Differences in physician communication when patients ask versus tell about religion/spirituality: a pilot study

Research suggests that physicians should pursue spiritual issues and that patients desire to discuss religion/spirituality (R/S) in medical encounters. This study explored the differences in physician communication in response to patient inquiry or disclosure of R/S and hypothesizes that physician communication will differ when patients disclose R/S as contrasted to inquire about R/S.

Family physicians and family medicine resident physicians were recruited from a family medicine department at a community hospital (n=27). An objective structured clinical examination, with a standardized patient encounter, was used to expose the participants to a conversation regarding R/S. Participants were assigned, by alternating clustered assignment, to two conditions: patient disclosure of R/S or patient inquiry about physician R/S. The primary outcome measure was physician response, specifically physician-control, partnership-building, and supportive-talk messages.

When the patient asks questions about R/S, physicians communicate more control messages and less supportive talk messages than when the patient discloses information about R/S.

Training physicians to anticipate and respond to patient disclosure and inquiry will increase the likelihood they can enact patient-centered strategies. These methods should focus on teaching residents how to be sensitive to the R/S context of their patients and to recognize their own intuitive reactions to patient communication in that context.