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Farr A Curlin

Publications and source records attributed to Farr A Curlin.

11 recordsLinked to original sources
PubMed2006

The association of physicians' religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter.

CONTEXT: Controversy exists regarding whether and how physicians should address religion/spirituality (R/S) with patients. OBJECTIVE: This study examines the relationship between physicians' religious characteristics and their attitudes and self-reported behaviors regarding R/S in the clinical encounter. METHODS: A cross-sectional mailed survey of a stratified random sample of 2000 practicing U.S. physicians from all specialties. Main criterion variables were self-reported practices of R/S inquiry, dialogue regarding R/S issues, and prayer with patients. Main predictor variables were intrinsic religiosity, spirituality, and religious affiliation. RESULTS: Response rate was 63%. Almost all physicians (91%) say it is appropriate to discuss R/S issues if the patient brings them up, and 73% say that when R/S issues comes up they often or always encourage patients' own R/S beliefs and practices. Doctors are more divided about when it is appropriate for physicians to inquire regarding R/S (45% believe it is usually or always inappropriate), talk about their own religious beliefs or experiences (14% say never, 43% say only when the patient asks), and pray with patients (17% say never, 53% say only when the patient asks). Physicians who identify themselves as more religious and more spiritual, particularly those who are Protestants, are significantly more likely to endorse and report each of the different ways of addressing R/S in the clinical encounter. CONCLUSIONS: Differences in physicians' religious and spiritual characteristics are associated with differing attitudes and behaviors regarding R/S in the clinical encounter. Discussions of the appropriateness of addressing R/S matters in the clinical encounter will need to grapple with these deeply rooted differences among physicians.

Attitude of Health Personnel↗
PubMed2005

When patients choose faith over medicine: physician perspectives on religiously related conflict in the medical encounter.

BACKGROUND: Patients at times disagree with medical recommendations for religious reasons. Despite a lively debate about how physicians should respond to patients' religious concerns, little is known about how physicians actually respond. We explored the ways in which physicians interpret and respond to conflict between medical recommendations and patients' religious commitments. METHODS: One-to-one, in-depth, semistructured interviews with 21 physicians from a range of religious affiliations, specialties, and practice settings. Interviews were transcribed, coded, and analyzed for emergent themes through an iterative process of textual analysis informed by the principle of constant comparison. RESULTS: Conflict introduced by religion is common and occurs in 3 types of settings: (1) those in which religious doctrines directly conflict with medical recommendations, (2) those that involve an area in which there is extensive controversy within the broader society, and (3) settings of relative medical uncertainty in which patients "choose faith over medicine." In response to such conflict, physicians first seek to accommodate patients' ideas by remaining open-minded and flexible in their approach. However, if they believe patients' religiously informed decisions will cause them to suffer harm, physicians make efforts to persuade patients to follow medical recommendations. CONCLUSIONS: When religiously related conflict arises, physicians appear to intuitively navigate a tension between respecting patients' autonomy by remaining open-minded and flexible and seeking patients' good by persuading them to follow medical recommendations. In such contexts, religion and medicine are intertwined, and moral counsel inheres in physicians' medical recommendations.

Adult↗
PubMed2005

How are religion and spirituality related to health? A study of physicians' perspectives.

BACKGROUND: Despite expansive medical literature regarding spirituality and medicine, little is known about physician beliefs regarding the influence of religion on health. METHODS: Semistructured interviews with 21 physicians regarding the intersection of religion, spirituality, and medicine. Interviews were transcribed, coded, and analyzed for emergent themes through an iterative process of qualitative textual analysis. RESULTS: All participants believed religion influences health, but they did not emphasize the influence of religion on outcomes. Instead, they focused on ways that religion provides a paradigm for understanding and making decisions related to illness and a community in which illness is experienced. Religion was described as beneficial when it enables patients to cope with illness but harmful when it leads to psychological conflict or conflict with medical recommendations. CONCLUSIONS: Empirical evidence for a "faith-health connection" may have little influence on physicians' conceptions of and approaches to religion in the patient encounter.

Adult↗
PubMed2005

Partnering together? Relationships between faith-based community health centers and neighborhood congregations.

