I am passing this on to the listserve...
I think Gary's thoughts are meaningful and thought provoking.
I would invite all on the serve to respond if they wish
to what he is saying....
Any other thoughts? Concerns? Solutions!?

STEVE


If you don't mind, I would like to forward this to Steve Kliewers ,
my co-chair of the Group on Spirituality of STFM, to be distributed
to all of our group STFM members on the listserve. I am copying him
on this email, so you two can correspond directly. These remarks may
indeed stimulate more ideas and discussion in the group.
Thanks,
Dana


Dana E. King MD
Department of Family Medicine
Medical University of South Carolina
295 Calhoun St.
Charleston, SC 29425
phone 843-792-8112
FAX 843-792-3598
"As for me and my house..."

>>> Gary McCord <gmccord@...> 08/31/04 02:43PM >>>
I would like to thank all of those who took the time to respond to
the
spirituality study. The reaction to our research exceeded my
expectations. The commentators on the article provided insightful,
heartfelt and thoughtful observations on our study as well as the
current state of spirituality in medicine. It is obvious to me that
there are many individuals who are very passionate about the
inclusion
of spirituality in medicine and who believe it is a vital element in
the
overall wellness of human beings. I noticed that most of the
commentators on our article have published spirituality studies of
their
own. Because of your continued interest and work in this area,
spirituality in medicine stays alive. Like Dr. Marchand, I am tired
of a
seemingly endless need to prove to certain individuals that spirit
has a
right to exist in medicine. The complex interactions between body,
mind
and spiritual elements define who you are as a person. None of these
elements exist independent of the others. Illness in one component
intimately affects the others. Ask anyone you know who has suffered
a
serious physical, mental or spiritual illness whether the illness
had an
important effect on the other elements.
Research needs to move beyond whether spirit has a right to exist in
medicine to how patients' spiritual concerns can be incorporated in
medical care in a meaningful and workable way for both patients and
physicians. As Dr. Craigie pointed out, the challenge may be to
define a
unique Family Medicine perspective on understanding and nurturing
patients' spiritual resources as part of delivering holistic health
care. Development of alternative investigative methods or scientific
paradigms may be necessary in order to adequately study how
understanding, compassion, belief and hope can be incorporated into
medical patients' spiritual care, but this is a worthy and necessary
goal if one is to provide some measure of spiritual care for which
patients are asking.
However, I do have an important concern. During the 20 years that I
have
done research at the medical school, I have worked with dozens of
primary care physicians. Every single one of them who are full-time
physicians are too busy. Most are way… too busy, and this situation
has
become much more acute in recent years. The health care system in
this
country continues to place an ever increasing number of requirements
on
practicing physicians. Additionally, the pace of medicine is getting
faster and faster with no end in sight. This kind of environment is
not
particularly conducive to spiritual exploration, especially for
someone
in spiritual distress. Spiritual investigation and resolution of
issues
requires a relaxed environment and a lack of time constraints, even
with
someone not in distress. Dr. Anandarajah points out that if one were
to
use the results of our study as a screening tool, the spiritually
distressed may not be adequately identified. I absolutely agree. The
patients needing the most help may be the least likely to get it.
Therefore, challenges for family medicine include not only how to
incorporate spirituality into health care delivery, but also how to
accomplish it within the current health care system.
To digress just a little, in the movie Dark City, a self-serving
race of
beings created what they believed was their ideal world. They had
some
measure of success at achieving their goals, but their plans fell
apart
when another person intervened. The person who won the battle
created a
world of his own, a wonderful, beautiful world. If I were that
person
and could create my own world, my health care system would be one
where
no one fell through the cracks. My health care system would give
physicians all of the time and resources they needed. My physicians
would be caring, kind-hearted people who were qualified to heal the
body, mind and spirit (i.e. my definition of primary care) and who
derived a great deal of satisfaction from making people feel better.
Most of the physicians that I know fit most of those criteria
already.
The structure of the health care system itself is the most
problematic
factor in delivering comprehensive care. Nevertheless, if all you do
is
to remember to express understanding, compassion and hope to your
seriously ill patients, it may go a long way in helping them to
better
cope and deal with their illness.

Gary McCord, M.A.
Research Coordinator, Department of Family Medicine
Northeastern Ohio Universities College of Medicine
4209 State Rt. 44
P.O. Box 95
Rootstown, OH 44272
330-325-6766
gmccord@...