Spiritual care: whose job is it anyway?

The use of spirituality and religion in coping with illness is widespread among primary care patients. Although the overwhelming majority of healthcare providers agree that they should be aware of patients' spiritual beliefs, that these beliefs may influence their healing, and that patients benefit from spiritual care, there remains considerable debate about who should inquire about spiritual beliefs and deliver spiritual care. The authors, a physician and a chaplain, propose that, in general, the role of the physician is to assess spiritual needs as they relate to healthcare (ie, briefly screen) and then refer to a professional pastoral caregiver as indicated (ie, to address those needs). The chaplain is the spiritual care specialist on the healthcare team and has the training necessary to treat spiritual distress in all its forms. Seeing the physician as the generalist in spiritual care and the chaplain as the specialist is a helpful model.