OBJECTIVE: The US Bureau of Primary Health Care has promoted collaboration between federally funded community health centers and neighborhood religious congregations, yet little is known about how such organizations currently interact in underserved neighborhoods. METHODS: Semistructured interviews were conducted with leaders from five faith-based, urban community health centers and 23 neighborhood congregations. Transcripts were coded for prevalent concepts and themes regarding collaborations between the two types of organizations. RESULTS: Collaborations between health centers and congregations are generally limited to modest sharing of resources and personnel and intermittent health promotion programs. Leaders of both types of organizations desire greater collaboration, but such desires appear to be frustrated by inadequate resources and differing priorities, visions, and philosophies. CONCLUSIONS: Increased collaboration between community health centers and neighborhood congregations will require efforts to overcome organizational differences, intercongregational tensions, and resource limitations. For the participants, comprehensive "faith partnerships" remain a desirable but elusive goal.

Attitude of Health Personnel↗
PubMed2005

Religious characteristics of U.S. physicians: a national survey.

BACKGROUND: Patients' religious commitments and religious communities are known to influence their experiences of illness and their medical decisions. Physicians are also dynamic partners in the doctor-patient relationship, yet little is known about the religious characteristics of physicians or how physicians' religious commitments shape the clinical encounter. OBJECTIVE: To provide a baseline description of physicians' religious characteristics, and to compare physicians' characteristics with those of the general U.S. population. DESIGN/PARTICIPANTS: Mailed survey of a stratified random sample of 2,000 practicing U.S. physicians. Comparable U.S. population data are derived from the 1998 General Social Survey. MEASUREMENTS/RESULTS: The response rate was 63%. Fifty-five percent of physicians say their religious beliefs influence their practice of medicine. Compared with the general population, physicians are more likely to be affiliated with religions that are underrepresented in the United States, less likely to say they try to carry their religious beliefs over into all other dealings in life (58% vs 73%), twice as likely to consider themselves spiritual but not religious (20% vs 9%), and twice as likely to cope with major problems in life without relying on God (61% vs 29%). CONCLUSIONS: Physicians' religious characteristics are diverse and they differ in many ways from those of the general population. Researchers, medical educators, and policy makers should further examine the ways in which physicians' religious commitments shape their clinical engagements.

Attitude of Health Personnel↗
PubMed2005

Strangers or friends? A proposal for a new spirituality-in-medicine ethic.

We argue that debate regarding whether and how physicians should engage religious concerns has proceeded under inadequate terms. The prevailing paradigm approaches dialogue regarding religion as a form of therapeutic technique, engaged by one stranger, the physician, upon another stranger, the patient. This stranger-technique framework focuses the debate on questions of physicians' competence, threats to patients' autonomy, and neutrality regarding religion, and in so doing, it too greatly circumscribes the scope of physician-patient dialogue. In contrast, we argue that dialogue regarding religion is better approached as a form of philosophical discourse about ultimate human concerns. Such moral discourse is often essential to the patient-physician relationship, and rather than shrinking from such discourse, physicians might engage patients regarding religious concerns guided by an ethic of moral friendship that seeks the patient's good through wisdom, candor, and respect.

Adult↗
PubMed2002

Racial, ethnic, and affluence differences in elderly patients' use of teaching hospitals.

OBJECTIVE: To understand the role of race, ethnicity, and affluence in elderly patients' use of teaching hospitals when they have that option. METHODS: Using a novel data set of 787,587 Medicare patients newly diagnosed with serious illness in 1993, we look at how sociodemographic factors influence whether patients use a teaching hospital for their initial hospitalization for their disease. We use hierarchical linear models to take into account differences in the availability of teaching hospitals to different groups. These models look within groups of people who live in the same county and ask what demographic factors make an individual within that county more or less likely to use a teaching hospital. RESULTS: We find that blacks are much more likely than whites to use teaching hospitals (odds ratio [OR], 1.75; 95% confidence interval [95% CI], 1.73 to 1.77). However, Hispanics and Asian-Americans are less likely to use teaching hospitals than are whites (Hispanic OR, 0.92; 95% CI, 0.88 to 0.97; Asian-American OR, 0.89; 95% CI, 0.82 to 0.97). Medicaid patients are less likely to use teaching hospitals (given their opportunities) than are non-Medicaid recipients (OR, 0.91; 95% CI, 0.90 to 0.92). And we find a curvilinear relationship with affluence, with those in the poorest and those in the wealthiest neighborhoods most likely to use a teaching hospital. CONCLUSION: The use of teaching hospitals is more complex that heretofore appreciated. Understanding why some groups do not go to teaching hospitals could be important for the health of those groups and of teaching hospitals.

Aged↗