At the same time, medical schools are teaching their students to talk about spiritual matters: Some 66 percent of medical schools now offer classes on spirituality and health, up from just 2 percent 15 years ago, according to internist Christina Puchalski of George Washington University, who administers a grant program for med schools developing courses. At 75 percent of the schools that offer these classes, such training is mandatory.
"We want our students to be prepared," says Kay Sandor, associate professor in the school of nursing at the University of Texas at Galveston and a course director for the Spirituality and Clinical Care course required of all its nursing and medical students. Patients, she says, "want more than their physical illness addressed. They want to be addressed in mind, body, and spirit."
Some veteran physicians have come to the same conclusion. Three years ago—and more than a decade after he started practicing medicine—Brad Moore, an internist and associate professor of medicine at George Washington University, began taking his patients' "spiritual histories," as well as their medical and family histories. He's found the process helps establish a better rapport with patients and, at times, sheds light on health practices. "I ask patients if there are any spiritual practices that are important to them. Most of the time, that's a nonthreatening question," says Moore. "If they say no, I don't usually push it."
His inquiries have helped reveal patients' dietary restrictions and use of alternative treatments. "It's important to understand how [patients'] faith beliefs are tied in to their health beliefs," he says. He even learned that one patient called herself a witch. "If you ask the question," he says, "you have to be ready to accept the answer you get."
When patients feel comfortable discussing their spiritual background with their doctors, it can help both parties tap into extra resources—internal and external—during a health crisis. When Puchalski found a tumor in Carrol Duggins-Diggs's breast, for instance, she was glad to know about her patient's strong faith. "I was able to ask, 'Where does your faith play a role in facing something like this?' That helped me convey the seriousness of the situation without taking away her hope."
More recently, when Duggins-Diggs has searched for strategies to help her control her weight, her doctor suggested she might read the Bible as a distraction instead of snacking. "I would never say, 'Focus on the Bible,' to someone I didn't know," says Puchalski. "But for her, it's a very obvious resource."