Religion a factor in referring to psychiatrist

Religion can interfere with 'connecting' to patient

Religion — or lack of religious beliefs — is a factor in the choice of psychiatry as a profession and in whether some physicians refer their patients to psychiatrists, according to a physician who has undertaken research on medicine and religious beliefs.

"Something about psychiatry, perhaps its historical ties to psychoanalysis and the anti-religious views of the early analysts such as Sigmund Freud, seems to dissuade religious medical students from choosing to specialize in this field," according to Farr Curlin, MD, assistant professor of medicine at the University of Chicago.

Curlin's survey of the religious beliefs and practices of American physicians has found that psychiatry is the "least religious" of all medical specialties. Among psychiatrists who have a religion, more than twice as many are Jewish and far fewer are Protestant or Catholic — the two most common religions among physicians overall — he says. Curlin's findings are published in the September 2007 issue of Psychiatric Services.

The survey revealed that religious physicians, especially Protestants, are less likely to refer patients to psychiatrists, and more likely to send them to members of the clergy or to a religious counselor.

"Previous surveys have documented the unusual religious profile of psychiatry," Curlin explains. "But this is the first study to suggest that that profile leads many physicians to look away from psychiatrists for help in responding to patients' psychological and spiritual suffering."

And because psychiatrists see patients struggling with emotional, personal, and relationship problems, he continues, "the gap between the religiousness of the average psychiatrist and her average patient may make it difficult for them to connect on a human level."

Curlin and colleagues surveyed 1,820 practicing physicians from all specialties in 2003, including an augmented number of psychiatrists; 1,144 (63%) physicians responded, including 100 psychiatrists.

Survey responses showed that while 61% of all American physicians were either Protestant (39%) or Catholic (22%), only 37% of psychiatrists were Protestant (27%) or Catholic (10%). Twenty-nine percent were Jewish, compared to 13% of all physicians. Seventeen percent of psychiatrists listed their religion as "none," compared to only 10% of all doctors.

Curlin's survey also included an anecdote designed to present "ambiguous symptoms of psychological distress" as a way to measure the willingness of physicians to refer patients to psychiatrists.

"A patient presents to you with continued deep grieving two months after the death of his wife. If you were to refer the patient, to which of the following would you prefer to refer first? A psychiatrist or psychologist, a clergy member or religious counselor, a health care chaplain, or other."

Overall, 56% of physicians indicated they would refer such a patient to a psychiatrist or psychologist, 25% to a clergy member or other religious counselor, 7% to a health care chaplain, and 12% to someone else.

Although Protestant physicians were only half as likely to send the patient to a psychiatrist, Jewish physicians were more likely to do so. Least likely were highly religious Protestants who attended church at least twice a month and responded to the survey that they looked to God for guidance "a great deal" or "quite a lot."