Religious Hospitals and Primary Care Physicians: Conflicts over Policies for Patient Care

Stulberg, Debra; Lawrence, Ryan E.; Shattuck, Jason; Curlin, Farr A.

doi:10.1007/s11606-010-1329-6

Cited by 35 publications

(23 citation statements)

References 17 publications

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“…In a nationally representative survey, primary care physicians were asked what doctors should do when they felt a service was clinically indicated but was prohibited by their hospital's religious policies. Some 86% responded that the right course of action was to refer the patient to a different facility . But this belief may not readily translate into patients’ getting timely information and referrals, and barriers other than Catholic hospital policy may also play a role.…”

Section: Resultsmentioning

confidence: 99%

Referrals for Services Prohibited In Catholic Health Care Facilities

Stulberg

Jackson

Freedman

2016

Perspect Sexual Reproductive

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Section: Resultsmentioning

confidence: 99%

Referrals for Services Prohibited In Catholic Health Care Facilities

Stulberg

Jackson

Freedman

2016

Perspect Sexual Reproductive

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“…As expected, these conflicts appear to be more common among obstetrician-gynecologists than was reported among general internists and family physicians in a prior study. 5 …”

Section: Commentmentioning

confidence: 99%

“…Popular media have reported recently on cases in which Catholic moral teaching has conflicted with physicians’ judgments about patient care, 4 and a national survey of internists and family physicians found that one in five of those who had worked in religiously affiliated institutions had experienced conflict with the institution over religiously-based policies for patient care. 5 Obstetrician-gynecologists’ experiences of conflict over religious hospital policies have not been formally examined in the literature.…”

Section: Introductionmentioning

confidence: 99%

Obstetrician-gynecologists, religious institutions, and conflicts regarding patient-care policies

Stulberg

Dude

Dahlquist

et al. 2012

American Journal of Obstetrics and Gynecology

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Objective To assess how common it is for obstetrician-gynecologists working in religiously-affiliated hospitals or practices to experience conflict with those institutions over religiously-based policies for patient care, and to identify the proportion of obstetrician-gynecologists who report that their hospitals restrict their options for treating ectopic pregnancy. Study Design Mailed survey, nationally representative sample of 1,800 practicing obstetrician–gynecologists. Results The response rate was 66%. Among obstetrician–gynecologists who practice in religiously affiliated institutions, 37% have had a conflict with their institution over religiously-based policies. These conflicts are most common in Catholic institutions (52%, adjusted Odds Ratio 8.7, 95% Confidence Interval 1.7–46.2). Few report that their options for treating ectopic pregnancy are limited by their hospitals (2.5% at non-Catholic institutions vs. 5.5% at Catholic, p=0.07). Conclusion Many obstetrician-gynecologists who practice in religiously-affiliated institutions have had conflicts over religiously-based policies. The effects of these conflicts on patient care and outcomes are an important area for future research.

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“…67 Importantly, recent studies have raised questions about how frequently religious commitments and moral beliefs lead to conflicts. 89 Lawrence and Curlin showed that religious physicians are more likely to believe they are never obligated to do what they personally believe is wrong, and they are more supportive of refusing to refer a patient who requests a controversial intervention to an accommodating provider. 10 This same study also found that foreign-born physicians were more likely than those born in the USA to report that physicians are sometimes obligated to do what they personally believe is wrong.…”

Section: Introductionmentioning

confidence: 99%

“…Although conflicts have been studied in several areas of medicine, 81112 little is known about the prevalence of conflicts among practicing ob/gyns. We therefore surveyed a nationally representative sample of ob/gyns to determine the frequencies of conflicts as well as their associations with physicians' personal and professional characteristics (focusing on religion, empathy, demographics and practice characteristics).…”

Section: Introductionmentioning

confidence: 99%

Conflict and emotional exhaustion in obstetrician-gynaecologists: a national survey

2010

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Context Conflicts over treatment decisions have been linked to physicians' emotional states. Objective To measure the prevalence of emotional exhaustion and conflicts over treatment decisions among US obstetrician/gynaecologists (ob/gyns), and to examine the relationship between the two and the physician characteristics that predict each. Methods Mailed survey of a stratified random sample of 1800 US ob/gyn physicians. Criterion variables were levels of emotional exhaustion and frequency of conflict with colleagues and patients. Predictors included physicians' religious characteristics and self-perceived empathy. Results Response rate among eligible physicians was 66% (1154/1760). 36% of ob/gyns reported high levels of emotional exhaustion, and majorities reported conflict with colleagues (59%) and patients (61%). Those reporting conflict were much more likely to report emotional exhaustion (58% vs 29% who never conflict, OR, 95% CI 2.8, 1.6 to 4.8 for conflict with colleagues; 55% versus 26%, OR, 95% CI 2.2, 1.4 to 3.5 for conflict with patients). Physicians with lower self-perceived empathy were more likely to report physician-patient conflicts (65% vs 58% with higher empathy, OR, 95% CI 1.4, 1.0 to 1.9), as were female ob/gyns (66% vs 57% of males, OR, 95% CI 1.5, 1.1 to 2.0). Foreign-born physicians were less likely to report such conflicts (47% vs 64% of US born, OR, 95% CI 0.5, 0.4 to 0.8). Physicians' religious characteristics were not significantly associated with reporting conflict. Conclusions Conflicts over treatment decisions are associated with physicians' empathy, gender, immigration history and level of emotional exhaustion. With respect to the latter, conflict in the clinical encounter may represent an overlooked source or sign of burnout among ob/gyns.

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Religious Hospitals and Primary Care Physicians: Conflicts over Policies for Patient Care

Abstract: Hospitals and policy-makers may need to balance the competing claims of physician autonomy and religiously based institutional policies.

Cited by 35 publications

References 17 publications

Referrals for Services Prohibited In Catholic Health Care Facilities

Referrals for Services Prohibited In Catholic Health Care Facilities

Obstetrician-gynecologists, religious institutions, and conflicts regarding patient-care policies

Conflict and emotional exhaustion in obstetrician-gynaecologists: a national survey

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