Physician Specialties Correlate With Political Affiliation

Marcia Frellick

October 12, 2016

Several medical specialties swing heavily Republican or heavily Democrat, according to unpublished data reported in the New York Times.

For example, most infectious disease specialists (77%), psychiatrists (76%), pediatricians (68%), and geriatricians (63%) are Democrats, the researchers found. In contrast, most surgeons, (67%) anesthesiologists (65%), urologists (62%), and ears/nose/throat specialists (61%) are Republicans.

Eitan D. Hersh, PhD, from the Department of Political Science, and Matthew N. Goldenberg, MD, from the Department of Psychiatry at Yale University in New Haven, Connecticut, compared party registration of voters in 29 states and all US physicians to sort the leanings of several specialties. The researchers used two data sets to gather the information, according to the New York Times: the National Provider Index and state voter information from Catalist LLC, a political data vendor.

Overall, the data show physicians nationwide are fairly split between the parties, but some specialties attract significantly more members of one party or the other.

Dr Hersh declined to share the raw data from his research with Medscape Medical News¸ but said the findings are important because patients already think a physician's gender and medical school, facts readily available online, are important in their personal provider choices, and party affiliation is another piece to consider.

In addition, as reported earlier by Medscape Medical News, Dr Hersh and Dr Goldenberg found in a separate study that a physician's political affiliation can affect patient care. Republicans, for instance, were more likely than Democrats to discuss the health implications and legal risks of marijuana, whereas Democrats were more likely to urge patients not to keep guns at home.

"I don't necessarily recommend that patients ask their doctors directly about [their political views]," Dr Hersh said. "But I have raised the possibility of making a website so people could look up their doctors' political affiliation."

"If I were looking for an ob-gyn and I had the choice of whether to see where they went to medical school or to see their party affiliation, I would choose their party affiliation," Dr Hersh said.

He recognizes that physicians would likely rebel against such a website, but argues that from a purely patient perspective, such information should be accessible.

"There would be a ton of resistance to it, but I'm not sure it's the wrong thing to do," he said.

Why the Differences?

It's impossible to say why a particular specialty is dominated by one party. But this research extends evidence of a changing physician landscape in terms of political leanings.

Twenty-five years ago, most physicians overall identified as Republicans, but that dominance had lessened by 2012, according to research published in 2014 by Adam Bonica, from the Department of Political Science at Stanford University in California, and colleagues.

In that study, the researchers compared political donations made by physicians in 1991 with those in made 2011 and 2012. They found that donations from physicians dropped from 70% to Republican candidates to 50% in that time, coauthor Howard Rosenthal, PhD, from the Wilf Family Department of Politics, New York University, New York City, told Medscape Medical News.

In their conclusion, the authors state: "The variables driving this change, including the increasing percentage of female physicians and the decreasing percentage of physicians in solo and small practices, are likely to drive further changes."

Dr Rosenthal said their findings and those of Dr Hersh and Dr Goldenberg found similar patterns indicating that party affiliation was linked with income and gender.

"The specialties with higher average earnings were the ones that were more Republican," Dr Rosenthal said.

David Rothman, PhD, from the Center on Medicine as a Profession, Columbia College of Physicians and Surgeons, New York City, who is a coauthor on the paper with Dr Bonica and Dr Rosenthal, told Medscape Medical News that women entering medicine has also affected the mix because more women, in general, lean more toward the Democratic party.

He said one interesting subfinding in their research was that "women surgeons were not as Democratic as women pediatricians, but they were more Democratic than male surgeons."

"It was fascinating for us to see how women had shifted the political balance among physicians, judging that balance by political contributions," Dr Rothman said.

Dr Rosenthal said another factor that has changed the landscape is employment of physicians. Regardless of specialty or gender, he said, those employed by hospitals are more likely to lean Democratic, and those in solo or small, for-profit practices are more likely to be Republican.

That has changed the political picture as medicine moves away from the small practice model and toward the employed physician model.

He notes that because physicians rarely change the party they contribute to over their lifetime, the changes likely reflect the affiliation of physicians who start their careers in an employed physician model, for instance, not those who make the switch from small practice to employed.

Dr Rothman said research about physicians' party affiliation is important to urge inclusion in major policy debates.

If you ask most members of the public, he says, they would say most physicians are Republican.

"Up to the 1990s, they would have been right," he said. "Perhaps as people start to understand there is both a Democrat and Republican contingent in medicine, you'll find politics engaging the physicians. Making physicians a part of your political alliance we think is very important."

Sally Satel, MD, a staff psychiatrist at Partners in Drug Abuse Rehabilitation Counseling, a drug addiction treatment clinic in Washington, DC, and a resident scholar at the American Enterprise Institute, said knowing political leanings can also be important for evaluating research.

"That's where agendas can creep in," she told Medscape Medical News. "Maybe people wouldn't entertain other hypotheses or other interpretations of their data," if they held strong beliefs in one ideology or the other, she said, noting that research on topics that touch on racism or disability can be vulnerable to interpretation based on world views.

Dr Hersh, Dr Satel, Dr Rothman, and Dr Rosenthal have disclosed no relevant financial relationships.

New York Times. Published online October 6, 2016. Full text

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