008; 83:1146–1152. Editor’s Note: A commentary on this article appears on page 1118–1120. The spiritual and religious identities, beliefs, and practices of physicians are beginning to be explored generally and as they relate to clinical relationships and decision making. A recent study found that religious physicians who for moral reasons oppose certain medical treatments such as administering sedation to dying patients are less likely to refer patients or disclose relevant information.1 In studies about withdrawal of life support, abortion, and other issues, religion has been associated with the decisions physicians make.2– 6 In a study of Pennsylvania internists, for example, after controlling for other independent variables, Catholic and Jewish physicians were less willing to withdraw life support, whereas younger clinicians and those practicing in tertiary care centers were more likely to do so.7 Despite these findings, it is only recently that descriptive information has been gathered about the spiritual and religious identities, beliefs, and practices of physicians in the United States.8 A survey based on a random national sample of physicians found that 55% of surveyed physicians felt that their religious beliefs influenced their medical practice.9 Physicians have become aware that a patient’s spiritual and religious beliefs and practices may play a role in coping with disease, medical decision making, and other health-related processes.10 –11 Interest has also recently increased about the religious beliefs and practices of general and specialist physicians and about how these belief systems may influence how they care for patients. Pediatricians care for nearly 100 million U.S. children, often playing an important role in the development of children and families.12 Data exist showing that religion and spirituality seem to influence pediatricians’ approaches to care. A single institutional survey of pediatric residents and faculty showed that those with strong religious and/or spiritual orientation demonstrated more positive attitudes toward incorporating religion and spirituality into their pediatric practice.13 A survey of pediatricians concerning the care of critically ill newborns found that religious affiliation influenced certain treatment decisions. Catholic pediatricians, for example, were less likely than other study participants to be swayed by parental opinions.14 A multinational survey of neonatologists found that those who rated religion as extremely or fairly important were less likely to have ever withheld intensive care or withdrawn mechanical ventilation.15 Although some evidence and observations16,17 suggest that pediatricians’ religious and spiritual backgrounds may influence, in subtle or more overt ways, their approach to patient care, little is known about their personal spiritual and religious identities, beliefs, and practices. This study builds on previous research as the first detailed survey about personal Please see the end of this article for information about the authors. Correspondence should be addressed to Dr. Catlin, Massachusetts General Hospital, 175 Cambridge St., Suite 516, Boston, MA 02114; telephone: (617) 724-9040; fax: (617) 724-9346; e-mail: ([email protected]). Academic Medicine, Vol. 83, No. 12 / December 2008 1146 religion and spirituality among academic pediatricians in 13 American academic medical centers. We gathered information from this subset of pediatricians because of their influential positions as teachers, researchers, clinicians, medical writers, and pediatric opinion leaders.