Grounding research and medical education about religion in actual physician-patient interaction: church attendance, social support, and older adults.

This article reviews the relation between social support and elder health, the social-support dimensions of religion, the relation between church attendance and elder health, the place of religion in the biopsychosocial model of medicine, and medical education's position on physician-patient communication about religion. It then examines the emergence of the topic of religion in actual visits. Data are 71 videotaped and transcribed, chronic-routine visits between 12 internal medicine physicians and their older patients. Religion was raised as a topic in 9 visits (13%). In every case, the topic was initiated by patients. The most frequent topic was church attendance (7 of 9 topics), which patients typically used as a contextualizing framework to relate and describe somatic problems. In no cases did physicians make efforts to support or facilitate patients' church attendance, as is advocated by medical education. Implications for medical education and the biopsychosocial model are discussed.