Despite wide support among physicians for practicing patient-centered care, clinical interactions are primarily driven by physicians' perception of relevance. These perceptions of relevance depend on the physician's own biographical background. While some physicians will perceive a connection between religion and patient health, this relevance will be less apparent for others. I argue here that physician responses when religious/spiritual topics come up during clinical interactions will depend on their own religious/spiritual background. The more central religion is for the physician, as reflected by their religious/spiritual orientation, intrinsic religiosity, and religious coping, the greater their perception of religion's impact on health outcomes and their inclusion of religion/spirituality within clinical interactions. Using a nationally representative sample of physicians in the U.S. and mediated path models, I estimate models for five different physician actions to evaluate these relationships. I find that a physician's religious background is strongly associated with whether or not they think religion impacts health outcomes, which is strongly predictive of inclusion. I also find that not all of the association between inclusion and physicians' religious background is mediated by thinking religion impacts health outcomes. Issues of religion's relevance for medicine are important to the degree that religious beliefs are an important dimension of patients' lives.
and Religious Content in Clinical InteractionsWho decides what is relevant in a conversation between a physician and patient? Is anything the patient wants to talk about or share with the physician fair game? Or is it the physician's role to direct the conversation toward what he or she sees as medically relevant?Most often it is the latter, and in the process, the physician's decision may actually bypass patient-centered care.Problems arise when patients want something different from the interaction with their physician. Toombs (1987) argues that patients almost universally understand their illnesses in terms of their everyday life while physicians tend to think of illnesses in terms of physical indicators with a named diagnosis and specific treatment. When patients and physicians talk about illness, they tend to be referencing different realities. If the gap between these realities is large enough, a failure in health care can occur (Toombs 1987).While both parties have a role to play during clinical conversations, both the physician's and patient's identity are biographically constrained, which means that out of each identity flows perhaps differing perceptions of conversational relevance. While ill patients understand their illness in terms of their everyday lives, they also have some idea of what information their physician expects them to share. What patients think they should share and what the physician wants them to share, however, is not always the same. Dubbin, Chang, and Shim (2013) find that even when physicians seek to pra...