The trend toward inclusion of some form of spiritual practice in healthcare appears to be accelerating - and maturing, from the speculative to the practical. This year, 72 medical schools - well over half of those in the United States - have offered some kind of course on spirituality and healing. This represents an increase from only three such courses in 1992.

Advocates for this approach, such as Dr. Herbert Benson of Harvard Medical School, are making the case that it's "not 'alternative,' not 'complementary,' but ... scientifically based and proven," as evidenced, he says, by those who are able to reduce stress through techniques such as prayer and meditation. "Ninety percent of Americans believe in God--how does that translate into health and well-being?" Dr. Benson asked.Benson spoke at a conference held under his direction Dec. 15 to 17 in Boston called "Spirituality and Healing in Medicine: Practical Usage in Contemporary Healthcare." It was presented by the Harvard Medical School Department of Continuing Education and the Mind/Body Medical Institute at Beth Israel Deaconess Medical Center.

At this year's conference, the latest in a series begun in 1995, emphasis was put on simple, practical tips for chronically time-pressed physicians who want to respond sensitively to patients' spiritual concerns but feel unprepared to do so. A number of conference speakers stressed that if caregivers are "authentically in the moment" with their patients, even brief encounters can be meaningful. "We can offer our totality in three to five minutes," said Natalia Vonnegut Beck, an Episcopal priest and a fellow at Harvard Medical School.

Healthcare workers were encouraged to make "spiritual assessments" of their patients, simple inquiries about their spiritual or religious beliefs and how they may be relevant to their medical situations. One simple approach presented by Dr. Christina Puchalski of George Washington University is what she calls the "FICA questions." FICA is a mnemonic for "faith, importance, community, address." That is, patients are asked: Do you have a faith tradition? How important is it? Are you in a faith community? And how do we address these issues in your healthcare?

In this context, Virginia Harris, chairman of The Christian Science Board of Directors, talked about "Science and Health with Key to the Scriptures" by Mary Baker Eddy, the founder of this newspaper. Ms. Harris focused on Mrs. Eddy's core concepts of God, of man as the child or "image and likeness" of God, and of a continuous relationship between God and His child. "Her book ... makes these ideas available and accessible to everyone," Ms. Harris said. "People can use this book without understanding the faith tradition of the Church of Christ, Scientist."

She read an e-mail from a physician in Los Angeles who remembered what he had been reading in Science and Health when he was involved in a boating accident and awaiting emergency help after hitting his head on some jagged rocks. "As I lay there, I heard a wonderful, assuring message say to me, 'Be very still.'... At the emergency room, to everyone's surprise, they found very little wrong with me."

As the conference was winding down, Dr. Donald Friedman, a rheumatologist from Philadelphia, said that his efforts to incorporate spirituality into his medical practice have grown out of his spiritual searching in his personal life. "It never dawned on me to take a spiritual assessment," he said, adding that he planned to make that a regular part of his practice.

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